Abstract:
BACKGROUND:Debates continue regarding optimal structures for governance and administration between medical schools and their teaching hospitals. METHODS:Structural integration (SI) for 85 academic health centers was characterized as high (single leader or fiduciary) or low (multiple leaders or fiduciaries). Functional alignment (FA) was estimated from questionnaire responses by teaching hospitals' chief executive officers, and an index was calculated quantifying organizational collaboration across several functional areas. SI and FA were examined for their association with global performance measures in teaching, research, clinical care, finance, and efficiency. RESULTS:AHCs with high SI had significantly higher FA, though overlap between high-SI and low-SI institutions was considerable. SI was not significantly associated with any performance measure. In contrast, FA was significantly associated with higher performance in teaching, research, and finance but not clinical care and efficiency. CONCLUSIONS:FA between medical schools and their primary teaching hospitals more strongly predicts academic health centers' performance than does SI. As demands for greater collaboration increase under health reform, emphasis should be placed on increasing FA rather than SI.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Keroack MA,McConkie NR,Johnson EK,Epting GJ,Thompson IM,Sanfilippo Fdoi
10.1016/j.amjsurg.2011.05.001subject
Has Abstractpub_date
2011-08-01 00:00:00pages
119-26issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(11)00312-6journal_volume
202pub_type
杂志文章,多中心研究abstract:BACKGROUND:Alcohol use may alter mental status and vital signs in injured patients, leading to increased testing during emergency department (ED) evaluation. We hypothesized that alcohol use increases the hospital charges when caring for these injured patients. METHODS:The National Hospital Ambulatory Medical Care Sur...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.08.014
更新日期:2013-07-01 00:00:00
abstract::Long-term results of postanal repair are poor. Many patients with neuropathic incontinence have evidence of anterior pelvic floor weakness. A more comprehensive surgical repair has therefore been developed that involves postanal repair, anterior levatorplasty, and external sphincter plication. Primary total pelvic flo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(92)90018-m
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Retractions of scientific articles represent attempts to correct the literature. Our goal was to examine retracted surgical papers. METHODS:NCBI PubMed database was queried using the search terms "surgery," "surg," or "surgical" and "retracted" or "retraction." Article details were recorded. RESULTS:There ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2017.11.033
更新日期:2018-11-01 00:00:00
abstract::Gastric emptying was delayed preoperatively in 9 of 19 patients with duodenal ulcer disease, but all 9 patients with evidence of retention by scan were asymptomatic; gastric emptying was normal in the remaining 10 patients. A significant delay in gastric emptying was documented by scan in 17 of 19 patients immediately...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90134-9
更新日期:1982-01-01 00:00:00
abstract:BACKGROUND:Laparoscopic colorectal surgery remains one of the most challenging techniques to learn. METHODS:The authors collected studies that have compared hand-assisted laparoscopic surgery (HALS) and open surgery for the treatment of colorectal disease over the past 17 years. Data of interest for HALS and open surg...
journal_title:American journal of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.amjsurg.2013.04.013
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Laparoscopic donor nephrectomy (LDN) is a new technique. While the short-term recipient renal function is equivalent to that of the traditional open nephrectomy (ODN), long-term function and potential exclusion criteria, such as the presence of multiple renal arteries, are as yet unknown. METHODS:Retrospect...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00260-8
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:This analysis was performed in order to determine whether primary tumor location in breast cancer affects the axillary sentinel lymph node (SLN) identification (ID) rate, the false negative (FN) rate, incidence of axillary nodal metastases, or the number of SLN identified. METHODS:In this prospective multi-...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/s0002-9610(01)00717-6
更新日期:2001-10-01 00:00:00
abstract::The portal-superior mesenteric vein (PV/SMV) is occasionally involved by a microscopic level of cancer invasion from pancreatic cancer even when it seems to be intact by a macroscopic inspection during surgery. Therefore, contact endoscopy, with which a high-magnification image of the methylene blue-stained PV/SMV wal...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.03.009
更新日期:2009-11-01 00:00:00
abstract::We the undersigned editors of the member journals of the Surgery Journal Editors Group (SJEG), in the furtherance of integrity in surgical and scientific publication, agree to adopt the guidelines established by the Committee on Publication Ethics (COPE). The COPE guidelines represent a means of addressing a variety o...
journal_title:American journal of surgery
pub_type: 社论
doi:10.1016/j.amjsurg.2010.06.001
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are sequelae of severe trauma. It is unknown if certain races are at greater risk of developing ALI/ARDS, and once established, if there are racial differences in the severity of lung injury or mortality. METHODS:Retrospective cohort stu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.02.003
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Prior studies have demonstrated that African-American (AA) donor kidneys are independently associated with an increased risk for graft loss. METHODS:We examined outcomes in comparable groups of AA deceased-donor (DD) kidney transplant patients receiving an AA donor (n=35) versus a Caucasian donor (C group; ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.08.025
更新日期:2010-03-01 00:00:00
abstract::Although the use of shunts for carotid artery surgery remains controversial, the hemodynamics of the shunts currently available have not been carefully evaluated in vivo. We developed an animal model using contralateral carotid artery ligation, which produced ipsilateral carotid blood flows (640 +/- 44 ml/min) and int...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90354-1
更新日期:1989-08-01 00:00:00
abstract:BACKGROUND:Breast cancer-related lymphedema remains a significant complication post mastectomy. Identifying patients at highest risk may better inform targeted healthcare resource allocation and improve outcomes. This study aims to identify lymphedema predictors after mastectomy to develop a simple, accurate risk asses...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.08.016
更新日期:2017-06-01 00:00:00
abstract::A genetic study of hybrid Baltimore blacks in relation to the presence of cancer may be timely since the mortality rate in blacks compared with the mortality rate in whites has increased considerably. The appearance of white genes in black persons may provide some help in such a study. A positive relationship was not ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90302-1
更新日期:1983-11-01 00:00:00
abstract::The type of endorectal pull-through described by Black was evaluated as an alternative method of anastomosis in 11 anterior resections in which anastomosis from above was impossible. The method is attractive from the standpoint of function because it preserves the distal rectum and leaves the anus intact. Technical po...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90249-6
更新日期:1979-07-01 00:00:00
abstract:BACKGROUND:This study characterizes the gastrointestinal (GI) microbiome in a pre-clinical polytrauma hemorrhage model. METHODS:Rats (n = 6) were anesthetized, hemorrhaged 20% of their blood volume, and subjected to a femur fracture and crush injuries to the small intestine, liver, and limb skeletal muscle without res...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.07.026
更新日期:2018-10-01 00:00:00
abstract::Seven patients with carcinoma in a thyroglossal duct cyst have received treatment over a 15 year period. Findings in all of these patients reflect the likelihood of carcinoma arising within thyroglossal duct tissue. In each patient there was sufficient histologic evidence of the presence of a thyroglossal duct cyst an...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90077-6
更新日期:1983-02-01 00:00:00
abstract::Typhlitis is a neutropenic enterocolitis of varying severity. Its incidence is increasing, particularly in patients with acute myelogenous leukemia undergoing high dose cytosine arabinoside chemotherapy. The onset is heralded by prodromal fever, watery or bloody diarrhea, abdominal distension, and nausea during the ph...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90547-7
更新日期:1986-05-01 00:00:00
abstract:BACKGROUND:Peritoneal macrophages play an important role in the immune response after abdominal operations. The stress response after these operations has been associated with impaired phagocytosis by peritoneal macrophages. This study examined the influence of minimally invasive techniques and preoperative corticoster...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.07.023
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:Over 1 million healthcare providers have participated in the Advanced Trauma Life Support course. No studies have evaluated factors that predict course performance. This study aims to identify these predictors. METHODS:All participants taking the course at 2 centers over a 4-year period were identified. Dem...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2015.03.007
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Multimodality monitoring and goal-directed therapy may not prevent blood flow and brain oxygen (Flow/BrOx) crisis. We sought to determine the impact of these events on outcome in patients with severe traumatic brain injury (sTBI). METHODS:Twenty-four patients with sTBI were treated to maintain intracranial ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.08.003
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Strategies for the effective application of palliative procedures are infrequently standardized and incompletely understood. The effect on patient outcome as determined by elements such as resolution of chief complaints, quality of life, pain control, morbidity of therapy, and resource utilization should pre...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(98)00323-7
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to describe the incidence and clinical/pathologic characteristics of papillary thyroid microcarcinoma (PMC) in a community hospital setting and to evaluate the frequency and characteristics of these lesions when unsuspected preoperatively. METHODS:A total of 723 patients underw...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.12.008
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Gastric stump carcinoma (GSC) has been studied after primary gastrectomy for benign disease but few studies have evaluated its correlation with gastric cancer. PATIENTS:We assessed 541 patients submitted to subtotal gastrectomy for early gastric cancer at least 15 years ago. RESULTS:GSC was diagnosed in 16...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2014.06.021
更新日期:2015-06-01 00:00:00
abstract::The first case of a carotid body chemodectoma that was diagnosed using dynamic radionuclide perfusion angiography and subsequently excised is presented. The value of this technic in the investigation of pulsatile tumors is emphasized. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90043-6
更新日期:1979-05-01 00:00:00
abstract::The traditional treatment of pneumothorax has been with a chest tube and hospitalization. A series of 35 patients with 41 pneumothoraces treated on an outpatient basis is presented here. A no. 12 chest tube connected to a Heimlich valve led to successful treatment in 88 percent of the cases. Failure of treatment requi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(81)80006-2
更新日期:1981-07-01 00:00:00
abstract::Evaluation of postoperative swallowing ability in thirty-eight patients having had partial laryngectomy indicates that there are marked differences in the degree of dysphagia among individuals with similar surgical defects. This variation in swallowing disability, however, appears to have definable limits. Rehabilitat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90266-0
更新日期:1978-10-01 00:00:00
abstract::Over a 10 year period, 54 patients presented with pancreatic trauma. During the first 5 years of the study, when pancreatography was not utilized for the assessment of pancreatic duct injury, 55 percent of the patients had major pancreatic complications. During the subsequent 5 years, suspected proximal duct injury wa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90173-8
更新日期:1982-05-01 00:00:00
abstract::Maximal anal pressures have been measured after proctoscopy in 145 patients with hemorrhoids, 48 patients with anal fissure, and 78 asymptomatic control subjects. Anal pressures in patients with hemorrhoids (106 +/- 40 cm H2O) and anal fissure (130 +/- 43 cm H2O) were very significantly higher than those of controls (...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90445-7
更新日期:1977-11-01 00:00:00
abstract:BACKGROUND:The efficacy of antibiotics in appendicitis remains controversial, and physicians are not confident in prescribing antibiotics as the first line treatment. This network meta-analysis was conducted to assess the efficacy and safety of individual antibiotics in uncomplicated appendicitis. METHODS:Randomized c...
journal_title:American journal of surgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.amjsurg.2018.10.009
更新日期:2019-07-01 00:00:00