Abstract:
:As the medical need and expenditure for chronic wound care have increased markedly over the past decade, wound centers have grown exponentially throughout the country. They can be community-based or hospital-based, and in either case, can be run by the facility or by a national chain. The wound center's viability is dependent on generated revenue, and its clinical effectiveness is based on a multidisciplinary approach to wound care. By incorporating the wound center into an existing hospital system, one can take advantage of the hospital's resources to effectively treat the more complex patients. Additionally, by focusing on limb salvage, the hospital attracts the critical limb ischemia and other complex patients that often require inpatient admission. We examined the Georgetown University Hospital Center for Wound Healing performance over the first 6 years of operation. Since opening the wound center in 1999, the number of outpatient visits has doubled, the wound care inpatient census has doubled, and the operative cases have increased 3-fold. Because the outpatient segment of the wound center can at best cover its direct cost, it cannot financially justify its existence. Hyperbaric oxygen (HBO) can increase the revenue to the point where the indirect costs are covered as well and the wound center can be revenue neutral. Due to the medical complexity of limb salvage patients, the inpatient collections are much higher than those of the outpatient wound center and therefore can serve as justification for the latter's financial viability. More importantly, with the wound center in place, the hospital can provide the local/regional community with a comprehensive service that can effectively treat the most challenging wounds. The success is built on a multidisciplinary team approach, use of evidence-based treatment protocols, efficient clinical structure, and a supportive hospital system. The beneficiaries include the patient with a healed wound, the physician with a gratifying practice, the health care system with lower costs, and the hospital with a steady influx of complex patients.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Attinger CE,Hoang H,Steinberg J,Couch K,Hubley K,Winger L,Kugler Mdoi
10.1016/j.ygyno.2008.07.044subject
Has Abstractpub_date
2008-11-01 00:00:00pages
S92-7issue
2 Suppleissn
0090-8258issn
1095-6859pii
S0090-8258(08)00601-Xjournal_volume
111pub_type
杂志文章abstract::From January 1, 1946, through January 1, 1986, at the University of Michigan, 60 patients were treated with Stage IB (FIGO) carcinoma of the cervix with lymph node metastases. Clinical variables were examined with regard to long-term survival. Prognostically significant variables were (1) highest level of lymph node i...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/s0090-8258(88)80022-2
更新日期:1988-11-01 00:00:00
abstract::The single most common cause leading to the diagnosis of endometrial cancer is postmenopausal bleeding. Although most patients with early-stage disease (FIGO stage I and II) can be cured, prognosis worsens considerably with increasing stage. While serum CA 125 levels are elevated only in a significant proportion of pa...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1997.4620
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:Primary vaginal adenosarcomas are extremely rare, and typical adenosarcomas are of low malignancy. However, aggressive forms with sarcomatous overgrowth have been reported, those appear to have a poor prognosis. CASE:A 52-year-old woman who had undergone prior surgery for uterine leiomyoma and an ovarian cy...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2004.08.004
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVES:We assessed the efficacy and toxicity of once-weekly topotecan (Hycamtin; GlaxoSmithKline) for relapsed or persistent epithelial ovarian cancer (EOC) and primary peritoneal carcinoma (PPC). METHODS:Patients with recurrent or persistent EOC and PPC previously treated with > or = 1 course of platinum-based ch...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2006.11.017
更新日期:2007-04-01 00:00:00
abstract:INTRODUCTION:Non-Hispanic black women are less often diagnosed with endometrial cancer than are non-Hispanic white women, but are more likely to die of their disease. Reasons for this disparity in outcome are not well understood. METHODS:The Surveillance, Epidemiology, and End-Results Program data were used to sample ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2004.11.041
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:To help determine whether global collaborations for prospective gynecologic surgery trials should include hospitals in developing countries, we compared surgical and oncologic outcomes of patients undergoing laparoscopic radical hysterectomy at a large comprehensive cancer center in the United States and a ca...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.01.007
更新日期:2012-05-01 00:00:00
abstract::A 75-year-old Japanese woman, who had an enlarged uterus and two nodules on the anterior vaginal wall, underwent wide excision of the anterior vaginal wall, bilateral inguinal lymphadenectomy, modified radical hysterectomy, and pelvic lymph node dissection. Her serum level of 5-S-cysteinyldopa (5-S-CD) was elevated, b...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1998.5176
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE:Cervical cancer is a disease caused in part by an infection with an oncogenic subtype of human papillomavirus (HPV). In this study we analysed all cervical cancer samples diagnosed in Iceland during two periods, 1958-1960 and 1995-1996, and asked whether significant changes in viral or immunological parameter...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/s0090-8258(03)00053-2
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the utility of amiodarone and its derivative dronedarone as novel drug repositioning candidates in EOC and to determine the potential pathways targeted by these drugs. METHODS:Drug-predict bioinformatics platform was used to assess the utility of amiodarone as a novel drug-repurposing candidate i...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2018.09.019
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:Human leukocyte antigens (HLA) play an important role in presenting virus antigens to immune cells that are responsible for the clearance of virus-infected cells and tumor cells. Herein, we evaluated whether genetic variants of HLA-DP and HLA-DQ are associated with cervical cancer risk. METHODS:We genotyped ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2013.02.017
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:To determine the prognostic significance of the 2002 revisions of the American Joint Committee on Cancer (AJCC) Staging System for cutaneous melanoma in melanoma of the vulva and review the current surgical utilized for treatment of this neoplasm. METHODS:Demographic, surgical and outcomes data were obtained...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2011.04.007
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:Inappropriate telomerase expression has been reported to be associated with the development and/or progression of malignancies. Therefore, the purpose of the study was to determine and evaluate the levels of telomerase activity in normal ovary, cystadenomas, low-malignant-potential tumors, and carcinomas of t...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1999.5506
更新日期:1999-09-01 00:00:00
abstract:PURPOSE:This report describes the strength and significance of the association between antecedent and mediating variables across four categories of quality of life (QOL) outcomes in 132 disease free women with ovarian germ cell survivors. METHODS:Survivors (n=132) participated in a mailed questionnaire and computer-as...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.01.042
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to determine whether ovarian preservation is feasible in younger endometrial cancer patients. METHODS:Endometrial cancer patients who underwent ovary-saving surgery were recruited from the tumor registries of 14 tertiary hospitals under the influence of the Korean Gynecologic...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2009.06.041
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Recurrence of endometrial cancer in the brain is a rare event generally accompanied by limited life expectancy. We present an unusual case of long-term survival following surgical resection of an intracranial endometrial cancer metastasis. CASE:The present case is a patient with FIGO stage IIB, grade III en...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2004.07.030
更新日期:2004-10-01 00:00:00
abstract::By serendipity we have had the opportunity to evaluate cis-platin-based chemotherapy in ovarian tumors of low malignant potential (LMP). Optimal (less than 1 cm residual disease) FIGO stage III ovarian carcinomas were randomly assigned to treatment with cisplatin plus cyclophosphamide with or without doxorubicin on a ...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0090-8258(91)90314-u
更新日期:1991-06-01 00:00:00
abstract::Aggressive tumor reduction surgery has been widely used in patients with advanced stage epithelial ovarian carcinoma before initiation of cytotoxic chemotherapy. No randomized controlled trial has been carried out to confirm the benefits of such procedures. To examine the role of cytoreductive surgery in the managemen...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1997.4839
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to evaluate the ability of the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) surgical risk calculator to predict complications in gynecologic oncology patients undergoing laparotomy. METHODS:A chart review of patients who underwent la...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2016.02.015
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:The incidence of postoperative delirium (PD) in the elderly ranges between 3-60% but has never been examined in gynecologic oncology. Our goal was to identify pre, intra, and postoperative risk factors associated with the development of PD. METHODS:English speaking women of 60 years and above undergoing maj...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2008.02.016
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVES:To compare survival of Hispanic white (HW) and non-Hispanic white (NHW) women with type II endometrial adenocarcinoma (EC). METHODS:Patients with serous, clear cell or grade 3 endometrioid EC were identified from the Surveillance, Epidemiology, and End Results (SEER) program 1988-2009 and were divided into ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2014.03.562
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of interleukin-7 (IL-7) gene transfection into an established ovarian carcinoma cell line (SKOV3) in vitro and evaluate the tumorigenicity of SKOV3-IL-7 in severe combined immunodeficient (SCID) mice. METHODS:IL-7 gene was transfected into SKOV3 cells by liposome. IL-7 mRNA and prot...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2003.10.036
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Chemotherapy-induced Fanconi syndrome is a dangerous condition that could lead to severe electrolyte disturbances and rarely to osteomalacia. CASE:A patient treated with ifosfamide for a metastatic cervix squamous-cell carcinoma was admitted for diffuse, symmetric bilateral pain in bones and articulations. ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2005.05.014
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:The expression of the CDK inhibitor p27Kip1 and the extent of endogenous oxidative DNA damage were evaluated in the multistep cervical carcinogenesis. METHODS:Archival specimens of low-grade (L) squamous intraepithelial lesions (SILs) (n=32), high-grade (H) SILs (n=24) and invasive carcinomas (n=48) of the c...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2003.12.008
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:We evaluated the activity and safety of the combination of topotecan, cisplatin and bevacizumab in patients with recurrent or persistent carcinoma of the cervix. METHODS:Eligible patients had persistent or recurrent cervical cancer not amenable to curative intent treatment. No prior chemotherapy for recurren...
journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ygyno.2013.04.009
更新日期:2013-07-01 00:00:00
abstract::We have previously reported an overall response rate of 41% and a median survival duration of 14 months in a series of 49 patients with metastatic or recurrent endometrial carcinoma treated by a combination of etoposide, 5-fluorouracil, and cisplatin. In order to increase response rate and survival duration, doxorubic...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
doi:10.1006/gyno.1997.4749
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:To estimate the likelihood of occult cancer diagnosis at prophylactic oophorectomy in BRCA1 and BRCA2 carriers in different age groups and to determine the histopathology of these lesions. METHODS:We describe a series of 159 female BRCA1 or BRCA2 carriers who underwent prophylactic oophorectomy at the Univer...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2005.06.065
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVES:To compare complete hydatidiform mole (CHM) clinical presentation and risk factors associated with GTN development between North American and South American adolescents. METHODS:This non-concurrent cohort study was undertaken including adolescents with CHM referred to centers in North America (New England T...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2016.07.002
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:Patients with recurrent ovarian cancer were treated intraperitoneally (ip) with a replication-deficient recombinant adenovirus (ADV) containing the herpes simplex virus thymidine kinase gene. Vector delivery was followed by intravenous administration of an antiherpetic prodrug and a topoisomerase I inhibitor....
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
doi:10.1006/gyno.2001.6442
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:To correlate findings on pathologic examination of loop electroexcisional procedure (LEEP) or cone biopsy specimens with residual disease in radical hysterectomy specimens in patients with stage IA2 cervical cancer to determine whether a subset of such patients may be eligible for conservative, fertility-spar...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2008.09.011
更新日期:2009-01-01 00:00:00
abstract::Ascitic fluid was obtained from a patient with ovarian endometrioid carcinoma. The cells obtained from the fluid were cultured in Eagle's minimum essential medium containing 15% fetal calf serum at 37 degrees C under humidified 5% CO2 and 95% air. Epithelial colonies grew rapidly in the primary culture and we were abl...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(84)90217-8
更新日期:1984-03-01 00:00:00