Abstract：
INTRODUCTION:Multi-Professional Triage Teams (MPTTs) were created to reduce the caseload of hospital orthopaedic clinics and this prospective study evaluated referrals made to a district general hospital orthopaedic department from a lower limb MPTT clinic. PATIENTS AND METHODS:Over 9 months, 277 referrals to a lower limb hospital orthopaedic clinic were assessed. The temporal delay to hospital clinic review between patients seen at the MPTT clinic and those referred directly by their general practitioner (GP) was analysed using an ANOVA test. A qualitative assessment of diagnoses given to patients reviewed at the MPTT clinic was performed. RESULTS:The 132 patients initially reviewed at the MPTT clinic and subsequently referred to a hospital consultant waited significantly longer (140 days compared to 62 days by direct GP referral; P < 0.05) to see an orthopaedic consultant. Over three-quarters of this patient cohort incorrectly identified the healthcare professional conducting their consultation at the MPTT clinic. One-third of cases (31%) had no diagnosis made and 22% were assessed as having an incorrect diagnosis. CONCLUSIONS:Time delays, patient confusion regarding professional roles and diagnostic indecision are significant problems for patients referred to hospital orthopaedic clinics from MPTT clinics. This risks sub-optimal patient care and may lead to future medicolegal implications.
journal_name
Ann R Coll Surg Engljournal_title
Annals of the Royal College of Surgeons of Englandauthors
Rogers BA,Kabir C,Bradley Ndoi
10.1308/003588408X318174subject
Has Abstractpub_date
2008-11-01 00:00:00pages
671-4issue
8eissn
0035-8843issn
1478-7083pii
9758journal_volume
90pub_type
杂志文章abstract：:Intact parathyroid hormone (PTHi) has a relatively short half-life and levels fall significantly within 15 min of the successful excision of all the abnormal parathyroid glands during surgery for hyperparathyroidism. Monitoring this fall has been suggested as useful in decreasing the failure rate of neck explorations ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1993-01-01 00:00:00
abstract：:A new process has been used to develop Biogel Super-Sensitive gloves which are thinner but theoretically as strong as standard Biogel gloves. The two types of glove were compared for their effects on manual sensitivity and dexterity in a randomised controlled trial. The Super-Sensitive gloves impaired sensitivity sign...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1996-05-01 00:00:00
abstract：:This study investigates incidence and outcome of iatrogenic vascular complications needing surgery in a single vascular unit serving interventional vascular radiology and interventional cardiology. Evolution of diagnostic and interventional cardiovascular radiology, along with the introduction of non-surgical therapie...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1999-01-01 00:00:00
abstract：OBJECTIVES:To determine the effects of cuts in surgical beds and operating lists upon the waiting list. To evaluate the effects of the Waiting List Initiative upon the total number of patients on the waiting list, the number of patients waiting for more than one year, and the ratio of patients with low priority, non-li...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1994-01-01 00:00:00
abstract：:Childhood achalasia is an uncommon condition characterised by the absence of oesophageal peristalsis together with increased resting pressure and failure of relaxation of the lower oesophageal sphincter. The currently accepted management is a modified Heller's cardiomyotomy with Nissen fundoplication; however, the lon...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1997-11-01 00:00:00
abstract：INTRODUCTION:Intertwining of bowel loops to form a knot is very rare cause of intestinal obstruction. Among intestinal knots, ileoileal knotting is the most rare, with only a handful of cases reported in literature. We present a rare case of ileoileal knotting and review of small bowel knots. The aim of this review was...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章,评审
doi：10.1308/rcsann.2020.0122
更新日期：2020-10-01 00:00:00
abstract：:A prospective controlled randomised study has been performed of 100 consecutive patients undergoing varicose vein surgery. One group underwent saphenofemoral flush ligation and multiple lower leg avulsions with the leg exsanguinated with a Rhys-Davies cuff, and ischaemia maintained with a pneumatic tourniquet. The oth...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1990-03-01 00:00:00
abstract：:A series of 21 patients (18 female) whose intractable constipation was treated by colectomy between 1976 and 1985 is reported. There was no mortality attributable to surgery in this series. Total colectomy with ileorectal anastomosis was the preferred operation, but it produced a satisfactory result in only 12 patient...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1987-03-01 00:00:00
abstract：:Surgical practice must be driven by wise professional judgements, involving complex deliberation, in the interests of ensuring the safe care of patients. Large amounts of energy are now being concentrated in training doctors in skills (competencies) in the belief that this will reduce risk to patients. Little thought ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type：
doi：10.1308/003588405X51164
更新日期：2005-07-01 00:00:00
abstract：INTRODUCTION:The retrojugular approach for carotid endarterectomy (CEA) has been reported to have the advantages of shorter operative time and ease of dissection, especially in high carotid lesions. Controversial opinion exists with regard to its safety and benefits over the conventional antejugular approach. METHODS:...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章,meta分析,评审
doi：10.1308/003588414X13814021679357
更新日期：2014-04-01 00:00:00
abstract：INTRODUCTION:Antegrade insertion of ureteric stent has become an established mode of management of upper tract obstruction secondary to ureteric pathology. It is conventionally performed as a two-stage procedure for various reasons but, more recently, a one-stage approach has been adopted. PATIENTS AND METHODS:We disc...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章,多中心研究
doi：10.1308/003588410X12518836439128
更新日期：2010-04-01 00:00:00
abstract：INTRODUCTION:The increased use of diagnostic laparoscopy for management of right iliac fossa pain may have lowered the threshold for removing normal appendices, particularly as there is a perception that this practice carries little additional morbidity. The aim of this retrospective audit was to determine the negative...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588414X13946184903801
更新日期：2014-10-01 00:00:00
abstract：:Three hundred and forty consecutive patients received successful spinal anaesthesia with 0.5% plain bupivacaine. A small randomised study of 40 of these cases showed little difference between 3.5 and 3 ml; however, analysis of its use in 200 patients receiving 3.5 ml (mean block T10.5 +/- 1 segment) and 100 receiving ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1983-01-01 00:00:00
abstract：:In spite of the suitability of the day surgery environment for most patients undergoing elective plastic surgery, day plastic surgery has not been universally adopted in the United Kingdom. The experience of one plastic surgeon gained in treating 5970 patients as day cases out of a total of 12,461 patients over 10 yea...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1994-03-01 00:00:00
abstract：:INTRODUCTION Often, left-sided colorectal surgery requires splenic flexure mobilisation (SFM) to allow a tension-free anastomosis to be carried out. This step is difficult and not without risk. We investigated a system of anatomical siting of the splenic flexure using computed tomography (CT). METHODS The Shrewsbury S...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2016.0298
更新日期：2017-03-01 00:00:00
abstract：:Introduction Emergency general surgery services in England are undergoing rapid structural change with the aim of improving care. In our centre, the key issues identified were high numbers of admissions, inappropriate referrals, prolonged waiting times, delayed senior input and poor patient satisfaction. A new model w...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2017.0081
更新日期：2017-09-01 00:00:00
abstract：INTRODUCTION:In future, outcomes following shoulder surgery may be subject to public survey. Many outcome measures exist but we do not know whether there is a consensus between shoulder surgeons in the UK. The aim of this study was to survey the preferred outcome measures used by National Health Service (NHS) shoulder ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588414X14055925058157
更新日期：2014-11-01 00:00:00
abstract：:We present a case of a chronic recurrent rectovaginal fistula that initially arose from complications of haemorrhoid surgery and had failed multiple prior surgical repairs. The fistula was successfully managed using viable cryopreserved placental tissue. ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2017.0157
更新日期：2017-11-01 00:00:00
abstract：:INTRODUCTION Central venous catheterisation (CVC) is a commonly performed procedure in a wide variety of hospital settings and is associated with appreciable morbidity. There is a paucity of literature focusing on mechanical complications specifically in the trauma setting. The aim of our study was to determine the sp...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2017.0022
更新日期：2017-05-01 00:00:00
abstract：:The prevalence of HIV in the UK has been estimated to be 1 in 1000 of the population. Surgeons are at particular risk of occupational transmission from infected blood. To determine the effect of HIV on surgical practice we sent a questionnaire to 681 general surgeons in England and Wales; 450 replied (66%). Of those w...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1990-09-01 00:00:00
abstract：:A change in the accepted routine of cross-leg repair is suggested in the interest of safety. In order to avoid infection in the donor site the skin graft is cut first. The flap is raised before the defect is prepared so that the problems of tension and 'tenting' are eliminated. This enables the flap to be sutured unde...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1980-07-01 00:00:00
abstract：:My first aim is to present the state of burn care during the few years before the Battle of Britain in August-October 1940. This gives the climate of thought in which McIndoe and his collegues faced the challenge of burns. We are inclined to forget the helplessness of surgeons faced with extensive burns at that time. ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 传,历史文章,杂志文章
doi：
更新日期：1979-09-01 00:00:00
abstract：:Acute ischaemic stroke is a devastating postoperative complication that significantly impacts upon a patient's quality of life. Endovascular retrieval of thromboembolic material from proximal cerebral arteries by mechanical thrombectomy is the new standard of care for patients presenting with a proximal artery occlusi...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2019.0028
更新日期：2019-05-01 00:00:00
abstract：:After thyroidectomy there is an appreciable incidence of hypothyroidism as judged by FT4I estimates. Pharmacological doses of iodine (10-300 mg/day) usually suppress, whereas physiological doses of iodine (< 5 mg/day) have been reported to both decrease and increase thyroid function. The value of iodine supplementatio...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1993-05-01 00:00:00
abstract：:A prospective study of all weekday emergency surgery performed in a district general hospital over an 18-month period was undertaken to assess the impact of a fully staffed, daytime operating theatre for emergency surgery on night-time operating and on consultant supervision of trainees. In the 12 months following the...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1993-11-01 00:00:00
abstract：:We describe the case of an 89-year old Caucasian woman admitted with confusion and severe clinical manifestations of acute hypercalcaemia. There was no history suggestive of any malignancy and initial management included correction of the hypercalcaemia with intravenous fluid therapy. Sestamibi parathyroid scintigraph...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2020.0101
更新日期：2020-10-01 00:00:00
abstract：:In 24 patients where the lower border of a cervical goitre was poorly defined, the value of simple lung function tests in the prediction of the presence of a retrosternal goitre was assessed. At operation there were nine patients with retrosternal extension (Group I) and 15 without (Group II). The preoperative PEF rat...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1991-07-01 00:00:00
abstract：:Annular small bowel ulceration is rare. We report three patients who presented with signs of chronic gastrointestinal blood loss. In two patients the main presenting symptom was intermittent abdominal pain while the third patient subsequently developed abdominal pain during the course of investigation. Preoperative lo...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1986-05-01 00:00:00
abstract：:Gastric tube conduit is the method of choice for restoring continuity of the digestive track after a partial or total esophagectomy. Redundant gastric conduit (i.e. an elongated, floppy conduit) is a rare cause of dysphagia in patients with long survival. Gastric tube volvulus is exceedingly rare with only three cases...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2018.0146
更新日期：2019-01-01 00:00:00
abstract：INTRODUCTION:Radial scars are benign breast lesions; their appearance on mammography may, however, mimic carcinoma. Needle core biopsy is performed for pre-operative diagnosis and, currently in Wales, all lesions with benign biopsy results are surgically excised. We have reviewed all cases of needle core biopsy-diagno...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588411X12851639107953
更新日期：2011-03-01 00:00:00
