Abstract：
BACKGROUND:Recent cognitive research in medicine has demonstrated that expert diagnosticians solve many clinical problems through "pattern recognition" rather than deductive reasoning strategies. Development of the ability to recognize and diagnose common surgical problems is a critical objective of undergraduate surgical education. A surgical pattern recognition examination (PAT) was developed to assess surgical diagnosis recognition in clerkship students. METHODS:Surgical faculty selected 18 diagnoses for 20 possible presenting complaints (eg, leg pain, soft tissue mass). A distinctive patient description was written for each diagnosis. An examination of 200 items was compiled covering 20 presenting complaints. RESULTS:The PAT was administered to clerkship students during the 1992-1993 academic year (n = 77). PAT scores ranged from 33% to 90% with a mean of 65% (SD = 12.7). PAT scores correlated highly with the National Board of Medical Examiners (NBME) Surgery Subject Examination (SSE) scores. The validity of the examination was assessed by a speeded administration of the exam to surgical house staff. Senior residents scored significantly higher than junior residents (mean 82% versus 63%, P = 0.004). Performance on the PAT was significantly affected by the order of the student rotation in the academic year (P = 0.02) while performance on the NBME SSE was not (P = 0.40), which is consistent with diagnostic ability improving with clinical experience. CONCLUSIONS:The surgical PAT examination is a new, reliable, and valid method for assessing diagnostic ability in third-year students.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Dunn MM,Woolliscroft JOdoi
10.1016/S0002-9610(99)80172-Xsubject
Has Abstractpub_date
1995-03-01 00:00:00pages
341-3issue
3eissn
0002-9610issn
1879-1883pii
S0002-9610(99)80172-Xjournal_volume
169pub_type
杂志文章abstract：:Rectal prolapse that is intractable to the usual medical therapy was successfully managed without significant complications in 10 patients by simple subcutaneous encirclement of the anus with a heavy nonabsorbable suture, which was in place until the suture was removed or broke after 4 to 6 months. Four patients requi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)81022-0
更新日期：1990-11-01 00:00:00
abstract：BACKGROUND:Primary hyperparathyroidism (HPT) is an undertreated disease. This study's purpose is to determine if the calcium levels correlate with prevalence of symptoms and surgical treatment in patients with primary HPT. METHOD:Patients treated in 2006-2015 with serum calcium≥10.0 mg/dL and PTH>65 pg/mL were identif...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.09.010
更新日期：2019-03-01 00:00:00
abstract：BACKGROUND:One of the issues in the debate surrounding the extent of thyroid excision for localized, well-differentiated thyroid cancer is the low morbidity rate reported after all degrees of thyroid resection. This study was conducted to determine morbidity and mortality after surgical resection for thyroid cancer. M...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80085-6
更新日期：1994-11-01 00:00:00
abstract：BACKGROUND:Administrative data can be used to identify cases of postoperative respiratory failure (PRF). We aimed to determine if recent changes to the Agency for Healthcare Research and Quality Patient Safety Indicator 11 (PSI 11) and adoption of clinical documentation improvement programs have improved the validity o...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2019.11.019
更新日期：2020-07-01 00:00:00
abstract：BACKGROUND:Changes in surgical training have raised concerns about residents' operative exposure and preparedness for independent practice. One way of addressing this concern is by optimizing teaching and feedback in the operating room (OR). The objective of this study was to perform a systematic review on perioperativ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2016.12.014
更新日期：2017-07-01 00:00:00
abstract：:A 54-year-old man on palliative treatment for disseminated cutaneous malignant melanoma presented with abdominal pain and abdominal distention. A computed tomography scan showed an area in the distal ileum suggesting intussusceptions. In an exploratory laparotomy, a 10-cm mass was found comprised of the distal ileum t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.09.018
更新日期：2009-07-01 00:00:00
abstract：BACKGROUND:In patients with primary hyperparathyroidism (HPTH) and previous thyroid operations, complications of parathyroidectomy are more frequent than in patients undergoing initial neck surgery. The aim of this study was to investigate the value of preoperative imaging with regard to its influence on the surgical s...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00197-x
更新日期：1999-11-01 00:00:00
abstract：:Eighty-five patients who underwent 100 transcatheter intraarterial thrombolytic infusions for occlusions of suprainguinal and infrainguinal grafts and arteries were analyzed to determine the initial and 6 month results. Analysis demonstrated that suprainguinal occlusions of arteries and grafts were most likely to both...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90454-x
更新日期：1986-12-01 00:00:00
abstract：:A total of ninety three patients with biliary tract disease were studied to determine the concentration of the pancreatic enzymes, amylase and lipase, in bile obtained from the gallbladder and/or common bile duct. Of seventy gallbladder bile samples, amylase levels were higher than actual or predicted serum levels in ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90055-2
更新日期：1979-03-01 00:00:00
abstract：:Between 1973 and 1989, 49 patients with gastrointestinal lymphomas were treated at the Virginia Mason Medical Center, Seattle, Washington, and followed in the tumor registry. The purpose of this review was to determine the influence of treatment on long-term survival of these patients. The mean age was 63 years (range...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90902-p
更新日期：1991-05-01 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:Professionalism and ethics are Accreditation Council for Graduate Medical Education (ACGME) core competencies, but there is little evidence regarding the effectiveness of ethics education. METHODS:General surgery residents at the University of Pittsburgh completed questionnaires measuring attitudes and know...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.08.002
更新日期：2010-11-01 00:00:00
abstract：:The lower extremity complications of 100 consecutive patients who required the placement of an intra-aortic balloon pump (IABP) during a 3-year period were studied. Indications for the IABP included hypotension during cardiac catheterization (33%) or coronary angioplasty (13%), hemodynamic instability after open heart...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)81192-4
更新日期：1992-11-01 00:00:00
abstract：:A technic of esophagogastrostomy is described for constructing an end-to-side, back-to-front anastomosis using stapling devices. Twelve consecutive cases are reported with no deaths and no anastomotic leaks. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90305-7
更新日期：1978-09-01 00:00:00
abstract：:The relative merits of the anterior and posterior approaches to the adrenal gland were assessed in a series of 103 patients with bilateral cortical hyperplasia or unilateral cortical adenoma (less than 25 g). In none of the patients was additional concomitant surgery planned. Sixty-four patients were operated on throu...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90010-1
更新日期：1982-09-01 00:00:00
abstract：:Although the incidence of anastomotic false aneurysms decreased precipitously with the cessation of usage of silk sutures for vascular anastomoses, the prevalence of these aneurysms has undoubtedly increased in keeping with an ever-increasing volume of peripheral vascular operations. Most aneurysms occur at femoral an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90338-0
更新日期：1983-12-01 00:00:00
abstract：:Limb ischemia due to blunt trauma, dissecting hematoma, and cardiac dysfunction jeopardizes limbs and lives more than is generally appreciated. Delay in diagnosis after blunt trauma led to major amputation in 21 percent of our patients. Current principles avoid those hazards. Five patients presented with acute limb is...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90513-x
更新日期：1982-08-01 00:00:00
abstract：:The dual tracer nuclear scintiscan using technetium and thallium to localize enlarged or ectopic parathyroid tissue has been reported to be highly accurate and efficacious. Fourteen previous series reporting results of the technique have been compiled from the literature and analyzed. This analysis has revealed a tota...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90798-7
更新日期：1987-05-01 00:00:00
abstract：:A controlled prospective study was conducted to compare the results of kidney preservation and transplantation in regard to the type of perfusate used for perfusion preservation. Cryoprecipitated plasma, plasma protein fraction and serum albumin solution were used as perfusate. Between February 1979 and July 1980, 176...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/0002-9610(81)90137-9
更新日期：1981-04-01 00:00:00
abstract：BACKGROUND:The current opinion is that the reflux of jejunal juice over the whole length of a long Roux-en-Y jejunal loop is very uncommon. We aimed to challenge this concept by monitoring the presence of bile in the organ proximal to a 60-cm loop during a 24-hour period with use of the Bilitec device, an optoelectroni...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00326-3
更新日期：2000-04-01 00:00:00
abstract：BACKGROUND:Urinary retention following inguinal hernia surgery is common and is believed to be associated with adrenergic over-stimulation of the smooth muscle in the bladder neck and prostate. The efficacy of prophylactic alpha-blockade in the prevention of urinary retention following elective inguinal hernia repair i...
journal_title：American journal of surgery
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.amjsurg.2017.02.017
更新日期：2018-08-01 00:00:00
abstract：:Intracellular growth hormone has been demonstrated in human mammary carcinoma cells by using an unlabeled antibody enzyme technic with horseradish peroxidase and antihorseradish peroxidase complex. Intense reaction was seen in both male and female mammary carcinoma cells. Positive staining was observed in nuclei and c...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90102-2
更新日期：1978-02-01 00:00:00
abstract：:A successful method for controlling intractable bleeding after endoscopic sphincterotomy is described. By passing a Fogarty catheter into the duodenum, balloon tamponade of the bleeding point is possible. By such a technique, major resective surgery can be avoided. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90092-2
更新日期：1994-02-01 00:00:00
abstract：BACKGROUND:Colonic inertia (CI) is a disturbance of colonic motility characterized by severe constipation and abdominal pain. This study was conducted to assess the results of total abdominal colectomy (TAC) in the management of CI. METHODS:A retrospective chart review of 55 patients who underwent TAC for CI was condu...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00820-0
更新日期：2001-12-01 00:00:00
abstract：:A new S-shaped cystic duct metal cannula was developed and used successfully in 200 cystic duct cholangiograms. It has the advantage of being easy to manipulate because the configuration does not obscure the vision and the resistance is less than that of plastic tubes, facilitating injection with lower pressure. It is...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90106-5
更新日期：1979-06-01 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:Predicting length of stay (LOS) is difficult for trauma and emergency general surgery (TEGS) patients. Our aim was to determine the accuracy of LOS predictions by TEGS team members and the NSQIP Risk Calculator and the patient factors associated with inaccurate predictions. METHODS:LOS for 200 TEGS patients...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.01.055
更新日期：2020-09-01 00:00:00
abstract：:Fifty men with hernias were operated on as outpatients: 42 went home the evening after surgery. The best results were obtained in patients with unilateral indirect hernias; those with direct hernias did not do quite as well. No patient required readmission to the hospital for complications. The cost was significantly ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90161-1
更新日期：1982-05-01 00:00:00
abstract：BACKGROUND:Vacuum Assisted Closure (VAC; Kinetic Concepts, Inc., San Antonio, TX) has been used to successfully treat a variety of complex wounds. This technique was investigated for use in managing Fournier's gangrene following initial debridement. METHODS:Ten patients with Fournier's gangrene were treated in this st...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.04.018
更新日期：2009-05-01 00:00:00
abstract：BACKGROUND:While vascular patency and overall viability of the gut can be evaluated perioperatively, damage to the mucosal barrier can hardly be judged in the perioperative setting and, moreover, will probably determine the clinical course. METHODS:In 19 consecutive cases with intestinal ischemia, the clinical course ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00048-2
更新日期：1997-07-01 00:00:00
