Abstract:
:Much literature supports the value of performance-based tests for obtaining an overall assessment of clinical skills; however, these tests can also identify specific deficits in medical curriculum and student learning. This study, conducted over a period of 2.5 years, used standardized patients to identify deficiencies in medical students' evaluation of a patient with "hoarseness and cough." Each of 230 students performed a physical examination and took a medical history, and each was evaluated on 29 items according to predetermined criteria. We conclude the following: (1) When examining a patient complaining of hoarseness and cough, students frequently did not screen for hemoptysis, thyroid problems, and otalgia; (2) Overall test performance correlated positively with the time of year of the rotation, but screening for certain items (including hemoptysis, thyroid problems, and otalgia) appeared not to depend on rotation; (3) Several important items significantly differentiated the more knowledgeable student from the less knowledgeable student.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Haydon R 3rd,Donnelly M,Schwartz R,Strodel W,Jones Rdoi
10.1016/s0002-9610(05)80072-8subject
Has Abstractpub_date
1994-07-01 00:00:00pages
57-64; discussion 64-5issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(05)80072-8journal_volume
168pub_type
杂志文章abstract:BACKGROUND:The purpose of this study was to investigate the impact of subcarinal dissection on short-term outcomes and survival after esophagectomy in patients with thoracic esophageal squamous cell carcinoma. METHODS:Patients without subcarinal dissection were matched randomly to patients with subcarinal dissection i...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.10.044
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Appendiceal perforation in patients with acute appendicitis may cause a variety of potentially life-threatening complications. Escherichia coli endotoxin has been shown to impact physiological bile flow in vivo. This had led to the theory that hyperbilirubinemia in patients with appendicitis may have a predi...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.amjsurg.2008.08.026
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Native arterial venous fistulas (NAVF) are generally considered preferable to synthetic grafts for chronic dialysis access. As increasing numbers of diabetic and elderly patients are treated, adequate NAVFs become more difficult to establish. Vascular ultrasonography (US) prior to NAVF surgery has received l...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01103-0
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:This study defines the entity of the hypertensive lower esophageal sphincter (HLES) and its treatment, including surgical implications. METHODS:Esophageal manometry was performed on 1,300 patients. Of these, 53 (4%) had HLES with resting pressure > 26.5 mm Hg, defined as the upper limit of normal resting LE...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/S0002-9610(96)00219-X
更新日期:1996-11-01 00:00:00
abstract::A review of 143 patients with 144 feeding jejunostomies was carried out. In the 129 patients in whom catheters were utilized, only 48 (45 percent) had no complications. Seventy-one patients (55 percent) suffered one or more catheter-related complications. Ten of these complications were life-threatening or fatal, incl...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80267-8
更新日期:1988-01-01 00:00:00
abstract::There has been a continuing evolution of the clinical spectrum of Candida infection in nonneutropenic patients. With better understanding of the predisposing factors for fungemia in critically ill patients, interest now centers on indications for early therapy, prior to the progression of colonization to fungemia. Rec...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(96)00350-9
更新日期:1996-12-01 00:00:00
abstract::Prophylactic bypass of the common duct and duodenum at the time of pancreatojejunostomy for chronic pancreatitis (triple bypass) has been recommended. If the subsequent development of parapancreatic obstruction were sufficiently frequent, such a recommendation would deserve more wide-spread application. In a group of ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90081-4
更新日期:1986-02-01 00:00:00
abstract:BACKGROUND:The Centers for Disease Control and Prevention reported that surgical site infections (SSIs) create a significant hospital burden. To date, few multi-institutional studies have been performed to evaluate the risk factors for SSIs in mastectomy patients. METHODS:By using the American College of Surgeons' Nat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.05.007
更新日期:2013-02-01 00:00:00
abstract::Primary prevention is defined as the prevention of gallstone formation; secondary prevention is defined as the prevention of clinical manifestations of gallstones--symptoms or more severe complications. For primary prevention, general "wellness" measures can be recommended from a theoretic standpoint. These include el...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(05)80958-4
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Antireflux operations restore lower esophageal sphincter (LES) function and hiatal anatomy; however, the relative contributions are unclear. METHODS:We measured the competency of fundoplications, exclusive of in vivo variables, in gastroesophageal explants from 8 cadavers. Using a multichannel manometer, es...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00313-4
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:New prognosticators are necessary for optimizing the extent of thyroidectomy and adjuvant radiotherapy in differentiated thyroid carcinoma. METHODS:Tumor microvessel density (MVD), expression of thymidine phosphorylase (dThdPase) and CD68 stained macrophages were evaluated in 71 differentiated thyroid carci...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00238-4
更新日期:1998-11-01 00:00:00
abstract::Reports in the surgical literature are conflicting as to whether appendectomy "in passing" during laparotomy for trauma or for some other disease state does or does not significantly increase patient morbidity or mortality. A chart survey of all appendectomies (342 for acute appendicitis and 146 as incidental procedur...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9610(83)90150-2
更新日期:1983-06-01 00:00:00
abstract:BACKGROUND:Previous evaluations of endoscopic hernia surgery mostly are based on small prospectively documented series or on a few randomized comparative studies. In the following, results of a large single-institution experience concerning the transabdominal preperitoneal patch (TAPP) technique with regard to the deve...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00074-9
更新日期:1998-06-01 00:00:00
abstract::Initial manifestations of AIDS in the head and neck area occur frequently. In fact, up to 40 percent of patients may have involvement of the head and neck. The most common malignancies are Kaposi's sarcoma and non-Hodgkin's lymphoma. Since AIDS-related malignancies are a relatively new problem for radiation oncologist...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90021-4
更新日期:1987-10-01 00:00:00
abstract::Fourteen operations were performed in 13 patients with total carotid artery occlusion. All patients had symptoms ranging in duration from a few hours to several months. Flow wa reestablished in 10 of the 14 arteries operated on, a success rate of 74 percent. Complication included one operative death and one permanent ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90366-9
更新日期:1980-05-01 00:00:00
abstract::Recurrent, nodular necrotizing granulomatous mastitis in two patients is reported in detail. Pathologic, immunologic, and bacteriologic studies in one patient indicate that this entity is different from plasmas cell mastitis, fat necrosis, mammary ductal ectasia, and the usual infectious and puerperal mastitis. System...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90397-0
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:The use of biologic markers to aid in individualizing wound treatment may help improve outcomes. A biologic marker that has been demonstrated to be predictive of healing in both chronic and acute wounds is wound tissue bacterial level. The objective of this study was to determine whether tissue bacterial lev...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.09.009
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Laparoscopic deroofing has been shown to produce good patient satisfaction and to have results similar to those of open surgical techniques. We evaluated the feasibility and efficacy of laparoscopic deroofing using an argon beam coagulator (ABC) in the patients with nonparasitic liver cysts. METHODS:Laparos...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01361-2
更新日期:2003-03-01 00:00:00
abstract::The antiproliferative effects of somatostatin on hepatocytes stimulated by hepatocyte growth factor (HGF) or epidermal growth factor (EGF) were investigated using primary cultures of adult rat hepatocytes. Somatostatin inhibits HGF-induced (at a dose of 10 ng/mL) or EGF-induced (at a dose of 100 ng/mL) 3H-thymidine in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(92)90271-r
更新日期:1992-01-01 00:00:00
abstract::Review of the diagnosis and treatment of patients with pancreatic pseudocysts over the past 8 years has led us to three conclusions regarding controversial aspects of their treatment. We found that patients who present with chronic pseudocysts can be identified with the help of computerized axial tomography and prompt...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80275-7
更新日期:1988-01-01 00:00:00
abstract::Splenectomy was performed in 20 patients with refractory cytopenias associated with systemic lupus erythematosus. An immediate and sustained increase in platelet count (greater than 150,000 cells/mm3) was achieved in 12 of 18 patients whose principal indication for operation was thrombocytopenia. Of seven patients wit...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80097-7
更新日期:1988-03-01 00:00:00
abstract:BACKGROUND:The Limberg flap (LF) procedure is widely performed for the treatment of sacrococcygeal pilonidal sinus (SPS); however, recurrences continues to be observed. The aim of this study was to assess the relationship between LF designs and the risk of SPS recurrence. METHODS:Sixty-one cases with recurrent disease...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2017.02.008
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:A left-sided gallbladder in a normally positioned liver is considered to be a very uncommon anomaly. Laparoscopic cholecystectomy can be performed safely, but bile duct injury is not unusual. It is associated with anomalous intrahepatic portal and biliary systems which impacts any form of partial hepatectomy...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.10.035
更新日期:2013-07-01 00:00:00
abstract::Four hundred seventy-eight patients with hand burns (786 hands) were treated at the burn service of the Massachusetts General Hospital. Long-term evaluation showed that early incision and immediate autografting of deep second degree, mixed second and third degree, and third degree full-thickness hand burns resulted in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80049-0
更新日期:1985-04-01 00:00:00
abstract:BACKGROUND:Laparoscopic parastomal hernia repair can be technically challenging. We herein present a simplified technique of laparoscopic parastomal hernia repair. METHODS:This technique entails fixation of the rolled mesh to the anterior abdominal wall before unfolding it, each side of the mesh is unfolded and fixed ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.06.034
更新日期:2008-09-01 00:00:00
abstract::Since 1972, 17 patients have been surgically treated for double aortic arch at our institution. The procedure became necessary before 12 months of age in 11 patients and before 24 months in 16 patients. The major symptoms were respiratory distress, noisy breathing, and respiratory infections; four patients also had dy...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80449-0
更新日期:1993-05-01 00:00:00
abstract::From 1971 through 1975, 104 patients with squamous carcinoma of the anterior and anterolateral floor of the mouth underwent surgery, irradiation therapy or a combination of both with the purpose of eliminating their tumors. No patient had received treatment before, and this effort was considered primary and definitive...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90212-3
更新日期:1980-10-01 00:00:00
abstract:BACKGROUND:Gallbladder inflammation and mucus hypersecretion are prominent features of cholesterol and pigment gallstones in humans and animals. The factors leading to inflammation and mucus hypersecretion are poorly understood. These studies examine the inflammatory potential of bile from dogs with pigment gallstones....
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(99)80099-3
更新日期:1996-01-01 00:00:00
abstract::Computerized tomographic scanning is being used with increasing frequency for the detection of abdominal aortic prosthetic complications. Although computerized tomography remains a very precise method for direct imaging of the retroperitoneal space, the interpretation of a postoperative computerized tomographic scan i...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(85)90125-4
更新日期:1985-08-01 00:00:00
abstract:BACKGROUND:Appropriate therapy for women over 70 years of age with breast cancer is currently a highly debated topic. The aim of this study was to determine whether a subset of patients could be identified in which lumpectomy alone, followed by tamoxifen, would offer adequate local, regional, and long-term control of d...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00474-8
更新日期:2000-09-01 00:00:00