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Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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PubMed1992

Positron emission tomography as a multi-institutional effort.

The consortium relationship at State University of New York at Buffalo School of Medicine and Biomedical Sciences have made it possible to establish in this community a multi-institutional effort to develop positron emission tomography (PET). The type of approach used and the modalities employed to generate community, university, and federal support are presented. The development of PET technology has led to a greater understanding between the various disciplines, and joint efforts have been made to establish pilot projects in a number of research protocols in the clinical applications that are currently available today. The consortium concept has led to early consideration by third-party carriers to consider reimbursement for those established PET procedures that can be applied clinically. Hopefully, with the passage of time and the maturation of a regional PET center, the concepts proposed might be used as models for other installations throughout the country.

Multi-Institutional Systems↗
PubMed1992

Implementation of a national nursing standards program.

At an annual nursing management conference of a multisystem hospital management firm, nursing executives expressed a need for developing nursing care standards. Because many of the hospitals were small or rural, they lacked some of the resources needed to develop such a program individually. Pooling resources so that all could benefit was an innovative and sensible approach. The authors describe the project that resulted in the development of a nation-wide standards program involving nearly 50 hospitals.

Models, Organizational↗
PubMed1992

Economic forces drive collaboration push.

Over 60 percent of CEOs surveyed say their hospital will belong to a regional, integrated health system by 1995. The question, they say, is not whether integration will happen, but how.

Attitude of Health Personnel↗
PubMed1992

Quality of health care and financial performance: is there a link?

The relation between operating margin and quality of care is investigated by using survey and financial data for 82 small and medium-sized hospitals. A positive relation between the variables is found, and implications of that relationship are discussed.

Attitude of Health Personnel↗
PubMed1979

This is the way it was in the 1970s.

Although regulatory, economic, and other concerns appear to have taken center stage in the health care field in the past decade, the real work of healing and comforting the sick goes on.

Cost Control↗
PubMed1992

Multi-institutional privileging: a pilot demonstration project of the United States Navy and the Joint Commission on Accreditation of Healthcare Organizations.

The U.S. Navy and the Joint Commission on Accreditation of Healthcare Organizations have undertaken a 3-year multi-institutional privileging project. The concept involves granting privileges in one Navy facility that are recognized throughout the system during the staff appointment period. It entails: (1) use of specialty-specific standardized privilege lists, (2) designation of one authority at a time to grant the appointment with privileges, (3) use of a single credentials file during the practitioner's career, and (4) medical staff bylaws applicable to the entire system. The concept is potentially useful in other armed services, the Veterans Administration, and some civilian systems.

Hospitals, Military↗
PubMed1978

Health care delivery: strength in numbers.

The number and types of multi-institutional arrangements among health care facilities are on the increase, and the days of the completely autonomous, independent hospital are coming to a close. Although by themselves hospital systems are no panacea in dealing with the challenges facing hospitals today, many such arrangements offer more opportunities than problems in coping with the rapid changes currently facing the health care industry. The pros and cons of seven arrangements are discussed in detail.

Area Health Education Centers↗
PubMed1992

Hypothermia in the sepsis syndrome and clinical outcome. The Methylprednisolone Severe Sepsis Study Group.

OBJECTIVE: To evaluate the consequences of clinical hypothermia associated with sepsis syndrome and septic shock. DESIGN: Analysis of data from a multi-institutional, randomized, placebo-controlled, prospective study with predetermined end-point analysis of development of shock, recovery from shock, hospital length of stay, and death. SETTING: Multi-institutional medical and surgical ICUs. PATIENTS: Patients meeting predetermined criteria for severe sepsis syndrome. INTERVENTIONS: Appropriate sepsis and shock care with 50% of patients receiving methylprednisolone and 50% receiving placebo. MEASUREMENTS AND MAIN RESULTS: The occurrence rate of hypothermia (< 35.5 degrees C) is 9% in this population. When compared with febrile patients, hypothermic patients had a higher frequency of central nervous system dysfunction (88% vs. 60%), increased serum bilirubin concentration (35% vs. 15%), prolonged prothrombin times (50% vs. 23%), shock (94% vs. 61%), failure to recover from shock (66% vs. 26%), and death (62% vs. 26%). The hypothermic patients were also more likely to be classified as having a rapidly or ultimately fatal disease upon study admission. CONCLUSIONS: This prospective study confirms that hypothermia associated with sepsis syndrome has a significant relationship to outcome manifest by increased frequency of shock and death from shock. This finding is in sharp contrast to the protective effects of induced hypothermia in septic animals and perhaps man.

Adolescent↗
PubMed2025

High Prevalence of Potential Molecular Therapeutic Targets in Poorly Differentiated Thyroid Carcinoma.

Poorly differentiated thyroid carcinoma (PDTC) is a rare thyroid cancer with aggressive clinical course and peculiar clinical/pathological characteristics but lacking effective therapeutic options, when surgery is not curative. We aimed at the molecular characterization of PDTC with a specific focus on the identification of potential therapeutic targets. A series of PDTC cases was selected from a multi-institutional network. Fifty-nine samples underwent wide targeted DNA and RNA next-generation sequencing (NGS) testing and immunohistochemical analysis for mismatch repair (MMR) proteins. Gene fusion analysis was enriched by 25 additional samples. Prevalence of MMR protein loss was 11.9%. The most prevalent mutations were in NRAS (25%) and TP53 (25%), mutually exclusive. TERT promoter (TERTp) mutations were detected in 19.6% of cases (10/51). NRAS-mutated cases were enriched for mutations in genes belonging to the same pathway. TP53-mutated samples lacked TERTp co-mutations, but were associated with mutations in PTEN and in genes related to MMR system and/or loss of MMR proteins. TERTp mutations were the most prevalent alterations (28%, 7/25) in a third group that lacked NRAS or TP53 mutations. Four cases harbored gene fusions, including two cases harboring the TBL1XR1::PIK3CA fusion that has never been reported in thyroid cancer, so far. In conclusion, PDTC may be genomically segregated in subgroups with specific molecular characteristics. Overall, targetable gene fusions have a prevalence of 9% (4/42). Moreover, 47% of cases are potential candidates for individualized target therapies since they harbor mutations in genes coding for potentially targetable molecules and/or have defects in the MMR system.

Humans↗