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https://www.readbyqxmd.com/read/27905814/medicare-and-medicaid-programs-cy-2017-home-health-prospective-payment-system-rate-update-home-health-value-based-purchasing-model-and-home-health-quality-reporting-requirements-final-rule
#1
(no author information available yet)
This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP)...
November 3, 2016: Federal Register
https://www.readbyqxmd.com/read/27901391/comparison-of-antibacterial-effects-among-three-foams-used-with-negative-pressure-wound-therapy-in-an-ex-vivo-equine-perfused-wound-model
#2
Lore L Van Hecke, Maarten Haspeslagh, Katleen Hermans, Ann M Martens
OBJECTIVE To compare antibacterial effects among 3 types of foam used with negative-pressure wound therapy (NPWT) in an ex vivo equine perfused wound model. SAMPLES Abdominal musculocutaneous flaps from 6 equine cadavers. PROCEDURES Each musculocutaneous flap was continuously perfused with saline (0.9% NaCl) solution. Four 5-cm circular wounds were created in each flap and contaminated with 10(6) CFUs of both Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA). After a 1-hour incubation period, 1 of 4 treatments (NPWT with silver-impregnated polyurethane foam [NPWT-AgPU], polyurethane foam [NPWT-PU], or polyvinyl alcohol foam [NPWT-PVA] or a nonadherent dressing containing polyhexamethylene biguanide without NPWT [control]) was randomly applied to each wound...
December 2016: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/27901277/negative-pressure-wound-therapy-for-prevention-and-treatment-of-surgical-site-infections-after-vascular-surgery
#3
REVIEW
S Acosta, M Björck, A Wanhainen
BACKGROUND: Indications for negative-pressure wound therapy (NPWT) in vascular surgical patients are expanding. The aim of this review was to outline the evidence for NPWT on open and closed wounds. METHODS: A PubMed, EMBASE and Cochrane Library search from 2007 to June 2016 was performed combining the medical subject headings terms 'wound infection', 'abdominal aortic aneurysm (AAA)', 'fasciotomy', 'vascular surgery' and 'NPWT' or 'VAC'. RESULTS: NPWT of open infected groin wounds was associated with shorter duration of wound healing by 47 days, and was more cost-effective than alginate dressings in one RCT...
November 30, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27898352/management-of-the-open-abdomen-using-negative-pressure-wound-therapy-with-instillation-in-severe-abdominal-sepsis-a-review-of-48-cases-in-hospital-mexico-costa-rica
#4
Pablo Sibaja, Alfredo Sanchez, Guillermo Villegas, Alvaro Apestegui, Esteban Mora
INTRODUCTION: Despite the numerous advances in recent years, severe abdominal sepsis (with associated organ failure associated with infection) remains a serious, life-threatening condition with a high mortality rate. OA is a viable alternative to the previously used scheduled repeat laparotomy or continuous peritoneal lavage. The use of Negative Pressure Wound Therapy (NPWT) has been described as a successful method of management of the open abdomen. Adding instillation of saline solution to NPWT in a programmed and controlled manner, could offer the clinician an additional tool for the management of complex septic abdomen...
November 17, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27896596/haemodynamic-and-functional-consequences-of-the-iatrogenic-atrial-septal-defect-following-mitraclip-therapy
#5
REVIEW
E A Hart, K Zwart, A J Teske, M Voskuil, P R Stella, S A J Chamuleau, A O Kraaijeveld
Percutaneous MitraClip placement for treatment of severe mitral regurgitation in high surgical risk patients is a commonly performed procedure and requires a transseptal puncture to reach the left atrium. The resulting iatrogenic atrial septal defect (iASD) is not routinely closed, yet the haemodynamic and functional consequences of a persisting defect are not fully understood. Despite positive effects such as acute left atrial pressure relief, persisting iASDs are associated with negative consequences, namely significant bidirectional shunting and subsequent worse clinical outcome...
November 28, 2016: Netherlands Heart Journal
https://www.readbyqxmd.com/read/27895083/locking-plate-external-fixation-and-negative-pressure-wound-therapy-for-treatment-of-a-primary-infection-in-a-closed-clavicle-fracture
#6
Robert M Kenyon, David I Morrissey, Diarmuid C Molony, John Francis Quinlan
Infection in a clavicle fracture is uncommon, but remains a challenging problem. A paucity of soft tissue coverage often combined with significant displacement and interfragmentary movement add complexity to an already difficult situation for effective infection treatment. External fixation in principle offers a means of achieving fracture stability, while the infection is being eradicated. We present the case of a closed clavicle fracture, initially treated conservatively, that presented 5 weeks later with infection...
November 28, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27883358/negative-pressure-wound-therapy-inhibit-inflammation-by-up-regulating-atf-3-and-down-regulating-nuclear-factor-%C3%AE%C2%BAb-in-diabetic-patients-with-foot-ulcerations
#7
T Wang, R He, J Zhao, J C Mei, M Z Shao, Y Pan, J Zhang, H S Wu, M Yu, W C Yan, L M Liu, F Liu, W P Jia
BACKGROUND: Negative pressure wound therapy (NPWT) was one of the most important treatments of diabetic foot, but the underlying mechanisms still remain elusive. This study aimed to evaluate the inflammatory signals involved in the effects of NPWT on diabetic foot ulcers. METHODS: We enrolled 22 patients with diabetic foot ulceration, eleven treated with NPWT and others treated with traditional debridement. All the patients were treated and observed for 1 week...
November 24, 2016: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/27879605/discussion-effects-of-incisional-negative-pressure-wound-therapy-on-primary-closed-defects-after-superficial-circumflex-iliac-artery-perforator-flap-harvest-randomized-controlled-study
#8
Eric Zielinski, Robert D Galiano
No abstract text is available yet for this article.
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27879604/effects-of-incisional-negative-pressure-wound-therapy-on-primary-closed-defects-after-superficial-circumflex-iliac-artery-perforator-flap-harvest-randomized-controlled-study
#9
Hyun-Suk Peter Suh, Joon Pio Hong
BACKGROUND: Prolonged hematoma or seroma after primary closure is a causative element in wound complications. This study evaluated the effects of negative-pressure wound therapy on primary closed wounds after superficial circumflex iliac artery perforator flap harvest. METHODS: This study was a prospective, randomized, clinical trial comparing conventional dressing against a single application of negative-pressure wound therapy for 5 days after primary closure. A total of 100 patients who had superficial circumflex iliac artery perforator flap harvest were enrolled...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27864732/impact-of-pharmaceutical-care-on-cardiovascular-risk-among-older-hiv-patients-on-antiretroviral-therapy
#10
Elza Aparecida Machado Domingues, Mónica Ferrit-Martín, Miguel Ángel Calleja-Hernández
Background Advances in the treatment of HIV infection have enabled better control of the disease, allowing patients to enjoy a longer life expectancy. However, the ageing of patients leads to an increased prevalence of cardiovascular disease. Various studies have found that pharmaceutical care results in better control of cardiovascular risk factors. Objective To measure the impact of pharmaceutical care on cardiovascular risk in patients older than 50 years receiving combination antiretroviral therapy. Setting Outpatient pharmacy service of a tertiary hospital, Spain...
November 18, 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27863029/endoluminal-vacuum-therapy-for-ivor-lewis-anastomotic-leaks-a-pilot-study-in-a-swine-model
#11
R B Scott, L A Ritter, A L Shada, S H Feldman, D E Kleiner
Anastomotic leaks are a serious complication associated with Ivor Lewis esophagectomies. Endoluminal negative pressure vacuum devices create a possible treatment alternative to conventional surgical intervention. Ten pigs had an intrathoracic esophageal anastomosis with a 1-cm defect. The experimental group had the device placed intraoperatively across the defect, whereas the control group did not. Once treatment was completed, a contrast fluoroscopic study and necropsy was performed. All control pigs had contrast extravasation on fluoroscopy and contamination on necropsy...
November 11, 2016: Clinical and Translational Science
https://www.readbyqxmd.com/read/27861333/isolated-neurosarcoidosis-mimicking-multifocal-meningiomas-a-diagnosis-pitfall-a-case-report
#12
Kun Wang, Xiaoying He, Wei Wang, Huanjiang Niu, Yirong Wang, Xiujun Cai, Shuxu Yang
INTRODUCTION: Neurosarcoidosis accounts for approximately 5% of the sarcoidosis, which develops exclusively in the nervous system and is always difficult to diagnose. We describe a rare case of isolated neurosarcoidosis mimicking as multifocal meningiomas. A 27-year-old male was admitted to our hospital with a history of unconsciousness and convulsion 1 month ago, which was suspected as a seizure. The results showed no abnormalities in complete blood count; serum electrolytes; erythrocyte sedimentation rate and ultrasonography of the liver, pancreas, spleen, kidney and parotid gland, and so on...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27861132/chronic-morel-lavall%C3%A3-e-lesion-a-novel-minimally-invasive-method-of-treatment
#13
Ramireddy Mettu, Harsha Vardhan Surath, Hanumantha Rao Chayam, Amaranth Surath
A Morel-Lavallée lesion is a closed internal degloving injury resulting from a shearing force applied to the skin. The etiology of this condition may be motor vehicle accidents, falls, contact sports (ie, football, wrestling),1 and iatrogenic after mammoplasty or abdominal liposuction.2 Common sites of the lesions include the pelvis and/or thigh.3 Isolated Morel-Lavallée lesions without underlying fracture are likely to be missed, which result in chronicity. Management of this condition often requires extensive surgical procedures such as debridement, sclerotherapy, serial percutaneous drainage, negative pressure wound therapy (NPWT), and skin grafting...
November 2016: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/27861131/management-of-open-lower-extremity-wounds-with-concomitant-fracture-using-a-porcine-urinary-bladder-matrix
#14
Bruce A Kraemer, Scott E Geiger, Oliver A Deigni, John Tracy Watson
BACKGROUND: Open wounds of the distal third of the leg and foot with exposed bone, fractures, and hardware are challenging wounds for which to achieve stable coverage. The orthopedic advances in lower extremity fracture management over the last 30 years have allowed a rethinking of the standard operative approach to close these complex wounds. MATERIALS AND METHODS: The ability of extracellular matrix (ECM) products to facilitate constructive remodeling of a wound seemed a reasonable approach for treatment, especially in patients who are often poor surgical candidates for more advanced reconstructive procedures...
November 2016: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/27857499/impact-of-negative-pressure-wound-therapy-on-open-diaphyseal-tibial-fractures-a-prospective-randomized-trial
#15
Siddharth R Virani, Aditya A Dahapute, S S Bava, Saurabh R Muni
INTRODUCTION: Open tibial fractures are associated with a high incidence of mainly osteomyelitis. Negative pressure wound therapy (NPWT) is a novel form of treatment that uses subatmospheric pressure to effect early wound healing. OBJECTIVES AND STUDY DESIGN: To determine the effect of NPWT on incidence of deep infections/osteomyelitis after open tibial fractures using a prospective randomized study design. MATERIALS AND METHODS: Ninety-three open tibial fractures were randomized into two groups receiving NPWT and the second group undergoing periodic irrigation, cleaning and debridement respectively...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27853690/superficial-burn-wound-healing-with-intermittent-negative-pressure-wound-therapy-under-limited-access-and-conventional-dressings
#16
Thittamaranahalli Muguregowda Honnegowda, Echalasara Govindarama Padmanabha Udupa, Pragna Rao, Pramod Kumar, Rekha Singh
BACKGROUND: Thermal injury is associated with several biochemical and histopathological alteration in tissue. Analysis of these objective parameters in research and clinical field are common to determine healing rate of burn wound. Negative pressure wound therapy has been achieved wide success in treating chronic wounds. This study determines superficial burn wound healing with intermittent negative pressure wound therapy under limited access and conventional dressings. METHODS: A total 50 patients were randomised into two equal groups: limited access and conventional dressing groups...
September 2016: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/27852684/resveratrol-as-add-on-therapy-in-subjects-with-well-controlled-type-2-diabetes-a-randomized-controlled-trial
#17
Silvie Timmers, Marlies de Ligt, Esther Phielix, Tineke van de Weijer, Jan Hansen, Esther Moonen-Kornips, Gert Schaart, Iris Kunz, Matthijs K C Hesselink, Vera B Schrauwen-Hinderling, Patrick Schrauwen
OBJECTIVE: To determine whether resveratrol supplementation can improve insulin sensitivity and promote overall metabolic health on top of standard diabetes care. RESEARCH DESIGN AND METHODS: Seventeen subjects with well-controlled type 2 diabetes (T2D) were treated with placebo and 150 mg/day resveratrol (resVida) in a randomized double-blind crossover study for 30 days. The main outcome measure was insulin sensitivity by the hyperinsulinemic-euglycemic clamp technique...
December 2016: Diabetes Care
https://www.readbyqxmd.com/read/27852360/-changes-and-implications-of-esophageal-function-in-patients-with-chronic-cough-induced-by-gastroesophageal-reflux
#18
X H Xu, L Yu, Q Chen, Y Huang, H H Sun, L S Yi, S C Xu, H J Lyu, Z M Qiu
Objective: To explore the changes in the esophageal function and their association with the therapeutic outcome in patients with gastroesophageal reflux-induced chronic cough (GERC). Methods: One hundred thirty-five patients with definite GERC consecutively referred to our respiratory clinic were recruited into the study between January 2012 and August 2015.Cough was due to acid reflux in 81 patients and non-acid reflux in 54 patients, with the favorable response to the standard antireflux therapy in 88 patients and to the intensified antireflux treatment in 47 patients...
November 12, 2016: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/27844201/impact-of-incisional-negative-pressure-wound-therapy-on-perineal-wound-healing-after-abdominoperineal-rectum-extirpation
#19
Armin Wiegering, Ulrich A Dietz, Caroline Corteville, Lars Plaßmeier, Christian Jurowich, Christoph-Thomas Germer, Katica Krajinovic
INTRODUCTION: Perineal wound healing disorders are one of the major complications following abdominoperineal rectum extirpation. METHODS AND RESULTS: We evaluated the impact of an "incisional negative pressure wound therapy" (iNPWT) system after abdominoperineal rectum extirpation in six patients. All patients had a neoadjuvant radiochemotherapy with 50.4 Gy and 5-FU. Five of the six patients (83%) experienced complication-free healing of the perineal wound after 5 to 12 days of iNPWT...
November 14, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27843733/clinical-effectiveness-of-negative-pressure-wound-therapy-following-surgical-resection-of-sternoclavicular-joint-infection-a-case-report
#20
Michelle Nguyen, Susan D Moffatt-Bruce, Robert E Merritt, Desmond M D'Souza
Septic arthritis of the sternoclavicular joint (SCJ) is a rare condition accounting for 0.5% of bone and joint infections. The majority of cases require joint resection and advancement flaps to provide coverage to the resulting wound defect. However, in the setting of an infected wound space, surgeons are often inclined to allow wound healing by secondary intention. Negative pressure wound therapy (NPWT) can be an important adjunct to promote and shorten wound healing time following SCJ resection.
October 4, 2016: Curēus
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