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https://www.readbyqxmd.com/read/29113672/vulvo-vaginal-reconstruction-after-radical-excision-for-treatment-of-vulvar-cancer-evaluation-of-feasibility-and-morbidity-of-different-surgical-techniques
#1
REVIEW
Violante Di Donato, Carlotta Bracchi, Emanuele Cigna, Lavinia Domenici, Angela Musella, Andrea Giannini, Francesca Lecce, Claudia Marchetti, Pierluigi Benedetti Panici
BACKGROUND: Vulvar cancer is a rare disease accounting for approximately 5% of female genital tract tumors worldwide. Currently surgery represents the mainstay alone or sometimes, in combination with chemo-radiotherapy, for locally advanced tumors and recurrent disease. However, significant physical and sexual impairment mostly due to anatomical distortion of external genitalia are a consequence of radical surgical treatment. Postoperative reconstruction after demolitive surgeries improves aesthetic and functional results, guarantees an adequate coverage of large tumors and assures safe surgical margin...
December 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28990694/suprafascial-versus-traditional-harvesting-technique-for-free-antero-lateral-thigh-flap-a-case-control-study-to-assess-the-best-functional-and-aesthetic-result-in-extremity-reconstruction
#2
Michele Maruccia, Nefer Fallico, Emanuele Cigna, Pedro Ciudad, Fabio Nicoli, Emilio Trignano, Eleonora Nacchiero, Giuseppe Giudice, Diego Ribuffo, Hung-Chi Chen
Clinical applications of ALT flap have currently extended to extremity (hand and foot) as well as oral cavity reconstruction. In these anatomical areas, the traditional harvesting technique presents a few disadvantages such as bulkiness of the recipient site and potential donor site morbidity including damage to the deep fascia and skin graft adhesions. The purpose of the present study was to compare the functional and aesthetic outcomes of upper and lower extremity reconstruction with either suprafascial or subfascial harvested anterolateral (ALT) flaps...
October 9, 2017: Microsurgery
https://www.readbyqxmd.com/read/28938348/-impact-of-evolving-radiation-therapy-techniques-on-implant-based-breast-reconstruction
#3
Federico Lo Torto, Paola Parisi, Donato Casella, Giuseppe Di Taranto, Emanuele Cigna, Diego Ribuffo
No abstract text is available yet for this article.
September 16, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28902768/economic-and-clinical-outcomes-resulting-from-the-stage-4-chronic-kidney-disease-case-management-quality-improvement-initiative
#4
Beverly Everett, Liana D Castel, Matthew McGinnis, Amy Beresky, Rudolph C Cane, Tasha Cooper, Rajesh K Davda, Donna Farmer, Stella M John, Denise L Sollars, John F Rausch
PURPOSE OF STUDY: Chronic kidney disease (CKD) is a costly and burdensome public health concern. The goal of this study was to evaluate the impact on outcomes and utilization of a pilot program to identify and engage beneficiaries with CKD at risk for progression from Stage 4 to Stage 5. PRIMARY PRACTICE SETTINGS: A quality improvement initiative was conducted to assess the impact of case management on costs and outcomes among 7,720 Cigna commercial medical beneficiaries with Stage 4 CKD enrolled in the United States between January 2012 and October 2012...
November 2017: Professional Case Management
https://www.readbyqxmd.com/read/28666696/vulvar-crohn-s-disease-a-rare-presentation
#5
Sarah T Cigna, Leia S Mitchell, Andrew T Goldstein
No abstract text is available yet for this article.
June 27, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28581874/cost-drivers-for-breast-lung-and-colorectal-cancer-care-in-a-commercially-insured-population-over-a-6-month-episode-an-economic-analysis-from-a-health-plan-perspective
#6
Bhuvana Sagar, Yu Shen Lin, Liana D Castel
AIMS: In the absence of clinical data, accurate identification of cost drivers is needed for economic comparison in an alternate payment model. From a health plan perspective using claims data in a commercial population, the objective was to identify and quantify the effects of cost drivers in economic models of breast, lung, and colorectal cancer costs over a 6-month episode following initial chemotherapy. RESEARCH DESIGN AND METHODS: This study analyzed claims data from 9,748 Cigna beneficiaries with diagnosis of breast, lung, and colorectal cancer following initial chemotherapy from January 1, 2014 to December 31, 2015...
July 3, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28299333/an-alternative-treatment-strategy-for-complicated-chronic-wounds-negative-pressure-therapy-over-mesh-skin-graft
#7
COMPARATIVE STUDY
Michele Maruccia, Maria G Onesti, Valentina Sorvillo, Antonio Albano, Luca A Dessy, Bruno Carlesimo, Mauro Tarallo, Marco Marcasciano, Giuseppe Giudice, Emanuele Cigna, Diego Ribuffo
Extensive skin defect represents a real problem and major challenge in plastic and reconstructive surgery. On one hand, skin grafts offer a practical method to deal with skin defects despite their unsuitability for several complicated wounds. On the other hand, negative pressure wound therapy (NPWT), applied before skin grafting, promotes granulation tissue growth. The aim of the study is to evaluate the improvement in wound healing given by the merger of these two different approaches. We treated 23 patients for large wounds of multiple factors...
2017: BioMed Research International
https://www.readbyqxmd.com/read/27991695/application-of-extended-bi-pedicle-anterolateral-thigh-free-flaps-for-reconstruction-of-large-defects-a-case-series
#8
Michele Maruccia, Georgios Orfaniotis, Pedro Ciudad, Fabio Nicoli, Emanuele Cigna, Giuseppe Giudice, Kidakorn Kiranantawat, Diego Ribuffo, Hung-Chi Chen
BACKGROUND: The anterolateral thigh flap is a workforce flap in reconstructive surgery, however, variations in it is vascular anatomy are not uncommon. These variations may affect flap design and survival, especially when large flaps are required. In some anatomical variants the anterolateral thigh flap is supplied by two separate dominant pedicles, and in these cases a bi-pedicle modification may be necessary to ensure complete flap viability. The aim of this report is to evaluate the outcomes, and present our approach in using bi-pedicle anterolateral thigh flaps as a method to reduce the risk of partial flap necrosis when reconstructing sizeable soft tissue defects...
December 19, 2016: Microsurgery
https://www.readbyqxmd.com/read/27783546/risk-of-nondherence-to-diabetes-medications-among-medicare-advantage-enrollees-development-of-a-validated-risk-prediction-tool
#9
Shivani K Mhatre, Omar Serna, Shubhada Sansgiry, Marc L Fleming, E James Essien, Sujit S Sansgiry
BACKGROUND: Low adherence to oral antidiabetic drugs (OADs) in the Medicare population can greatly reduce Centers for Medicare & Medicaid Services (CMS) star ratings for managed care organizations (MCOs). OBJECTIVE: To develop and validate a risk assessment tool (Prescription Medication Adherence Prediction Tool for Diabetes Medications [RxAPT-D]) to predict nonadherence to OADs using Medicare claims data. METHODS: In this retrospective observational study, claims data for members enrolled in a Medicare Advantage Prescription Drug (MA-PD) program in Houston, Texas, were used...
November 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27692046/transfer-of-the-potato-plant-isolates-of-pectobacterium-wasabiae-to-pectobacterium-parmentieri-sp-nov
#10
Slimane Khayi, Jérémy Cigna, Teik Min Chong, Angélique Quêtu-Laurent, Kok-Gan Chan, Valérie Hélias, Denis Faure
Pectobacterium wasabiae was originally isolated from Japanese horseradish (Eutrema wasabi), but recently some Pectobacterium isolates collected from potato plants and tubers displaying blackleg and soft rot symptoms were also assigned to P. wasabiae. Here, combining genomic and phenotypical data, we re-evaluated their taxonomic position. PacBio and Illumina technologies were used to complete the genome sequences of P. wasabiae CFBP 3304T and RNS 08-42-1A. Multi-locus sequence analysis showed that the P. wasabiae strains RNS 08-42-1A, SCC3193, CFIA1002 and WPP163, which were collected from potato plant environment, constituted a separate clade from the original Japanese horseradish P...
December 2016: International Journal of Systematic and Evolutionary Microbiology
https://www.readbyqxmd.com/read/27662393/measuring-the-cost-implications-of-the-collaborative-accountable-care-initiative-in-texas
#11
Vivian Ho, Timothy K Allen, Urie Kim, William P Keenan, Meei-Hsiang Ku-Goto, Mark Sanderson
OBJECTIVES: We analyzed changes in healthcare spending associated with the implementation of Cigna's Collaborative Accountable Care (CAC) initiative in a large multi-clinic physician practice. STUDY DESIGN: We compared claims from 2009, prior to the CAC initiative, against claims for 2010 to 2011, contrasting the patients covered by Cigna's CAC initiative with patients in other practices in the same geographic area covered by Cigna's medical plan. METHODS: We used a propensity weighted difference-in-differences approach, adjusting for age, sex, health status, and secular trends to isolate the treatment effect of the CAC...
2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27592841/identification-of-embryo-fetal-cells-in-celomic-fluid-using-morphological-and-short-tandem-repeats-analysis
#12
Antonino Giambona, Filippo Leto, Gianfranca Damiani, Cristina Jakil, Valentina Cigna, Giovanna Schillaci, Giuseppe Stampone, Aldo Volpes, Adolfo Allegra, Kypros H Nicolaides, George Makrydimas, Cristina Passarello, Aurelio Maggio
OBJECTIVE: The main problem to wide acceptability of celocentesis as earlier prenatal diagnosis is contamination of the sample by maternal cells. The objective of this study was to investigate the cellular composition of celomic fluid for morphological discrimination between maternal and embryo-fetal cells. METHOD: Celomic fluids were aspired by ultrasound-guided transcervical celocentesis at 7-9 weeks' gestation from singleton pregnancies before surgical termination for psychological reasons...
October 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/27563529/prenatal-diagnosis-of-a-variant-of-the-azygos-venous-system
#13
Clelia Lo Verso, Valentina Cigna, Gianfranca Damiani, Laura Lo Verso, Rossella Conti, Vincenzo Duca
BACKGROUND: The azygos venous system consists of the azygos vein on the right side and the hemiazygos and accessory hemiazygos on the left side. The azygos vein runs through the abdominal cavity along the right side of the vertebral bodies, in a cranial direction, passes through the diaphragm and reaches the mediastinum, where it forms the arch of the azygos which flows into the superior vena cava. Along its course, the azygos vein communicates with the intercostal veins on the right, the hemiazygos vein that collects blood from the left lower intercostal veins, and accessory hemiazygos vein that drains into the left upper intercostal veins...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27219226/skin-reduction-breast-reconstructions-with-prepectoral-implant
#14
Glenda Giorgia Caputo, Alberto Marchetti, Edoardo Dalla Pozza, Enrico Vigato, Lavinia Domenici, Emanuele Cigna, Maurizio Governa
UNLABELLED: Skin-reduction mastectomy with prepectoral implant reconstruction is a novel technique for immediate breast reconstruction, with subcutaneous implant placement in patients eligible for skin-reducing mastectomy. Implants were placed above the pectoralis muscles in a compound pocket made by a dermal flap and acellular dermal matrix. The procedure was performed on 33 breasts in 27 selected patients. In three cases, there was skin ischemia; in one case, it healed spontaneously; and in two patients, a surgical necrosectomy and primary closure were needed...
June 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27015053/a-pharmacist-telephone-intervention-to-identify-adherence-barriers-and-improve-adherence-among-nonadherent-patients-with-comorbid-hypertension-and-diabetes-in-a-medicare-advantage-plan
#15
Susan M Abughosh, Xin Wang, Omar Serna, Chris Henges, Santhi Masilamani, Ekere James Essien, Nancy Chung, Marc Fleming
BACKGROUND: Patients with comorbid hypertension (HTN) and diabetes mellitus (DM) are at a high risk of developing macrovascular and microvascular complications of DM. Controlling high blood pressure can greatly reduce these complications. Angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) are recommended for patients with both DM and HTN by the American Diabetes Association guidelines, and their benefit and efficacy in reducing macrovascular and microvascular complications of DM have been well documented...
January 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27010139/is-the-prognosis-and-course-of-acral-melanoma-related-to-site-specific-clinicopathological-features
#16
MULTICENTER STUDY
G Paolino, M W Bekkenk, D Didona, L Eibenschutz, A G Richetta, C Cantisani, G Viti, A Carbone, P Buccini, P De Simone, A Ferrari, E Scali, S Calvieri, V Silipo, E Cigna, G P Viti, U Bottoni
OBJECTIVE: Acral melanoma is an uncommon type of melanoma in Caucasian patients. However, acral melanoma is the most common type of melanoma in African and Asian patients. Comparison analyses between hand-acral melanoma and foot-acral melanoma have been rarely reported in the literature. Acral melanoma is an uncommon melanocytic tumor characterized by an intrinsic aggressiveness, with specific histological and clinicopathological features. Acral melanoma involves the palms, soles and sub-ungueal sites...
March 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27003560/physician-perception-of-patient-medication-adherence-in-a-cohort-of-medicare-advantage-plans-in-texas
#17
Amanda Winters, Tara Esse, Archita Bhansali, Omar Serna, Shivani Mhatre, Sujit Sansgiry
BACKGROUND: Prescription medication adherence is a known health-related barrier for elderly patients, leading to insufficient disease control and negative health outcomes. The Centers for Medicare & Medicaid Services (CMS) have placed significant emphasis on medication adherence, through the Part D star measures, revolving around treatment for chronic disease states such as hypertension, diabetes, and hyperlipidemia. However, it is unclear if physicians fully grasp the extent of nonadherence within their patient populations with regard to these medications, specifically those patients enrolled in Medicare Advantage Prescription Drug (MA-PD) plans...
March 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/26891446/embryo-fetal-erythroid-cell-selection-from-celomic-fluid-allows-earlier-prenatal-diagnosis-of-hemoglobinopathies
#18
Antonino Giambona, Gianfranca Damiani, Filippo Leto, Cristina Jakil, Disma Renda, Valentina Cigna, Giovanna Schillaci, Francesco Picciotto, Kypros H Nicolaides, Cristina Passarello, George Makrydimas, Aurelio Maggio
OBJECTIVE: Celocentesis, which involves aspiration of celomic fluid at 7-9 weeks' gestation, can potentially provide early prenatal diagnosis of single-gene disorders. The main barrier to wide acceptability of this technique is contamination of the sample by maternal cells. This problem can be overcome through selection of embryo-fetal erythroid precursors, which are found in celomatic fluid. METHOD: Embryo-fetal erythroid precursors were selected by an anti-CD71 MicroBeads method or by direct micromanipulator pickup of the cells selected on the basis of their morphology...
April 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/26818147/real-life-experience-with-liver-iron-concentration-r2-mri-measurement-in-patients-with-hemoglobinopathies-baseline-data-from-licnet
#19
MULTICENTER STUDY
Angela Vitrano, Giuseppina Calvaruso, Lorenzo Tesé, Francesco Gioia, Filippo Cassarà, Saveria Campisi, Franco Butera, Valeria Commendatore, Michele Rizzo, Vincenzo Santoro, Valeria Cigna, Alessandra Quota, Sabrina Bagnato, Crocetta Argento, Carmelo Fidone, Dario Schembari, Calogera Gerardi, Filippo Barbiera, Giuseppe Bellisssima, Giovanni Giugno, Gesualdo Polizzi, Rosamaria Rosso, Giovanna Abbate, Vincenzo Caruso, Elisabetta Chiodi, Maria Rita Gamberini, Benedetta Giorgi, Maria Caterina Putti, Aldo Filosa, Maria Rosaria De Ritis, Esther Oliva, Nicola Arcadi, Maria Fustaneo, Laura Mistretta, Rosario Di Maggio, Massimiliano Sacco, Di Salvo Veronica, Antonino Giangreco, Aurelio Maggio
BACKGROUND: Real-life data on the use of R2 MRI for the assessment of liver iron concentration (LIC) remain limited. METHODS: We conducted a cross-sectional analysis on 363 patients (mean age 35.6 yr, 44.1% men) with hemoglobinopathies (204 β-thalassemia major [TM], 102 β-thalassemia intermedia [TI], and 57 sickle cell disease [SCD]) that were evaluated with R2 MRI as part of LICNET, an MRI network of 13 Italian treatment centers. RESULTS: The mean LIC was 7...
October 2016: European Journal of Haematology
https://www.readbyqxmd.com/read/26744862/coverage-of-exposed-hardware-after-lower-leg-fractures-with-free-flaps-or-pedicled-flaps
#20
REVIEW
N Fallico, F Somma, E Cigna, L A Dessy, M Tarallo, D Ribuffo
OBJECTIVE: The placement of osteosynthetic materials in the leg may be complicated by hardware exposure. Successful soft tissue reconstruction often provides a critical means for limb salvage in patients with hardware exposure in the leg. Free flaps are currently considered the standard surgical procedure for soft tissue coverage of the wounds with internal hardware exposure. However, to date, no conclusive literature shows the superiority of a specific type of flap. MATERIALS AND METHODS: The current review compares data from the literature concerning outcomes and complications of free and pedicled flaps for exposed osteosynthetic material preservation in the leg...
December 2015: European Review for Medical and Pharmacological Sciences
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