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D Casella, G Di Taranto, M Marcasciano, S Sordi, A Kothari, T Kovacs, F Lo Torto, E Cigna, D Ribuffo, C Calabrese
BACKGROUND: Although demand for prophylactic mastectomy is increasing over time among women at a high risk for breast cancer, there is a paucity of studies on long term patient-reported outcomes after this procedure. METHODS: Between January 2011 and January 2015, 46 patients documented BRCA1/2 mutation carriers, eligible for prophylactic nipple-sparing mastectomy (NSM) and immediate breast prosthetic reconstruction were registered at our institutions. Patients underwent NSM and subcutaneous reconstruction with implant covered by a titanium-coated polypropylene mesh (TiLoop® )...
February 15, 2018: Breast: Official Journal of the European Society of Mastology
Claudia D'Anna, Diego Cigna, Caterina Di Sano, Serena Di Vincenzo, Paola Dino, Maria Ferraro, Luca Bini, Laura Bianchi, Francesca Di Gaudio, Mark Gjomarkaj, Elisabetta Pace
The integrity of the respiratory epithelium is crucial for airway homeostasis. Tobacco smoke exposure and recurrent infections of the airways play a crucial role in the progression and in the decline of the respiratory function in chronic obstructive pulmonary disease (COPD). The aim of this study was to detect differentially expressed proteins in a bronchial epithelial cell line (16-HBE) stimulated with cigarette smoke extract (CSE) and lipopolysaccharide (LPS), a constituent of gram-negative bacteria, alone and/or in combination, by using two-dimensional electrophoresis (2DE) analysis coupled with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry...
November 2017: Experimental Lung Research
Ambrish Singh, Salman Hussain, Abul Kalam Najmi
AIM: To assess the use of Cochrane Reviews to inform the medical policy documents of major US private payers. METHODS: The publically available drug policy documents of the five major US private payers (covering about 50% market) namely: Anthem, Aetna, Cigna, Humana and United Healthcare (UHC) were assessed in February 2017 and reviewed to find whether they had used Cochrane Reviews. We extracted information such as use of Cochrane Reviews, number of Cochrane Reviews used, context of use and impact of Cochrane Reviews on policy, and Cochrane Review Group (CRG) and Cochrane Center linked to the Cochrane Review...
November 2017: Journal of Evidence-based Medicine
Luigi Losco, Emanuele Cigna
No abstract text is available yet for this article.
February 17, 2018: Aesthetic Surgery Journal
Frank Diamond
The insurer's general manager of behavioral and EAP services wants to make mental health care more mainstream. Only 17% of American adults function with optimal mental health. "We talk about it as if it's them over there, but 83% of us have a need."
November 2017: Managed Care
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
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...
November 2017: Microsurgery
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
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
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
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
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
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
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
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
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
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
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
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
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
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