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https://www.readbyqxmd.com/read/28647442/the-impact-of-the-transition-from-volume-to-value-on-heart-failure-care-implications-of-novel-payment-models-and-quality-improvement-initiatives
#1
REVIEW
Dushyanth Srinivasan, Nihar R Desai
In response to wide variation in quality and outcomes as well as escalating health care costs, the U.S. health care system is transitioning away from a volume based payment system to a quality- and value-based system. Medicare, the largest insurer and payer of healthcare, has accelerated the movement towards value-based care with the development and implementation of myriad alternative payment models and pay for performance programs as part of the Affordable Care Act. Given that heart failure affects a significant number of Medicare patients and these patients account for a disproportionate amount of healthcare utilization and spending, heart failure has become a focal point for these initiatives...
June 21, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28645232/interplay-between-innate-immunity-and-the-plant-microbiota
#2
Stéphane Hacquard, Stijn Spaepen, Ruben Garrido-Oter, Paul Schulze-Lefert
The innate immune system of plants recognizes microbial pathogens and terminates their growth. However, recent findings suggest that at least one layer of this system is also engaged in cooperative plant-microbe interactions and influences host colonization by beneficial microbial communities. This immune layer involves sensing of microbe-associated molecular patterns (MAMPs) by pattern recognition receptors (PRRs) that initiate quantitative immune responses to control host-microbial load, whereas diversification of MAMPs and PRRs emerges as a mechanism that locally sculpts microbial assemblages in plant populations...
June 23, 2017: Annual Review of Phytopathology
https://www.readbyqxmd.com/read/28645182/stereotactic-radiosurgery-for-brainstem-arteriovenous-malformations-a-multicenter-study
#3
Or Cohen-Inbar, Robert M Starke, Cheng-Chia Lee, Hideyuki Kano, Paul Huang, Douglas Kondziolka, Inga S Grills, Danilo Silva, Mohmoud Abbassy, Symeon Missios, Gene H Barnett, L Dade Lunsford, Jason P Sheehan
BACKGROUND: The management of brainstem arteriovenous malformations (bAVMs) is a formidable challenge. bAVMs harbor higher morbidity and mortality compared to other locations. OBJECTIVE: To review the outcomes following stereotactic radiosurgery (SRS) of bAVMs in a multicenter study. METHODS: Six medical centers contributed data from 205 patients through the International Gamma Knife Research Foundation. Median age was 32 yr (6-81). Median nidus volume was 1...
June 21, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28644979/intraoperative-fast-ripples-independently-predict-postsurgical-epilepsy-outcome-comparison-with-other-electrocorticographic-phenomena
#4
Shaun A Hussain, Gary W Mathern, Phoebe Hung, Julius Weng, Raman Sankar, Joyce Y Wu
In the surgical management of epilepsy, the resection of cortex exhibiting interictal fast ripples (250-500Hz) on electrocorticography has been linked to postoperative seizure-freedom. Although fast ripples appear to accurately identify the epileptogenic zone-the minimum tissue that must be removed at surgery to achieve seizure-freedom-it has not been established that fast ripples are a superior biomarker in comparison with multimodal presurgical neuroimaging and other electrocorticography abnormalities. Hence, in the prediction of postoperative seizure-freedom, we compared the value of fast ripples with other intraoperative electocorticography abnormalities including focal slowing, paroxysmal fast activity, intermittent spike discharges, continuous epileptiform discharges, focal attenuation, and intraoperative seizures, as well as complete resection of the lesion defined by MRI and other neuroimaging...
June 16, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28644697/contemporary-treatment-of-renal-tumors-a-questionnaire-survey-in-the-nordic-countries-the-norenca-i-study
#5
Harry Nisen, Petrus Järvinen, Magnus Fovaeus, Eirikur Guðmundsson, Bjarne Kromann-Andersen, Börje Ljungberg, Lars Lund, Frode Nilsen, Pernilla Sundqvist, Christian Beisland
OBJECTIVE: The five Nordic countries comprise 25 million people, and have similar treatment traditions and healthcare systems. To take advantage of these similarities, a collaborative group (Nordic Renal Cancer Group, NORENCA) was founded in 2015. MATERIALS AND METHODS: A questionnaire of 17 questions on renal tumor management and surgical education was designed and sent to 91 institutions performing renal tumor surgery in 2015. The response rate was 68% (62 hospitals), including 28 academic, 25 central and nine district hospitals...
June 23, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28644300/breathlessness-in-the-primary-care-setting
#6
Noel Baxter
PURPOSE OF REVIEW: Breathlessness is a high-volume problem with 10% of adults experiencing the symptom daily placing a heavy burden on the health and wider economy. As it worsens, they enter the specialist and hospital-based symptom services where costs quickly escalate and people may find themselves in a place not of their choosing. For many, their care will be delivered by a disease or organ specialist and can find themselves passing between physicians without coordination for symptom support...
July 20, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28644155/transvenous-before-surgical-hybrid-procedure
#7
Joseph J Tiano, Robert Drennan, John Novella, Rafael Squiteri, Malcolm Robinson, Albert DiMeo, Lindsey Scierka, Paul LeLorier
BACKGROUND: Historically, persistent atrial fibrillation (PeAF) and long standing persistent atrial fibrillation (LSPeAF) have demonstrated limited clinical success despite hybrid approaches. OBJECTIVE: We describe our experience with the endocardial-before-epicardial approach defined by a comprehensive endovascular approach preceding and guiding the epicardial approach which includes an extensive posterior wall ablation. METHODS: 40 patients were followed over a 12 month period...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28643065/laparoscopic-distal-pancreatectomy-for-pancreatic-cancer-is-safe-and-effective
#8
Marita D Bauman, David G Becerra, E Molly Kilbane, Nicholas J Zyromski, C Max Schmidt, Henry A Pitt, Attila Nakeeb, Michael G House, Eugene P Ceppa
PURPOSE: To compare the short-term and oncologic outcomes of patients with pancreatic ductal adenocarcinoma (PDAC) undergoing laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP). METHODS: Consecutive cases of distal pancreatectomy (DP) (n = 422) were reviewed at a single high-volume institution over a 10-year period (2005-2014). Inclusion criteria consisted of any patient with PDAC by surgical pathology. Ninety-day outcomes were monitored through a prospectively maintained pancreatic resection database...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28642164/joint-loading-and-proximal-tibia-subchondral-trabecular-bone-microarchitecture-differ-with-walking-gait-patterns-in-end-stage-knee-osteoarthritis
#9
Bryant C Roberts, Lucian B Solomon, Graham Mercer, Karen J Reynolds, Dominic Thewlis, Egon Perilli
OBJECTIVES: To (1) stratify subgroups according to their distinct walking gait patterns in end-stage knee osteoarthritis (OA) patients; (2) compare measures of joint loading and proximal tibia subchondral trabecular bone (STB) microarchitecture among subgroups. DESIGN: Twenty-five knee OA patients undergoing total knee arthroplasty had pre-operative gait analysis. Following surgery, excised tibial plateaus were micro-CT-scanned and STB microarchitecture analysed in four tibial condylar regions of interest...
June 19, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28642025/total-laparoscopic-resection-surgery-for-a-cervical-carcinoma-that%C3%A2-recurred-in-the-pelvic-sidewall-after-radical-hysterectomy-and%C3%A2-adjuvant-concurrent-chemoradiotherapy
#10
Hiroyuki Kanao, Yoichi Aoki, Kazuyoshi Kato, Maki Matoda, Sanshiro Okamoto, Hidetaka Nomura, Kohei Omatsu, Kuniko Utsugi, Nobuhiro Takeshima
STUDY OBJECTIVE: To show total laparoscopic resection of a cervical carcinoma that recurred at the left pelvic sidewall after radical hysterectomy and concurrent chemoradiotherapy (CCRT). DESIGN: A step-by-step demonstration of the technique in a surgical video, including the strategy for achieving complete surgical resection with negative margins (R0 resection) (Canadian Task Force Classification III). SETTING: For high-risk cervical carcinoma, radical hysterectomy and adjuvant CCRT is the standard treatment, but even this multimodal therapy cannot prevent recurrence...
June 19, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28640786/a-standardized-approach-for-transfusion-medicine-support-in-patients-with-morbidly-adherent-placenta
#11
Anil K Panigrahi, Amanda Yeaton-Massey, Sara Bakhtary, Jennifer Andrews, Deirdre J Lyell, Alexander J Butwick, Lawrence Tim Goodnough
BACKGROUND: The incidence of placenta accreta (PA) has increased from 0.8 to 3.0 in 1000 pregnancies, driven by increased rates of cesarean deliveries (32.2% in 2014) of births in the United States. The average blood loss for a delivery complicated by PA ranges from 2000 to 5000 mL, frequently requiring substantial transfusion medicine support. We report our own institutional multidisciplinary approach for managing such patients, along with transfusion medicine outcomes, in this setting over a 5-year period...
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28640177/the-efficacy-of-fibrin-sealant-patches-in-reducing-the-incidence-of-lymphatic-morbidity-after-radical-lymphadenectomy-a-meta-analysis
#12
Maria Luisa Gasparri, Ilary Ruscito, Daniele Bolla, Pierluigi Benedetti Panici, Michael D Mueller, Andrea Papadia
BACKGROUND: Although pivotal in the oncological management of most tumors, radical lymphadenectomy is associated with a significant number of lymphatic complications. The aim of this meta-analysis is to evaluate the efficacy of fibrinogen sealant patches in reducing lymphadenectomy-related postoperative complications. METHODS/MATERIALS: The electronic databases PubMed, Medline, and Scopus were searched using the terms "lymphadenectomy" or "lymph node dissection" and "TachoSil," "TachoComb," or "fibrin sealant patch...
July 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28639972/imaging-in-repaired-tetralogy-of-fallot-with-a-focus-on-recent-advances-in-echocardiography
#13
Guillermo Larios, Mark K Friedberg
PURPOSE OF REVIEW: Imaging is essential for the management of adults with repaired tetralogy of Fallot (rToF). Echocardiography and cardiac magnetic resonance imaging are the central modalities to assess rToF. Here we review recent literature on imaging rToF, focusing on echocardiography and advances in assessment of cardiac mechanics. RECENT FINDINGS: Several two-dimensional, three-dimensional, and Doppler echo parameters have been proposed to assess pulmonary regurgitation, right ventricular volumes and ejection fraction, but most of them still have important limitations in their feasibility and reliability compared to cardiac magnetic resonance (CMR)...
July 20, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28639869/economic-burden-of-inpatient-admission-of-ankle-fractures
#14
Justin D Stull, Suneel B Bhat, Justin M Kane, Steven M Raikin
BACKGROUND: Ankle fractures are among the most prevalent traumatic orthopaedic injuries. A large proportion of patients sustaining operative ankle fractures are admitted directly from the emergency department prior to operative management. In the authors' experience, however, many closed ankle injuries may be safely and effectively managed on an outpatient basis. The aim of this study was to characterize the economic impact of routine inpatient admission of ankle fractures. METHODS: A retrospective review of all outpatient ankle fracture surgery performed by a single foot and ankle fellowship-trained surgeon at a tertiary level academic center in 2012 was conducted to identify any patients requiring postoperative inpatient admission...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28639438/body-composition-analysis-to-study-long-term-training-effects-in-elite-male-water-polo-athletes
#15
Giovanni Melchiorri, Valerio Viero, Roberto Sorge, Tamara Triossi, Alessandro Campagna, Stella L Volpe, Dalgisio Lecis, Virginia Tancredi, Angela Andreoli
BACKGROUND: Elite water polo athletes undergo heavy training programs throughout the year, but especially to prepare major competitions, such as the Olympics. Optimal athletic performance is a result of many factors, including proper management of the intensity and volume of training, nutrition and recovery between training sessions. When training is excessive in relation to recovery may occur non functional overreaching (NFO). NFO can degenerate into overtraining syndrome (OTS) resulting in a decrease in athletic performance, with likely changes in body weight and body composition...
June 21, 2017: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/28639005/central-hepatectomy-still-plays-an-important-role-in-treatment-of-early-stage-centrally-located-hepatocellular-carcinoma
#16
Chun-Han Chen, Tzu-Hao Huang, Cheng-Chih Chang, Wei-Feng Li, Ting-Lung Lin, Chih-Chi Wang
BACKGROUND: Surgical management of centrally located hepatocellular carcinoma (CL-HCC) poses a great challenge. Major hepatectomy (MH) might compromise future remnant liver volume (FRLV), while the long-term benefits of central hepatectomy (CH) had not been well demonstrated. METHODS: Consecutive patients with early-stage CL-HCC who underwent liver resection were enrolled. Fifteen patients underwent CH, while thirty-three were subjected to MH. All relevant clinicopathological variables were analyzed...
June 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28637788/the-effects-of-neuromodulation-in-a-novel-obese-prone-rat-model-of-detrusor-underactivity
#17
Eric J Gonzalez, Warren M Grill
Obesity is a global epidemic associated with an increased risk for lower urinary tract dysfunction. Inefficient voiding and urinary retention may arise in late-stage obesity when the expulsive force of the detrusor smooth muscle cannot overcome outlet resistance. Detrusor underactivity (DUA) and impaired contractility may contribute to the pathogenesis of non-obstructive urinary retention. We used cystometry and electrical stimulation of peripheral nerves (pudendal and pelvic n.) to characterize and improve bladder function in urethane-anesthetized obese-prone (OP) and obese-resistant (OR) rats following diet-induced obesity (DIO)...
June 21, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28637377/the-candidatus-liberibacter-host-interface-insights-into-pathogenesis-mechanisms-and-disease-control
#18
Nian Wang, Elizabeth A Pierson, João Carlos Setubal, Jin Xu, Julien G Levy, Yunzeng Zhang, Jinyun Li, Luiz Thiberio Rangel, Joaquim Martins
"Candidatus Liberibacter" species are associated with economically devastating diseases of citrus, potato, and many other crops. The importance of these diseases as well as the proliferation of new diseases on a wider host range is likely to increase as the insects vectoring the "Ca. Liberibacter" species expand their territories worldwide. Here, we review the progress on understanding pathogenesis mechanisms of "Ca. Liberibacter" species and the control approaches for diseases they cause. We discuss the Liberibacter virulence traits, including secretion systems, putative effectors, and lipopolysaccharides (LPSs), as well as other important traits likely to contribute to disease development, e...
June 21, 2017: Annual Review of Phytopathology
https://www.readbyqxmd.com/read/28636971/simulated-long-term-effects-of-varying-tree-retention-on-wood-production-dead-wood-and-carbon-stock-changes
#19
Francesca Santaniello, Line B Djupström, Thomas Ranius, Jan Weslien, Jörgen Rudolphi, Johan Sonesson
Boreal forests are an important source of timber and pulp wood, but provide also other products and services. Utilizing a simulation program and field data from a tree retention experiment in a Scots pine forest in central Sweden, we simulated the consequences during the following 100 years of various levels of retention on production of merchantable wood, dead wood input (as a proxy for biodiversity), and carbon stock changes. At the stand level, wood production decreased with increased retention levels, while dead wood input and carbon stock increased...
June 18, 2017: Journal of Environmental Management
https://www.readbyqxmd.com/read/28635070/adjuvant-treatment-with-qilin-pill-for-men-with-oligoasthenospermia-a-meta-analysis-of-randomized-controlled-trials
#20
REVIEW
Xin Jin, Changfeng Man, Dandan Gong, Yu Fan
Qilin pill has been used in the management of oligoasthenospermia. This meta-analysis aimed to evaluate the effects of Qilin pill as an adjunctive therapy on semen parameters in oligoasthenospermic men. A comprehensive literature search was conducted in PubMed, Embase, Cochrane Library, Wanfang, CNKI, and VIP databases until June 2016. Randomized controlled trials (RCTs) that evaluated Qilin pill as an adjunctive therapy in oligoasthenospermic were included. Dichotomous data and continuous data were calculated as the risk ratio (RR) and mean difference (MD) with their 95% confidence interval (CI), respectively...
June 21, 2017: Phytotherapy Research: PTR
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