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https://www.readbyqxmd.com/read/28688550/a-quality-study-of-family-centered-care-coordination-to-improve-care-for-children-undergoing-tracheostomy-and-the-quality-of-life-for-their-caregivers
#1
Christopher Hartnick, Gillian Diercks, Vanessa De Guzman, Elizabeth Hartnick, Jeanne Van Cleave, Kevin Callans
IMPORTANCE: Approximately 4000 U.S. children undergo tracheostomy yearly [1], and these surgeries often result in hospital re-admissions that have definite cost and caregiver burdens due to complications that are avoidable with proper training and support. OBJECTIVE: To assess the impact of a Family-Centered Care Coordination (FCCC) program on the quality of care received by children undergoing tracheostomy and their caregivers. DESIGN: Caregivers of children undergoing tracheostomies from January 2012 to January 2013 and then a different set of caregivers of children undergoing tracheostomies from January 2015 to January 2016 completed both the Pediatric Tracheostomy Health Status Instrument (PTHSI) 1 month after discharge and the Medical Complications Associated with Pediatric Tracheostomy (MCAT) questionnaire 6 months after initial tracheostomy...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28635036/time-driven-activity-based-costing-to-estimate-cost-of-care-at-multidisciplinary-aerodigestive-centers
#2
Jordan A Garcia, Bipin Mistry, Stephen Hardy, Mary Shannon Fracchia, Cheryl Hersh, Carissa Wentland, Joseph Vadakekalam, Robert Kaplan, Christopher J Hartnick
OBJECTIVES/HYPOTHESIS: Providing high-value healthcare to patients is increasingly becoming an objective for providers including those at multidisciplinary aerodigestive centers. Measuring value has two components: 1) identify relevant health outcomes and 2) determine relevant treatment costs. Via their inherent structure, multidisciplinary care units consolidate care for complex patients. However, their potential impact on decreasing healthcare costs is less clear. The goal of this study was to estimate the potential cost savings of treating patients with laryngeal clefts at multidisciplinary aerodigestive centers...
June 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28576522/pd-l1-expression-and-cd8-infiltration-shows-heterogeneity-in-juvenile-recurrent-respiratory-papillomatosis
#3
Tingyu Liu, Max Greenberg, Carissa Wentland, Brandon Sepe, Sarah Bowe, Gillian Diercks, Tiffany Huynh, Mari Mino-Kenudson, Richard Schlegel, David Kodack, Cyril Benes, Jeffrey Engelman, Christopher Hartnick
INTRODUCTION: Tumor immunotherapy have broadened therapeutic options for tumor treatment. The role of immune function in juvenile recurrent respiratory papillomatosis (JRRP) has not been investigated. Applying immunoblockade inhibitors as a novel disease treatment is unclear. Our study, for the first time, evaluates immune infiltration and immuno-suppressive molecule expression in JRRP. Our study provides insights in possibly treating this disease with tumor immunotherapies. We aimed to determine expression of programmed death-ligand 1 (PD-L1), a cancer escape protein, and presence of CD8+ T cell infiltration in tumor microenvironment...
April 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28434885/early-performance-on-an-eye-surgery-simulator-predicts-subsequent-resident-surgical-performance
#4
Ramak Roohipoor, Mehdi Yaseri, Amir Teymourpour, Carolyn Kloek, John B Miller, John I Loewenstein
OBJECTIVE: To examine early performance on an eye surgery simulator and its relationship to subsequent live surgical performance in a single large residency program. DESIGN: Retrospective study. SETTING: Massachusetts Eye and Ear, Harvard Medical School, Department of Ophthalmology. METHODS: In a retrospective study, we compared performance of 30 first-year ophthalmology residents on an eye surgery simulator to their surgical skills as third-year residents...
April 20, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28426852/an-outbreak-of-endogenous-fungal-endophthalmitis-among-intravenous-drug-abusers-in-new-england
#5
MULTICENTER STUDY
Aubrey R Tirpack, Jay S Duker, Caroline R Baumal
Importance: Intravenous drug abuse (IVDA) is a known risk factor for endogenous fungal endophthalmitis (EFE), a severe intraocular infection caused by hematogenous seeding of mycotic organisms to the eye. Reporting significant increases in heroin-related deaths since 2014, the New England region is in the midst of an opioid crisis that has led to a substantial increase in patients at risk for this vision-threatening disease. Objective: To present an update on characteristics, management, and visual outcomes in patients with EFE...
June 1, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28328735/building-workforce-capacity-abroad-while-strengthening-global-health-programs-at-home-participation-of-seven-harvard-affiliated-institutions-in-a-health-professional-training-initiative-in-rwanda
#6
Corrado Cancedda, Robert Riviello, Kim Wilson, Kirstin W Scott, Meenu Tuteja, Jane R Barrow, Bethany Hedt-Gauthier, Gene Bukhman, Jennifer Scott, Danny Milner, Giuseppe Raviola, Barbara Weissman, Stacy Smith, Tej Nuthulaganti, Craig D McClain, Barbara E Bierer, Paul E Farmer, Anne E Becker, Agnes Binagwaho, Joseph Rhatigan, David E Golan
A consortium of 22 U.S. academic institutions is currently participating in the Rwanda Human Resources for Health Program (HRH Program). Led by the Rwandan Ministry of Health and funded by both the U.S. Government and the Global Fund to Fight AIDS, Tuberculosis and Malaria, the primary goal of this seven-year initiative is to help Rwanda train the number of health professionals necessary to reach the country's health workforce targets. Since 2012, the participating U.S. academic institutions have deployed faculty from a variety of health-related disciplines and clinical specialties to Rwanda...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28267396/quantitative-efficacy-of-external-and-internal-browpexy-performed-in-conjunction-with-blepharoplasty
#7
Ali Mokhtarzadeh, Guy G Massry, Elena Bitrian, Andrew R Harrison
Browpexy surgery is a minimally invasive surgical adjunct to upper blepharoplasty. The traditional internal (IB) approach is well documented, while the newer external (EB) variant has only recently been described. To date, there is little quantitative data to evaluate the efficacy of either procedure, and no data to compare results between the two. We determine the efficacy of, and compare surgical results between, internal and external browpexy surgery in lifting the central and lateral brow. A 3.5-year retrospective review of patients undergoing internal and external browpexy surgery to assess the amount of central and lateral lift to the brow was performed...
April 2017: Orbit
https://www.readbyqxmd.com/read/28255228/rituximab-as-a-monotherapy-or-in-combination-therapy-for-the-treatment-of-non-paraneoplastic-autoimmune-retinopathy
#8
Arash Maleki, Neerav Lamba, Lina Ma, Stacey Lee, Alexander Schmidt, C Stephen Foster
PURPOSE: To examine the efficacy of rituximab as a monotherapy or in combination therapy for the treatment of patients with non-paraneoplastic autoimmune retinopathy. METHODS: Twelve eyes of six patients with non-paraneoplastic autoimmune retinopathy who were treated with rituximab and had at least 6 months of follow-up were included. Demographic data, clinical data, visual field parameters, electroretinography parameters, and anti-retinal and anti-optic nerve autoantibody bands were collected from the Massachusetts Eye Research and Surgery Institution database between September 2010 and January 2015...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/28253231/baseline-prevalence-of-birth-defects-associated-with-congenital-zika-virus-infection-massachusetts-north-carolina-and-atlanta-georgia-2013-2014
#9
Janet D Cragan, Cara T Mai, Emily E Petersen, Rebecca F Liberman, Nina E Forestieri, Alissa C Stevens, Augustina Delaney, April L Dawson, Sascha R Ellington, Carrie K Shapiro-Mendoza, Julie E Dunn, Cathleen A Higgins, Robert E Meyer, Tonya Williams, Kara N D Polen, Kim Newsome, Megan Reynolds, Jennifer Isenburg, Suzanne M Gilboa, Dana M Meaney-Delman, Cynthia A Moore, Coleen A Boyle, Margaret A Honein
Zika virus infection during pregnancy can cause serious brain abnormalities, but the full range of adverse outcomes is unknown (1). To better understand the impact of birth defects resulting from Zika virus infection, the CDC surveillance case definition established in 2016 for birth defects potentially related to Zika virus infection* (2) was retrospectively applied to population-based birth defects surveillance data collected during 2013-2014 in three areas before the introduction of Zika virus (the pre-Zika years) into the World Health Organization's Region of the Americas (Americas) (3)...
March 3, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28196198/en-face-doppler-optical-coherence-tomography-measurement-of-total-retinal-blood-flow-in-diabetic-retinopathy-and-diabetic-macular-edema
#10
COMPARATIVE STUDY
ByungKun Lee, Eduardo A Novais, Nadia K Waheed, Mehreen Adhi, Talisa E de Carlo, Emily D Cole, Eric M Moult, WooJhon Choi, Mark Lane, Caroline R Baumal, Jay S Duker, James G Fujimoto
Importance: Alterations in ocular blood flow play an important role in the pathogenesis and progression of diabetic retinopathy (DR). However, the measurement of retinal blood flow in clinical studies has been challenging. En face Doppler optical coherence tomography (OCT) provides an effective method for measuring total retinal blood flow (TRBF) in the clinic. Objective: To investigate TRBF in eyes with DR of varying severity, with or without diabetic macular edema (DME), using en face Doppler OCT...
March 1, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28181367/periocular-breast-carcinoma-metastases-correlation-of-clinical-radiologic-and-histopathologic-features
#11
Natalie Homer, Frederick A Jakobiec, Anna Stagner, Mary Elizabeth Cunnane, Suzanne K Freitag, Aaron Fay, Michael K Yoon
IMPORTANCE: To describe presenting patterns of breast cancer metastases to the orbit and eyelids BACKGROUND: To provide clinical, radiographic, and pathologic correlations of breast metastases to the orbit or eyelids and evaluate radiographic volumetric orbital changes DESIGN: Retrospective review in an academic center PARTICIPANTS: Ten female patients with periocular metastatic breast carcinoma who were seen at the Massachusetts Eye and Ear Infirmary Oculoplastics Clinic METHODS: Retrospective review of patient records, imaging and pathology findings...
February 9, 2017: Clinical & Experimental Ophthalmology
https://www.readbyqxmd.com/read/28153439/validation-of-the-retinal-detachment-after-open-globe-injury-rd-ogi-score-as-an-effective-tool-for-predicting-retinal-detachment
#12
Katarzyna Brodowska, Tomasz P Stryjewski, Evangelia Papavasileiou, Yewlin E Chee, Dean Eliott
PURPOSE: The Retinal Detachment after Open Globe Injury (RD-OGI) Score is a clinical prediction model that was developed at the Massachusetts Eye and Ear Infirmary to predict the risk of retinal detachment (RD) after open globe injury (OGI). This study sought to validate the RD-OGI Score in an independent cohort of patients. DESIGN: Retrospective cohort study. PARTICIPANTS: The predictive value of the RD-OGI Score was evaluated by comparing the original RD-OGI Scores of 893 eyes with OGI that presented between 1999 and 2011 (the derivation cohort) with 184 eyes with OGI that presented from January 1, 2012, to January 31, 2014 (the validation cohort)...
May 2017: Ophthalmology
https://www.readbyqxmd.com/read/28006052/association-of-low-vitamin-d-levels-with-noninfectious-anterior-uveitis
#13
Lindsay A Grotting, Samaneh Davoudi, Deanna Palenzuela, George N Papaliodis, Lucia Sobrin
Importance: Vitamin D plays an important role in both the innate and adaptive immune systems. It has been shown to contribute to the etiology of T-cell-mediated autoimmune diseases through the upregulation of type 2 anti-inflammatory T helper cells and the suppression of type 1 T helper cells. Noninfectious uveitis is postulated to be caused by immune dysfunction. Objective: To determine whether there is an association between vitamin D levels and noninfectious anterior uveitis...
December 22, 2016: JAMA Ophthalmology
https://www.readbyqxmd.com/read/27913719/surgical-site-infections-in-major-head-and-neck-surgeries-involving-pedicled-flap-reconstruction
#14
Neerav Goyal, Bharat B Yarlagadda, Daniel G Deschler, Kevin S Emerick, Derrick T Lin, Debbie L Rich, James W Rocco, Marlene L Durand
OBJECTIVE: To evaluate surgical site infections (SSI) after pedicled reconstruction in head and neck surgery. METHODS: Records of patients with pedicled flap reconstructions between 2009 and 2014 at Massachusetts Eye and Ear were reviewed. Onset of SSI or fistula ≤30 days postoperatively was noted. A free flap cohort was reviewed for comparison. RESULTS: Two hundred and eight pedicled reconstructions were performed for cancer (83%), osteoradionecrosis (7%), and other reasons (10%)...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27754769/treatment-of-serpiginous-choroiditis-with-chlorambucil-a-report-of-17-patients
#15
Nazanin Ebrahimiadib, Bobeck S Modjtahedi, Samaneh Davoudi, C Stephen Foster
PURPOSE: To evaluate the efficacy of chlorambucil in the treatment of serpiginous choroiditis. METHODS: Patient records from the Massachusetts Eye Research and Surgery Institution (MERSI) were reviewed from over the past 10 years. In total, 17 patients with the diagnosis of serpiginous choroiditis treated with chlorambucil were identified. QuantiFERON gold was negative in all of them. Chlorambucil was started at 0.15 mg/kg and dosage was titrated up using weekly white blood cell (WBC) count to achieve a target cell number of 3...
October 18, 2016: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/27749618/clinical-presentation-and-bacteriology-of-eyebrow-infections-the-massachusetts-eye-and-ear-infirmary-experience-2008-2015
#16
Anaïs L Carniciu, Jonathan Chou, Ilya Leskov, Suzanne K Freitag
PURPOSE: This study retrospectively reviews preseptal cellulitis and abscesses involving the eyebrow to elucidate the bacteriology and potential causative factors. METHODS: A retrospective chart review was conducted to identify patients who had been diagnosed with preseptal cellulitis or abscess involving the eyebrow at the Massachusetts Eye and Ear Infirmary between 2008 and 2015. Demographic, clinical, and microbiological data were collected. RESULTS: Eighty patients with eyebrow infections were identified, of whom 49 (61...
October 5, 2016: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27681002/infliximab-therapy-in-patients-with-noninfectious-intermediate-uveitis-resistant-to-conventional-immunomodulatory-therapy
#17
Arash Maleki, Haitham F Sahawneh, Lina Ma, Halea Meese, Yuchen He, C Stephen Foster
PURPOSE: To examine the efficacy and safety of infliximab therapy in the treatment for noninfectious intermediate uveitis resistant to conventional immunomodulatory therapy. METHODS: Forty-four eyes of 23 patients with resistant noninfectious intermediate uveitis who were treated with infliximab infusions for a minimum period of 3 months were included. Demographic data, clinical data, and fluorescein angiography and optical coherence tomography findings were collected from the Massachusetts Eye Research and Surgery Institution database between August 2005 and February 2014...
May 2017: Retina
https://www.readbyqxmd.com/read/27626471/evaluation-of-static-and-dynamic-balance-in-athletes-with-anterior-cruciate-ligament-injury-a-controlled-study
#18
Tiago Lazzaretti Fernandes, Ellen Cristina Rodrigues Felix, Felipe Bessa, Natália Ms Luna, Dai Sugimoto, Júlia Maria D'Andrea Greve, Arnaldo José Hernandez
OBJECTIVES: Anterior cruciate ligament injury leads to adaptive responses to maintain postural control. However, there is no consensus regarding whether leg dominance also affects postural control in athletes with anterior cruciate ligament injury. The purpose of this study was to evaluate dynamic and static postural control among athletes with and without anterior cruciate ligament injury to the dominant leg. METHODS: Twenty-eight athletes, twenty-one males and seven females aged 15-45 years, were allocated to one of two groups: the anterior cruciate ligament injury group (26±3 years) or the control group without anterior cruciate ligament injury (25±6...
August 2016: Clinics
https://www.readbyqxmd.com/read/27608418/post-hybrid-cochlear-implant-hearing-loss-and-endolymphatic-hydrops
#19
Akira Ishiyama, Joni Doherty, Gail Ishiyama, Alicia M Quesnel, Ivan Lopez, Fred H Linthicum
OBJECTIVE: To evaluate for potential causes of delayed loss of residual hearing that variably occurs with hybrid cochlear implants. STUDY DESIGN: Histopathological evaluation of 29 human temporal bone (HTB) with cochlear implant (CI). SETTING: The Neurotology and House HTB Laboratory of UCLA (House-UCLA). SUBJECTS AND METHODS: HTB from CI patients from the House-UCLA HTB Laboratory (n = 28) and one courtesy of Massachusetts Eye and Ear Infirmary (MEEI)...
December 2016: Otology & Neurotology
https://www.readbyqxmd.com/read/27565392/outcomes-in-endoscopic-ear-surgery
#20
REVIEW
Ruwan Kiringoda, Elliott D Kozin, Daniel J Lee
Endoscopic ear surgery (EES) provides several advantages compared with traditional binocular microscopy, including a wide-field view, improved resolution with high magnification, and visual access to hidden corridors of the middle ear. Although binocular microscopic-assisted surgical techniques remain the gold standard for most otologists, EES is slowly emerging as a viable alternative for performing otologic surgery at several centers in the United States and abroad. In this review, we evaluate the current body of literature regarding EES outcomes, summarize our EES outcomes at the Massachusetts Eye and Ear Infirmary, and compare these results with data for microscopic-assisted otologic surgery...
October 2016: Otolaryngologic Clinics of North America
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