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https://www.readbyqxmd.com/read/28108823/which-clinical-and-patient-factors-influence-the-national-economic-burden-of-hospital-readmissions-after-total-joint-arthroplasty
#1
Steven M Kurtz, Edmund C Lau, Kevin L Ong, Edward M Adler, Frank R Kolisek, Michael T Manley
BACKGROUND: The Affordable Care Act of 2010 advanced the economic model of bundled payments for total joint arthroplasty (TJA), in which hospitals will be financially responsible for readmissions, typically at 90 days after surgery. However, little is known about the financial burden of readmissions and what patient, clinical, and hospital factors drive readmission costs. QUESTIONS/PURPOSES: (1) What is the incidence, payer mix, and demographics of THA and TKA readmissions in the United States? (2) What patient, clinical, and hospital factors are associated with the cost of 30- and 90-day readmissions after primary THA and TKA? (3) Are there any differences in the economic burden of THA and TKA readmissions between payers? (4) What types of THA and TKA readmissions are most costly to the US hospital system? METHODS: The recently developed Nationwide Readmissions Database from the Healthcare Cost and Utilization Project (2006 hospitals from 21 states) was used to identify 719,394 primary TJAs and 62,493 90-day readmissions in the first 9 months of 2013 based on International Classification of Diseases, 9th Revision, Clinical Modification codes...
January 20, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28105624/-clinical-research-of-delta-shaped-anastomosis-technology-in-laparoscopic-distal-gastrectomy-and-digestive-tract-reconstruction
#2
Bo Gao, Qingxing Huang, Jianhong Dong
OBJECTIVE: To evaluate the feasibility and safety of the delta-shaped anastomosis in laparoscopic distal gastrectomy and digestive tract reconstruction. METHODS: Clinical data of 34 gastric cancer patients undergoing laparoscopic distal gastrectomy with the delta-shaped anastomosis for digestive tract reconstruction (delta-shaped group) and 83 gastric cancer patients undergoing laparoscopic distal gastrectomy with Billroth I( for digestive tract reconstruction (Billroth group) by same surgeon team from July 2013 to July 2015 at the Department of Digestive Surgery, Affiliated Tumor Hospital of Shanxi Medical University were retrospectively analyzed...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28105483/gastric-acid-secretion-and-gastrin-release-during-continuous-vagal-neuromonitoring-in-thyroid-surgery
#3
Liu Xiaoli, Che-Wei Wu, Hoon Yub Kim, Wen Tian, Feng-Yu Chiang, Renbin Liu, Angkoon Anuwong, Gregory W Randolph, Gianlorenzo Dionigi, Matteo Lavazza
PURPOSE: The vagus nerve (VN) has essential regulatory roles in the gastric acid secretion and gastrin release. Continuous intraoperative neuromonitoring (CIONM) via VN stimulation is a promising technique in thyroid surgery because it potentially avoids injury to the recurrent laryngeal nerve. However, no studies have investigated changes in gastric acid secretion and gastrin release during CIONM. METHOD: This prospective study of 58 thyroid surgery patients compared gastric acid and serum gastrin at five time points: (1) before skin incision, (2) after baseline calibration of CIONM probe, (3) +20 min from baseline, (4) before probe removal, and (5) after extubation...
January 19, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28102920/evaluation-of-peripheral-intravenous-catheter-induced-local-complications-in-pediatrics
#4
Baraka M R Abusafia, Handan Boztepe
AIM: This study was conducted to evaluate the local complications in children who had a peripheral intravenous catheter. BACKGROUND: Currently, the insertion of peripheral intravenous catheters occurs in most children that are hospitalized. However, the development of some complications associated with the insertion of these catheters are unavoidable. A significant aspect of nursing care is to ensure the safety of the placement and management of peripheral intravenous catheters in children...
January 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28102451/cauda-equina-syndrome-presentation-outcome-and-predictors-with-focus-on-micturition-defecation-and-sexual-dysfunction
#5
N S Korse, J A Pijpers, E van Zwet, H W Elzevier, C L A Vleggeert-Lankamp
BACKGROUND: Even though micturition, defecation, and sexual function are substantially affected in cauda equina syndrome (CES), data on outcome are scarce. METHODS: Medical files of patients operated on lumbar herniated disc were screened for CES and retrospectively analyzed for baseline characteristics, outcome of micturition, defecation, and sexual function and possible predictors. RESULTS: Seventy-five CES patients (52% men) were included with a mean age of 44 years...
January 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28102450/hidden-blood-loss-and-the-influential-factors-after-percutaneous-kyphoplasty-surgery
#6
Yao-Sen Wu, Hui Zhang, Wen-Hao Zheng, Zhen-Hua Feng, Ze-Xin Chen, Yan Lin
PURPOSE: Percutaneous kyphoplasty (PKP) is a minimally invasive procedure for the treatment of osteoporotic vertebral compression fractures (OVCFs). It is generally considered that there is little blood loss during the surgery. However, a significant perioperative hidden blood loss (HBL) is neglected. This study was to examine the amount of HBL and determine the influential factors during PKP. METHODS: From January 2015 to January 2016, 115 patients with OVCFs who were scheduled to have a PKP were enrolled in this study...
January 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28101755/does-n-terminal-pro-brain-type-natriuretic-peptide-predict-cardiac-complications-after-hip-fracture-surgery
#7
Hiroki Ushirozako, Tsuyoshi Ohishi, Tomotada Fujita, Daisuke Suzuki, Kazufumi Yamamoto, Tomohiro Banno, Hiroyuki Takase, Yukihiro Matsuyama
BACKGROUND: Elderly patients with hip fracture are at risk for cardiac complications. N-terminal pro-brain type natriuretic peptide (NT-proBNP) has been shown to predict cardiac complications in surgical patients; however, to our knowledge, only two studies have evaluated the utility of this test in patients with hip fracture. We believe it is important to assess a more accurate cutoff value of NT-proBNP with exclusion of patients with renal failure. QUESTIONS/PURPOSES: To assess the association between preoperative NT-proBNP and cardiac complications after hip fracture surgery...
January 18, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28101677/emesis-and-nausea-related-to-single-agent-trabectedin-in-ovarian-cancer-patients-a-sub-study-of-the-mito15-project
#8
Marilena Di Napoli, Chiara Della Pepa, Laura Arenare, Giovanni Scambia, Domenica Lorusso, Francesco Raspagliesi, Gabriella Ferrandina, Vanda Salutari, Roberto Sorio, Anna Maria Mosconi, Giorgia Mangili, Lucia Borgato, Stefano Lepori, Angela Salvino, Sandro Pignata, Sabrina Chiara Cecere
The MITO 15 was a prospective, single-arm trial, evaluating trabectedin monotherapy in patients with recurrent ovarian cancer (OC) who were BRCA mutation-carriers or had a BRCAness phenotype. It is largely reported that trabectedin may induce nausea and vomiting but the real emetogenic potential of the drug, in the different schedules, has never been fully described; furthermore, OC patients are known to have an enhanced risk of developing nausea and vomiting due to female gender, abdominal spreading of the disease, and major surgery experienced by most of them...
January 19, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28100945/study-of-433-operated-cases-of-thoracic-trauma
#9
Muharrem Çakmak, Mehmet Nail Kandemir
Patients with thoracic trauma constitute one third of all the trauma cases. Of traumatic patients, 20-25 % die because of thoracic trauma. Our aim was to compare our clinical experience and the results with the related literature. Four hundred thirty-three patients, who underwent surgical interventions due to thoracic trauma, were evaluated. The latest form of treatment applied were taken as the criteria for the quantitative detection of patients. Continuous variables were expressed as mean ± standard deviation, while categorical variables were explained as number and percentage...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28100669/the-preventive-value-of-epidural-calcitonin-in-patients-with-lower-limb-amputation
#10
Ayman A Yousef, Amr M Aborahma
BACKGROUND:  Postamputation pain is highly prevalent after limb amputation with neuropathic nature; calcitonin may effectively relieve many neuropathic pain states. DESIGN:  Double-blind randomized multicenter study. SETTING:  Our study hypothesis is to evaluate the preventive value of epidural calcitonin on postoperative pain, grade of phantom pain, and the development of allodynia and hyperalgesia in patients undergoing lower limb amputation...
January 18, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28099962/quality-of-life-after-intestinal-resection-in-patients-with-crohn-disease-a-systematic-review
#11
Francis J Ha, Louisa Thong, Hanan Khalil
BACKGROUND/AIMS: Most patients with Crohn disease (CD) require surgery within 10 years of diagnosis. Intestinal resection is the most commonly performed operation although the effects on health-related quality of life (HRQOL), particularly long-term, are contentious. METHODS: We conducted a systematic review evaluating the impact of intestinal resection on the HRQOL of CD patients, predictors of postoperative HRQOL, and patient satisfaction with surgery. RESULTS: Nine studies including 1,108 CD patients undergoing intestinal resection were identified as eligible for inclusion...
January 19, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28099283/the-characteristics-of-excimer-laser-refractive-surgery-candidates
#12
Hassan Hashemi, Mehdi Khabazkhoob, Reza Pakzad, Abbasali Yekta, Marzieh Nojomi, Payam Nabovati
PURPOSE: To determine the demographic and refractive characteristics of excimer laser refractive surgery candidates in Iran. METHODS: This was a cross-sectional study between 2010 and 2014. All information was collected from 28 centers randomly selected from 12 provinces. Then, for each season of the year, one week was chosen through simple random selection, and within each week, 3 days were again chosen randomly. All excimer laser surgical procedures performed during these 3 days were identified by training staff, and data were extracted from patient charts...
January 17, 2017: Eye & Contact Lens
https://www.readbyqxmd.com/read/28098106/the-role-of-dynamic-renal-scintigraphy-on-clinical-decision-making-in-hydronephrotic-children
#13
Seçil Arslansoyu Çamlar, Nazlı Deveci, Alper Soylu, Mehmet Atilla Türkmen, Derya Özmen, Gamze Çapakaya, Salih Kavukçu
Hydronephrosis may be related to an obstructive cause, ureteropelvic/uretero-vesical junction obstruction or nonobstructive [vesicoureteral reflux (VUR)]. When an obstructive pathology is considered, dynamic renal scintigraphy may help to predict whether it is a true obstruction or not. In this study, we aimed to determine the contribution of dynamic renal scintigraphy with [99] mTc-MAG-3 to the clinical decision-making for surgery in hydronephrotic children. Files of the patients evaluated by MAG-3 scintigraphy for antenatal (AH)/postnatal (PH) hydronephrosis between 1992 and 2014 were reviewed...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28097111/fucntional-and-radiological-outcome-of-surgical-management-of-acetabular-fractures-in-tertiary-care-hospital
#14
Faizan Iqbal, Intikhab Taufiq, Muhammad Kazim Raheem Najjad, Naveed Khan, Osama Bin Zia
PURPOSE: Acetabular fractures are mainly caused by trauma and the incidence is rising in developing countries. Initially these fractures were managed conservatively, due to lack of specialized and dedicated acetabulum surgery centres. Our aim is to study the radiological and functional outcomes of surgical management of acetabular fractures in tertiary care hospital. MATERIALS AND METHODS: Total 50 patients were enrolled. The patients with acetabular fractures were enrolled between the years 2012 to 2014...
December 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/28095557/the-photodynamic-therapy-experience-of-a-high-volume-laser-and-dermatologic-surgery-center
#15
David E Orbuch, Lauren Penn, Bradley S Bloom, Jeremy A Brauer, Daniel B Shin, Joshua Greenbaum, Leonard J Bernstein, Elliot T Weiss, Robert T Anolik, Roy G Geronemus
BACKGROUND: Photodynamic therapy (PDT) is an FDA approved treatment for actinic keratoses (AK's) although multiple off-label indi- cations are reported. Despite frequent use for AK's, no clear consensus exists regarding protocols for overall treatment parameters. METHODS: Retrospective chart review of 1,491 subjects who underwent PDT between 2007 and 2011 at a high volume laser surgery center. Demographic information, clinical history, treatment data, and subsequent diagnosis of skin cancers were recorded...
November 1, 2016: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28095042/gauging-the-extent-of-thyroidectomy-for-indeterminate-thyroid-nodules-an-oncologic-perspective
#16
David F Schneider, Linda M Cherney Stafford, Nicole Brys, Caprice C Greenberg, Courtney J Balentine, Dawn M Elfenbein, Susan C Pitt
INTRODUCTION: Increasing emphasis is being placed on appropriateness of care and avoidance of over- and under-treatment. Indeterminate thyroid nodules (ITN), present a particular risk for this problem because cancer found via diagnostic lobectomy (DL) often requires a completion thyroidectomy (CT). However, initial total thyroidectomy (TT) for benign ITN results in lifelong thyroid hormone replacement. We sought to measure the accuracy and factors associated with the extent of initial thyroidectomy for ITN...
January 17, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28094190/three-or-more-preoperative-injections-is-the-most-significant-risk-factor-for-revision-surgery-after-operative-treatment-of-lateral-epicondylitis-an-analysis-of-3863-patients
#17
Ryan M Degen, Jourdan M Cancienne, Christopher L Camp, David W Altchek, Joshua S Dines, Brian C Werner
BACKGROUND: This study was conducted to identify the rate of failure of operative treatment of lateral epicondylitis, defined as progression to ipsilateral revision surgery, and associated patient-specific risk factors for failure. METHODS: A national database was used to identify patients undergoing surgical treatment of lateral epicondylitis from 2005 to 2012. Patients undergoing concomitant procedures were excluded. Patients who then required subsequent ipsilateral extensor carpi radialis brevis débridement or release within 2 years were identified using similar methods...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28094014/a-new-methodology-for-assessment-of-pectus-excavatum-correction-after-bar-removal-in-nuss-procedure-preliminary-study
#18
João Gomes-Fonseca, João L Vilaça, Tiago Henriques-Coelho, Bruno Direito-Santos, António C M Pinho, Jaime C Fonseca, Jorge Correia-Pinto
PURPOSE: The objective is to present a new methodology to assess quantitatively the impact of bar removal on the anterior chest wall, among patients with pectus excavatum who have undergone the Nuss procedure, and present a preliminary study using this methodology. METHODS: We propose to acquire, for each patient, the surface of the anterior chest wall using a three-dimensional laser scanner at subsequent time points (short term: before and after surgery; long term: follow-up visit, 6months, and 12months after surgery)...
January 7, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28092340/decompression-surgery-alone-versus-decompression-plus-fusion-in-symptomatic-lumbar-spinal-stenosis-a-swiss-prospective-multi-center-cohort-study-with-3-years-of-follow-up
#19
Nils H Ulrich, Jakob M Burgstaller, Giuseppe Pichierri, Maria M Wertli, Mazda Farshad, François Porchet, Johann Steurer, Ulrike Held
STUDY DESIGN: Retrospective analysis of a prospective, multicenter cohort study. OBJECTIVE: To estimate the added effect of surgical fusion as compared to decompression surgery alone in symptomatic lumbar spinal stenosis patients with spondylolisthesis. SUMMARY OF BACKGROUND DATA: The optimal surgical management of lumbar spinal stenosis patients with spondylolisthesis remains controversial. METHODS: Patients of the LSOS with confirmed DLSS and spondylolisthesis were enrolled in this study...
January 13, 2017: Spine
https://www.readbyqxmd.com/read/28091802/increased-risk-of-revision-reoperation-and-implant-constraint-in-tka-after-multiligament-knee-surgery
#20
Steven I Pancio, Paul L Sousa, Aaron J Krych, Matthew P Abdel, Bruce A Levy, Diane L Dahm, Michael J Stuart
BACKGROUND: The risk of major complications and revision arthroplasty after TKA in patients who previously underwent multiligament knee surgery have been poorly characterized. QUESTIONS/PURPOSES: Is multiligament knee surgery before TKA associated with (1) worse implant survival, (2) increased use of TKA design constraint, (3) a greater risk for major complications, and (4) poorer scores for pain and function compared with similar patients receiving TKA for primary osteoarthritis? METHODS: Fifty-nine TKAs were performed at our institution between 1985 and 2014 in 59 patients (36 men, 23 women; mean age, 53 years) with a history of previous multiligament knee surgery (≥ two ligaments)...
January 13, 2017: Clinical Orthopaedics and related Research
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