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Werner de Cruppé, Max Geraedts
STUDY AIM: The minimum volume standards for hospitals in Germany, in force since 2004, provide four exemptions for non-complying hospitals. This study investigates the extent and importance of these exemptions for complex procedures on the oesophagus and pancreas for all non-complying hospitals and for the revised minimum volume regulations in force since the beginning of 2018. METHOD: Longitudinal, descriptive analyses of data on minimum volume standards and their exemptions for complex procedures on the oesophagus and pancreas, as presented by the hospital quality report cards of the reporting years from 2006 to 2014...
March 16, 2018: Zentralblatt Für Chirurgie
Christopher D Witiw, Fabrice Smieliauskas, John E O'Toole, Michael G Fehlings, Richard G Fessler
BACKGROUND: Surgery for cervical radiculopathy is often approached by either anterior cervical discectomy and fusion (ACDF) or posterior cervical foraminotomy (PCF). ACDF is more common; however, recent single center studies suggest comparable efficacy and significant cost savings with PCF in appropriately selected patients. OBJECTIVE: To compare utilization, adverse events, and costs for each approach from a national perspective. METHODS: Adults undergoing single level ACDF or PCF for cervical radiculopathy were included from a US commercial health insurance claims database spanning 2003 to 2014...
March 14, 2018: Neurosurgery
Claire E Webster, Jon Clasper, Daniel J Stinner, Joseph Eliahoo, Spyros D Masouros
Background: Throughout history, traumatic amputation of the lower extremity has been a notable feature of all conflicts involving explosive incidents. Even at the close of the recent conflicts in Afghanistan, there were deaths that were deemed "potentially survivable." The purpose of this study is to characterize lower extremity blast injury and to determine if their amputation levels and associated injury characteristics correlate with a higher risk of mortality. Methods: the UK Joint Theatre Trauma Registry (JTTR) was interrogated to identify all lower extremity traumatic amputations sustained in both Iraq and Afghanistan between January 2003 and the end of UK operations in August 2014...
March 14, 2018: Military Medicine
Gordon G Wisbach, Joshua Peters, Jenise Leon Guerrero, Nelson Mozzini, Helen Metzger
Introduction: The obesity epidemic in the USA includes active duty service members in the military and effects physical readiness. At the Naval Medical Center San Diego command, the Health & Wellness Department is charged with administering the Weight Management Programs (WMP) for sailors in the San Diego area to ensure military physical readiness requirements. The optimal allocation of personnel and resources to manage these programs is paramount for mission success. We analyzed the cost and effectiveness of the WMPs for the active duty population stationed at Naval Medical Center San Diego (NMCSD) with the intent of offering potential recommendations for program optimization...
March 14, 2018: Military Medicine
Bryan W Heckman, K Michael Cummings, Georges J Nahas, Marc C Willemsen, Richard J O'Connor, Ron Borland, Alexander A Hirsch, Warren K Bickel, Matthew J Carpenter
Introduction: The demand for alternative nicotine/tobacco products is not well established. This paper uses a behavioral economic approach to test whether smokers have differential demand for conventional factory-made, electronic, and very low nicotine content cigarettes (FMCs/ECs/VLNCs) and uses the prospective cohort design to test the predictive validity of demand indices on subsequent use of commercially available FMCs and ECs. Methods: Daily smokers (>16 years) from the Netherlands completed an online survey in April 2014 (N=1215)...
March 14, 2018: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
Kang An, Hang Yin, Ju Mei, Jiaquan Zhu, Min Tang
OBJECTIVES: We retrospectively analysed data from non-valvular atrial fibrillation (AF) patients who underwent minimally invasive surgical AF ablation at our centre. Our purpose was to explore the atrial endocardial expression of von Willebrand factor (vWF) and thrombomodulin (TM) and their association with rhythm results after the procedure. METHODS: From January 2014 to May 2015, 60 patients underwent minimally invasive surgical AF ablation at our centre. Left atrial appendage samples were obtained during the procedure and immunohistochemistry for endocardial markers including vWF and TM was performed and semi-quantitatively graded...
March 14, 2018: Interactive Cardiovascular and Thoracic Surgery
Kazuma Takashima, Takashi Sakai, Hidetoshi Hamada, Masaki Takao, Nobuhiko Sugano
BACKGROUND: Many studies have confirmed that the size and location of necrotic lesions are major factors that affect the prevalence of collapse and prognosis in patients with osteonecrosis of the femoral head (ONFH). Although several classification systems categorize and quantify ONFH, there is no agreement on which one is most useful for the purpose. QUESTIONS/PURPOSES: We compared the Steinberg, modified Kerboul, and Japanese Investigation Committee (JIC) classifications of ONFH in terms of (1) the correlation among the three different classification systems...
March 15, 2018: Clinical Orthopaedics and related Research
Neil E O'Connell, Louise Marston, Sally Spencer, Lorraine H DeSouza, Benedict M Wand
BACKGROUND: This is an updated version of the original Cochrane Review published in 2010, Issue 9, and last updated in 2014, Issue 4. Non-invasive brain stimulation techniques aim to induce an electrical stimulation of the brain in an attempt to reduce chronic pain by directly altering brain activity. They include repetitive transcranial magnetic stimulation (rTMS), cranial electrotherapy stimulation (CES), transcranial direct current stimulation (tDCS), transcranial random noise stimulation (tRNS) and reduced impedance non-invasive cortical electrostimulation (RINCE)...
March 16, 2018: Cochrane Database of Systematic Reviews
Vinayak Narayan, Hima Pendharkar, Bhagavatula Indira Devi, Dhananjaya I Bhat, Dhaval P Shukla
Background: The conventional medical management of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is associated with uncertainty of outcome and complications. Aims and Objectives: To examine the effect of direct intra-arterial nimodipine therapy on outcome in patients with delayed cerebral ischemia (DCI). Settings and Design: The retrospective observational study was conducted at a single neurosurgical unit and interventional neuroradiolgy suite of a center managing SAH...
March 2018: Neurology India
Vedavathi Kunnanayaka, Puneet Jain, Suvasini Sharma, Anju Seth, Satinder Aneja
Background: West syndrome is a catastrophic epilepsy syndrome characterized by infantile spasms, hypsarrhythmia, and developmental arrest or regression. Aim: The aim of this study was to explore the role of pyridoxine in the management of infantile spasms. Setting and Design: This was a pilot, randomized, open-label trial conducted at a tertiary level hospital from November 2012 to March 2014. Materials and Methods: Children aged 3 months to 3 years presenting with infantile spasms in clusters (at least 1 cluster/day) with hypsarrhythmia or its variants on electroencephalogram (EEG) were enrolled...
March 2018: Neurology India
Francisco Vaz-Guimaraes, Maria Koutourousiou, John R de Almeida, Elizabeth C Tyler-Kabara, Juan C Fernandez-Miranda, Eric W Wang, Carl H Snyderman, Paul A Gardner
OBJECTIVE Epidermoid and dermoid cysts may be found along the cranial base and are commonly resected via open transcranial approaches. The use of endoscopic endonasal approaches for resection of these tumors has been rarely reported. METHODS The authors retrospectively reviewed the medical records of 21 patients who underwent endoscopic endonasal surgery for epidermoid and dermoid cyst resection at the University of Pittsburgh Medical Center between January 2005 and June 2014. Surgical outcomes and variables that might affect the extent of resection and complications were analyzed...
March 16, 2018: Journal of Neurosurgery
Shailja Tibrewal, Ramesh Kekunnaya
PURPOSE: The aim of the study was to determine the risk of anterior segment ischemia (ASI) after simultaneous three rectus muscle surgery. METHODS: A retrospective cohort study was conducted. All patients who underwent simultaneous three rectus muscle surgery from January 2003 to December 2014 were included. Medical records were reviewed for signs of acute ASI in the postoperative period or presence of any late sequelae. Those patients who had pre-existing corneal pathology obscuring visualisation of anterior chamber and iris were excluded...
March 16, 2018: Strabismus
Bettina von Dessauer, Carmen Benavente, Emilia Monje, Jazmina Bongain, Nadia Ordenes
OBJECTIVE: Describe the frequency and characteristics of PICU patients who undergo a process of withholding or withdrawing life-sustaining treatment (LTSV), between 2004 y 2014. PATIENTS AND METHOD: A retrospective, observational descriptive study, using two documents for quality assessment in the PICU of Hospital Roberto del Río: 1) daily individual patient tracking log and 2) daily record of quality indicators, including LTSV, both updated daily at the morning visit...
December 2017: Revista Chilena de Pediatría
Rolando Saavedra O, Fresia Solís F, Carmina Domic C
INTRODUCTION: Children scalded by the tearing of hot-water bottles presented a sudden and significa tive increase around 2000 in Chile. For this reason the Aid to Burned Children Corporation (COA-NIQUEM) publicized prevention concepts concerning the careful use of this device and raised a voice of alarm to authorities. Later, the National Normalization Institute introduced quality certification standards for hot water bottles sold in the country. OBJECTIVES: Determine the impact of preventive measures and quality certification for hot water bottles in burns caused by tearing of the device on children...
December 2017: Revista Chilena de Pediatría
Franka Metzner, Stephanie Pahlke, Alice Diesing, Nina Marin, Fionna Klasen, Silke Pawils, Michael Schulte-Markwort, Hertha Richter-Appelt
Complex Trauma-related Disorders in Research and Practice Frequent traumata in childhood and adolescence are long-term or repeated interpersonal traumata caused by perpetrators in the close environment of the minors. For the description of the extensive symptoms after interpersonal Type II traumata, the complex trauma-related disorders Complex Posttraumatic Stress Disorder (CPTSD) or Disorder of Extreme Stress Not Otherwise Specified (DESNOS) and the Developmental Trauma Disorder (DTD) are being discussed for inclusion in the classification systems for mental disorders...
March 2018: Praxis der Kinderpsychologie und Kinderpsychiatrie
Marco Guarene, Carla Badulli, Anna L Cremaschi, Ilaria Sbarsi, Rosalia Cacciatore, Carmine Tinelli, Annamaria Pasi, Paola Bergamaschi, Cesare G Perotti
INTRODUCTION: Allele-level donor-recipient match at HLA-A, HLA-B, HLA-C and HLA-DRB1 loci impacts the outcome after cord blood transplantation for hematologic malignancies and modifies the strategy of donor selection. High definition of both class I and II HLA loci at time of listing is a way to improve the attractiveness of cord blood bank inventories, reducing the time for donor search and procurement and simplifying donor choice, in particular, for patients of non-European heritage...
March 1, 2018: International Journal of Artificial Organs
William F McIntyre, David Conen, Brian Olshansky, Jonathan L Halperin, Emil Hayek, Menno V Huisman, Gregory Y H Lip, Shihai Lu, Jeff S Healey
BACKGROUND: Antithrombotic prophylaxis with oral anticoagulation (OAC) substantially reduces stroke and mortality in patients with atrial fibrillation (AF). HYPOTHESIS: Analysis of data in GLORIA-AF, an international, observational registry of patients with newly-diagnosed AF, can identify factors associated with treatment decisions and outcomes. METHODS: Multivariable regression identified patient, physician, and temporal factors associated with OAC prescription, versus management with antiplatelet drugs or no antithrombotic drugs in North American patients enrolled between November 2011 and February 2014...
March 15, 2018: Clinical Cardiology
Ibrahim Nassour, Alana Christie, Michael A Choti, John C Mansour, Rebecca M Minter, Patricio M Polanco, Mathew M Augustine, Matthew R Porembka, Xian-Jin Xie, Sam C Wang
BACKGROUND: The evaluation of lymph node involvement is an essential component of cancer staging. Examining an inadequate number of lymph nodes potentially results in understaging. Current guidelines for lymph node retrieval for ampullary adenocarcinoma are based on data extrapolated from other periampullary malignancies and may not be applicable. The aim of this study was to determine the number of lymph nodes that should be examined in resection specimens to optimize staging in ampullary adenocarcinoma...
March 15, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Andre Roelke, Nicole Franke, Chris Biemann, Ralph Radach, Arthur M Jacobs, Markus J Hofmann
The theoretical "difficulty in separating association strength from [semantic] feature overlap" has resulted in inconsistent findings of either the presence or absence of "pure" associative priming in recent literature (Hutchison, 2003, Psychonomic Bulletin & Review, 10(4), p. 787). The present study used co-occurrence statistics of words in sentences to provide a full factorial manipulation of direct association (strong/no) and the number of common associates (many/no) of the prime and target words...
March 15, 2018: Psychonomic Bulletin & Review
C Sparano, G Parenti, A Cilotti, L Bencini, M Calistri, E Mannucci, C Biagini, V Vezzosi, M Mannelli, G Forti, L Petrone
BACKGROUND: The increasing frequency in the diagnosis of thyroid nodules has raised a growing interest in the search for new diagnostic tools to better select patients deserving surgery. In 2014, the major Italian Societies involved in the field drafted a new cytological classification, to better stratify pre-surgical risk of thyroid cancer, especially for the indeterminate category, split into TIR3A and TIR3B subclasses, associated to different therapeutic decisions. MATERIALS AND METHODS: This retrospective cross-sectional survey analyzed thyroid fine-needle aspiration biopsy performed at our outpatient clinic before and after the introduction of the new SIAPEC-IAP consensus in May 2014...
March 15, 2018: Journal of Endocrinological Investigation
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