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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/28106520/impact-of-area-deprivation-index-on-coronary-stent-utilization-in-a-medicare-nationwide-cohort
#2
Tushar A Tuliani, Maithili Shenoy, Milind Parikh, Kenneth Jutzy, Anthony Hilliard
Area Deprivation Index (ADI) is a marker of neighborhood deprivation. This study investigates utilization of coronary bare-metal stent (BMS) and drug-eluting stent (DES) in Medicare patients across hospitals with varying ADI. Data were abstracted using Diagnosis-Related Group (DRG) codes 249 (BMS without major complications or comorbidities [MCC]), 246, and 247 (DES with and without MCC, respectively) from the 2011-2012 Medicare Provider Utilization and Payment Data Inpatient File, which was linked to American Hospital Association data (to determine bed size, location, ownership, teaching status), and ADI for each hospital zip code was obtained...
January 20, 2017: Population Health Management
https://www.readbyqxmd.com/read/28101526/rapamycin-resistant-mtor-activity-is-required-for-sensory-axon-regeneration-induced-by-a-conditioning-lesion
#3
Weitao Chen, Na Lu, Yue Ding, Yuan Wang, Leung Ting Chan, Xu Wang, Xin Gao, Songshan Jiang, Kai Liu
Neuronal mammalian target of rapamycin (mTOR) activity is a critical determinant of the intrinsic regenerative ability of mature neurons in the adult central nervous system (CNS). However, whether its action also applies to peripheral nervous system (PNS) neurons after injury remains elusive. To address this issue unambiguously, we used genetic approaches to determine the role of mTOR signaling in sensory axon regeneration in mice. We showed that deleting mTOR in dorsal root ganglion (DRG) neurons suppressed the axon regeneration induced by conditioning lesions...
November 2016: ENeuro
https://www.readbyqxmd.com/read/28100220/effect-of-patient-s-age-on-the-profitability-of-inpatient-cardiac-catheterization-a-contribution-margin-analysis-of-frequently-performed-procedures-over-a-5-year-period
#4
Gunnar Plehn, Thomas Butz, Petra Maagh, Axel Meissner
BACKGROUND: Due to a continuing age shift in the German society hospital providers are concerned about the additional costs associated with the treatment of elderly patients. It is not clear if cardiac catheterization in aged patients leads to higher resource utilization and if DRG-revenues do compensate for this factor. METHODS: Procedure-related and administrative data of all patients who underwent cardiac catheterization at a tertiary heart center between 2007 and 2011 were collected and analyzed...
January 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28097492/activation-of-trpm2-and-trpv1-channels-in-dorsal-root-ganglion-by-nadph-oxidase-and-protein-kinase-c-molecular-pathways-a-patch-clamp-study
#5
Mustafa Nazıroğlu
Despite considerable research, the mechanisms of neuropathic pain induced by excessive oxidative stress production and overload calcium ion (Ca(2+)) entry in dorsal root ganglion (DRG) remain substantially unidentified. The transient receptor potential melastatin 2 (TRPM2) and vanilloid 1 (TRPV1) channels are activated with different stimuli including oxidative stress. TRPM2 and TRPV1 have been shown to be involved in induction of neuropathic pain. However, the activation mechanisms of TRPM2 and TRPV1 via NADPH oxidase and protein kinase C (PKC) pathways are poorly understood...
January 17, 2017: Journal of Molecular Neuroscience: MN
https://www.readbyqxmd.com/read/28096250/clinical-management-of-unruptured-intracranial-aneurysm-in-germany-a-nationwide-observational-study-over-a-5-year-period-2005-2009
#6
Victor Walendy, Andreas Stang
OBJECTIVES: Our aim was to provide nationwide age-standardised rates (ASR) on the usage of endovascular coiling and neurosurgical clipping for unruptured intracranial aneurysm (UIA) treatment in Germany. SETTING: Nationwide observational study using the Diagnosis-Related-Groups (DRG) statistics for the years 2005-2009 (overall 83 million hospitalisations). PARTICIPANTS: From 2005 to 2009, overall 39 155 hospitalisations with a diagnosis of UIA occurred in Germany...
January 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28095324/formalin-injection-produces-long-lasting-hypersensitivity-with-characteristics-of-neuropathic-pain
#7
Ana Belen Salinas-Abarca, Sabino Hazael Avila-Rojas, Paulino Barragán-Iglesias, Jorge Baruch Pineda-Farias, Vinicio Granados-Soto
The purpose of this study was to investigate whether 1%, 2% or 5% formalin injection produce hypersensitivity with characteristics of the neuropathic pain induced by spinal nerve injury. Formalin injection (1%, 2% and 5%) produced concentration-dependent long-lasting (at least 14 days) mechanical allodynia and hyperalgesia in both paws. Likewise, L5/L6 spinal nerve ligation induced allodynia and hyperalgesia in both paws. The intensity of hypersensitivity was greater in the ipsilateral than in the contralateral paw in all models...
January 14, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28094445/presynaptic-inhibition-of-transient-receptor-potential-vanilloid-type-1-trpv1-receptors-by-norepinephrine-in-nociceptive-neurons
#8
Saikat Chakraborty, Vincent Elvezio, Martin Kaczocha, Mario Rebecchi, Michelino Puopolo
The transient receptor potential vanilloid type 1 (TRPV1) receptor is a well-known contributor to nociceptor excitability. To address whether norepinephrine can down-regulate TRPV1 channel activity in nociceptors and reduce their synaptic transmission, the effects of norepinephrine and clonidine were tested on the capsaicin-activated current recorded from acutely dissociated small diameter (<27 μm) dorsal root ganglia (DRG) neurons and on miniature excitatory postsynaptic currents (mEPSCs) recorded from large lamina I neurons in horizontal spinal cord slices...
January 17, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28089870/large-dense-core-vesicle-exocytosis-from-mouse-dorsal-root-ganglion-neurons-is-regulated-by-neuropeptide-y
#9
Anneka Bost, Ali H Shaib, Yvonne Schwarz, Barbara A Niemeyer, Ute Becherer
Peptidergic dorsal root ganglion (DRG) neurons transmit sensory and nociceptive information from the periphery to the central nervous system. Their synaptic activity is profoundly affected by neuromodulatory peptides stored and released from large dense-core vesicles (LDCVs). However, the mechanism of peptide secretion from DRG neurons is poorly understood. Using total internal reflection fluorescence microscopy (TIRFM), we visualized individual LDCVs loaded with fluorescent neuropeptide Y (NPY) and analyzed their stimulation-dependent release...
January 12, 2017: Neuroscience
https://www.readbyqxmd.com/read/28088617/assessing-physician-productivity-following-norwegian-hospital-reform-a-panel-and-data-envelopment-analysis
#10
Karl Arne Johannessen, Sverre A C Kittelsen, Terje P Hagen
BACKGROUND: Although health care reforms may improve efficiency at the macro level, less is known regarding their effects on the utilization of health care personnel. Following the 2002 Norwegian hospital reform, we studied the productivity of the physician workforce and the effect of personnel mix on this measure in all nineteen Norwegian hospitals from 2001 to 2013. METHODS: We used panel analysis and non-parametric data envelopment analysis (DEA) to study physician productivity defined as patient treatments per full-time equivalent (FTE) physician...
January 6, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28081357/assessment-of-neuronal-cell-based-cytotoxicity-of-neurotoxins-from-an-estuarine-nemertean-in-the-han-river-estuary
#11
Yeo Seon Kwon, Seul Ki Min, Seung Ju Yeon, Jin Ha Hwang, Jae-Sang Hong, Hwa Sung Shin
A heteronemertean, Yininemertes pratensis was collected in Han River Estuary, South Korea. This estuarine nemertean has been known for harmful effects by the local fishermen to the glass eels, juveniles of Japanese eels Anguilla japonica, migrating to fresh water. The present study confirmed the neurotoxic effects of this heteronemertean ribbon worm at the cellular level. 5, 11-dideoxy TTX (288 m/z) and 11-norTTX-6(S)-01 (m/z 305.97), derivative types of neurotoxic TTX, were identified through HPLC and MALDI-TOF MS...
January 12, 2017: Journal of Microbiology and Biotechnology
https://www.readbyqxmd.com/read/28079757/pathogenesis-of-abdominal-pain-in-bowel-obstruction-role-of-mechanical-stress-induced-upregulation-of-nerve-growth-factor-in-gut-smooth-muscle-cells
#12
You-Min Lin, Yu Fu, John Winston, Ravi Radhakrishnan, Sushil K Sarna, Li-Yen M Huang, Xuan-Zheng Shi
Abdominal pain is one of the major symptoms in bowel obstruction (BO); its cellular mechanisms remain incompletely understood. We tested the hypothesis that mechanical stress in obstruction upregulates expression of nociception mediator nerve growth factor (NGF) in gut smooth muscle cells (SMC), and NGF sensitizes primary sensory nerve to contribute to pain in BO. Partial colon obstruction was induced with a silicon band implanted in the distal bowel of Sprague-Dawley rats. Colon-projecting sensory neurons in the dorsal root ganglia (DRG, T13 to L2) were identified for patch clamp and gene expression studies...
January 6, 2017: Pain
https://www.readbyqxmd.com/read/28079752/changes-in-dorsal-root-ganglion-gene-expression-in-response-to-spinal-cord-stimulation
#13
Dana M Tilley, David L Cedeño, Courtney A Kelley, Margaret DeMaegd, Ramsin Benyamin, Ricardo Vallejo
BACKGROUND AND OBJECTIVES: Spinal cord stimulation (SCS) has been shown to influence pain-related genes in the spinal cord directly under the stimulating electrodes. There is limited information regarding changes occurring at the dorsal root ganglion (DRG). This study evaluates gene expression in the DRG in response to SCS therapy. METHODS: Rats were randomized into experimental or control groups (n = 6 per group). Experimental animals underwent spared-nerve injury, implantation of lead, and continuous SCS (72 hours)...
January 11, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28075461/resistance-of-interleukin-6-to-the-extracellular-inhibitory-environment-promotes-axonal-regeneration-and-functional-recovery-following-spinal-cord-injury
#14
Gang Yang, Wen-Yuan Tang
Interleukin-6 (IL)-6 was originally discovered as a factor that contributes to the secondary pathological and inflammatory response in the central nervous system (CNS) following injury. However, accumulating evidence suggests that IL-6 is also involved in functional and structural recovery following CNS injury by promoting axonal sprou-ting. This suggests a potential dual role of IL-6 in CNS injury. However, the definitive function of IL-6 in neural injury and the corresponding underlying mechanisms are still topics of controversy...
February 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/28075022/the-mechanistic-basis-for-photobiomodulation-therapy-of-neuropathic-pain-by-near-infrared-laser-light
#15
Vanessa Milanesi Holanda, Maria Cristina Chavantes, Xingjia Wu, Juanita J Anders
BACKGROUND AND OBJECTIVE: Various irradiances have been reported to be beneficial for the treatment of neuropathic pain with near infrared light. However, the mechanistic basis for the beneficial outcomes may vary based on the level of irradiance or fluence rate used. Using in vivo and in vitro experimental models, this study determined the mechanistic basis of photobiomodulation therapy (PBMT) for the treatment of neuropathic pain using a high irradiance. STUDY DESIGN/MATERIALS AND METHODS: In vitro experiments: Cultured, rat DRG were randomly assigned to control or laser treatment (LT) groups with different irradiation times (2, 5, 30, 60, or 120 seconds)...
January 11, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28074495/comparison-of-medicaid-payments-relative-to-medicare-using-inpatient-acute-care-claims-from-the-medicaid-program-fiscal-year-2010-fiscal-year-2011
#16
Devin A Stone, Bridget A Dickensheets, John A Poisal
OBJECTIVE: To compare Medicaid fee-for-service (FFS) inpatient hospital payments to expected Medicare payments. DATA SOURCES: Medicaid and Medicare claims data, Medicare's MS-DRG grouper and inpatient prospective payment system pricer (IPPS pricer). STUDY DESIGN: Medicaid FFS inpatient hospital claims were run through Medicare's MS-DRG grouper and IPPS pricer to compare Medicaid's actual payment against what Medicare would have paid for the same claim...
January 10, 2017: Health Services Research
https://www.readbyqxmd.com/read/28073317/activation-of-kcnq-channels-suppresses-spontaneous-activity-in-drg-neurons-and-reduces-chronic-pain-after-spinal-cord-injury
#17
Zizhen Wu, Lin Li, Fuhua Xie, Junhui Du, Yan Zuo, Jeffrey A Frost, Susan M Carlton, Edgar T Walters, Qing Yang
A majority of people who have sustained spinal cord injury (SCI) experience chronic pain after injury, and this pain is highly resistant to available treatments. Contusive SCI in rats at T10 results in hyperexcitability of primary sensory neurons, which contributes to chronic pain. KCNQ channels are widely expressed in nociceptive dorsal root ganglion (DRG) neurons, are important for controlling their excitability, and their activation has proven effective in reducing pain in peripheral nerve injury and inflammation models...
January 10, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28070856/mir-29c-prkci-regulates-axonal-growth-of-dorsal-root-ganglia-neurons-under-hyperglycemia
#18
Longfei Jia, Lei Wang, Michael Chopp, Chao Li, Yi Zhang, Alexandra Szalad, Zheng Gang Zhang
Diabetes initially induces distal axonal damage of peripheral nerves, but molecular mechanisms that mediate axonal injury are not fully understood. MircoRNAs (miRNAs) regulate axonal growth. We found that diabetic db/db mice exhibited substantial upregulation of miR-29c in dorsal root ganglia (DRG) neurons, sciatic nerve, and foot pad tissues. Bioinformatic analysis revealed PRKCI, a gene that encodes a member of the protein kinase C (PKC) iota, as a putative target for miR-29c. Western blot analysis showed that diabetic mice exhibited a considerable reduction of PRKCI protein levels in sciatic nerve tissues and DRG neurons...
January 9, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28069923/map7-regulates-axon-collateral-branch-development-in-dorsal-root-ganglia-neurons
#19
Stephen R Tymanskyj, Benjamin Yang, Aditi Falnikar, Angelo C Lepore, Le Ma
: Collateral branches from axons are key components of functional neural circuits that allow neurons to connect with multiple synaptic targets. Like axon growth and guidance, formation of collateral branches depends on the regulation of microtubules, but how such regulation is coordinated to ensure proper circuit development is not known. Based on microarray analysis, we have identified a role for microtubule-associated protein 7 (MAP7) during collateral branch development of dorsal root ganglia (DRG) sensory neurons...
January 9, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28065732/a317491-relieved-hiv-gp120-associated-neuropathic-pain-involved-in-p2x3-receptor-in-dorsal-root-ganglia
#20
Zhihua Yi, Shenqiang Rao, Shuai Ouyang, Yi Bai, Jinpu Yang, Yucheng Ma, Xinyao Han, Bing Wu, Lifang Zou, Tianyu Jia, Shanhong Zhao, Xiaju Hu, Qiongqiong Lei, Yun Gao, Shuangmei Liu, Hong Xu, Chunping Zhang, Shangdong Liang, Guilin Li
Glycoprotein 120 (gp120) is an HIV envelope glycoprotein. Gp120 can directly stimulate the primary sensory afferent neurons and cause hyperalgesia. The P2X3 receptor in dorsal root ganglia (DRG) is involved in the transmission of pain. In this study, we aimed to explore the role of the P2X3 receptor in gp120-induced neuropathic pain. Our data showed that mechanical and thermal hyperalgesia in rats treated with gp120 were increased compared to those in the control group. The expression levels of the P2X3 mRNA and protein in rats treated with gp120 were higher than those in the control group...
January 5, 2017: Brain Research Bulletin
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