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https://www.readbyqxmd.com/read/28643062/loss-of-medicaid-insurance-after-successful-bariatric-surgery-an-unintended-outcome
#1
J Hunter Mehaffey, Eric J Charles, Irving L Kron, Bruce Schirmer, Peter T Hallowell
BACKGROUND: Bariatric surgery leads to dramatic weight loss and improved overall health, which may affect insurance status for certain patients. Traditional Medicaid provides coverage for children, pregnant women, and disabled adults, while expanded Medicaid provides insurance coverage to all adults with incomes up to 138% of the federal poverty level. We hypothesized that successful bariatric surgery would lead to improved health status but an unintended loss of Medicaid coverage. METHODS: All patients who underwent bariatric surgery at a single institution in a non-expansion state from 1985 through 2015 were identified using a prospectively collected database...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28636506/incidence-and-predictors-of-atrial-fibrillation-after-coronary-artery-bypass-surgery-detection-by-event-loop-recorder-monitoring-from-a-contemporary-multicentre-cohort
#2
Zainab Abdel-Salam, Wail Nammas
Background Atrial fibrillation (AF) is a frequent complication after cardiac surgery. We explored the incidence and predictors of post-operative AF at 30-day follow-up in an unselected multi-centre cohort of patients undergoing elective coronary artery bypass grafting (CABG) in contemporary practice. Methods and results We enrolled 740 consecutive patients scheduled for elective CABG with or without valve surgery. Cardiac rhythm was continuously monitored for 15 days after surgery by an ambulatory event loop recorder...
March 21, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28633782/factors-predicting-length-of-hospital-stay-and-extended-care-facility-admission-after-hindfoot-arthrodesis-procedures
#3
Jacob Deister, Brian G Cothern, Chad Williams, Andrew W Froehle, Richard T Laughlin
Delayed identification of patients requiring admission to extended care facilities (ECFs) can lead to greater healthcare costs through an increased length of hospital stay (LOHS). Previous studies of hip and knee arthroplasty identified factors associated with a likely discharge to an ECF. These issues have not been extensively studied for major hindfoot procedures. We conducted a retrospective review of 198 cases treated during a 3-year period to identify the risk factors for an extended LOHS and ECF admission after ankle arthrodesis, triple arthrodesis, pantalar arthrodesis, and subtalar arthrodesis...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28632560/preoperative-depression-smoking-and-employment-status-are-significant-factors-in-patient-satisfaction-after-lumbar-spine-surgery
#4
Laura Chapin, Kelly Ward, Timothy Ryken
STUDY DESIGN: Prospective cohort study. OBJECTIVE: To determine whether comorbidities and demographics, identified preoperatively, can impact patient outcomes and satisfaction after lumbar spine surgery. SUMMARY OF BACKGROUND DATA: The surgical treatment of lower back pain does not always eliminate a patient's pain and symptoms. Revision surgeries are costly and expose the patient to additional risk. We aim to identify patient characteristics that may suggest a greater or lesser likelihood of postsurgical success by examining patient-reported measures and outcomes after surgery...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28630035/the-effects-of-preoperative-volume-replacement-in-diabetic-patients-undergoing-coronary-artery-bypass-grafting-surgery-protocol-for-a-randomized-controlled-trial-verdict-trial
#5
Madeleine Clout, Tracy Harris, Chris Rogers, Lucy Culliford, Jodi Taylor, Gianni Angelini, Pradeep Narayan, Barnaby Reeves, James Hillier, Kate Ashton, Kunal Sarkar, Raimondo Ascione
BACKGROUND: Diabetes mellitus is a major risk factor for prolonged hospital stays, renal failure, and mortality in patients having coronary artery bypass grafting (CABG). Complications pose a serious threat to patients and prolong intensive care and hospital stays. Low glomerular filtration rate (GFR) due to existing renal impairment or volume depletion may exacerbate acute renal impairment/failure in these patients. Preoperative volume replacement therapy (VRT) is reported to increase the GFR and we hypothesize that VRT will reduce renal impairment and related complications in diabetic patients...
June 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28625949/discussion-on-the-risk-factors-of-developing-cardiovascular-diseases-cvd-after-the-kidney-transplantation
#6
Kai Wang, Qing-Shan Qu, Shu-Zhai Miao, Yanxuan Zhang, Xin Jing
To discuss the risk factors of developing cardiovascular disease (CVD) after the kidney transplantation. Retrospective analysis on the data of 1106 patients who had been underwent kidney allotransplantation in People's Hospital of Zhengzhou from July, 2010 to Dec, 2014 and conformed to the inclusion criteria was taken. Cox proportional hazard model was used to analyze the risk factors of developing CVD after the kidney transplantation. 7 days, 1 month, 3 months, 6 months and 12 months before and after the operation, the data collection and following-up visits were respectively arranged...
January 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28625238/-risk-factors-of-perioperative-intra-aortic-balloon-pump-complications-in-cardiac-surgery-a-12-year-single-institution-analysis
#7
Hongyan Zhou, Yonghui Zhang, Yu Du, Fangfang Cao, Ji Wang, Li Zhao, Yu Nie, Haitao Zhang
OBJECTIVE: To investigate the incidence and risk factors of the complications in perioperative intra-aortic balloon pump (IABP) supported cardiac surgical patients. METHODS: The clinical data of adult cardiac surgery patients undergoing IABP in Fuwai Hospital from January 2005 to January 2017 were enrolled. The patients were divided into complications group and no complications group. Demographic characteristics, diagnosis, perioperative clinical parameters, IABP related data, and IABP complications (including ischemia, bleeding, vascular injury and mechanical problems) were collected...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28620753/population-pharmacokinetics-of-cyclosporine-a-in-japanese-renal-transplant-patients-comprehensive-analysis-in-a-single-center
#8
Akira Okada, Hidetaka Ushigome, Misaki Kanamori, Aya Morikochi, Hidefumi Kasai, Tadashi Kosaka, Takatoshi Kokuhu, Asako Nishimura, Nobuhito Shibata, Keizo Fukushima, Norio Yoshimura, Nobuyuki Sugioka
PURPOSE: Cyclosporine A (CyA), a potent immunosuppressive agent used in renal transplantation, has a narrow therapeutic window and a large variability in blood concentrations. This study aimed to develop a population pharmacokinetic (PPK) model of CyA in living-donor renal transplant patients at a single center and identify factors influencing CyA pharmacokinetics (PK). METHODS: A total of 660 points (preoperative) and 4785 points (postoperative) of blood concentration data from 98 patients who underwent renal transplantation were used...
June 15, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28618390/thirty-day-non-seizure-outcomes-following-temporal-lobectomy-for-adult-epilepsy
#9
Brandon A Sherrod, Matthew C Davis, Kristen O Riley
OBJECTIVE: Multi-institutional rates of acute adverse outcomes other than seizures after temporal lobectomy (TL) are not well understood. Here we analyzed short-term morbidity and mortality following TL using a validated national database. PATIENTS AND METHODS: The multi-institutional American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was queried by Current Procedural Terminology (CPT) code for TL procedures performed for adult patients with diagnoses related to epilepsy from 2008 to 2014...
June 8, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28613217/macular-edema-after-cataract-surgery-in-eyes-with-preoperative-retinal-vein-occlusion
#10
Han Joo Cho, Hyun Ji Hwang, Hyoung Seok Kim, Dong Won Lee, Chul Gu Kim, Byoung Yeop Kim, Jong Woo Kim
PURPOSE: To evaluate the incidence of pseudophakic macular edema (PME) in eyes with a history of retinal vein occlusion before cataract surgery and to identify any associated risk factors. METHODS: The records of 21,332 eyes that underwent cataract surgery were retrospectively reviewed. Eyes that had retinal vein occlusion preoperatively with no evidence of macular pathology on optical coherence tomography at the time of surgery and no macular edema treatment at least 6 months before surgery were included...
May 2, 2017: Retina
https://www.readbyqxmd.com/read/28612915/how-to-predict-the-risk-of-postoperative-complications-after-coronary-artery-bypass-grafting-in-patients-under-50-and-over-80-years-old-a-retrospective-cross-sectional-study
#11
Jacek Piątek, Anna Kędziora, Grzegorz Kiełbasa, Marta Olszewska, Dorota Sobczyk, Bryan HyoChan Song, Janusz Konstanty-Kalandyk, Tomasz Darocha, Karol Wierzbicki, Irena Milaniak, Krzysztof Wróbel, Bogusław Kapelak
BACKGROUND: Coronary artery disease (CAD) remains the leading cause of death in developed countries and there is an increasing number of both young and elderly patients requiring surgical treatment. Despite improvement of conventional risk stratification scores (EuroSCORE II, STS risk score), all of the calculations are estimated based on the typical population and the studies emphasize that the scales may need further investigation and modernization, as demographic changes of the population suffering from CAD are unavoidable...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28605474/digital-innovations-and-emerging-technologies-for-enhanced-recovery-programmes
#12
F Michard, T J Gan, H Kehlet
Enhanced recovery programmes (ERPs) are increasingly used to improve post-surgical recovery. However, compliance to various components of ERPs-a key determinant of success-remains sub-optimal. Emerging technologies have the potential to help patients and caregivers to improve compliance with ERPs.Preoperative physical condition, a major determinant of postoperative outcome, could be optimized with the use of text messages (SMS) or digital applications (Apps) designed to facilitate smoking cessation, modify physical activity, and better manage hypertension and diabetes...
June 9, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28605469/surgical-ablation-for-persistent-atrial-fibrillation-in-concomitant-cardiac-surgery-mid-long-term-result%C3%A2
#13
Wenda Gu, Huiming Guo, Cong Lu, Huanlei Huang, Jing Liu, Jian Liu, Bin Xie, Ruobin Wu, Jimei Chen, Jian Zhuang
OBJECTIVES: Surgical ablation is an option for patients with atrial fibrillation (AF) undergoing concomitant cardiac surgery. This study aims to evaluate the outcome of surgical ablation during concomitant cardiac surgery and to identify the independent predictors for a primary end-point consisting of AF or atrial flutter (AFL) recurrence, death, permanent pacemaker implantation and necessity for anti-arrhythmic drugs and the effects of reintervention for AF/AFL recurrence. METHODS: A retrospective analysis was performed for 1028 patients who underwent surgical ablation during concomitant cardiac surgery from October 2004 to April 2015...
June 12, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28604415/sarcopenia-is-a-predictor-of-surgical-morbidity-in-inflammatory-bowel-disease
#14
Mark Pedersen, John Cromwell, Peter Nau
BACKGROUND: Sarcopenia is associated with an increased risk of operative morbidity and mortality. The impact of sarcopenia in inflammatory bowel disease (IBD) has not been evaluated. This study assessed the role of sarcopenia on operative outcomes in IBD. METHODS: A retrospective review of American College of Surgeons National Surgical Quality Improvement Program data of patients with IBD was completed. Records were abstracted for comorbidities and perioperative complications...
June 9, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28603408/efficacy-of-nepafenac-ophthalmic-suspension-0-1-in-improving-clinical-outcomes-following-cataract-surgery-in-patients-with-diabetes-an-analysis-of-two-randomized-studies
#15
Rishi P Singh, Giovanni Staurenghi, Ayala Pollack, Adeniyi Adewale, Thomas M Walker, Dana Sager, Robert Lehmann
OBJECTIVE: To assess the efficacy of nepafenac 0.1% ophthalmic suspension in improving the clinical outcomes following cataract surgery (CS) in patients with nonproliferative diabetic retinopathy. METHODS: In two similar multicenter, randomized studies, patients received either nepafenac 0.1% or vehicle, instilled three times daily starting a day prior to surgery and continuing for 90 days postoperatively. A post hoc analysis of these two studies was conducted to assess 1) the likelihood for development of postoperative macular edema (ME), based on the percentage of patients who developed ME (≥30% increase from preoperative baseline in central subfield macular thickness) within 90 days following CS and 2) best-corrected visual acuity (BCVA) endpoints, including the percentage of patients with a BCVA improvement of ≥15 letters from preoperative baseline to Day 14 and maintained through Day 90...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/28601567/impact-of-evidence-based-interventions-on-wound-complications-after-cesarean
#16
Lorene A Temming, Nandini Raghuraman, Ebony B Carter, Molly J Stout, Roxane M Rampersad, George A Macones, Alison G Cahill, Methodius G Tuuli
BACKGROUND: A number of evidence-based interventions have been proposed to reduce post cesarean wound complications. Examples of such interventions include appropriate timing of preoperative antibiotics, appropriate choice of skin antisepsis, closure of the subcutaneous layer if subcutaneous depth is ≥ 2 cm, and subcuticular skin closure with suture rather than staples. However, the collective impact of these measures is unclear. OBJECTIVE: We sought to estimate the impact of a group of evidence-based surgical measures (prophylactic antibiotics administered prior to skin incision, chlorhexidine-alcohol for skin antisepsis, closure of subcutaneous layer, and subcuticular skin closure with suture) on wound complications after cesarean, and to estimate residual risk factors for wound complications...
June 7, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28601329/predictors-of-readmission-in-nonagenarians-analysis-of-the-american-college-of-surgeons-national-surgical-quality-improvement-project-dataset
#17
Zachary Hothem, Dustin Baker, Christina S Jenkins, Jason Douglas, Rose E Callahan, Catherine C Shuell, Graham W Long, Robert J Welsh
BACKGROUND: Increased longevity has led to more nonagenarians undergoing elective surgery. Development of predictive models for hospital readmission may identify patients who benefit from preoperative optimization and postoperative transition of care intervention. Our goal was to identify significant predictors of 30-d readmission in nonagenarians undergoing elective surgery. METHODS: Nonagenarians undergoing elective surgery from January 2011 to December 2012 were identified using the American College of Surgeons National Surgical Quality Improvement Project participant use data files...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601250/efficacy-safety-and-risk-factors-for-failure-of-standalone-ab-interno-gelatin-microstent-implantation-versus-standalone-trabeculectomy
#18
Matthew B Schlenker, Husayn Gulamhusein, Ina Conrad-Hengerer, Alix Somers, Markus Lenzhofer, Ingeborg Stalmans, Herbert Reitsamer, Fritz H Hengerer, Iqbal Ike K Ahmed
PURPOSE: To compare the efficacy, safety, and risk factors for failure of standalone ab interno gelatin microstent implantation with mitomycin C (MMC) versus trabeculectomy with MMC. DESIGN: International, multicenter, retrospective interventional cohort study. PARTICIPANTS: Three hundred fifty-four eyes of 293 patients (185 microstent and 169 trabeculectomy) with no prior incisional surgery. METHODS: Consecutive eyes with uncontrolled glaucoma underwent microstent or trabeculectomy surgery from January 1, 2011 through July 31, 2015 at 4 academic ophthalmology centers: Toronto, Canada; Frankfurt, Germany; Salzburg, Austria; and Leuven, Belgium...
June 7, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28596920/patient-factors-predicting-weight-loss-after-roux-en-y-gastric-bypass
#19
Linda Sillén, Ellen Andersson
OBJECTIVE: The purpose of this study was to identify preoperative factors predicting weight loss following Roux-en-Y gastric bypass (RYGB) surgery. MATERIAL AND METHODS: 281 patients subjected to RYGB between January 2006 and June 2012 were included. Demographic, physical, and socioeconomic factors were assessed with regression analysis. Dependent variable was percent of excess weight loss (% EWL) at follow-up. RESULTS: Follow-up data at one year was available in 96%, at two years in 88%, and at three years in 65% of the patients...
2017: Journal of Obesity
https://www.readbyqxmd.com/read/28593552/a-reformed-surgical-treatment-modality-for-children-with-giant-cystic-craniopharyngioma
#20
Wanchun Zhu, Xiang Li, Jintao He, Tao Sun, Chunde Li, Jian Gong
OBJECTIVE: Surgical removal plays an important role in treating children's craniopharyngioma. For a safe and minimally invasive craniotomy, a reformed surgical modality was proposed in this paper by combining the insertion of an Ommaya reservoir system (ORS) by stereotactic puncture, aspiration of cystic fluid in 2-day interval for consecutive 7-10 days, and the delayed tumor resection. PATIENTS AND METHODS: Eleven patients (aged from 5 to 9 years old) with giant cystic craniopharyngiomas who had undergone the reformed surgical modality during November 2014 and December 2015 were collected as group A...
June 7, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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