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https://www.readbyqxmd.com/read/27930278/for-love-not-money-the-financial-implications-of-surgical-fellowship-training
#1
Paul M Inclan, Adam S Hyde, Michael Hulme, Jeffrey E Carter
Surgical residents cite increased income potential as a motivation for pursuing fellowship training, despite little evidence supporting this perception. Thus, our goal is to quantify the financial impact of surgical fellowship training on financial career value. By using Medical Group Management Association and Association of American Medical Colleges physician income data, and accounting for resident salary, student debt, a progressive tax structure, and forgone wages associated with prolonged training, we generated a net present value (NPV) for both generalist and subspecialist surgeons...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27927516/preoperative-mrsa-screening-in-pediatric-spine-surgery-a-helpful-tool-or-a-waste-of-time-and-money
#2
Scott J Luhmann, June C Smith
OBJECTIVES: To review the use of preoperative screening for Staphylococcus aureus for all pediatric spine procedures that was instituted at our facility in a multimodal approach to decrease the frequency of postoperative wound infections. SUMMARY OF BACKGROUND DATA: Four years ago at our facility, a multimodal approach to decrease the frequency of postoperative infections after pediatric spine surgery was instituted. METHODS: A single-center, single-surgeon pediatric spine surgery database was queried to identify all patients who had preoperative S...
July 2016: Spine Deformity
https://www.readbyqxmd.com/read/27927504/does-the-type-of-metal-instrumentation-affect-the-risk-of-surgical-site-infection-in-pediatric-scoliosis-surgery
#3
Margaret L Wright, David L Skaggs, Hiroko Matsumoto, Regina P Woon, Ashley Trocle, John M Flynn, Michael G Vitale
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To determine the association of implant metal composition with the risk of surgical site infection (SSI) following pediatric spine surgery. SUMMARY OF BACKGROUND DATA: SSI is a well-described complication following pediatric spine surgery. Many risk factors have been identified in the literature, but controversy remains regarding metal composition as a risk factor. METHODS: This was a retrospective study of patients who underwent posterior spinal instrumentation procedures between January 1, 2006, and December 31, 2008, at three large children's hospitals for any etiology of scoliosis and had at least 1 year of postoperative follow-up...
May 2016: Spine Deformity
https://www.readbyqxmd.com/read/27923375/the-surgical-strategy-for-eosinophilic-granuloma-of-the-pediatric-cervical-spine-complicated-with-neurologic-deficit-and-or-spinal-instability
#4
Nanzhe Zhong, Wei Xu, Tong Meng, Xinghai Yang, Wangjun Yan, Jianru Xiao
BACKGROUND: Various therapeutic approaches have been proposed for the treatment of pediatric patients with eosinophilic granuloma (EG) of the cervical spine. Our aim was to discuss and present our experience with the individualized surgical intervention of pediatric cervical EG complicated with neurologic deficits and/or spinal instability. METHODS: We retrospectively analyzed the clinical data of 19 children who were diagnosed with cervical EG comor spinal/or spinal instability (evaluated by the Spinal Instability Neoplastic Score, SINS ≥ 7) and treated surgically in our institution...
December 7, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27919406/pediatric-surgical-readmissions-are-they-truly-preventable
#5
Erin G Brown, Jamie E Anderson, Debra Burgess, Richard J Bold, Diana L Farmer
BACKGROUND/PURPOSE: Reimbursement penalties for excess hospital readmissions have begun for the pediatric population. Therefore, research determining incidence and predictors is critical. METHODS: A retrospective review of University HealthSystem Consortium database (N=258 hospitals; 2,723,621 patients) for pediatric patients (age 0-17years) hospitalized from 9/2011 to 3/2015 was performed. Outcome measures were 7-, 14-, and 30-day readmission rates. Hospital and patient characteristics were evaluated to identify predictors of readmission...
October 28, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27857788/ultrasonography-and-magnetic-resonance-imaging-evaluation-of-pediatric-spinal-anomalies
#6
Dhaval Durlabhbhai Dhingani, Deb Kumar Boruah, Hemonta Kumar Dutta, Rudra Kanta Gogoi
CONTEXT: Spinal dysraphisms are congenital abnormalities of the spine due to imperfect fusion of midline mesenchymal, bony and neural structures. Imaging plays a vital role in their evaluation as significant portion of patients may present with concurrent anomalies that need to be corrected simultaneously to avoid repeat surgeries. AIMS: The aims of the study were to evaluate Spinal dysraphisms using USG and MRI and to correlate imaging findings with operative findings in patients undergoing surgery...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27836772/return-to-play-in-athletes-with-spinal-cord-concussion-a-systematic-literature-review
#7
REVIEW
Narihito Nagoshi, Lindsay Tetreault, Hiroaki Nakashima, Aria Nouri, Michael G Fehlings
STUDY DESIGN: Systematic review OBJECTIVE: To evaluate whether spinal cord concussion (SCC) patients can safely return to play sports and if there are factors that can predict SCC recurrence or development of a spinal cord injury (SCI). SUMMARY OF BACKGROUND DATA: Although SCC is a reversible neurologic disturbance of spinal cord function, its management and the implications for return to play controversial. METHODS: We conducted a systematic search of the literature using keywords Cervical Spine AND Sports AND Injuries in six databases...
November 8, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27833778/magnetic-resonance-imaging-analysis-of-caudal-regression-syndrome-and-concomitant-anomalies-in-pediatric-patients
#8
Deb K Boruah, Dhaval D Dhingani, Sashidhar Achar, Arjun Prakash, Antony Augustine, Shantiranjan Sanyal, Manoj Gogoi, Kangkana Mahanta
OBJECTIVE: The aim of this study was to evaluate the magnetic resonance imaging (MRI) findings of caudal regression syndrome (CRS) and concomitant anomalies in pediatric patients. MATERIALS AND METHODS: A hospital-based cross-sectional retrospective study was conducted. The study group comprised 21 pediatric patients presenting to the Departments of Radiodiagnosis and Pediatric Surgery in a tertiary care hospital from May 2011 to April 2016. All patients were initially evaluated clinically followed by MRI...
2016: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/27792108/efficacy-of-intraoperative-neurophysiologic-monitoring-for-pediatric-cervical-spine-surgery
#9
Daniel G Tobert, Michael P Glotzbecker, M Timothy Hresko, Lawrence I Karlin, Mark R Proctor, John B Emans, Patricia E Miller, Daniel J Hedequist
STUDY DESIGN: Clinical case series OBJECTIVE.: To investigate the efficacy of intraoperative neuromonitoring in pediatric cervical spine surgery SUMMARY OF BACKGROUND DATA.: Intraoperative neuromonitoring (IONM) consisting of somatosensory evoked potentials (SSEP) and transcranial motor evoked potentials (tcMEP) has been shown to effectively prevent permaneny neurologic injury in deformity surgery. The role of IONM during pediatric cervical spine surgery is not well documented. Advances in cervical spine instrumentation have expanded the surgical options in pediatric populations...
October 25, 2016: Spine
https://www.readbyqxmd.com/read/27785761/using-physiological-monitoring-data-for-performance-feedback-an-initiative-using-thermoregulation-metrics
#10
Matthias Görges, Nicholas C West, Simon D Whyte
BACKGROUND: Feedback of performance data can improve professional practice and outcomes. Vital signs are not routinely used for quality improvement because of their limited access. Intraoperative hypothermia has been associated with deleterious effects, including surgical site infections and bleeding. We speculated that providing feedback could help keep temperature monitoring and management a priority in the anesthesiologist's mind, thereby improving perioperative temperature management...
October 26, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27761411/30-months-follow-up-of-an-early-enzyme-replacement-therapy-in-a-severe-morquio-a-patient-about-one-case
#11
J Do Cao, A Wiedemann, T Quinaux, S F Battaglia-Hsu, L Mainard, R Froissart, C Bonnemains, S Ragot, B Leheup, P Journeau, F Feillet
: Patients under 5 years were not evaluated in the phase-3 study for enzyme replacement therapy (ERT) in MPS IV A. Here we describe the evolution of a severe Morquio A pediatric patient who was diagnosed at 19 months old and treated by ERT at 21 months old for the next 30 months. Applying the standard ERT protocol on this very young patient appeared to reduce his urinary excretion of glycosaminoglycans (GAGs); the improvements in both the 6 minute-walk test (6MWT) and the stair climb test, however, were no different than those reported in the nature history study...
December 2016: Molecular Genetics and Metabolism Reports
https://www.readbyqxmd.com/read/27686572/fractures-of-the-axis-a-review-of-pediatric-adult-and-geriatric-injuries
#12
REVIEW
Megan E Gornet, Michael P Kelly
Fractures of the second cervical vertebra (C2, axis) are common in adult spine surgery. Those fractures occurring in younger adult patients are often associated with high-energy mechanism trauma, resulting in a "Hangman's Fracture." Management of these fractures is often successful with nonoperative means, though surgery may be needed in those fractures with greater displacement and injury to the C2-C3 disc. Older patients are more likely to sustain fractures of the odontoid process. The evidence supporting surgical management of these fractures is evolving, as there may be a mortality benefit to surgery...
December 2016: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/27683698/kyphotic-deformity-after-laminectomy-surgery-for-a-gunshot-wound-to-the-spine-a-case-report
#13
Ali Babashahi, Morteza Taheri
Spinal kyphotic deformity after spinal laminectomy or laminoplasty is more common in pediatric patients than adults. Laminectomy can lead to decreased cartilage growth, anterior wedging and posterior spinal muscle insufficiency which can result in kyphotic deformity. Herein we outline a case report of a child presenting with kyphotic deformity after receiving a spinal laminectomy to treat a penetrating spinal trauma. The 8-year-old male presented with penetrating spinal trauma following a gunshot wound and subsequently underwent L1 laminectomy and thecal sac decompression to remove the foreign body...
March 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27683689/bone-morphogenetic-protein-in-pediatric-spine-fusion-surgery
#14
REVIEW
Robert W Molinari, Christine Kerr, Danielle Kerr
BACKGROUND: There is a paucity of literature describing the use of bone graft substitutes to achieve fusion in the pediatric spine. Outcomes and complications involving the off-label use of bone morphogenetic protein 2 (BMP-2) in the pediatric spine are not clearly defined. The purpose of this study is to review the existing literature with respect to reported outcomes and complications involving the use of low-dose BMP-2 in pediatric patients. METHODS: A Medline and PubMed literature search was conducted using the words bone morphogenetic protein, BMP, rh-BMP-2, bone graft substitutes, and pediatric spine...
March 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27603188/does-reoperation-risk-vary-for-different-types-of-pediatric-scoliosis
#15
Justin C Paul, Baron S Lonner, Shaleen Vira, David Feldman, Thomas J Errico
STUDY DESIGN: Retrospective cohort study of spine fusion surgery utilizing the New York State Inpatient Database. OBJECTIVE: The objective was to determine whether there were differences in reoperation rates among pediatric scoliosis associated with various etiologies compared with idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: The incidence of postoperative complications and reoperations is known to vary among patients with diverse scoliosis pathologies...
September 3, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27603185/use-of-patient-reported-outcome-measures-in-pediatric-orthopaedic-literature
#16
Lisa Phillips, Sasha Carsen, Anisha Vasireddi, Kishore Mulpuri
BACKGROUND: Patient-reported outcomes are increasingly used as primary measures of success and impact of health care services. There is no current consensus on the efficacy of functional health status (FHS) or health-related quality of life (HRQoL) evaluation in pediatric orthopaedic surgery. The purpose of this study was to quantify and characterize the use of such patient-reported outcomes in the pediatric orthopaedic literature over the last several years. METHODS: A cross-sectional review of 6 orthopaedic journals-Journal of Bone and Joint Surgery, Bone and Joint Journal, Spine, Journal of Pediatric Orthopaedics A, Journal of Pediatric Orthopaedics B, and Journal of Children's Orthopaedics, was conducted by 2 independent reviewers...
September 3, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27590862/management-and-outcome-of-chordomas-in-the-pediatric-population-the-hospital-for-sick-children-experience-and-review-of-the-literature
#17
Vassilios Tsitouras, Shelly Wang, Peter Dirks, James Drake, Eric Bouffet, Cynthia Hawkins, Suzanne Laughlin, James T Rutka
Chordomas are tumors arising from remnants of the embryological notochord, most commonly found in the spheno-occipital, spinal, or sacro-coccygeal areas. They are rare tumors in the pediatric population and are challenging to manage due to their difficult accessibility, proximity to important anatomy and extension into adjacent structures. We report a series of 10 children treated for chordoma at The Hospital for Sick Children focusing on their surgery, adjuvant therapy and long-term outcomes. A retrospective review involving patient charts, radiographic imaging, and pathology slides was performed for 10 chordoma patients during the period from 1987-2015...
December 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27564793/perioperative-vision-loss-in-spine-surgery-and-other-orthopaedic-procedures
#18
Alvin W Su, Shuai-Chun Lin, A Noelle Larson
Perioperative vision loss is a rare complication of orthopaedic surgery and has been documented after spine, knee, hip, and shoulder procedures. It is associated with several ophthalmologic diagnoses, most commonly ischemic optic neuropathy. Although the pathophysiology remains unclear, current evidence suggests that systemic hemodynamic compromise and altered balance of intraocular perfusion contribute to the development of ischemic optic neuropathy. Although vision recovery has been reported, the prognosis of perioperative vision loss is poor, and no proven effective treatment is available...
October 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27530889/validation-of-an-inanimate-low-cost-model-for-training-minimal-invasive-surgery-mis-of-esophageal-atresia-with-tracheoesophageal-fistula-ae-tef-repair
#19
Maximiliano Alejo Maricic, María Marcela Bailez, Susana P Rodriguez
UNLABELLED: We present the results of the validation of an inanimate model created for training thoracoscopic treatment of esophageal atresia with lower tracheoesophageal fistula (EA/TEF). MATERIALS AND METHODS: We used different domestic materials such as a piece of wood (support), corrugated plastic tubes (PVC) of different sizes to simulate ribs, intercostal spaces, trachea and spine and tubular latex balloons to simulate the esophagus and lungs to make the basic model...
September 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27499651/new-developments-in-the-treatment-of-early-onset-spinal-deformity-role-of-the-shilla-growth-guidance-system
#20
REVIEW
Sean M Morell, Richard E McCarthy
Early-onset scoliosis is a complex condition with multiple facets. The goal of treating any spinal deformity is to improve the condition of the patient with the least intervention necessary. A system that allows for continuation of natural spinal growth while correcting the deformity should be the goal of treating this complex condition. The SHILLA growth guidance system allows for continued growth of the pediatric spine while correcting and guiding the apex and guiding the future growth of the curvature. The system involves selective fusion across the apex of the curvature, and minimally invasive instrumentation is then used above and below the apex to allow for continued growth of the spine...
2016: Medical Devices: Evidence and Research
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