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Costs of surgery

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https://www.readbyqxmd.com/read/28333337/tubal-anastomosis-after-previous-sterilization-a-systematic-review
#1
Jacoba A H van Seeters, Su Jen Chua, Ben W J Mol, Carolien A M Koks
BACKGROUND: Female sterilization is one of the most common contraceptive methods. A small number of women, however, opt for reversal of sterilization procedures after they experience regret. Procedures can be performed by laparotomy or laparoscopy, with or without robotic assistance. Another commonly utilized alternative is IVF. The choice between surgery and IVF is often influenced by reimbursement politics for that particular geographic location. OBJECTIVE AND RATIONALE: We evaluated the fertility outcomes of different surgical methods available for the reversal of female sterilization, compared these to IVF and assessed the prognostic factors for success...
February 22, 2017: Human Reproduction Update
https://www.readbyqxmd.com/read/28332105/emergency-department-burden-of-diverticulitis-in-the-usa-2006-2013
#2
Andrea Bollom, Jasmine Austrie, William Hirsch, Judy Nee, Daniel Friedlander, Kelli Ellingson, Vivian Cheng, Anthony Lembo
GOALS: The aim of this study was to analyze recent trends in emergency department (ED) visits for diverticulitis between 2006 and 2013. BACKGROUND: Acute diverticulitis is a serious medical condition that frequently leads to ED visits, hospitalizations, and surgeries resulting in a significant health care burden. METHODS: Data were obtained from the National Emergency Department Sample (NEDS) records in which diverticulitis (ICD-9-CM codes 562...
March 22, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28332061/tutorial-assistance-for-board-certification-in-surgery-frequency-associated-time-and-cost
#3
Robert Mechera, Salome Dell-Kuster, Marco von Strauss Und Torney, Igor Langer, Markus Furrer, Heiner C Bucher, Rachel Rosenthal
BACKGROUND: Tutorial assistance is related to extra time and cost, and the hospitals' financial compensation for this activity is under debate. We therefore aimed at quantifying the extra time and resulting cost required to train one surgical resident in the operating theatre for board certification in Switzerland as an example of a training curriculum involving several surgical subspecialties. Additionally, we intended to quantify the percentage of tutorial assistance. METHODS: We analysed 200,700 operations carried out between 2008 and 2012...
March 22, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28331952/diagnostic-strategies-for-posttraumatic-osteomyelitis-a-survey-amongst-dutch-medical-specialists-demonstrates-the-need-for-a-consensus-protocol
#4
G A M Govaert, A W J M Glaudemans, J J W Ploegmakers, A R Viddeleer, K W Wendt, I H F Reininga
INTRODUCTION: Posttraumatic osteomyelitis (PTO) is a feared complication after surgical fracture care. Late diagnosis can result in interrupted and prolonged rehabilitation programmes, inability to work, medical dependency, unnecessary hospital admissions, and high medical and non-medical costs. Primary aim of this study was to assess preferred diagnostic imaging strategies for diagnosing PTO amongst orthopaedic and trauma surgeons, radiologists, and nuclear medicine physicians. Secondary aims were to determine the preferred serum inflammatory marker for diagnosing PTO and the existence of a local hospital protocol to diagnose and manage PTO...
March 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28331607/-simplified-international-recommendations-for-the-implementation-of-patient-blood-management-sir4pbm
#5
Patrick Meybohm, Bernd Froessler, Lawrence T Goodnough, Andrew A Klein, Manuel Muñoz, Michael F Murphy, Toby Richards, Aryeh Shander, Donat R Spahn, Kai Zacharowski
BACKGROUND: More than 30% of the world's population are anemic with serious medical and economic consequences. Red blood cell transfusion is the mainstay to correct anemia, but it is also one of the top five overused procedures and carries its own risk and cost burden. Patient blood management (PBM) is a patient-centered and multidisciplinary approach to manage anemia, minimize iatrogenic blood loss, and harness tolerance to anemia in an effort to improve patient outcome. Despite resolution 63...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28330800/tourniquet-and-closed-suction-drains-in-total-knee-arthroplasty-no-beneficial-effects-on-bleeding-management-and-knee-function-at-a-higher-cost
#6
David Yin, JoséeDelisle, AndreeaBanica, Andrea Senay, Pierre Ranger, G Yves Laflamme, Jiang Jun, Julio Fernandes
BACKGROUND: Blood loss is a major concern in total knee arthroplasty (TKA) along with postoperative knee function. The present study explores the impact of tourniquet (T) and closed-suction drains (D) on these parameters in TKA. MATERIALS AND METHODS: A prospective study was conducted on 111 patients admitted for TKA. Subjects were divided into three groups: 36 in group T+D+, 42 in T-D+ and 33 in T-D- (where T+: prolonged tourniquet use, T-: cementation-only tourniquet, D+: closed-suction drain use, and D-: no drain)...
March 19, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28329584/reusing-surgical-instruments-during-mohs-micrographic-surgery-safe-from-infection-but-not-free-from-risk
#7
Tatyana A Petukhova, Thomas H King, Kenny J Omlin, Daniel B Eisen
We report several scenarios of compromise in patient safety owing to the re-use of mis-assigned patient's surgical instruments in Mohs micrographic surgery.We discuss the breaks in universal protocols that others may experience in their practices and describe corrective measures that our institutions employed to avoid such future events.There is a lack of publication in the literature on the topic of mis-assigned instrument use in Mohs surgery. We believe that the  practice of re-using instruments is cost-effective and therefore common...
October 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28329352/costs-and-consequences-of-early-hospital-discharge-after-major-inpatient-surgery-in-older-adults
#8
Scott E Regenbogen, Anne H Cain-Nielsen, Edward C Norton, Lena M Chen, John D Birkmeyer, Jonathan S Skinner
Importance: As prospective payment transitions to bundled reimbursement, many US hospitals are implementing protocols to shorten hospitalization after major surgery. These efforts could have unintended consequences and increase overall surgical episode spending if they induce more frequent postdischarge care use or readmissions. Objective: To evaluate the association between early postoperative discharge practices and overall surgical episode spending and expenditures for postdischarge care use and readmissions...
March 22, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28328806/craniosynostosis-scheuermann-s-disease-and-intellectual-disability-resembling-shprintzen-goldberg-syndrome-a-report-on-a-family-over-4-generations-case-report
#9
Ali Al Kaissi, Zahra Marrakchi, Nabil M Nassib, Jochen Hofstaetter, Franz Grill, Rudolf Ganger, Susanne Gerit Kircher
RATIONALE: Craniosynostosis is a disorder characterized by premature fusion of cranial sutures with subsequent development of abnormal craniofacial contour associated with variable skeletal and extra-skeletal abnormalities. In this family syndromic type of craniosynostosis was recognized and the etiology behind diverse forms of deformities have been diagnosed. PATIENT CONCERNS: The negative impact of the disorder on the child and his family is enormous. Particularly when the diagnosis is late and little can be done...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328635/a-systematic-review-of-the-use-of-telemedicine-in-plastic-and-reconstructive-surgery-and-dermatology
#10
Krishna S Vyas, H Rhodes Hambrick, Afaaf Shakir, Shane D Morrison, Duy C Tran, Keon Pearson, Henry C Vasconez, Samir Mardini, Amanda A Gosman, Marek Dobke, Mark S Granick
BACKGROUND: Telemedicine, the use of information technology and telecommunication to provide healthcare at a distance, is a burgeoning field with applications throughout medicine. Given the visual nature of plastic surgery and dermatology, telemedicine has a myriad of potential applications within the field. METHODS: A comprehensive literature review of articles published on telemedicine since January 2010 was performed. Articles were selected for their relevance to plastic and reconstructive surgery and dermatology, and then reviewed for their discussion of the applications, benefits, and limitations of telemedicine in practice...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28328260/reducing-the-incidence-of-parastomal-hernia-with-a-simple-surgical-technique
#11
Kevin Heyles, Alex Almoudaris
The incidence of parastomal hernia is reported at between 10% and 50%. The development of a hernia after stoma surgery can lead to both physical and psychological problems and may reduce the individual's quality of life. Many garments and appliances are aimed at managing a stoma and a peri-stomal hernia. From a surgical perspective, to date there has been no real success in achieving a reduction in parastomal hernia incidence. The cost of managing a parastomal hernia is reported as being in excess of £1 million a year in England for non-surgical management alone...
March 9, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28327960/geographic-and-hospital-variation-in-cost-of-lumbar-laminectomy-and-lumbar-fusion-for-degenerative-conditions
#12
Corinna C Zygourakis, Caterina Y Liu, Glenn Wakam, Christopher Moriates, Christy Boscardin, Christopher P Ames, Praveen V Mummaneni, John Ratliff, R Adams Dudley, Ralph Gonzales
BACKGROUND: Spinal surgery costs vary significantly across hospitals and regions, but there is insufficient understanding of what drives this variation. OBJECTIVE: To examine the factors underlying the cost variation for lumbar laminectomy/discectomy and lumbar fusions. METHODS: We obtained patient information (age, gender, race, severity of illness, risk of mortality, population of county of residence, median zipcode income, insurance status, elective vs nonelective admission, length of stay) and hospital data (region, hospital type, bed size, wage index) for all patients who underwent lumbar laminectomy/discectomy (n = 181 267) or lumbar fusions (n = 433 364) for degenerative conditions in the 2001 to 2013 National Inpatient Sample database...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327930/the-use-of-vancomycin-powder-for-surgical-prophylaxis-following-craniotomy
#13
Vinod Ravikumar, Allen L Ho, Arjun V Pendhakar, Eric S Sussman, Kevin Kwong-Hon Chow, Gordon Li
BACKGROUND: Intrawound vancomycin powder has been studied extensively in spinal fusion surgeries and been found to reduce rates of surgical site infections (SSIs) significantly. Despite its success in spinal surgeries, topical vancomycin has not been extensively studied with respect to cranial neurosurgery. OBJECTIVE: To evaluate the efficacy of intrawound topical vancomycin for prevention of SSIs following open craniotomies. METHODS: We retrospectively analyzed a large series of 350 patients from 2011 to 2015 in a pre/postintervention study of use of topical vancomycin to reduce postoperative craniotomy infection rates...
January 25, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327904/the-cost-of-brain-surgery-awake-vs-asleep-craniotomy-for-perirolandic-region-tumors
#14
Chikezie I Eseonu, Jordina Rincon-Torroella, Karim ReFaey, Alfredo Quiñones-Hinojosa
BACKGROUND: Cost effectiveness has become an important factor in the health care system, requiring surgeons to improve efficacy of procedures while reducing costs. An awake craniotomy (AC) with direct cortical stimulation (DCS) presents one method to resect eloquent region tumors; however, some authors assert that this procedure is an expensive alternative to surgery under general anesthesia (GA) with neuromonitoring. OBJECTIVE: To evaluate the cost effectiveness and clinical outcomes between AC and GA patients...
March 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327417/appositional-bone-graft-tunneled-technical-note
#15
Roberto Almeida de Azevedo, Felipe Seoane Matos, Leonardo Morais Godoy Figueiredo
INTRODUCTION: A satisfactory positioning of the dental implants is very important in the cosmetic and functional outcome in this treatment for edentulous. Insertion of an endosseous implant in the correct positioning requires sufficient bone volume. Therefore, bone-grafting procedures are becoming increasingly common, especially for the augmentation of horizontally deficient ridges. PRESENTATION OF CASE: Many patients have been treated with this technique of appositional Bone Graft Tunneled at our clinic since 2005...
February 20, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28326894/cost-comparison-of-laparoscopic-colectomy-versus-open-colectomy-in-colon-cancer
#16
Kathryn Fitch, Andrew Bochner, Deborah S Keller
BACKGROUND: Laparoscopic colectomy has been shown to be safe, oncologically comparable, and clinically beneficial over open colectomy for colon cancer, but utilization remains low. OBJECTIVES: To evaluate the cost of laparoscopic colectomy vs. open colectomy for colon cancer. METHODS: We conducted a retrospective claims data analysis using the 2012 and 2013 Truven Health Analytics MarketScan Commercial Claims and Encounter Database. The denominator population consisted of individuals who had commercial insurance coverage in all months of 2012 and >1 month in 2013 and pharmacy coverage throughout eligibility...
March 22, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28326298/effects-of-escherichia-coli-derived-recombinant-human-bone-morphogenetic-protein-2-loaded-porous-hydroxyaptite-based-ceramics-on-calvarial-defect-in-rabbits
#17
Shin-Young Kim, Youngkyun Lee, Seung-Jun Seo, Jae-Hong Lim, Yong-Gun Kim
BACKGROUND: Recombinant human bone morphogenetic proteins (rhBMPs) have been widely used in regenerative therapies to promote bone formation. The production of rhBMPs using bacterial systems such as Escherichia coli (E. coli) is estimated to facilitate clinical applications by lowering the cost without compromising biological activity. In clinical practice, rhBMP-2 and osteoconductive carriers (e.g., hydroxyapatite [HA] and bovine bone xenograft) are used together. This study examined the effect of E...
February 2017: Journal of Bone Metabolism
https://www.readbyqxmd.com/read/28325634/emerging-roles-of-coblation-in-rhinology-and-skull-base-surgery
#18
REVIEW
Garret W Choby, Peter H Hwang
Coblation is a technology that incorporates bipolar radiofrequency energy to ablate tissue at relatively low temperatures. Its use for sinonasal surgery is actively being investigated, including applications for turbinate reduction, sinus surgery, skull base surgery, and adenoidectomy. Potential benefits include reduction in blood loss, improved endoscopic surgical visualization, and reduction in postoperative pain. The main drawbacks are its relatively high cost, potential adverse effects on functional epithelium, and relative paucity of long-term outcomes...
March 18, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28324951/mentor-s-brain-functional-connectivity-network-during-robotic-assisted-surgery-mentorship
#19
Somayeh B Shafiei, Scott T Doyle, Khurshid A Guru
In many complicated cognitive-motor tasks mentoring is inevitable during the learning process. Although mentors are expert in doing the task, trainee's operation might be new for a mentor. This makes mentoring a very difficult task which demands not only the knowledge and experience of a mentor, but also his/her ability to follow trainee's movements and patiently advise him/her during the operation. We hypothesize that information binding throughout the mentor's brain areas, contributed to the task, changes as the expertise level of the trainee improves from novice to intermediate and expert...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28324671/dose-de-escalation-of-intrapleural-tissue-plasminogen-activator-therapy-for-pleural-infection-the-adapt-project
#20
Natalia Popowicz, Oliver Bintcliffe, Duneesha De Fonseka, Kevin G Blyth, Nicola A Smith, Francesco Piccolo, Geoffrey Martin, Donny Wong, Anthony Edey, Nick Maskell, Y C Gary Lee
RATIONALE: Intrapleural therapy with a combination of tissue plasminogen activator (tPA) 10mg and deoxyribonuclease (DNase) 5mg administered twice daily has been shown in randomized and open-label studies to enable adequate drainage of over 90% of infected pleural effusions without surgery. Potential bleeding risks associated with intrapleural tPA and the drug costs remain important concerns. The ongoing ADAPT (Alteplase Dose Assessment for Pleural infection Therapy) project aims to investigate the efficacy and safety of dose de-escalation for intrapleural tPA...
March 21, 2017: Annals of the American Thoracic Society
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