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https://www.readbyqxmd.com/read/28916216/coronary-artery-bypass-grafting-bundled-payment-proposal-will-have-significant-financial-impact-on-hospitals
#1
Robert B Hawkins, J Hunter Mehaffey, Kenan W Yount, Leora T Yarboro, Clifford Fonner, Irving L Kron, Mohammed Quader, Alan Speir, Jeffrey Rich, Gorav Ailawadi
OBJECTIVES: The Centers for Medicare and Medicaid Services plans to institute a 5-year trial of bundled payments for coronary artery bypass grafting through 90 days after discharge. To investigate the impact, we reviewed actual inpatient costs for patients undergoing bypass surgery relative to the target price. METHODS: A total of 13,276 Medicare patients with estimated cost data underwent isolated coronary artery bypass grafting from 2008 to 2015 in 18 hospitals over 8 Medicare-defined regions within the Commonwealth of Virginia...
July 29, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28873970/immunosuppressive-agents-in-adult-kidney-transplantation-in-the-national-health-service-a-model-based-economic-evaluation
#2
Tristan M Snowsill, Jason Moore, Ruben E Mujica Mota, Jaime L Peters, Tracey L Jones-Hughes, Nicola J Huxley, Helen F Coelho, Marcela Haasova, Chris Cooper, Jenny A Lowe, Jo L Varley-Campbell, Louise Crathorne, Matt J Allwood, Rob Anderson
Background: Immunosuppression is required in kidney transplantation to prevent rejection and prolong graft survival. We conducted an economic evaluation to support England's National Institute for Health and Care Excellence in developing updated guidance on the use of immunosuppression, incorporating new immunosuppressive agents, and addressing changes in pricing and the evidence base. Methods: A discrete-time state transition model was developed to simulate adult kidney transplant patients over their lifetime...
July 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28832865/drivers-of-payment-variation-in-90-day-coronary-artery-bypass-grafting-episodes
#3
Vinay Guduguntla, John D Syrjamaki, Chad Ellimoottil, David C Miller, Richard L Prager, Edward C Norton, Patricia Theurer, Donald S Likosky, James M Dupree
Importance: Coronary artery bypass grafting (CABG) is scheduled to become a mandatory Medicare bundled payment program in January 2018. A contemporary understanding of 90-day CABG episode payments and their drivers is necessary to inform health policy, hospital strategy, and clinical quality improvement activities. Furthermore, insight into current CABG payments and their variation is important for understanding the potential effects of bundled payment models in cardiac care. Objective: To examine CABG payment variation and its drivers...
August 23, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28797445/characteristics-and-long-term-outcomes-of-head-and-neck-squamous-cell-carcinoma-after-solid-organ-transplantation
#4
Samer Alsidawi, Katharine A Price, Ashish V Chintakuntlawar, Gustavo F Westin, Joaquin J Garcia, Daniel J Ma, Scott H Okuno
INTRODUCTION: Immunosuppression after solid organ transplant prevents graft rejection, but leads to increased incidence of various malignancies including head and neck squamous cell carcinoma (HNSCC). Outcomes of patients with post-transplant HNSCC are unknown. MATERIALS AND METHODS: We retrospectively identified patients who developed HNSCC after solid organ transplant between 1995 and 2010. Adults with pathology-proven HNSCC and adequate follow up were included...
September 2017: Oral Oncology
https://www.readbyqxmd.com/read/28749899/effect-of-donor-and-recipient-diabetes-status-on-descemet-membrane-endothelial-keratoplasty-adherence-and-survival
#5
Marianne O Price, Marek Lisek, Matthew T Feng, Francis W Price
PURPOSE: To evaluate whether donor and/or recipient diabetes status affects the outcomes of Descemet membrane endothelial keratoplasty (DMEK). METHODS: A consecutive, single-center DMEK case series was reviewed. The outcome measures were success of surgeon tissue preparation, air reinjection rate, Kaplan-Meier 4-year graft replacement/failure rate for any reason, and endothelial cell loss. RESULTS: The donor had a history of diabetes in 504 of 1791 cases (28%) and the recipient in 14%...
October 2017: Cornea
https://www.readbyqxmd.com/read/28722060/poly-amino-acid-polyester-graft-copolymer-nanoparticles-for-the-acid-mediated-release-of-doxorubicin
#6
Daniel J Price, Mthulisi Khuphe, Robert P W Davies, James R McLaughlan, Nicola Ingram, Paul D Thornton
Biodegradable polymers have emerged as highly effective drug delivery vehicles. We combine N-carboxyanhydride and O-carboxyanhydride ring opening polymerisations to synthesise a poly(amino acid)-polyester graft copolymer capable of encapsulating, and subsequently releasing doxorubicin via acid-mediated hydrolysis. Consequently, the nanoparticles detailed are extremely promising vehicles for the controlled delivery of chemotherapeutic agents.
July 19, 2017: Chemical Communications: Chem Comm
https://www.readbyqxmd.com/read/28669475/editorial-commentary-robbing-peter-to-pay-paul-is-osteochondral-autograft-transplantation-of-the-elbow-capitellum-worth-the-price
#7
EDITORIAL
Paul E Caldwell
Osteochondritis dissecans (OCD) of the elbow capitellum is a common disorder that causes pain and functional limitation in the athletic adolescent elbow. Many surgical options have been proposed over the years, but none has stood the test of time. A recent well-written systematic review highlights the treatment options and recognizes a growing trend toward osteochondral allograft transplantation as the ideal solution. Unfortunately, the study also underscores the paucity of evidence on which we base our treatment decisions for OCD of the elbow in the young athlete...
July 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28668459/are-outcomes-of-thoracoabdominal-aortic-aneurysm-repair-different-in-men-versus-women-a-propensity-matched-comparison
#8
Konstantinos Spiliotopoulos, Matt D Price, Hiruni S Amarasekara, Susan Y Green, Qianzi Zhang, Ourania Preventza, Joseph S Coselli, Scott A LeMaire
OBJECTIVE: Women fare worse than men after many cardiovascular operations, including coronary artery bypass grafting and valve surgery. We sought to determine whether sex affects outcomes after open thoracoabdominal aortic aneurysm repair. METHODS: We evaluated data on 3353 consecutive patients (1281 women, 38.2%) who underwent open thoracoabdominal aortic aneurysm repair between October 1986 and July 2015. We compared preoperative characteristics, surgical variables, and outcomes between men and women in the overall group...
June 3, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28577670/cangrelor-reduces-the-risk-of-ischemic-complications-in-patients-with-single-vessel-and-multi-vessel-disease-undergoing-percutaneous-coronary-intervention-insights-from-the-champion-phoenix-trial
#9
RANDOMIZED CONTROLLED TRIAL
Freddy Abnousi, Vandana Sundaram, Celina M Yong, Jayne Prats, Efthymios N Deliargyris, Gregg W Stone, Christian W Hamm, Philippe Gabriel Steg, Charles Michael Gibson, Harvey D White, Matthew J Price, Philippe Généreux, Manisha Desai, Lingyao Yang, Victoria Y Ding, Robert A Harrington, Deepak L Bhatt, Kenneth W Mahaffey
OBJECTIVE: To examine the safety and efficacy of cangrelor in patients with single-vessel disease (SVD) and multi-vessel disease (MVD). BACKGROUND: Cangrelor, an intravenous, rapidly acting P2Y12 inhibitor, is superior to clopidogrel in reducing ischemic events among patients receiving percutaneous coronary intervention (PCI). METHODS: We studied a modified intention to treat population of patients with SVD and MVD from the CHAMPION PHOENIX trial...
June 2017: American Heart Journal
https://www.readbyqxmd.com/read/28570440/successful-reinnervation-of-the-diaphragm-after-intercostal-to-phrenic-nerve-neurotization-in-patients-with-high-spinal-cord-injury
#10
Kulvir S Nandra, Martin Harari, Thea P Price, Patrick J Greaney, Michael S Weinstein
OBJECTIVE: Our objective in this study was to extend diaphragmatic pacing therapy to include paraplegic patients with high cervical spinal cord injuries between C3 and C5. INTRODUCTION: Diaphragmatic pacing has been used in patients experiencing ventilator-dependent respiratory failure due to spinal cord injury as a means to reduce or eliminate the need for mechanical ventilation. However, this technique relies on intact phrenic nerve function. Recently, phrenic nerve reconstruction with intercostal nerve grafting has expanded the indications for diaphragmatic pacing...
August 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28542087/validity-of-postmortem-glycated-hemoglobin-to-determine-status-of-diabetes-mellitus-in-corneal-donors
#11
Mark C Soper, Santica M Marcovina, Caroline K Hoover, Peter M Calhoun, Kristen E McCoy, Christopher G Stoeger, Gregory A Schmidt, Baha M Arafah, Marianne O Price, Loretta B Szczotka-Flynn, Jonathan H Lass
PURPOSE: To examine the stability of postmortem glycated hemoglobin (HbA1c) measurement and its relationship to premortem glycemia. METHODS: Postmortem blood samples were obtained from 32 donors (8 known diabetic) and shipped on ice to a central laboratory to examine the stability of HbA1c measurements during the first 9 postmortem days. Thirty-nine other suspected diabetic donors underwent comparison of premortem and postmortem HbA1c measurements. RESULTS: Postmortem HbA1c measurements remained stable after 9 postmortem days (all measurements within ±0...
May 23, 2017: Cornea
https://www.readbyqxmd.com/read/28457188/functional-tissue-engineering-a-prevascularized-cardiac-muscle-construct-for-validating-human-mesenchymal-stem-cells-engraftment-potential-in-vitro
#12
Mani T Valarmathi, John W Fuseler, Jay D Potts, Jeffrey M Davis, Robert L Price
The influence of somatic stem cells in the stimulation of mammalian cardiac muscle regeneration is still in its early stages, and so far, it has been difficult to determine the efficacy of the procedures that have been employed. The outstanding question remains whether stem cells derived from the bone marrow or some other location within or outside of the heart can populate a region of myocardial damage and transform into tissue-specific differentiated progenies, and also exhibit functional synchronization...
May 25, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28329352/costs-and-consequences-of-early-hospital-discharge-after-major-inpatient-surgery-in-older-adults
#13
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...
May 17, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28198539/cytomegalovirus-infection-alters-phenotypes-of-different-%C3%AE-%C3%AE-t-cell-subsets-in-renal-transplant-recipients-with-long-term-stable-graft-function
#14
Silvia Lee, Jacquita S Affandi, Ashley B Irish, Patricia Price
Cytomegalovirus (CMV) infection alters the phenotypic profiles of T-cells and NK cells in healthy and immunocompromised individuals. Here, we examined the effects of CMV infection on the phenotype and functions of γδ T-cell subsets in renal transplant recipients (RTR) stable several years after transplantation (n = 80) and healthy controls (n = 72). Differentiation status, function, and expression of HLA-DR, CD57, and LIR-1 on Vδ2(-) and Vδ2(+) γδ T-cells were examined in peripheral blood cells using flow cytometry...
August 2017: Journal of Medical Virology
https://www.readbyqxmd.com/read/28157815/resistance-of-mandibular-polyurethane-replicas-to-fracture-after-removal-of-blocks-from-the-symphysis-and-ramus
#15
Mohanad Al-Sabbagh, Georgios Romanos, Scott R Price, David A Puleo, Fonda G Robinson, Mark V Thomas
BACKGROUND: When block grafts are harvested intraorally, the donor sites may act as stress concentrators and alter the structural integrity of the mandible. PURPOSE: The study aimed to compare displacement and load failure between intact polyurethane mandibular replicas and similar replicas from which blocks were taken at the symphysis or the ramus. It also aimed to identify trends of load failure. MATERIALS AND METHODS: Thirty-five mandibular replicas were tested to failure with an electromagnetic material testing unit...
June 2017: Implant Dentistry
https://www.readbyqxmd.com/read/28097811/fc-silent-anti-cd154-domain-antibody-effectively-prevents-nonhuman-primate-renal-allograft-rejection
#16
S C Kim, W Wakwe, L B Higginbotham, D V Mathews, C P Breeden, A C Stephenson, J Jenkins, E Strobert, K Price, L Price, R Kuhn, H Wang, A Yamniuk, S Suchard, A B Farris, T C Pearson, C P Larsen, M L Ford, A Suri, S Nadler, A B Adams
The advent of costimulation blockade provides the prospect for targeted therapy with improved graft survival in transplant patients. Perhaps the most effective costimulation blockade in experimental models is the use of reagents to block the CD40/CD154 pathway. Unfortunately, successful clinical translation of anti-CD154 therapy has not been achieved. In an attempt to develop an agent that is as effective as previous CD154 blocking antibodies but lacks the risk of thromboembolism, we evaluated the efficacy and safety of a novel anti-human CD154 domain antibody (dAb, BMS-986004)...
May 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/27993208/the-price-of-surgery-markup-of-operative-procedures-in-the-united-states
#17
COMPARATIVE STUDY
Faiz Gani, Martin A Makary, Timothy M Pawlik
BACKGROUND: Despite cost containment efforts, the price for surgery is not subject to any regulations. We sought to characterize and compare variability in pricing for commonly performed major surgical procedures across the United States. METHODS: Medicare claims corresponding to eight major surgical procedures (aortic aneurysm repair, aortic valvuloplasty, carotid endartectomy, coronary artery bypass grafting, esophagectomy, pancreatectomy, liver resection, and colectomy) were identified using the Medicare Provider Utilization and Payment Data Physician and Other Supplier Public Use File for 2013...
February 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27955936/do-prices-reflect-the-costs-of-cardiac-surgery-in-the-elderly
#18
Pedro Coelho, Vanessa Rodrigues, Luís Miranda, José Fragata, Pedro Pita Barros
INTRODUCTION: Payment for cardiac surgery in Portugal is based on a contract agreement between hospitals and the health ministry. Our aim was to compare the prices paid according to this contract agreement with calculated costs in a population of patients aged ≥65 years undergoing cardiac surgery in one hospital department. METHODS: Data on 250 patients operated between September 2011 and September 2012 were prospectively collected. The procedures studied were coronary artery bypass graft surgery (CABG) (n=67), valve surgery (n=156) and combined CABG and valve surgery (n=27)...
January 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/27862079/discarded-livers-find-a-new-life-engineered-liver-grafts-using-hepatocytes-recovered-from-marginal-livers
#19
Basak E Uygun, Maria-Louisa Izamis, Maria Jaramillo, Yibin Chen, Gavrielle Price, Sinan Ozer, Martin L Yarmush
Treatment for end-stage liver failure is restricted by the critical shortage of donor organs; about 4000 people die in the USA while waiting for a transplantable organ. This situation has been a major driving force behind the rise of tissue engineering to build artificial tissues/organs. Recent advancements in creating transplantable liver grafts using decellularized liver scaffolds bring the field closer to clinical translation. However, a source of readily available and highly functional adult hepatocytes in adequate numbers for regenerative liver therapies still remains unclear...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27787489/chimney-versus-fenestrated-endovascular-aortic-repair-for-juxta-renal-aneurysms
#20
Caroline Caradu, Xavier Berard, Gérard Sassoust, Dominique Midy, Eric Ducasse
BACKGROUND: Anatomical constrains, high price and manufacturing delay restrict fenestrated (F)-endovascular aortic repair (EVAR) to elective patients in specialized centers. Chimney graft (CG)-EVAR offers an alternative but uncertainties remain over target vessel's patency and type Ia endoleaks (ELs). METHODS: We reviewed the literature reporting F-EVAR and CG-EVAR for juxtarenal aneurysms between January 2005 and July 2016. RESULTS: Fifteen studies on F-EVAR, 8 on CG-EVAR and 5 on both techniques were included; 1748 F-EVAR patients (3993 target vessels) vs 757 (1158 target vessels, 13% symptomatic and 7% ruptured)...
October 27, 2016: Journal of Cardiovascular Surgery
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