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https://www.readbyqxmd.com/read/28937935/the-impact-of-the-2006-massachusetts-health-care-reform-law-on-spine-surgery-patient-payer-mix-status-and-age
#1
Nicolas W Villelli, Hong Yan, Jian Zou, Nicholas M Barbaro
OBJECTIVE Several similarities exist between the Massachusetts health care reform law of 2006 and the Affordable Care Act (ACA). The authors' prior neurosurgical research showed a decrease in uninsured surgeries without a significant change in surgical volume after the Massachusetts reform. An analysis of the payer-mix status and the age of spine surgery patients, before and after the policy, should provide insight into the future impact of the ACA on spine surgery in the US. METHODS Using the Massachusetts State Inpatient Database and spine ICD-9-CM procedure codes, the authors obtained demographic information on patients undergoing spine surgery between 2001 and 2012...
September 15, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28936068/hydrocephalus-associated-with-large-vestibular-schwannoma-management-options-and-factors-predicting-requirement-of-cerebrospinal-fluid-diversion-after-primary-surgery
#2
A R Prabhuraj, Nishanth Sadashiva, Santhosh Kumar, Dhaval Shukla, Dhananjaya Bhat, Bhagavatula Indira Devi, Sampath Somanna
OBJECTIVE: Obstructive hydrocephalus (HCP) related to vestibular schwannoma occurs in large tumors compressing the fourth ventricle. Symptoms related to HCP are expected to alleviate after resection of the tumor and decompression of the cerebrospinal fluid (CSF) pathways. However, some patients may require permanent cerebrospinal diversion even after surgery due to persistent HCP. In this study, the authors try to find out the factors associated with the requirement of CSF diversion after vestibular schwannoma surgery in cases of persistent HCP...
August 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28934884/effect-of-a-rapidly-degrading-presolidified-10-kda-chitosan-blood-implant-and-subchondral-marrow-stimulation-surgical-approach-on-cartilage-resurfacing-in-a-sheep-model
#3
Angela D Bell, Mark B Hurtig, Eric Quenneville, Georges-Étienne Rivard, Caroline D Hoemann
Objective This study tested the hypothesis that presolidified chitosan-blood implants are retained in subchondral bone channels perforated in critical-size sheep cartilage defects, and promote bone repair and hyaline-like cartilage resurfacing versus blood implant. Design Cartilage defects (10 × 10 mm) with 3 bone channels (1 drill, 2 Jamshidi biopsy, 2 mm diameter), and 6 small microfracture holes were created bilaterally in n = 11 sheep knee medial condyles. In one knee, 10 kDa chitosan-NaCl/blood implant (presolidified using recombinant factor VIIa or tissue factor), was inserted into each drill and Jamshidi hole...
October 2017: Cartilage
https://www.readbyqxmd.com/read/28933805/perioperative-administration-of-buffered-versus-non-buffered-crystalloid-intravenous-fluid-to-improve-outcomes-following-adult-surgical-procedures
#4
REVIEW
Sohail Bampoe, Peter M Odor, Ahilanandan Dushianthan, Elliott Bennett-Guerrero, Suzie Cro, Tong J Gan, Michael Pw Grocott, Michael Fm James, Michael G Mythen, Catherine Mn O'Malley, Anthony M Roche, Kathy Rowan, Edward Burdett
BACKGROUND: Perioperative fluid strategies influence clinical outcomes following major surgery. Many intravenous fluid preparations are based on simple solutions, such as normal saline, that feature an electrolyte composition that differs from that of physiological plasma. Buffered fluids have a theoretical advantage of containing a substrate that acts to maintain the body's acid-base status - typically a bicarbonate or a bicarbonate precursor such as maleate, gluconate, lactate, or acetate...
September 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28933328/-local-application-of-tranexamic-acid-in-total-hip-arthroplasty-decreases-blood-loss-and-consumption-of-blood-transfusion
#5
J Lošťák, J Gallo, M Večeřa, J Špička, K Langová
PURPOSE OF THE STUDY The primary aim of our study was to identify the effects of local application of tranexamic acid (TXA, Exacyl) on the amount of postoperative blood loss and blood transfusion requirement in primary total hip arthroplasty. We also recorded the levels of postoperative haemoglobin and its drop in early period after surgery. In each patient, we monitored in detail the incidence of early complications (haematoma, wound exudate). Lastly, the economic aspect of TXA administration was also taken into account...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28933042/anterior-chamber-changes-after-implantable-collamer-lens-implantation-in-high-myopia-using-pentacam-a-prospective-study
#6
Mohamed Nagy Elmohamady, Walid Abdelghaffar
INTRODUCTION: The objective of this study was to evaluate the changes of the anterior chamber (AC) of the eye after implantable Collamer lens (ICL) implantation in high myopia by using the Pentacam. METHODS: The prospective study included 34 high myopic patients (34 eyes). All patients were treated with Visian implantable Collamer lens (ICL) (Staar Surgical Co.) implantation. The Pentacam (Oculus) was used for all cases preoperatively and 1, 3 and 6 months postoperatively...
September 20, 2017: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/28932917/the-met-needs-for-pediatric-surgical-conditions-in-sierra-leone-estimating-the-gap
#7
Carmen Mesas Burgos, Håkon Angell Bolkan, Donald Bash-Taqi, Lars Hagander, Johan Von Screeb
BACKGROUND: In low- and middle-income countries, there is a gap between the need for surgery and its equitable provision, and a lack of proxy indicators to estimate this gap. Sierra Leone is a West African country with close to three million children. It is unknown to what extent the surgical needs of these children are met. AIM: To describe a nationwide provision of pediatric surgical procedures and to assess pediatric hernia repair as a proxy indicator for the shortage of surgical care in the pediatric population in Sierra Leone...
September 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28932560/cost-and-effectiveness-of-lung-lobectomy-by-video-assisted-thoracic-surgery-for-lung-cancer
#8
Juan J Mafé, Beatriz Planelles, Santos Asensio, Jorge Cerezal, María-Del-Mar Inda, Javier Lacueva, Maria-Dolores Esteban, Luis Hernández, Concepción Martín, Benno Baschwitz, Ana M Peiró
BACKGROUND: Video-assisted thoracic surgery (VATS) emerged as a minimally invasive surgery for diseases in the field of thoracic surgery. We herein reviewed our experience on thoracoscopic lobectomy for early lung cancer and evaluated Health System use. METHODS: A cost-effectiveness study was performed comparing VATS vs. open thoracic surgery (OPEN) for lung cancer patients. Demographic data, tumor localization, dynamic pulmonary function tests [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), diffusion capacity (DLCO) and maximal oxygen uptake (VO2max)], surgical approach, postoperative details, and complications were recorded and analyzed...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28932244/does-microscope-assistance-in-cold-steel-tonsillectomy-reduce-the-risk-of-postoperative-hemorrhage-results-of-a-prospective-cohort-study
#9
Thomas Wilhelm, Jan Wittlinger, Robert Georgiew, Christian Güldner, Stephan Hoch, Afshin Teymoortash, Thomas Günzel, Petar Stankovic
BACKGROUND: Posttonsillectomy hemorrhage (PTH) is the most feared complication. Dissection near the tonsillar capsule under microscopic view (TEmic) could be assumed to decrease PTH compared to traditional tonsillectomy (TEtrad). METHODS: In this study, patients were evaluated with respect to the need for surgical control (R/N: return/no return to theater (RTT): the day of surgery [0] or thereafter [1]). The findings at resection site and pain were measured. RESULTS: 869 patients were included (183 TEmic; 686 TEtrad)...
2017: International Journal of Otolaryngology
https://www.readbyqxmd.com/read/28931255/initial-single-center-technical-experience-with-the-brainpath-system-for-acute-intracerebral-hemorrhage-evacuation
#10
Andrew M Bauer, Peter A Rasmussen, Mark D Bain
BACKGROUND: Surgical intervention has been proposed as a means of reducing the high morbidity and mortality associated with acute intracerebral hemorrhage (ICH), but many previously reported studies have failed to show a clinically significant benefit. Newer, minimally invasive approaches have shown some promise. OBJECTIVE: We report our early single-center technical experience with minimally invasive clot evacuation using the BrainPath system. METHODS: Prospective data were collected on patients who underwent ICH evacuation with BrainPath at the Cleveland Clinic from August 2013 to May 2015...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28930104/liver-transplantation-in-the-obese-cirrhotic-patient
#11
Erin K Spengler, Jacqueline G O'Leary, Helen S Te, Shari Rogal, Anjana A Pillai, Abdullah Al-Osaimi, Archita Desai, James N Fleming, Daniel Ganger, Anil Seetharam, Georgios Tsoulfas, Martin Montenovo, Jennifer C Lai
Despite the rapidly increasing prevalence of obesity in the transplant population, the optimal management of obese liver transplant candidates remains undefined. Setting strict body mass index cutoffs for transplant candidacy remains controversial, with limited data to guide this practice. Body mass index is an imperfect measure of surgical risk in this population, partly due to volume overload and variable visceral adiposity. Weight loss before transplantation may be beneficial, but it remains important to avoid protein calorie malnutrition and sarcopenia...
October 2017: Transplantation
https://www.readbyqxmd.com/read/28930037/regional-consolidation-of-orthopedic-surgery-impacts-on-hip-fracture-surgery-access-and-outcomes
#12
Sara A Kreindler, Lanette Siragusa, Eric Bohm, Wendy Rudnick, Colleen J Metge
BACKGROUND: Timely access to orthopedic trauma surgery is essential for optimal outcomes. Regionalization of some types of surgery has shown positive effects on access, timeliness and outcomes. We investigated how the consolidation of orthopedic surgery in 1 Canadian health region affected patients requiring hip fracture surgery. METHODS: We retrieved administrative data on all regional emergency department visits for lower-extremity injury and all linked inpatient stays from January 2010 through March 2013, identifying 1885 hip-fracture surgeries...
September 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28929861/ulipristal-acetate-and-extracellular-matrix-production-in-human-leiomyomas-in-vivo-a-laboratory-analysis-of-a-randomized-placebo-controlled-trial
#13
Jeris Cox, Minnie Malik, Joy Britten, Terrence Lewis, William H Catherino
In a prior randomized controlled study, patients treated with ulipristal acetate (UPA) or placebo for 3 months had a decrease in leiomyoma size. A total of 10 patients' tissue samples (5 placebo and 5 treated with 10 mg/d UPA) that underwent hysterectomy and tissue preservation were identified from this study. Quantitative real-time reverse transcriptase polymerase chain reaction and Western blotting were used to assess fold gene and protein expression of extracellular membrane (ECM) proteins: collagen 1A (COL1A), fibronectin (FN1), and versican (VCAN) of the samples...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/28929810/dynamic-contrast-enhanced-perfusion-area-detector-ct-preliminary-comparison-of-diagnostic-performance-for-n-stage-assessment-with-fdg-pet-ct-in-non-small-cell-lung-cancer
#14
Yoshiharu Ohno, Yasuko Fujisawa, Naoki Sugihara, Yuji Kishida, Shinichiro Seki, Hisanobu Koyama, Takeshi Yoshikawa
OBJECTIVE: The objective of our study was to directly compare the capability of dynamic first-pass contrast-enhanced (CE) perfusion area-detector CT (ADCT) and FDG PET/CT for differentiation of metastatic from nonmetastatic lymph nodes and assessment of N stage in patients with non-small cell lung carcinoma (NSCLC). SUBJECTS AND METHODS: Seventy-seven consecutive patients, 45 men (mean age ± SD, 70.4 ± 5.9 years) and 32 women (71.2 ± 7.7 years), underwent dynamic first-pass CE-perfusion ADCT at two or three different positions for covering the entire thorax, FDG PET/CT, surgical treatment, and pathologic examination...
September 20, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28928606/quantification-of-ventricular-unloading-by-3d-echocardiography-in-single-ventricle-of-left-ventricular-morphology-following-superior-cavo-pulmonary-anastomosis-and-fontan-completion-a-feasibility-study
#15
Deepa Sasikumar, Bijulal Sasidharan, Baiju S Dharan, Arun Gopalakrishnan, Kavasseri M Krishnamoorthy, Sivasubramanian Sivasankaran
BACKGROUND: Three-dimensional echocardiography. (3DE) is comparable to cardiac magnetic resonance imaging for estimating ventricular volume in congenital heart diseases. However, there are limited data on estimation of ventricular volumes by 3DE in univentricular heart and change in ventricular volumes after surgical creation of cavopulmonary connection. We sought to quantify the unloading of the single ventricle of left ventricular. (LV) morphology by 3DE after superior cavopulmonary anastomosis...
September 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28928490/the-application-of-volumometry-as-an-indication-criterion-in-blow-out-fractures-the-first-results-from-a-prospective-study
#16
Daniel Kovar, Richard Holy, Zdenek Voldrich, Pavel Voska, Jan Lestak, Jaromir Astl
Backgroung and Aim. This work builds on our publication on the subject of creating a mathematical model for calculating the volume of proplaped soft tissue of the orbit in blow-out fractures, which aids us greatly in our choice of the most effective treatment immediately post-accident. PATIENTS AND METHODS: In this prospective study (2014 - 2016) we treated 29 patients with blow-out fractures. 18 (62%) were treated conservatively and in 11 (38%) we proceeded surgically. We decided whether surgical or non-surgical therapy was appropriate on the basis of clinical ENT, eye examination and the total volume of prolapsed orbital soft tissue...
August 31, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/28927806/-aging-prevention-new-surgical-techniques-and-future-options-for-facial-rejuvenation
#17
C Le Louarn
Prevention of aging is mainly obtained through appropriate health practices, modulated by the genetic causes of aging. Causes of facial structural aging include gravity, volume loss, contraction of the mimic muscles and obviously biological aging of tissues. Among the very numerous new surgical technique of facial rejuvenation, we could point out: for the frontal region, obviously we are focus on the endoscopic and non-endoscopic frontal lifts. But also, we should note the transcutaneous Brow Shaping which with a well defined, step by step technique is indeed a simple way to improve a possible difficult situation; concerning the mid-face lift, as the main risk is the secondary eyelid malposition, a high Smas or a temporo-malar lift can be performed...
September 15, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28927740/comparative-evaluation-of-iodine-125-radioactive-seed-localization-and-wire-localization-for-resection-of-breast-lesions
#18
Vi Thuy Tran, Julie David, Erica Patocskai, Mathieu Zummo-Soucy, Rami Younan, Lucie Lalonde, Maude Labelle, Mona El Khoury, André Robidoux, Isabelle Trop
PURPOSE: Radioactive seed localization (RSL) uses a titanium seed labeled with iodine-125 energy for surgery of nonpalpable breast lesions. RSL facilitates radiology-surgery scheduling and allows for improved oncoplasty compared with wire localization (WL). The purpose of this work was to compare the 2 techniques. METHODS: We performed a retrospective study of all breast lesions operated with RSL between February 2013 and March 2015 at our university institution, and compared with an equivalent number of surgeries performed with a single WL...
September 15, 2017: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
https://www.readbyqxmd.com/read/28927210/navigation-and-image-injection-for-control-of-bone-removal-and-osteotomy-planes-in-spine-surgery
#19
Michael Kosterhon, Angelika Gutenberg, Sven Rainer Kantelhardt, Elefterios Archavlis, Alf Giese
BACKGROUND AND IMPORTANCE: In contrast to cranial interventions, neuronavigation in spinal surgery is used in few applications, not tapping into its full technological potential. We have developed a method to preoperatively create virtual resection planes and volumes for spinal osteotomies and export 3-D operation plans to a navigation system controlling intraoperative visualization using a surgical microscope's head-up display. The method was developed using a Sawbone ® model of the lumbar spine, demonstrating feasibility with high precision...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28926384/effect-of-surgeon-and-hospital-volume-on-morbidity-and-mortality-after-hip-fracture
#20
Kanu Okike, Priscilla H Chan, Elizabeth W Paxton
BACKGROUND: Prior studies have examined the relationship between surgeon and hospital volumes and outcome following hip fracture surgical procedures, but the results have been inconclusive. The purpose of this study was to assess the hip fracture volume-outcome relationship by analyzing data from a large, managed care registry. METHODS: The Kaiser Permanente Hip Fracture Registry prospectively records information on surgically treated hip fractures within the managed health-care system...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
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