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    Heterogeneity among hospitals statewide in percentage shares of the annual growth of surgical caseloads of inpatient and outpatient major therapeutic procedures.
    J Clin Anesth 2018 Apr 17. Epub 2018 Apr 17.
    Department of Anesthesiology, Perioperative Medicine & Pain Management, University of Miami, Miller School of Medicine, 1400 NW 12th Avenue, Suite 3075, Miami, FL 33136, United States. Electronic address:
    Study Objective: Suppose that it were a generalizable finding, in both densely populated and rural states, that there is marked heterogeneity among hospitals in the percentage change in surgical caseload and/or in the total change in caseload. Then, individual hospitals should not simply rely on federal and state forecasts to infer their expected growth. Likewise, individual hospitals and their anesthesiology groups would best not rely on national or US regional surgical trends as causal reasons for local trends in caseload. Read More

    Safety and Efficacy of Arterial Closure Devices in an Office Based Angiosuite.
    Ann Vasc Surg 2018 Apr 12. Epub 2018 Apr 12.
    DFW Vascular Group 221 W. Colorado Blvd Pavilion II suite 625 Dallas, TX 75208. Electronic address:
    Background: We aimed to compare the safety and efficacy of 5 arterial closure devices in an outpatient endovascular surgery center.

    Materials And Methods: We retrospectively reviewed all cases using femoral arterial access performed between January 2012 and December 2013. Five different arterial closure devices (AngioSeal, Perclose, StarClose, ExoSeal, and Mynx) were used by 7 endovascular surgeons. Read More

    Physician Assistants and Nurse Practitioners in Head and Neck Surgery.
    Cancer Treat Res 2018 ;174:17-30
    City of Hope National Medical Center, Duarte, CA, USA.
    This chapter explores the role of advanced practice clinicians (APCs) and patient care coordinators in the head and neck cancer setting. APCs, which include physician assistants (PAs) and nurse practitioners (NPs), are licensed professional healthcare providers who diagnose and treat illnesses, order and interpret diagnostic tests, and prescribe pharmaceutical and non-pharmaceutical therapies. Although the training, education, and licensure differ between PAs and NPs, their roles are quite similar in head and neck surgery. Read More

    The outpatient total hip arthroplasty : a paradigm change.
    Bone Joint J 2018 Jan;100-B(1 Supple A):31-35
    Joint Implant Surgeons, 7277 Smith's Mill Road, Suite 200, New Albany, Ohio 43054, USA.
    Aims: To examine incidence of complications associated with outpatient total hip arthroplasty (THA), and to see if medical comorbidities are associated with complications or extended length of stay.

    Patients And Methods: From June 2013 to December 2016, 1279 patients underwent 1472 outpatient THAs at our free-standing ambulatory surgery centre. Records were reviewed to determine frequency of pre-operative medical comorbidities and post-operative need for overnight stay and complications which arose. Read More

    Outcomes and Direct Costs of Inferior Vena Cava Filter Placement and Retrieval within the IR and Surgical Settings.
    J Vasc Interv Radiol 2018 Feb 6;29(2):170-175. Epub 2017 Dec 6.
    Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio; Northwest Radiology, St. Vincent Health, 5901 Technology Center Dr., Indianapolis, IN 46278. Electronic address:
    Purpose: To compare the outcomes and costs of inferior vena cava (IVC) filter placement and retrieval in the interventional radiology (IR) and surgical departments at a tertiary-care center.

    Materials And Methods: Retrospective review was performed of 142 sequential outpatient IVC filter placements and 244 retrievals performed in the IR suite and operating room (OR) from 2013 to 2016. Patient demographic data, procedural characteristics, outcomes, and direct costs were compared between cohorts. Read More

    Lack of generalizability of observational studies' findings for turnover time reduction and growth in surgery based on the State of Iowa, where from one year to the next, most growth was attributable to surgeons performing only a few cases per week.
    J Clin Anesth 2018 Feb 24;44:107-113. Epub 2017 Nov 24.
    Department of Anesthesiology, Perioperative Medicine & Pain Management, University of Miami, Miller School of Medicine, 1400 NW 12th Avenue, Suite 3075, Miami, FL 33136, United States. Electronic address:
    Study Objective: Three observational studies at large teaching hospitals found that reducing turnover times resulted in the surgeons performing more cases. We sought to determine if these findings are generalizable to other hospitals, because, if so, reducing turnover times may be an important mechanism for hospitals to use for growing caseloads.

    Design: Observational cohort study. Read More

    Contraception Update: Sterilization.
    FP Essent 2017 Nov;462:30-34
    Christiana Care Health System Value Institute Ammon Center 2E55, 4755 Ogletown-Stanton Rd, Newark, DE 19718.
    Female sterilization procedures include postpartum partial salpingectomy via cesarean or minilaparotomy incision, interval laparoscopic procedures, or hysteroscopic placement of microinserts. Rates of failure and serious complications are low and comparable among the various methods. A hysteroscopic procedure requires a 3-month confirmatory hysterosalpingogram before it is considered effective for contraception. Read More

    Ambulatory anterior cervical discectomy and fusion is associated with a higher risk of revision surgery and perioperative complications: an analysis of a large nationwide database.
    Spine J 2017 Nov 16. Epub 2017 Nov 16.
    Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, 1250 16th St., Santa Monica, CA 90404. Electronic address:
    Background Context: With the changing landscape of health care, outpatient spine surgery is being more commonly performed to reduce cost and to improve efficiency. Anterior cervical discectomy and fusion (ACDF) is one of the most common spine surgeries performed and demand is expected to increase with an aging population.

    Purpose: The objective of this study was to determine the nationwide trends and relative complication rates associated with outpatient ACDF. Read More

    Outpatient Shoulder Arthroplasty.
    Orthop Clin North Am 2018 Jan 26;49(1):73-79. Epub 2017 Oct 26.
    Shoulder and Elbow Surgery, Department of Orthopaedic Surgery, University of Tennessee-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN 38104, USA. Electronic address:
    Health care policy makers have placed increased attention on the cost of health care making outpatient joint arthroplasty an attractive alternative to routine hospital admission. Recent studies have shown outpatient shoulder arthroplasty is a safe and cost-effective alternative to inpatient shoulder arthroplasty. Proper patient selection, patient education, effective pain management strategies, and attention to intraoperative blood loss are keys in the success of outpatient shoulder arthroplasty. Read More

    Hand Surgery in the Ambulatory Surgery Center.
    Orthop Clin North Am 2018 Jan;49(1):69-72
    Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN 38104, USA. Electronic address:
    Outpatient surgery, especially in free-standing ambulatory surgery centers (ASC), provides a safe, cost-effective option for a variety of surgical procedures and has become the preferred choice over inpatient and hospital-based outpatient surgery for most hand and wrist procedures. Complication rates after ASC hand surgery are low (0.2%-2. Read More

    Use of Wide-awake Local Anesthesia No Tourniquet in Hand and Wrist Surgery.
    Orthop Clin North Am 2018 Jan;49(1):63-68
    Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN 38104, USA.
    WALANT (wide-awake local anesthesia no tourniquet) appears to be a safe and effective anesthesia technique for many hand and wrist surgeries. Patient satisfaction is high because of the avoidance of preoperative testing and hospital admission. Postoperative recovery is rapid, and procedures can be done in outpatient settings, resulting in substantial savings in time and money. Read More

    Outpatient Management of Ankle Fractures.
    Orthop Clin North Am 2018 Jan;49(1):103-108
    Foot and Ankle, Foot and Ankle Orthopedic Fellowship, Department of Orthopedic Surgery, Northwestern Memorial Hospital, Northwestern University, Feinberg School of Medicine, 676 North St. Clair, Suite 1350, Chicago, IL 60611, USA. Electronic address:
    Interest in outpatient orthopedic surgery has been fueled by provider desire to control costs and development of rapid recovery protocols. Open reduction and internal fixation (ORIF) is a commonly elected treatment strategy for ankle fracture that may be performed in an outpatient setting. Lessons on cost-savings of the outpatient model in orthopedics can be learned in total joint replacement and spine surgery. Read More

    Open treatment of ankle fracture as inpatient increases risk of complication.
    J Orthop Traumatol 2017 Dec 26;18(4):431-438. Epub 2017 Oct 26.
    Vanderbilt Orthopaedic Institute Center for Health Policy, Department of Orthopaedics, Vanderbilt University Medical Center, 1215 21st Avenue South, Suite 4200, Medical Center East, South Tower, Nashville, TN, 37232, USA.
    Background: Ankle fracture is one of the most common injuries treated by orthopaedic surgeons, and its incidence is only expected to rise with an aging population. It is also associated with often costly complications, yet there is little literature on risk factors, especially modifiable ones, driving these complications. The aim of this study is to reveal whether inpatient treatment after ankle fracture is associated with higher incidence of postoperative complications. Read More

    The digital divide in adoption and use of mobile health technology among caregivers of pediatric surgery patients.
    J Pediatr Surg 2017 Sep 1. Epub 2017 Sep 1.
    Department of Pediatric Surgery, The McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin Street, Suite 5.258, Houston, TX 77030, United States; Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, United States; Department of Pediatric Patient Care, Children's Cancer Hospital, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1400 Pressler St., Unit 1406, Houston, TX 77030, United States. Electronic address:
    Purpose: The purpose of this study was to identify mobile Health (mHealth) technology utilization among caregivers of pediatric surgery patients.

    Methods: We provided a modified version of the 2012 mobile health survey from the Pew Research Center to English and Spanish-speaking caregivers of children aged <18years presenting to pediatric surgical outpatient clinics from June to July of 2016.

    Results: A total of 171 caregivers completed the survey and included 57 (34%) whites, 30 (18%) blacks, 75 (44%) Hispanics, and 6 (4%) other races. Read More

    At most hospitals in the state of Iowa, most surgeons' daily lists of elective cases include only 1 or 2 cases: Individual surgeons' percentage operating room utilization is a consistently unreliable metric.
    J Clin Anesth 2017 Nov 29;42:88-92. Epub 2017 Aug 29.
    Department of Anesthesiology, Perioperative Medicine & Pain Management, University of Miami, Miller School of Medicine, 1400 NW 12th Avenue, Suite 3075, Miami, FL 33136, United States. Electronic address:
    Study Objective: Percentage utilization of operating room (OR) time is not an appropriate endpoint for planning additional OR time for surgeons with high caseloads, and cannot be measured accurately for surgeons with low caseloads. Nonetheless, many OR directors claim that their hospitals make decisions based on individual surgeons' OR utilizations. This incongruity could be explained by the OR managers considering the earlier mathematical studies, performed using data from a few large teaching hospitals, as irrelevant to their hospitals. Read More

    Validity of a smartphone protractor to measure sagittal parameters in adult spinal deformity.
    Spine J 2017 Oct 14;17(10):1559-1564. Epub 2017 Aug 14.
    Department of Orthopedic Surgery, Yawkey Center for Outpatient Care, Massachusetts General Hospital, 55 Fruit St, Suite 3A, Boston, MA 02114, USA.
    Background Context: Smartphones have become an integral tool in the daily life of health-care professionals (Franko 2011). Their ease of use and wide availability often make smartphones the first tool surgeons use to perform measurements. This technique has been validated for certain orthopedic pathologies (Shaw 2012; Quek 2014; Milanese 2014; Milani 2014), but never to assess sagittal parameters in adult spinal deformity (ASD). Read More

    Patient with a total artificial heart maintained on outpatient dialysis while listed for combined organ transplant, a single center experience.
    Hemodial Int 2017 10 11;21(4):E69-E72. Epub 2017 Aug 11.
    Division of Nephrology, Department of Medicine, Ronald Regan Medical Center, David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
    Advanced mechanical circulatory support is increasingly being used with more sophisticated devices that can deliver pulsatile rather than continuous flow. These devices are more portable as well, allowing patients to await cardiac transplantation in an outpatient setting. It is known that patients with renal failure are at increased risk for developing worsening acute kidney injury during implantation of a ventricular assist device (VAD) or more advanced modalities like a total artificial heart (TAH). Read More

    Outcomes of Gartland type III supracondylar fractures treated using Blount's method.
    Orthop Traumatol Surg Res 2017 Nov 3;103(7):1121-1125. Epub 2017 Aug 3.
    Service d'orthopédie infantile, hôpitaux pédiatriques de Nice CHU-Lenval, 57, avenue de la Californie, 06000 Nice, France. Electronic address:
    Background: Supracondylar fractures of the elbow with major displacement are usually treated by surgical pinning and less often non-operatively as described by Blount. The objective of this study was to assess the clinical and radiological outcomes of Gartland type III supracondylar fractures treated at least 3 years earlier using Blount's method.

    Hypothesis: Blount's method produces good outcomes after more than 3 years when used to treat Gartland type III supracondylar fractures of the humerus. Read More

    Pre-transplant depression as a predictor of adherence and morbidities after orthotopic heart transplantation.
    J Cardiothorac Surg 2017 Jul 25;12(1):62. Epub 2017 Jul 25.
    Cardiovascular and Thoracic Surgery, Rush University Medical Center, Rush University Medical Center, 1725 W Harrison, Suite 1156 POB, Chicago, IL, 60612, USA.
    Background: Psychosocial factors are useful predictors of adverse outcomes after solid organ transplantation. Although depression is a known predictor of poor outcomes in patients who undergo orthotopic heart transplantation (OHT) and is actively screened for during pre-transplant evaluation, the effects of early identification of this entity on post-transplant outcomes are not clearly understood. The purpose of this study was to evaluate the impact of pre-transplant depression on outcomes after OHT. Read More

    Type B Aortic Dissections: Current Guidelines for Treatment.
    Cardiol Clin 2017 Aug 26;35(3):387-410. Epub 2017 May 26.
    Division of Vascular Surgery, Department of Surgery, Keck School of Medicine of USC, University of Southern California, 1520 San Pablo Street, HCC II, Suite 4300, Los Angeles, CA 90033-5330, USA. Electronic address:
    Stanford type B aortic dissections (TBADs) involve the descending aorta and can present with complications, including malperfusion syndrome or aortic rupture, which are associated with significant morbidity and mortality if left untreated. Clinical diagnosis is straightforward, typically confirmed using CT angiography. Treatment begins with immediate anti-impulse medical therapy. Read More

    Comparative outcomes of outpatient and inpatient total shoulder arthroplasty: an analysis of the Medicare dataset.
    Bone Joint J 2017 Jul;99-B(7):934-938
    Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St, Suite 300, Chicago, IL 60612, USA.
    Aims: The aim of the present study was to compare the 30- and 90-day re-admission rates and complication rates of outpatient and inpatient total shoulder arthroplasty (TSA).

    Patients And Methods: The United States Medicare Standard Analytical Files database was questioned to identify patients who had undergone outpatient or inpatient TSA between 2005 and 2012. Patient characteristics were compared between the two groups using chi-squared analysis. Read More

    Social well-being is associated with less pro-inflammatory and pro-metastatic leukocyte gene expression in women after surgery for breast cancer.
    Breast Cancer Res Treat 2017 Aug 30;165(1):169-180. Epub 2017 May 30.
    Department of Psychology, University of Miami, 5665 Ponce De Leon Blvd., Coral Gables, FL, 33146, USA.
    Purpose: Satisfaction with social resources, or "social well-being," relates to better adaptation and longer survival after breast cancer diagnosis. Biobehavioral mechanisms linking social well-being (SWB) to mental and physical health may involve inflammatory signaling. We tested whether reports of greater SWB were associated with lower levels of pro-inflammatory and pro-metastatic leukocyte gene expression after surgery for non-metastatic breast cancer. Read More

    Preoperative risk stratification of critically ill patients.
    J Clin Anesth 2017 Jun 7;39:122-127. Epub 2017 Apr 7.
    David Geffen School of Medicine, Ronald Reagan Medical Center, UCLA, 757 Westwood Plz. Suite 3325, Los Angeles, CA 90095, United States.
    Study Objective: Risk assessment historically emphasized cardiac morbidity and mortality in elective, outpatient, non-cardiac surgery. However, critically ill patients increasingly present for therapeutic interventions. Our study investigated the relationship of American Society of Anesthesiologists (ASA) class, revised cardiac risk index (RCRI), and sequential organ failure assessment (SOFA) score with survival to discharge in critically ill patients with respiratory failure. Read More

    Outpatient treatment of osteomyelitis with telavancin.
    Int J Antimicrob Agents 2017 Jul 26;50(1):93-96. Epub 2017 Apr 26.
    Infectious Diseases Associates, 1425 S. Osprey Ave., Suite 1, Sarasota, FL 34239, USA.
    Telavancin is a lipoglycopeptide antibiotic with bactericidal activity against Gram-positive pathogens including Staphylococcus aureus, the most frequent cause of osteomyelitis. Treatment is often challenging due to needs for surgical intervention along with prolonged administration of intravenous antimicrobials, frequently in an outpatient setting. This was a retrospective analysis of the efficacy and safety of telavancin for treatment of osteomyelitis provided as outpatient parenteral antimicrobial therapy (OPAT) in physician office infusion centres. Read More

    Outpatient Emergencies: Acute Heart Failure.
    Med Clin North Am 2017 May 2;101(3):507-519. Epub 2017 Mar 2.
    Department of Medicine, Jefferson Heart Institute, Sidney Kimmel Medical College of Thomas Jefferson University, 925 Chestnut Street, Suite 323A, Philadelphia, PA 19107, USA. Electronic address:
    Heart failure is an epidemic in the United States and a major health problem worldwide. The syndrome of acute heart failure is marked by a recent onset of symptoms usually in terms of days to a few weeks of worsening fatigue, shortness of breath, orthopnea, swelling, and sudden onset of weight gain. Physicians caring for patients with heart failure must know the risk factors for this disease, pathophysiology, symptomatology, important examination findings, key diagnostic tests, and management approach so as to improve symptoms and reduce mortality. Read More

    Complications and Outcomes After Gynecomastia Surgery: Analysis of 204 Pediatric and 1583 Adult Cases from a National Multi-center Database.
    Aesthetic Plast Surg 2017 Aug 24;41(4):761-767. Epub 2017 Mar 24.
    Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine, 6560 Fannin Street, Scurlock Tower, Suite 2200, Houston, TX, 77030, USA.
    Background: Gynecomastia is a common disease that is prevalent across all age groups of boys and men. Although benign in nature, it can lead to psychological and social distress, prompting affected patients to seek medical attention. Management strategies include observation and drug therapy, yet surgical procedures remain the hallmark of treatment. Read More

    ST-segment elevation myocardial infarction, systems of care. An urgent need for policies to co-ordinate care in order to decrease in-hospital mortality.
    Int J Cardiol 2017 Aug 15;240:82-86. Epub 2017 Feb 15.
    University of Nevada School of Medicine, Division of Cardiovascular Medicine, United States. Electronic address:
    Background: Regional trends for ST-segment elevation myocardial infarction (STEMI) treatment is not known in the state of Nevada.

    Hypothesis: Great disparity exists for treatment for STEMI in different geographical areas of Nevada. There is a great potential to improve treatment and outcomes of STEMI patients in the State of Nevada. Read More

    Flat detector CT and its applications in the endovascular treatment of wide-necked intracranial aneurysms-A literature review.
    Eur J Radiol 2017 Mar 26;88:26-31. Epub 2016 Dec 26.
    Microvention - Terumo, Tustin, CA, USA. Electronic address:
    Flat detector CT (FDCT) provides cross sectional imaging within an angiographic suite and is increasingly gaining popularity in various areas of interventional radiology, as an alternative imaging modality. Its relatively high spatial resolution improves visualization of intraluminal devices such as intracranial stents or flow-diverters. Device deployment and positioning, in relation to the parent vessel and surrounding structures, are easily assessible with FDCT. Read More

    Risk associated with perioperative red blood cell transfusion in cranial surgery.
    Neurosurg Rev 2017 Oct 3;40(4):633-642. Epub 2017 Feb 3.
    The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, and Department of Neurosurgery, The Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
    We assessed the impact of intra- and postoperative RBC transfusion on postoperative morbidity and mortality in cranial surgery. A total of 8924 adult patients who underwent cranial surgery were identified in the 2006-2011 American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database. Patients undergoing a biopsy, radiosurgery, or outpatient surgery were excluded. Read More

    Formalin disinfection of prostate biopsy needles may reduce post-biopsy infectious complications.
    Prostate Cancer Prostatic Dis 2017 Jun 24;20(2):216-220. Epub 2017 Jan 24.
    Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
    Background: We sought to determine whether formalin disinfection of prostate biopsy needles between cores reduces post-biopsy urinary tract infections (UTIs).

    Methods: We reviewed a single-surgeon experience of transrectal prostate biopsies from 2010 to 2014. Biopsies were performed in either an operative suite, where 10% formalin was used to disinfect the needle tip between each biopsy core, or an outpatient clinic, where formalin was not used. Read More

    You can't blame the wreck on the train.
    Am J Surg 2017 Nov 21;214(5):974-978. Epub 2016 Dec 21.
    ACGME, 515 N. State Street, Suite 2000, Chicago, IL, 60654, USA. Electronic address:
    General surgical residency education is faced with a number of challenges today. Among those are resident duty hour limitations, the fact that residency is hospital-based despite the practice of general surgery being largely outpatient, changing diseases and conditions treated by the general surgeon and changing methods of treatment, development and maintenance of a user friendly curriculum and the support and provision for faculty development. The greatest single barrier, though, to education of the surgical resident is the lack of appropriate supervision. Read More

    Stemmed tibial revision component alignment: Does an anatomic conflict exist?
    Knee 2016 Dec 29;23(6):996-1001. Epub 2016 Oct 29.
    Houston Methodist Orthopedics & Sports Medicine, 6445 Main St., Outpatient Center, Suite 2500, Houston, TX 77030, United States. Electronic address:
    Introduction: Obtaining satisfactory coronal plane alignment is important for success in revision total knee arthroplasty (TKA). The study objective was to determine tibial coronal plane alignment after TKA when a tibial stem was used and assess if there was an anatomic conflict in tibial stemmed component alignment.

    Materials And Methods: A radiographic review of 88 revision TKA cases was performed. Read More

    Impact of Inpatient Versus Outpatient Total Joint Arthroplasty on 30-Day Hospital Readmission Rates and Unplanned Episodes of Care.
    Orthop Clin North Am 2017 Jan 28;48(1):15-23. Epub 2016 Oct 28.
    OrthoCarolina Hip & Knee Center, 2001 Vail Avenue, Suite 200A, Charlotte, NC 28207, USA.
    This article describes a study comparing 30-day readmission rates between patients undergoing outpatient versus inpatient total hip (THA) and knee (TKA) arthroplasty. A retrospective review of 137 patients undergoing outpatient total joint arthroplasty (TJA) and 106 patients undergoing inpatient (minimum 2-day hospital stay) TJA was conducted. Unplanned hospital readmissions and unplanned episodes of care were recorded. Read More

    Roads, Maps, and Destinations: the Journey of Left Ventricular Assist Device Implantation in Ambulatory Patients with Advanced Heart Failure.
    Curr Cardiol Rep 2016 Dec;18(12):132
    , 6550 Fannin St. Suite 1901, Houston, TX, 77030, USA.
    Purpose Of Review: The benefit of left ventricular assist devices in patients dependent on inotropes or temporary mechanical support is clear. There is a large population of advanced heart failure patients who are ambulatory and not dependent on inotropes, but in whom mortality remains high. We review the limited evidence regarding the benefits and risks of LVADs in this population. Read More

    Chronic caesarian section scar pain treated with fascial scar release techniques: A case series.
    J Bodyw Mov Ther 2016 Oct 10;20(4):906-913. Epub 2016 Mar 10.
    Physical Therapist, Savannah, GE, USA.
    Objective: To describe outcomes of two subjects with chronically painful Caesarian section (C-section) scars following an intervention of specific myofascial scar release techniques.

    Study Design: Case series.

    Background: Over 1. Read More

    Estimating the Societal Benefits of THA After Accounting for Work Status and Productivity: A Markov Model Approach.
    Clin Orthop Relat Res 2016 Dec 3;474(12):2645-2654. Epub 2016 Oct 3.
    University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
    Background: Demand for total hip arthroplasty (THA) is high and expected to continue to grow during the next decade. Although much of this growth includes working-aged patients, cost-effectiveness studies on THA have not fully incorporated the productivity effects from surgery.

    Questions/purposes: We asked: (1) What is the expected effect of THA on patients' employment and earnings? (2) How does accounting for these effects influence the cost-effectiveness of THA relative to nonsurgical treatment?

    Methods: Taking a societal perspective, we used a Markov model to assess the overall cost-effectiveness of THA compared with nonsurgical treatment. Read More

    Treatment Patterns and Economic Burden in Patients Treated for Acromegaly in the USA.
    Drugs Real World Outcomes 2015 Sep;2(3):299-309
    Ipsen Pharma SAS, Boulogne-Billancourt, France.
    Background: Acromegaly is a rare, debilitating condition for which data on the associated treatment patterns and economic burden are limited.

    Objective: Our objective was to examine patient characteristics, treatment patterns, and healthcare resource utilization (HRU)/costs for individuals with acromegaly treated with surgical and/or medical therapy in the USA.

    Methods: Using a large US claims database, adults with new episodes of acromegaly between 1 July 2007 and 31 December 2010 were identified (the first observed diagnosis being the index date). Read More

    The use of custom 3D printed stereotactic frames for laser interstitial thermal ablation: technical note.
    Neurosurg Focus 2016 Oct;41(4):E3
    Department of Neurosurgery, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania.
    Over the last several years, laser interstitial thermotherapy (LITT) has gained wide acceptance for the treatment of a myriad of cranial lesions. A wide variety of techniques for placement of the laser fiber have been reported with a spectrum of perceived benefits and drawbacks. The authors present the first report of a customized 3D printed stereotactic frame for LITT. Read More

    Evaluation of American Society of Anesthesiologists classification as 30-day morbidity predictor after single-level elective anterior cervical discectomy and fusion.
    Spine J 2017 03 23;17(3):313-320. Epub 2016 Sep 23.
    Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, NMH/Arkes Family Pavilion Suite 2210, 676 N Saint Clair, Chicago, IL 60611, USA. Electronic address:
    Background Context: Higher American Society of Anesthesiologists (ASA) classification is a known predictor of postoperative complication in diverse surgical settings. However, its predictive value is not established in single-level elective anterior cervical discectomy and fusion (SLE-ACDF).

    Purpose: This study aimed to evaluate the predictive value of ASA classification system on 30-day morbidity following SLE-ACDF. Read More

    Aspirin, Plavix, and Other Antiplatelet Medications: What the Oral and Maxillofacial Surgeon Needs to Know.
    Oral Maxillofac Surg Clin North Am 2016 Nov 29;28(4):497-506. Epub 2016 Aug 29.
    Private Practice, Greater Waterbury OMS, 435 Highland Avenue, Suite 100, Cheshire, CT 06410, USA; Beau Visage Med Spa, 435 Highland Avenue, Suite 100, Cheshire, CT 06410, USA; Division of Oral and Maxillofacial Surgery, Department of Craniofacial Sciences, University of Connecticut, 263 Farmington Avenue, Farmington, CT 06030, USA. Electronic address:
    Most patients with coronary artery disease and peripheral vascular disease are on long-term antiplatelet therapy and dual therapy. Achieving a balance between ischemic and bleeding risk remains an important factor in managing patients on antiplatelet therapy. For most outpatient surgical procedures, maintenance and continuation of this therapy are recommended. Read More

    Unresectable Hepatocellular Carcinoma: Radioembolization Versus Chemoembolization: A Systematic Review and Meta-analysis.
    Cardiovasc Intervent Radiol 2016 Nov 1;39(11):1580-1588. Epub 2016 Sep 1.
    Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami - Miller School of Medicine, Miami, FL, USA.
    Background: Transarterial radioembolization (TARE) has emerged as a newer regional therapy to transarterial chemoembolization (TACE) for treatment of unresectable hepatocellular carcinoma (HCC). The aim of this study is to compare clinical outcomes of both the techniques.

    Methods: Online search for studies comparing TARE to TACE from 2005 to present was performed. Read More

    Compliance of Perioperative Antibiotic Dosing and Surgical Site Infection Rate in Office-Based Elective Surgery.
    Plast Reconstr Surg Glob Open 2016 May 19;4(5):e710. Epub 2016 May 19.
    DAVinci Plastic Surgery, Wash.; DAVinci Plastic Surgery, Georgetown University School of Medicine, Wash.; and Department of Mathematics and Statistics, American University, Wash.
    Background: A best practice goal to reduce surgical site infection includes administration of antibiotics in the ideal preoperative window. This article evaluates an office surgical suite antibiotic administration rate and compares it with the timing of a local hospital treating a similar patient population. The hypothesis was that similar or better compliance and surgical site infection rates can be achieved in the office-based suite. Read More

    Modification of claims-based measures improves identification of comorbidities in non-elderly women undergoing mastectomy for breast cancer: a retrospective cohort study.
    BMC Health Serv Res 2016 08 16;16(a):388. Epub 2016 Aug 16.
    Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, 660 South Euclid Ave. Campus Box 8051, St. Louis, MO, 63110, USA.
    Background: Accurate identification of underlying health conditions is important to fully adjust for confounders in studies using insurer claims data. Our objective was to evaluate the ability of four modifications to a standard claims-based measure to estimate the prevalence of select comorbid conditions compared with national prevalence estimates.

    Methods: In a cohort of 11,973 privately insured women aged 18-64 years with mastectomy from 1/04-12/11 in the HealthCore Integrated Research Database, we identified diabetes, hypertension, deficiency anemia, smoking, and obesity from inpatient and outpatient claims for the year prior to surgery using four different algorithms. Read More

    A retrospective comparison of robotic cholecystectomy versus laparoscopic cholecystectomy: operative outcomes and cost analysis.
    Surg Endosc 2017 03 5;31(3):1436-1441. Epub 2016 Aug 5.
    Division of General and Gastrointestinal Surgery, Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, 395 W 12th Ave, Suite 654, Columbus, OH, 43210, USA.
    Introduction: Robotic-assisted surgery is gaining popularity in general surgery. Our objective was to evaluate and compare operative outcomes and total costs for robotic cholecystectomy (RC) and laparoscopic cholecystectomy (LC).

    Methods And Procedures: A retrospective review was performed for all patients who underwent single-procedure RC and LC from January 2011 to July 2015 by a single surgeon at a large academic medical center. Read More

    Advanced Ultrasound-Guided Interventions for Tendinopathy.
    Phys Med Rehabil Clin N Am 2016 Aug;27(3):733-48
    Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
    Tendinopathy is increasingly recognized as an important cause of musculoskeletal pain and disability. Tendinopathy is thought to be principally a degenerative process, rather than inflammatory as was traditionally believed. Consequently, traditional tendinopathy treatments focused solely on decreasing inflammation have often been ineffective or even harmful. Read More

    Palliative epilepsy surgery in Dravet syndrome-case series and review of the literature.
    Childs Nerv Syst 2016 Sep 27;32(9):1703-8. Epub 2016 Jul 27.
    Department of Neurosurgery, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO, 63130, USA.
    Purpose: Dravet syndrome (DS), also known as severe myoclonic epilepsy of infancy (SMEI), is a rare genetic disorder that results in severe childhood-onset epilepsy. Children with DS initially present with seizures in the first year of life that are often associated with fevers. With age, multiple seizure types develop. Read More

    CT-Guided, Ethanol Sympatholysis for Primary Axillary-Palmar Hyperhidrosis.
    Cardiovasc Intervent Radiol 2016 Dec 26;39(12):1722-1727. Epub 2016 Jul 26.
    Vascular & Interventional Radiology, Johns Hopkins Hospital, 1800 Orleans Street, Sheikh Zayed Tower-Suite 7203, Baltimore, MD, USA.
    Purpose: Primary hyperhidrosis is an excessive sweating due to an overactive sympathetic system. Our objective was to test the feasibility and provide early data on the safety/efficacy of CT-guided sympatholysis, for primary hyperhidrosis.

    Materials And Methods: Nine consecutive patients with axillary-palmar hyperhidrosis were treated between 2013 and 2015. Read More

    Six- and twelve-month documented removal rates among women electing postpartum inpatient compared to delayed or interval contraceptive implant insertions after Medicaid payment reform.
    Contraception 2017 Jan 8;95(1):71-76. Epub 2016 Jul 8.
    Department of Obstetrics and Gynecology, Greenville Health System, 890 W. Faris Road, Greenville, SC 29605, USA. Electronic address:
    Objective: This study aims to document 6- and 12-month removal rates for women receiving the contraceptive implant inpatient postpartum versus those receiving the same contraceptive method during an outpatient visit, in a setting where postpartum inpatient long-acting reversible contraceptive (LARC) services (devices plus provider insertion costs) are reimbursed by Medicaid.

    Study Design: We conducted a retrospective cohort study among Medicaid-enrolled women using medical record review for all women receiving the etonogestrel implant between July 1, 2007 and June 30, 2014. We compared the percentage of women with the implant removed at 6 and 12 months as well as reasons for early removal, for inpatient postpartum implant insertions vs. Read More

    Treatment outcomes and lessons learned from 5134 cases of outpatient office-based endovascular procedures in a vascular surgical practice.
    Vascular 2017 Apr 9;25(2):115-122. Epub 2016 Jul 9.
    2 University Vascular Associates, Los Angeles, CA, USA.
    Introduction The office-based endovascular facility has increased in number recently due in part to expedient patient experience. This study analyzed treatment outcomes of procedures performed in our office-based endovascular suite. Methods Treatment outcomes of 5134 consecutive procedures performed in our office-based endovascular suites from 2006 to 2013 were analyzed. Read More

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