1,648 results match your criteria expansion january

Factors Associated With State-Specific Medicaid Expansion and Receipt of Autologous Breast Reconstruction Among Patients Undergoing Mastectomy.

JAMA Netw Open 2021 Aug 2;4(8):e2119141. Epub 2021 Aug 2.

Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor.

Importance: Despite demonstrated psychosocial benefits, autologous breast reconstruction remains underutilized. An analysis of the association between Medicaid expansion and autologous breast reconstruction has yet to be performed.

Objective: To compare autologous breast reconstruction rates and determine the association between Medicaid expansion and breast reconstruction. Read More

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Effective use of weight-based enoxaparin for deep vein thrombosis chemoprophylaxis in patients with traumatic brain injury.

Am J Surg 2021 Jul 28. Epub 2021 Jul 28.

Augusta University, Department of Surgery, Division of Trauma/Surgical Critical Care, 1120 15th Street, BB-4415, Augusta, GA, 30912, USA. Electronic address:

Background: Enoxaparin is the recommended agent for deep vein thrombosis (DVT) chemoprophylaxis in trauma patients. Current literature suggests weight-based dosing is superior to standard dosing for adequate chemoprophylaxis. Literature regarding the use of weight-based enoxaparin in the setting of traumatic brain injury (TBI) however is limited. Read More

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[Complications of head and neck expansion: Acting on modifiable factors. A study of 98 prothesis].

Ann Chir Plast Esthet 2021 Jul 27. Epub 2021 Jul 27.

Hôpital Charles Nicole, Tunis, Tunisie. Electronic address:

Background: Tissue expansion is a key tool in the therapeutic arsenal that is proposed for repairing soft tissue losses of the head and neck. This technique, however interesting it may be, is not without its risks. The aim of this work is to identify the different steps of this procedure, determine the complications risk factors inherent to each step of the expansion and propose recommendations to improve functional and aesthetic results. Read More

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Changes of stent-graft orientation after frozen elephant trunk treatment in aortic dissection.

Eur J Cardiothorac Surg 2021 Jul 30. Epub 2021 Jul 30.

Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, Essen, Germany.

Objectives: Our goal was to evaluate the extent of stent-graft (SG) elastic recoil in the descending aorta after the frozen elephant trunk procedure in acute (AAD) and chronic (CAD) aortic dissection as well as the impact of SG movement on distal stent graft-induced new entry (d-SINE).

Methods: We retrospectively analysed 149 (105 AAD, 44 CAD) of 259 aortic dissection patients after the frozen elephant trunk procedure between January 2005 and April 2019. Inclusion criteria were at least 1-year computed tomography angiography (CTA) aortic examinations during a follow-up time of 3. Read More

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Improvement in Breast Reconstruction Disparities following Medicaid Expansion under the Affordable Care Act.

Ann Surg Oncol 2021 Jul 28. Epub 2021 Jul 28.

Loma Linda University Health, Loma Linda, CA, USA.

Background:  Under the Affordable Care Act, Medicaid expansion effective 1 January 2014 aimed to increase access to health care. We sought to determine the association of Medicaid expansion with disparities in utilization of breast reconstruction.

Methods: Non-Hispanic Black (NHB) and White (NHW) breast cancer patients undergoing mastectomy +/- reconstruction between 2010 and 2017 were selected from the National Cancer Database. Read More

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Nonenteric Adenoviruses Associated with Gastroenteritis in Hospitalized Children.

Microbiol Spectr 2021 Jul 28:e0030021. Epub 2021 Jul 28.

Institute of Microbiology, Department of Molecular and Translational Medicine, University of Brescia-Spedali Civili, Brescia, Italy.

The object of this study was to investigate the frequency of human adenovirus (HAdV) infections in hospitalized pediatric patients. Stool samples were collected during a 1-year period (February 2018 to January 2019). HAdV was detected by a broad-range PCR and genotyped by sequencing and phylogenetic analysis. Read More

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ACA Medicaid expansion association with racial disparity reductions in timely cancer treatment.

Am J Manag Care 2021 Jul;27(7):274-281

Flatiron Health, Inc, 233 Spring St, Fifth Fl, New York, NY 10025. Email:

Objectives: Racial disparities in cancer care and outcomes remain a societal challenge. Medicaid expansion through the Affordable Care Act was intended to improve health care access and equity. This study aimed to assess whether state Medicaid expansions were associated with a reduction in racial disparities in timely treatment among patients diagnosed with advanced cancer. Read More

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Radiomics and machine learning to predict aggressive type 2 endoleaks after endovascular aneurysm repair: a proof of concept.

Acta Radiol 2021 Jul 27:2841851211032443. Epub 2021 Jul 27.

Interventional Radiology Unit, Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece.

Background: Persistent type 2 endoleaks (T2EL) require lifelong surveillance to avoid potentially life-threatening complications.

Purpose: To evaluate the performance of radiomic features (RF) derived from computed tomography angiography (CTA), for differentiating aggressive from benign T2ELs after endovascular aneurysm repair (EVAR).

Material And Methods: A prospective study was performed on patients who underwent EVAR from January 2018 to January 2020. Read More

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Sexual and reproductive health services provided by community pharmacists: a scoping review.

BMJ Open 2021 07 26;11(7):e047034. Epub 2021 Jul 26.

Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada

Objectives: Pharmacists are increasingly providing patient-focused services in community pharmacies, including in the area of sexual and reproductive health (SRH). Specific SRH areas have been the focus of research, but a broader perspective is needed to position pharmacists as SRH providers. This review explored research that described and evaluated professional pharmacy services across a broad range of SRH areas. Read More

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Correlation analysis between rim enhancement features of contrast-enhanced ultrasound and lymph node metastasis in breast cancer.

Am J Transl Res 2021 15;13(6):7193-7199. Epub 2021 Jun 15.

Department of Ultrasound Medicine, Heping Hospital Affiliated to Changzhi Medical College Changzhi, Shanxi, China.

Objective: To explore the correlation between rim enhancement features of contrast-enhanced ultrasound and lymphatic metastasis, and to provide theoretical support for clinical treatment of breast cancer.

Methods: 387 breast cancer patients (748 axillary lymph nodes in total) treated in our hospital from January 2017 to January 2020 were selected and analyzed by contrast-enhanced ultrasound. Pathological examination showed that 540 axillary lymph nodes showed metastasis whereas 208 axillary lymph nodes did not show metastasis. Read More

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Short Term Outcomes of Distal Extended EndoVascular Aortic Repair (DEEVAR) Petticoat in Acute and Subacute Complicated Type B Aortic Dissection.

Eur J Vasc Endovasc Surg 2021 Jul 20. Epub 2021 Jul 20.

Division of Vascular Surgery, Department of Cardiovascular Diseases, A. Manzoni Hospital, Lecco, Italy.

Objective: The aim of this study was to evaluate the peri-operative and short term results of institutional experience with the Distal Extended EndoVascular Aortic Repair PETTICOAT (DEEVAR PETTICOAT) procedure.

Methods: This was a single centre, observational study. From January 2015 to December 2019, 53 patients were admitted to the institution for treatment of acute and subacute complicated type B aortic dissection. Read More

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Medical Debt in the US, 2009-2020.

JAMA 2021 07;326(3):250-256

National Bureau of Economic Research, Cambridge, Massachusetts.

Importance: Medical debt is an increasing concern in the US, yet there is limited understanding of the amount and distribution of medical debt, and its association with health care policies.

Objective: To measure the amount of medical debt nationally and by geographic region and income group and its association with Medicaid expansion under the Affordable Care Act.

Design, Setting, And Participants: Data on medical debt in collections were obtained from a nationally representative 10% panel of consumer credit reports between January 2009 and June 2020 (reflecting care provided prior to the COVID-19 pandemic). Read More

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Neighborhood Characteristics and Cancer Survivorship: An Overview of the Current Literature on Neighborhood Landscapes and Cancer Care.

Int J Environ Res Public Health 2021 07 5;18(13). Epub 2021 Jul 5.

Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA.

There is a growing literature on the association between neighborhood contexts and cancer survivorship. To understand the current trends and the gaps in the literature, we aimed to answer the following questions: To what degree, and how, has cancer survivorship research accounted for neighborhood-level effects? What neighborhood metrics have been used to operationalize neighborhood factors? To what degree do the neighborhood level metrics considered in cancer research reflect neighborhood development as identified in the Leadership for Energy and Environmental Design for Neighborhood Development (LEED-ND) guidelines? We first conducted a review guided by PRISMA extension for scoping review of the extant literature on neighborhood effects and cancer survivorship outcomes from January 2000 to January 2021. Second, we categorized the studied neighborhood metrics under six main themes. Read More

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Disability-Adjusted Life-Years Associated With Intracerebral Hemorrhage and Secondary Injury.

JAMA Netw Open 2021 Jul 1;4(7):e2115859. Epub 2021 Jul 1.

Department of Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Importance: Intracerebral hemorrhage (ICH) contributes significantly to the global burden of disease.

Objective: To examine the association of ICH and secondary injury with disability-adjusted life-years (DALYs) for the individual patient.

Design, Setting, And Participants: This cohort study was conducted using data from the Universitätsklinikum Erlangen Cohort of Patients With Spontaneous Intracerebral Hemorrhage study. Read More

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An Innovative Approach to Educating Medical Students About Personal Finance.

Cureus 2021 Jun 10;13(6):e15579. Epub 2021 Jun 10.

Department of Surgery, Florida State University College of Medicine, Tallahassee, USA.

Background The lack of financial literacy among medical students and physicians is a well-documented problem that is yet to be sufficiently addressed. The full immersion of physicians into their scientific education and medical training makes it challenging to also comprehensively learn about personal finance. With the vast debt that most medical students undergo, it is crucial to focus on this issue. Read More

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Evaluation of Insurance Coverage and Cancer Stage at Diagnosis Among Low-Income Adults With Renal Cell Carcinoma After Passage of the Patient Protection and Affordable Care Act.

JAMA Netw Open 2021 Jul 1;4(7):e2116267. Epub 2021 Jul 1.

Department of Urology, University of California, San Diego, School of Medicine, La Jolla.

Importance: The association of the Patient Protection and Affordable Care Act (ACA) with insurance status and cancer stage at diagnosis among patients with renal cell carcinoma (RCC) is unknown.

Objective: To test the hypothesis that the ACA may be associated with increased access to care through expansion of insurance, which may vary based on income.

Design, Setting, And Participants: This retrospective cohort analysis included patients diagnosed with RCC from January 1, 2010, to December 31, 2016, in the National Cancer Database. Read More

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Fluid status changes during the transition in infants of diabetic mothers.

Eur J Pediatr 2021 Jul 15. Epub 2021 Jul 15.

Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.

In animal and human neonates, expansion of the extracellular fluid volume is associated with "wet" lung and poor respiratory outcomes. To define fluid status changes during the transition from fetal to neonatal life in infants of diabetic mothers (IDM), we conducted a single-centre (Policlinico Abano Terme, Abano Terme, Italy) study of 66 IDM and a 1:2 matched control group from January 1 to September 30, 2020. Fluid status changes were assessed by computing Δ Hct from umbilical cord blood at birth and capillary heel Hct at 48 h, accounting for body weight decrease. Read More

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Patient and Visit Characteristics of Families Accessing Pediatric Urgent Care Telemedicine During the COVID-19 Pandemic.

Telemed J E Health 2021 Jul 15. Epub 2021 Jul 15.

Center for Health Delivery Innovation, Nemours Children's Health, Jacksonville, Florida, USA.

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Development of the Defense Registry for Emergency Airway Management (DREAM).

Med J (Ft Sam Houst Tex) 2021 Apr-Jun(PB 8-21-04/05/06):93-97

US Army Institute of Surgical Research, JBSA Fort Sam Houston, TX, Brooke Army Medical Center, JBSA Fort Sam Houston, TX, and Uniformed Services University of the Health Sciences, Bethesda, MD.

Introduction: Airway obstruction is the second leading cause of potentially preventable death on the battlefield. Endotracheal intubation is a critical skill needed by emergency military physicians to manage these patients. Our objective is to describe the development of the Defense Registry for Emergency Airway Management (DREAM) at Brooke Army Medical Center (BAMC), a level 1 trauma center over a 7-month period. Read More

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Tranexamic Acid in Intracerebral Hemorrhage: A Meta-Analysis.

Zhang Yu Liu Ling

Int J Neurosci 2021 Jul 7:1-12. Epub 2021 Jul 7.

Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

:Tranexamic acid(TA) is an antifibrinolytic agent, which has shown an effect on reducing blood loss in many diseases. Tranexamic acid might be beneficial for intracerebral hemorrhage(ICH). However, whether TA can treatment of intracerebral hemorrhage is still controversial. Read More

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Association of rural location and long acting reversible contraceptive use among Oregon Medicaid recipients.

Contraception 2021 Jul 2. Epub 2021 Jul 2.

Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, OR, United States.

Objective: To evaluate whether the use of long-acting, reversible contraception (LARC) is equitably accessible to Medicaid recipients in rural and urban areas. We also determined whether women's health specialists' availability was associated with the type of LARC used.

Study Design: We used claims data for 242,057 adult women who were continuously enrolled in Oregon Medicaid for at least one year and at risk of pregnancy from January 1, 2015, through December 31, 2017 to assess the association between LARC utilization and (1) rurality and (2) provider supply. Read More

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Predictive Ability of Ultraearly Hematoma Growth and Spot Sign for Redefined Hematoma Expansion in Patients with Spontaneous Intracerebral Hemorrhage.

J Stroke Cerebrovasc Dis 2021 Jun 29;30(9):105950. Epub 2021 Jun 29.

Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, PR China. Electronic address:

Background: Redefined hematoma expansion (rHE) including intraventricular hematoma expansion (IVHE) is a new concept in intracerebral hemorrhage (ICH), with better prognostic ability compared to the conventional hematoma expansion. Ultraearly hematoma growth (uHG) and computed tomography angiography (CTA) spot sign are both useful indictors to predict HE and poor clinical outcome. This study aims to explore the clinical characteristics of rHE in retrospective cohort and evaluate the predictive ability of uHG and spot sign in rHE. Read More

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Attitudes towards the COVID-19 Vaccine and Willingness to Get Vaccinated among Healthcare Workers in French Guiana: The Influence of Geographical Origin.

Vaccines (Basel) 2021 Jun 21;9(6). Epub 2021 Jun 21.

Centre d'Investigation Clinique Antilles Guyane, CIC Inserm 1424, DRISP, Centre Hospitalier de Cayenne, Av des Flamboyants, 97300 Cayenne, France.

In the context of the global COVID-19 pandemic and the expansion of the more transmissible 20J/501Y.V3 (Gamma) variant of concern (VOC), mRNA vaccines have been made available in French Guiana, an overseas French territory in South America, from mid-January 2021. This study aimed to estimate the willingness to be vaccinated and the socio-demographic and motivational correlates among Health Care Workers (HCWs) in French Guiana. Read More

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Use of Technology to Promote Health and Wellbeing of People Who Are Homeless: A Systematic Review.

Int J Environ Res Public Health 2021 06 25;18(13). Epub 2021 Jun 25.

Department of Nursing Science, Faculty of Health and Social Sciences, Bournemouth University, Poole BH12 5BB, UK.

Background: People who are homeless experience poorer health outcomes and challenges accessing healthcare contribute to the experienced health inequality. There has been an expansion in using technology to promote health and wellbeing and technology has the potential to enable people who are socially excluded, including those who are homeless, to be able to access health services. However, little research has been undertaken to explore how technology is used to promote health and wellbeing for those who are homeless. Read More

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Assessing the performance of a method for case-mix adjustment in the Korean Diagnosis-Related Groups (KDRG) system and its policy implications.

Health Res Policy Syst 2021 Jun 29;19(1):98. Epub 2021 Jun 29.

Department of Preventive Medicine and Public Health, College of Medicine, The Catholic University, Main building No. 223, 222 Banpodaero, Seoul, Korea.

Background: To evaluate the performance of the patient clinical complexity level (PCCL) mechanism, which is the patient-level complexity adjustment factor within the Korean Diagnosis-Related Groups (KDRG) patient classification system, in explaining the variation in resource consumption within age adjacent diagnosis-related groups (AADRGs).

Methods: We used the inpatient claims data from a public hospital in Korea from 1 January 2017 to 30 June 2019, with 18 846 claims and 138 AADRGs. The differences in the total average payment between the four PCCL levels for each AADRG was tested using ANOVA and Duncan's post hoc test. Read More

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Estimated Cost-effectiveness of Solar-Powered Oxygen Delivery for Pneumonia in Young Children in Low-Resource Settings.

JAMA Netw Open 2021 Jun 1;4(6):e2114686. Epub 2021 Jun 1.

University of Alberta, Edmonton, Canada.

Importance: Pneumonia is the leading cause of childhood mortality worldwide. Severe pneumonia associated with hypoxemia requires oxygen therapy; however, access remains unreliable in low- and middle-income countries. Solar-powered oxygen delivery (solar-powered O2) has been shown to be a safe and effective technology for delivering medical oxygen. Read More

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Phase 1 dose-escalation and pharmacokinetic study of regorafenib in paediatric patients with recurrent or refractory solid malignancies.

Eur J Cancer 2021 Aug 20;153:142-152. Epub 2021 Jun 20.

Children & Young People's Unit, Paediatric and Adolescent Oncology Drug Development Team, The Royal Marsden NHS Foundation Trust and Division of Clinical Studies, Institute of Cancer Research, Sutton, UK.

Background: This phase 1 study evaluated safety, pharmacokinetics (PK), maximum tolerated dose (MTD), and antitumour activity of regorafenib in paediatric patients with solid tumours.

Patients And Methods: Patients (aged 6 months to <18 years) with recurrent/refractory solid tumours received oral regorafenib once daily for 3 weeks on/1 week off. The starting dose (60 mg/m) was derived from an adult physiology-based PK model and scaled to children; dose escalation was followed by safety expansion of the MTD cohort. Read More

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Initial survival of the Isis® total trapeziometacarpal prosthesis with conical trunk threaded cups.

Rev Esp Cir Ortop Traumatol 2021 Jun 17. Epub 2021 Jun 17.

Servicio de Cirugía Ortopédica y Traumatología, Unidad de Mano y Muñeca, Hospital Universitario Marqués de Valdecilla, Santander, España; Universidad de Cantabria, Santander, España.

Introduction: The treatment of trapeziometacarpal osteoarthritis through the implantation of total trapeziometacarpal prostheses is in continuous expansion. The Isis® prosthesis is a trunk-conical threaded anchorage prosthesis. Our objective was to assess the functional results and survival of this implant for at least one year of follow-up. Read More

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The impact of expanding health insurance coverage for anti-cancer drugs on cancer survival in Korea.

Cancer Med 2021 Jul 18;10(13):4555-4563. Epub 2021 Jun 18.

Department of Research, Health Insurance Review & Assessment Service, Wonju, South Korea.

Background: To reduce out-of-pocket costs, the Korean government expanded health insurance reimbursement in anti-cancer drugs for cancer patients in 2013. Our objective was to examine the impact of the benefit coverage expansion policy on healthcare utilization and overall survival (OS) among patients with six types of solid cancer after the policy of expanding health insurance coverage.

Methods: This study analyzed a before-and-after retrospective cohort of patients newly diagnosed with six types of solid cancer (stomach cancer, colorectal cancer, lung cancer, liver cancer, breast cancer, and prostate cancer) from January 1, 2009 to December 31, 2015 in Korea. Read More

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Optimized strategy of rotational atherectomy of underexpanded coronary stents in patients with acute coronary syndrome.

World J Emerg Med 2021 ;12(3):198-201

Department of Cardiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China.

Background: Stent under-expansion is a main cause of acute coronary syndrome (ACS), which can lead to serious clinical outcomes. The rotational atherectomy of underexpanded coronary stents (academically called stent ablation, SA) by intravascular ultrasound (IVUS) may provide more visual reference in the intervention. We aim to analyze the procedural and long-term outcomes of the optimized strategy of SA in patients with ACS and to provide real-world data on this technique. Read More

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January 2021