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https://read.qxmd.com/read/30747682/variability-in-critical-care-related-charge-markups-in-medicare-patients
#1
Joshua Tseng, Harry C Sax, Rodrigo F Alban
Charge markups for health care are variable and inflated several times beyond cost. Using the 2015 Medicare Provider Fee-For-Service Utilization and Payment Data file, we identified providers who billed for critical care hours and related procedures, including CPR, EKG interpretation, central line placement, arterial line placement, chest tube/thoracentesis, and emergent endotracheal intubation. Markup ratios (MRs), defined as the amount charged divided by the amount allowable, were calculated and compared; 42...
October 1, 2018: American Surgeon
https://read.qxmd.com/read/30717030/stability-sensory-attributes-and-acceptance-of-panettones-elaborated-with-lactobacillus-fermentum-ial-4541-and-wickerhamomyces-anomallus-ial-4533
#2
Raquel Facco Stefanello, Elizabeth Harumi Nabeshima, Aline de Oliveira Garcia, Rosane Teresinha Heck, Marcelo Valle Garcia, Leadir Lucy Martins Fries, Marina Venturini Copetti
This work aimed to elaborate sourdough panettones with Lactobacillus fermentum (LF) and Wickerhamomyces anomallus (WA) evaluating their microbiological stability, physical and chemical characteristics as well as the impact of these microorganisms on sensory aspects and consumer acceptance. For characterization, panettones were elaborated by long fermentation, using two selected microorganisms, LF and WA in different proportions; and control panettones were formulated using commercial yeast with and without preservative...
February 2019: Food Research International
https://read.qxmd.com/read/30698825/selective-versus-standard-cerebro-myocardial-perfusion-in-neonates-undergoing-aortic-arch-repair-a-multi-center-study
#3
Giovanni Battista Luciani, Stiljan Hoxha, Emanuela Angeli, Francesco Petridis, Lucio Careddu, Alessio Rungatscher, Massimo Caputo, Gaetano Gargiulo
BACKGROUND: The results of neonatal aortic arch surgery using cerebro-myocardial perfusion were analyzed. Selective cerebral and myocardial perfusion, using two separate pump rotors, was compared with standard, using a single pump rotor with an arterial line Y-connector. METHODS: Between 5/2008-5/2016, 69 consecutive neonates underwent arch repair using either selective cerebro-myocardial perfusion (Group A, n=34) or standard (Group B, n=35). The groups were similar for age, weight, BSA, prevalence of one-stage or staged repair and single ventricle palliation; male gender was more frequent in Group A...
January 30, 2019: Artificial Organs
https://read.qxmd.com/read/30644649/effect-of-vasopressin-on-a-porcine-model-of-persistent-pulmonary-hypertension-of-the-newborn
#4
Reem Amer, Yasser N Elsayed, Marjory Ruth Graham, Anurag S Sikarwar, Martha Hinton, Shyamala Dakshinamurti
BACKGROUND: Persistent pulmonary hypertension of the newborn (PPHN) is due to a failure of pulmonary vascular relaxation. Vasopressin, a systemic vasoconstrictor acting on smooth muscle AVPR1a receptors, is used in treatment of PPHN. We sought to determine acute effects of vasopressin infusion on pulmonary hemodynamics in a large animal model of hypoxic PPHN. METHODS: PPHN was induced in 6 newborn piglets by 72 h normobaric hypoxia (FiO2 = 0.10); controls were 7 age-matched 3-day-old piglets...
January 15, 2019: Pediatric Pulmonology
https://read.qxmd.com/read/30642679/evaluation-of-dynamic-ultrasound-for-arterial-access-in-children-undergoing-cardiac-surgery
#5
Genevieve E Staudt, Susan S Eagle, Alexander K Hughes, Brian S Donahue
OBJECTIVE: To evaluate the effect of dynamic ultrasound (US) on the need for surgical intervention to achieve successful arterial cannulation in the pediatric cardiac surgery population. DESIGN: Retrospective, observational study. SETTING: Single, academic, pediatric hospital in the United States. PARTICIPANTS: The study comprised 3,569 consecutive patients who had an arterial catheter placed in the operating room before undergoing congenital heart surgery between January 2004 and September 2016...
December 1, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://read.qxmd.com/read/30641324/totally-endoscopic-ventricular-septal-defect-repair-using-bilateral-femoral-arterial-cannulation-in-an-8-year-old-girl
#6
Huy Q Dang, Huong T Le
INTRODUCTION: There are few reports on applying totally endoscopic surgery (TES) for repairing ventricular septal defect (VSD), especially in children. CASE PRESENTATION: We described an 8-year-old girl, weighing 17 kg, who was diagnosed with peri-membranous VSD and patent ductus arteriosus (PDA). The patient had undergone trans-catheter PDA closure first, and 3 weeks later, TES was performed for VSD repair through 4 small trocars (one 12 mm trocar and three 5 mm trocars) without robotic assistance...
January 9, 2019: International Journal of Surgery Case Reports
https://read.qxmd.com/read/30627811/managing-pathologic-scars-by-injecting-auto-cross-linked-hyaluronic-acid-a-preliminary-prospective-clinical-study
#7
Michele Riccio, Andrea Marchesini, Letizia Senesi, Edlira Skrami, Rosaria Gesuita, Francesco De Francesco
BACKGROUND: Pathological scars are unattractive and may significantly impair the patient's quality of life. Current treatments provide inconsistent results, and none may be regarded as definitive. Recently, an auto-cross-linked hyaluronic acid (HA) formulation, IAL-SYSTEM ACP, featuring a long residence time and an enhanced safety profile, has been successfully used to prevent surgical adhesions, treat tendon lesions and rejuvenate the face and the décolletage. This study aims to preliminarily investigate whether IAL-SYSTEM ACP may also be effective in treating pathological scars resulting from burns, trauma or iatrogenic causes...
January 9, 2019: Aesthetic Plastic Surgery
https://read.qxmd.com/read/30624291/monitoring-haemodynamic-response-to-fluid-challenge-in-icu-comparison-of-pressure-recording-analytical-method-and-oesophageal-doppler-a-prospective-observational-study
#8
Romain Barthélémy, Arthur Neuschwander, Fatou Dramé, Maximilien Redouté, David Ditchi, Jules Stern, Alexandre Mebazaa, Romain Pirracchio, Benjamin G Chousterman
BACKGROUND: The ability of the pressure recording analytical method (PRAM) in tracking change in cardiac output (ΔCO) after a fluid challenge in ICU needs to be evaluated with the most contemporary comparison methods recommended by experts. OBJECTIVE: Our objective was to report the trending ability of PRAM in tracking ΔCO after a fluid challenge in ICU and to compare this with oesophageal Doppler monitoring (ODM). DESIGN: Prospective, observational study...
February 2019: European Journal of Anaesthesiology
https://read.qxmd.com/read/30609176/feasibility-and-indicator-outcomes-using-computerized-clinical-decision-support-in-pediatric-traumatic-brain-injury-anesthesia-care
#9
Ashley A Colletti, Taniga Kiatchai, Vivian H Lyons, Bala G Nair, Rosemary M Grant, Monica S Vavilala
BACKGROUND: Traumatic brain injury anesthesia care is complex. The use of clinical decision support to improve pediatric trauma care has not been examined. AIM: To examine feasibility, reliability, and key performance indicators for traumatic brain injury anesthesia care using clinical decision support. METHODS: Clinical decision support was activated for patients under 19 years undergoing craniotomy for suspected traumatic brain injury. Anesthesia providers were prompted to adhere to process measures via on-screen alerts and notified in real time of abnormal monitor data or laboratory results (unwanted key performance indicator events)...
January 4, 2019: Paediatric Anaesthesia
https://read.qxmd.com/read/30607570/randomized-double-blind-controlled-study-on-the-safety-and-efficacy-of-a-novel-injectable-cross-linked-hyaluronic-gel-for-the-correction-of-moderate-to-severe-nasolabial-wrinkles
#10
Pasquale Fino, Marco Toscani, Francesca Romana Grippaudo, Nicola Giordan, Nicolò Scuderi
INTRODUCTION: The current study compares two hyaluronic acid fillers, Ial System Duo and Belotero Basic/Balance, for the treatment of wrinkles. MATERIALS AND METHODS: This is a single-center, double-blind randomized controlled study. Inclusion criteria consisted of subjects with bilateral nasolabial wrinkles. Each subject was treated with both products: One was applied on the right side and the other on the left side of the face. The quantity of product injected and any problems or local reactions (erythema, edema, pain or itching) were recorded and reassessed at 3 and 6 months and then monthly until complete absorption of the product...
January 3, 2019: Aesthetic Plastic Surgery
https://read.qxmd.com/read/30599986/survival-and-stability-of-lactobacillus-fermentum-and-wickerhamomyces-anomalus-strains-upon-lyophilisation-with-different-cryoprotectant-agents
#11
Raquel Facco Stefanello, Elizabeth Harumi Nabeshima, Beatriz Thie Iamanaka, Aline Ludwig, Leadir Lucy Martins Fries, Angélica Olivier Bernardi, Marina Venturini Copetti
The stability of microorganisms along the time is important for allowing their industrial use as starter agents, improving fermentation processes. This study aimed to evaluate the survival and maintenance of the cell viability of the lactic acid bacteria Lactobacillus fermentum IAL 4541 and the yeast Wickerhamomyces anomalus IAL 4533, both isolated from wheat sourdough, after lyophilisation with different cryoprotectant and storage at room temperature along a year. Treatments involved adding control solution (S1 = 0...
January 2019: Food Research International
https://read.qxmd.com/read/30557214/graduating-fellows-procedural-comfort-level-with-pulmonary-critical-care-procedures
#12
Daniel B Knox, William W Wong
BACKGROUND: Graduating fellows from pulmonary and critical care programs are expected to independently perform bronchoscopy and common medical procedures in the intensive care unit. Given variable exposure and learning opportunities at different training programs, little is known about how comfortable graduating fellows are with these procedures. METHODS: A survey concerning the ACGME required procedures for pulmonary and critical care fellowship was sent to graduating fellows and program directors at all ACGME accredited subspecialty fellowship programs in pulmonary, critical care, and combined pulmonary critical care medicine...
December 14, 2018: Journal of Bronchology & Interventional Pulmonology
https://read.qxmd.com/read/30555807/declining-procedures-by-pediatric-critical-care-medicine-fellowship-trainees
#13
Branden M Engorn, Christopher J L Newth, Margaret J Klein, Elizabeth A Bragg, Rebecca D Margolis, Patrick A Ross
Background: Pediatric Critical Care Medicine Fellowship trainees need to acquire skills to perform procedures. Over the last several years there have been advances that allowed for less invasive forms of interventions. Objective: Our hypothesis was that over the past decade the rate of procedures performed by Pediatric Critical Care Medicine Fellowship trainees decreased. Methods: Retrospective review at a single institution, tertiary, academic, children's hospital of patients admitted from July 1, 2007-June 30, 2017 to the Pediatric Intensive Care Unit and Cardiothoracic Intensive Care Unit...
2018: Frontiers in Pediatrics
https://read.qxmd.com/read/30540642/monitoring-haemodynamic-response-to-fluid-challenge-in-icu-comparison-of-pressure-recording-analytical-method-and-oesophageal-doppler
#14
Romain Barthélémy, Arthur Neuschwander, Fatou Dramé, Maximilien Redouté, David Ditchi, Jules Stern, Alexandre Mebazaa, Romain Pirracchio, Benjamin G Chousterman
BACKGROUND: The ability of the pressure recording analytical method (PRAM) in tracking change in cardiac output (ΔCO) after a fluid challenge in ICU needs to be evaluated with the most contemporary comparison methods recommended by experts. OBJECTIVE: Our objective was to report the trending ability of PRAM in tracking ΔCO after a fluid challenge in ICU and to compare this with oesophageal Doppler monitoring (ODM). DESIGN: Prospective, observational study...
December 11, 2018: European Journal of Anaesthesiology
https://read.qxmd.com/read/30514327/epidemiology-of-mechanically-ventilated-patients-treated-in-icu-and-non-icu-settings-in-japan-a-retrospective-database-study
#15
Yoshiaki Iwashita, Kazuto Yamashita, Hiroshi Ikai, Masamitsu Sanui, Hiroshi Imai, Yuichi Imanaka
BACKGROUND: In most countries, patients receiving mechanical ventilation (MV) are treated in intensive care units (ICUs). However, in some countries, including Japan, many patients on MV are not treated in ICUs. There are insufficient epidemiological data on these patients. Here, we sought to describe the epidemiology of patients on MV in Japan by comparing and contrasting patients on MV treated in ICUs and in non-ICU settings. A preliminary comparison of patient outcomes between ICU and non-ICU patients was a secondary objective...
December 4, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/30511646/-finger-necrosis-following-arterial-cannulation-a-case-report
#16
Atli Steinn Valgardsson, Sigurbergur Karason, Elin Laxdal, Kristin Huld Haraldsdottir
Arterial cannulation is a common procedure in critically ill patients, as it facilitates continuous monitoring of blood pressure, titration of inotropes, vasopressors and fluids and is also used for blood sampling. Serious complications from arterial lines are very rare, permanent ischemic damage occurs in less than 0,1% of patients. We report the case of a 60-year-old woman in septic shock caused by a perforated duodenal ulcer which was treated with emergent laparoscopic repair. She required high doses of vasopressors and received several arterial lines, including lines in both the ulnar and the radial arteries of the left arm...
December 2018: Læknablađiđ
https://read.qxmd.com/read/30489332/perioperative-invasive-vascular-catheterization-associated-with-increased-risk-of-postoperative-infection-in-lumbar-spine-surgery-an-analysis-of-114-259-patient-records
#17
Edward Compton, Patrick Heindel, Blake Formanek, Kyle Schoell, Zorica Buser, Jeffrey C Wang
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: This study's objective was to determine whether perioperative invasive vascular catheter placement, independent of comorbid conditions, modified the risk of postoperative infection in lumbar spine surgery. SUMMARY OF BACKGROUND DATA: Infection is a risk inherent to lumbar spine surgery, with overall postoperative infection rates of 0.86%-8.5%. Patients experiencing postoperative infection have higher rates of mortality, revision surgeries, pseudarthrosis, and worsening pain and disability...
November 26, 2018: Clinical Spine Surgery
https://read.qxmd.com/read/30460178/making-care-better-in-the-pediatric-intensive-care-unit
#18
REVIEW
Heather A Wolfe, Elizabeth H Mack
The relatively young field of pediatric critical care has seen a shift from an approach with little consideration for the complications and adverse effects resulting from the procedures and medications to a more cautious approach with careful concern for the associated risks. Many senior pediatric intensivists recall a time when nearly every patient had a central venous line and arterial line; and hospital acquired infections, pressure injuries, unplanned extubations, and venous thromboemboli were expected costs of aggressive care...
October 2018: Translational Pediatrics
https://read.qxmd.com/read/30447193/heparin-binding-protein-in-adult-heart-surgery
#19
Eero Pesonen, Arie Passov, Ulla-Stina Salminen, Minna Ilmakunnas, Antti Vento, Juha Aittomäki, Sture Andersson, Alexey Schramko
BACKGROUND: Heparin binding protein (HBP) is released from neutrophilic secretory vesicles upon neutrophil adhesion on the endothelium. HBP mediates capillary hyperpermeability experimentally. In sepsis, HBP predicts organ dysfunction. Cardiopulmonary bypass induces both neutrophil activation and hyperpermeability. We hypothesized that in cardiopulmonary bypass, HBP is released in the reperfused coronary circulation concomitantly with neutrophil adhesion. METHODS: In 30 patients undergoing aortic valve replacement, concomitant blood samples were drawn from the coronary sinus and arterial line before aortic crossclamping and 5 min after reperfusion to calculate transcoronary differences...
November 14, 2018: Annals of Thoracic Surgery
https://read.qxmd.com/read/30444787/ulnar-artery-thrombosis-following-tranexamic-acid-administration-for-craniosynostosis-repair
#20
Eugene Chung, Helena I Karlberg
Pediatric craniosynostosis repair with cranial vault reconstructive surgery can be associated with significant blood loss. Tranexamic acid (TXA), an antifibrinolytic agent, has been shown to decrease blood loss and transfusion volume in craniofacial surgery. Nonetheless data regarding the safety of TXA remains limited. The authors describe a case of ulnar artery thrombosis following ulnar arterial line placement in a patient who received TXA for cranial vault reconstructive surgery.
November 15, 2018: Journal of Craniofacial Surgery
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