Objective: Identify differences in Medicare reimbursement changes for general otolaryngology, pediatric otolaryngology, head and neck oncology, laryngology, rhinology, otology, facial plastic and reconstructive surgery, and sleep surgery subspecialties from 2013 to 2024.
Methods: Subspecialty-based procedures' facility prices and relative value units (RVUs) were sourced from the Centers for Medicare & Medicaid Services' Physician Fee Schedule. Prices were adjusted for inflation, and the average percent change in facility price and RVUs for each subspecialty was calculated.
Objective We analyzed changes in reimbursement rates for cardiothoracic surgery procedures from 2013 to 2022 to identify interstate variance and compare changes in reimbursement between procedural groups. Methods The Center for Medicare and Medicaid Services database was analyzed to find the 100 highest-grossing cardiothoracic surgery CPT codes from 2013 to 2022. Medicare Administrative Contractor codes were utilized to identify reimbursement for each state.
View Article and Find Full Text PDFThis study analyzed the geographic variation in annual Medicare reimbursement changes for common burn surgery procedures from 2011 to 2022 to clarify trends in reimbursement. The Center for Medicare and Medicaid Services' Physician fee schedule database was analyzed to find state-by-state reimbursement rates for the most common burn surgery procedures. Physician reimbursement was adjusted for inflation utilizing the consumer price index.
View Article and Find Full Text PDFGenes Chromosomes Cancer
September 2024
Introduction: Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) is a high risk form of ALL associated with dismal outcomes in the pre-tyrosine kinase inhibitor (TKI) era. Addition of a TKI to chemotherapy improves outcomes. Therefore, testing for the presence of the Philadelphia chromosome by at least two methods at the time of diagnosis is critical.
View Article and Find Full Text PDFLancet Reg Health West Pac
July 2024
Background: Health systems have a dual imperative to take action on climate change. First, they must develop climate resilient health services in response to the direct and indirect impacts of climate change on health. Second, they must reduce their own carbon footprint since health systems are a significant contributor to global greenhouse gas emissions.
View Article and Find Full Text PDFIntroduction: There is an urgent need to determine the safety, effectiveness and cost-effectiveness of novel antiviral treatments for COVID-19 in vaccinated patients in the community at increased risk of morbidity and mortality from COVID-19.
Methods And Analysis: PANORAMIC is a UK-wide, open-label, prospective, adaptive, multiarm platform, randomised clinical trial that evaluates antiviral treatments for COVID-19 in the community. A master protocol governs the addition of new antiviral treatments as they become available, and the introduction and cessation of existing interventions via interim analyses.
The solution phase anion binding behavior of a water-stable bidentate pnictogen bond donor was studied. A modest change in the visible absorption spectrum allowed for the determination of the binding constants. High binding constants were observed with cyanide, cyanate, and acetate, and these were corroborated with density functional theory (DFT) calculations.
View Article and Find Full Text PDFPurpose: Failure to respond to induction chemotherapy portends a poor outcome in childhood acute lymphoblastic leukemia (ALL) and is more frequent in T-cell ALL (T-ALL) than B-cell ALL. We aimed to address the limited understanding of clinical and genetic factors that influence outcome in a cohort of patients with T-ALL induction failure (IF).
Methods: We studied all cases of T-ALL IF on two consecutive multinational randomized trials, UKALL2003 and UKALL2011, to define risk factors, treatment, and outcomes.
Background: Successful comprehensive population-based approaches to chronic disease prevention leverage mass media to amplify messages and support a culture of health. We report on a community-engaged formative evaluation to segment audiences and identify major themes to guide campaign message development for a transformative health communication campaign.
Methods: Four key phases of campaign development: (I) Formative evaluation to identify priorities, guiding themes, and audience segments (interviews/focus groups with residents, = 85; representatives of community-based partner organizations, = 10); (II) Brand development (focus groups and closed-ended surveys; = 56); (III) Message testing approaches to verbal and visual appeals (= 50 resident intercept interviews); (IV) Workshop (= 26 participants representing 15 organizations).
Background: The safety, effectiveness, and cost-effectiveness of molnupiravir, an oral antiviral medication for SARS-CoV-2, has not been established in vaccinated patients in the community at increased risk of morbidity and mortality from COVID-19. We aimed to establish whether the addition of molnupiravir to usual care reduced hospital admissions and deaths associated with COVID-19 in this population.
Methods: PANORAMIC was a UK-based, national, multicentre, open-label, multigroup, prospective, platform adaptive randomised controlled trial.
A well-known complication of COVID-19 is hypercoagulability in both the venous and arterial circulation. Most cases of hypercoagulability-related complications have been described in hospitalized patients with severe diseases and multiple comorbidities. However, this report outlines a case of myocardial infarction in a young patient with no prior medical history after only a mild course of COVID-19.
View Article and Find Full Text PDFVirus-specific T-cells (VSTs) from third-party donors mediate short- and long-term antiviral effects in allogeneic hematopoietic stem cell transplant (HSCT) recipients with relapsed or refractory viral infections. We investigated early administration of third-party VSTs, together with antiviral therapy in patients requiring treatment for first cytomegalovirus (CMV) or Epstein-Barr virus (EBV) infection. Thirty HSCT patients were treated with 1 to 4 VST infusions (2 × 107 cells/m2; CMV n=27, EBV n=3) at a median of 4 days after initiation of antiviral treatment.
View Article and Find Full Text PDFThe prevalence of problematic Internet use (PIU) and its associated negative outcomes among college students has been heavily researched in developed countries. However, despite the increased accessibility of the Internet and indicators which may suggest PIU in developing countries such as Jamaica, PIU in this context remains grossly understudied. This study surveyed 277 Jamaican university students and found evidence of PIU, with younger respondents (ages 18-23) at risk.
View Article and Find Full Text PDFWe designed a trial to simultaneously address the problems of graft versus host disease (GVHD), infection, and recurrence of malignancy after allogeneic stem cell transplantation. CD34 stem cell isolation was used to minimize the development of acute and chronic GVHD. Two prophylactic infusions, one combining donor-derived cytomegalovirus, Epstein-Barr virus, and Aspergillus fumigatus specific T-cells and the other comprising donor-derived CD19 directed chimeric antigen receptor (CAR) bearing T-cells, were given 21-28 days after transplant.
View Article and Find Full Text PDFWorldwide, socio-cultural determinants have been shown to influence the beliefs of patients about their health and decision making for treatment. This is consistent with the evidence that cultural and religious beliefs affect illness conceptualization and behaviors of Jamaican patients living with non-communicable diseases, such as diabetes mellitus and hypertension. Despite these known socio-cultural influences, an acknowledgment of relevance of adherence to pharmacotherapy has been grossly understudied.
View Article and Find Full Text PDFPhosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) signaling is commonly dysregulated in acute lymphoblastic leukemia (ALL). The TACL2014-001 phase I trial of the mTOR inhibitor temsirolimus in combination with cyclophosphamide and etoposide was performed in children and adolescents with relapsed/refractory ALL. Temsirolimus was administered intravenously (IV) on days 1 and 8 with cyclophosphamide 440 mg/m2 and etoposide 100 mg/m2 IV daily on days 1-5.
View Article and Find Full Text PDFIntroduction: Central cancer registries are responsible for managing appropriate research contacts and record releases. Do not contact (DNC) flags are used by some registries to indicate patients who should not be contacted or included in research. Longitudinal changes in DNC coding practices and definitions may result in a lack of code standardization and inaccurately include or exclude individuals from research.
View Article and Find Full Text PDFCytomegalovirus (CMV) is a human herpes virus that causes significant morbidity and mortality in immunosuppressed children. CMV primary infection causes a clinically mild disease in healthy children, usually in early childhood; the virus then utilises several mechanisms to establish host latency, which allows for periodic reactivation, particularly when the host is immunocompromised. It is this reactivation that is responsible for the significant morbidity and mortality in immunocompromised children.
View Article and Find Full Text PDFBackground: Drug-coated balloon (DCB) technology was developed as an alternative treatment for obstructive coronary artery disease (CAD) and in-stent restenosis (ISR). Management of coronary ISR is clinically challenging and frequently encountered in practice. The Agent DCB uses an inactive excipient to effectively deliver a targeted, therapeutic dose of paclitaxel to the vessel wall.
View Article and Find Full Text PDF