Discharge Disposition after Total Hip Arthroplasty: A 10-Year Analysis of Trends and Predictors of Nonhome Discharge (2011-2021).

Background: Total hip arthroplasty (THA) practices are evolving under the influence of the current value-based healthcare system and bundled payment models. This study aimed to (1) evaluate national trends in discharge disposition and postoperative outcomes after THA, (2) compare discharge cohorts on episode-of-care parameters, and (3) determine predictors of nonhome discharge from 2011 to 2021.

Methods: The National Surgical Quality Improvement Program database was queried for THA data from 2011 to 2021.

Differentiating seborrheic keratosis from melanoma among lesions exhibiting blue-white veil: A retrospective study.

Background: Differentiating melanoma (MM) from seborrheic keratosis (SK) containing a blue-white veil (BWV) remains challenging.

Objective: Identify dermoscopic features that can improve upon the differentiation between MMs and SKs exhibiting BWV.

Methods: Images from 110 MMs and 121 SKs containing BWV were aggregated, and 91 MMs and 62 SKs from this data set had complete agreement on the presence of BWV according to 3 expert dermoscopists.

Are Otolaryngologists Seeing More Cough? Longitudinal Trends and Patterns.

Objective: Otolaryngologists play an increasing role in managing cough, but little data exists examining the demographics of this patient population and the referral patterns that influence their access to care. This study sought to elucidate these factors using a longitudinal, nationwide database to minimize sampling bias and identify trends representative of the national population.

Study Design: Nationally representative survey.

Improvements in Precision of Relative Binding Free Energy Calculations Afforded by the Alchemical Enhanced Sampling (ACES) Approach.

Accurate predictions of how strongly small molecules bind to proteins, such as those afforded by relative binding free energy (RBFE) calculations, can greatly increase the efficiency of the hit-to-lead and lead optimization stages of the drug discovery process. The success of such calculations, however, relies heavily on their precision. Here, we show that a recently developed alchemical enhanced sampling (ACES) approach can consistently improve the precision of RBFE calculations on a large and diverse set of proteins and small molecule ligands.

Preoperative Hypoalbuminemia Predicts 30-day Complications in Head and Neck Microvascular Surgery.

Introduction: Hypoalbuminemia, a marker for poor nutritional status, has been associated with postoperative complications, including head and neck cancer surgery. This study investigates the impact of hypoalbuminemia on head and neck microvascular free tissue transfer reconstruction.

Methods: This retrospective cohort study queried the 2005-2021 American College of Surgeons National Surgical Quality Improvement Program databases.

Positive Trends in Racial Disparities for Head and Neck Microvascular Reconstructive Surgery.

Objective: To evaluate national trends in racial disparities for patients undergoing head and neck reconstructive surgery.

Methods: Retrospective analysis using the 2008 to 2021 American College of Surgeons National Surgical Quality Improvement Program database. Patients receiving microvascular free tissue transfer were eligible for inclusion.

Longitudinal Analysis of the Use of Facial Reanimation Procedures for Bell's Palsy.

Treatment of Bell's palsy ranges from medical management with high-dose corticosteroids to complex facial reanimation procedures. To characterize the number of static, dynamic, and combined facial reanimation procedures for the management of Bell's palsy using a national database over time. This retrospective cohort study included patients in the 2013-2020 National Surgical Quality Improvement Project database with a postoperative diagnosis of Bell's palsy.

Hospital-associated venous thromboembolism prophylaxis use by risk assessment at a large integrated health care network in Northern California.

Background: Hospital-acquired venous thromboembolism (HA VTE) is a preventable complication in hospitalized patients.

Objective: We aimed to examine the use of pharmacologic prophylaxis (pPPX) and compare two risk assessment methods for HA VTE: a retrospective electronic Padua Score (ePaduaKP) and admitting clinician's choice of risk within the admission orderset (low, moderate, or high).

Design, Settings And Participants: We retrospectively analyzed prophylaxis orders for adult medical admissions (2013-2019) at Kaiser Permanente Northern California, excluding surgical and ICU patients.

Robotic Assisted Percutaneous Coronary Intervention: Initial Australian Experience.

Background & Aim: Robotic-assisted percutaneous coronary intervention (R-PCI) has been increasingly performed overseas. Initial observations have demonstrated its clinical efficacy and safety with additional potential benefits of more accurate lesion assessment and stent deployment, with reduced radiation exposure to operators and patients. However, data from randomised controlled trials or clinical experience from Australia are lacking.

Measuring food insecurity among a national sample of children with recurrent acute otitis media.

Introduction: Acute otitis media is one of the most common reasons for pediatric medical visits in the United States. Additionally, past studies have linked food insecurity and malnutrition with increased infections and worse health outcomes. However, there is a lack of information on the risk factors for food insecurity in specific patient populations, including the pediatric recurrent acute otitis media (RAOM) population.

Stomatin-like protein 3 modulates the responses of Aδ, but not C fiber bone afferent neurons to noxious mechanical stimulation in an animal model of acute experimental bone pain.

STOML3 is a membrane bound scaffolding protein that has been shown to facilitate the opening of mechanically sensitive ion channels and contribute to noxious mechanical sensation, allodynia and hyperalgesia. In this study, we aimed to determine the role of STOML3 in noxious mechanical sensitivity of bone afferent neurons and carrageenan-induced acute inflammation in the bone. An electrophysiological bone-nerve preparation was used to make recordings of the activity and sensitivity of bone afferent neurons that innervate the tibial marrow cavity in anaesthetised rats, in response to noxious mechanical stimuli delivered to the marrow cavity, before and after injection of either the STOML3 oligomerisation inhibitor OB-1 or vehicle, in either naïve animals or animals with carrageenan-induced inflammation of the marrow cavity.

Online Patient Education Materials on Iron Deficiency Anemia Are Too Difficult to Read and Low Quality: A Readability and Quality Analysis.

Introduction Patients increasingly rely on online health information to understand and manage their diseases. Concerns about the quality and readability of these materials have been reported in the literature. Poor quality and difficult-to-read information lead to delayed diagnoses and adverse outcomes.

A Medicare Physician Fee Schedule Analysis of Reimbursement Trends in Laryngology from 2000 to 2021.

Objective: The purpose of this study is to characterize Medicare reimbursement trends for laryngology procedures over the last two decades.

Methods: This analysis used CMS' Physician Fee Schedule (PFS) Look-Up Tool to determine the reimbursement rate of 48 common laryngology procedures, which were divided into four groups based on their practice setting and clinical use: office-based, airway, voice disorders, and dysphagia. The PFS reports the physician service reimbursement for "facilities" and global reimbursement for "non-facilities".

Early Effects of Ticagrelor Versus Clopidogrel on Peripheral Endothelial Function After Non-ST-Elevation Acute Coronary Syndrome and Assessment of Its Relationship With Coronary Microvascular Function.

Peripheral endothelial dysfunction is an independent predictor of adverse long-term prognosis after acute coronary syndrome. Data are lacking on the effects of oral P2Y12-inhibitors on peripheral endothelial function in non-ST-elevation acute coronary syndrome (NSTEACS). Furthermore, the relation between peripheral endothelial function and invasive indexes of coronary microvascular function in NSTEACS is unclear.

Are All Patients Going Home after Total Knee Arthroplasty? A Temporal Analysis of Discharge Trends and Predictors of Nonhome Discharge (2011-2020).

Value-based orthopaedic surgery and reimbursement changes for total knee arthroplasty (TKA) are potential factors shaping arthroplasty practice nationwide. This study aimed to evaluate (1) trends in discharge disposition (home vs nonhome discharge), (2) episode-of-care outcomes for home and nonhome discharge cohorts, and (3) predictors of nonhome discharge among patients undergoing TKA from 2011 to 2020. The National Surgical Quality Improvement Program database was reviewed for all primary TKAs from 2011 to 2020.

Major National Shifts to Outpatient Total Knee Arthroplasties in the United States: A 10-Year Trends Analysis of Procedure Volumes, Complications, and Healthcare Utilizations (2010 to 2020).

Background: The removal of total knee arthroplasty (TKA) from inpatient-only lists accelerated changes in orthopaedic surgical practices across the United States. This study aimed to (1) quantify the annual volume of inpatient/outpatient primary TKAs; (2) compare patient characteristics before/after the year 2018; and (3) compare annual trends in 30-day readmissions, 30-day complications, and healthcare utilization parameters for inpatient/outpatient TKAs.

Methods: The National Surgical Quality Improvement Program was reviewed (January 2010 to December 2020) for patients who underwent primary TKA (n = 470,456).

Trends and Risk Factors for Venous Thromboembolism Among Hospitalized Medical Patients.

Importance: While hospital-associated venous thromboembolism (HA-VTE) is a known complication of hospitalization, contemporary incidence and outcomes data are scarce and methodologically contested.

Objective: To define and validate an automated electronic health record (EHR)-based algorithm for retrospective detection of HA-VTE and examine contemporary HA-VTE incidence, previously reported risk factors, and outcomes.

Design, Setting, And Participants: This cohort study was conducted using hospital admissions between January 1, 2013, and June 30, 2021, with follow-up until December 31, 2021.

Normative values of renin and aldosterone in clinically stable preterm neonates.

Background: There is a paucity of literature on the normative levels of plasma renin concentration (PRC) and serum aldosterone (SA) in premature neonates. This study aims to provide normative data on PRC and SA levels in preterm neonates in the first 2 weeks after birth and explore associations with maternal, perinatal, or postnatal factors.

Methods: Neonates born at 26- to 34-week gestation were recruited from two neonatal intensive care units in Canada and Australia.

Geographic disparities in access to immunotherapy clinical trials for metastatic melanoma.

Survival outcomes for metastatic melanoma have drastically improved with the advent of immunotherapy. Access to ongoing immunotherapy clinical trials has become increasingly important to patients with advanced disease. We sought to quantify geographic disparities in access to these trials by U.

A Case of Complex Percutaneous Coronary Intervention for ST Elevation Myocardial Infarction Caused by Extension of Type A Aortic Dissection into the Left Main Coronary Artery.

Aortic dissection extending into the left main coronary artery is rare and carries high mortality, especially when resulting in extensive myocardial infarction. Here we report a case of retrograde extension of type A aortic dissection into the left main coronary artery causing ST-segment elevation myocardial infarction managed by complex percutaneous coronary intervention, which resulted in temporary stabilization of the patient. We briefly review current literature on this approach.