A New Method of Assessing the Impact of Evidence-Based Medicine on Claim Outcomes.

Objective: The objective of this study is to develop a method of quantifying compliance with Evidence-Based Medicine (EBM) guidelines as a means of assessing the relationship between the use of EBM guidelines and illness absence and costs in workers' compensation.

Methods: A total of 45,951 indemnity claims with two years of development filed between 2008 and 2013 were utilized to develop the methodology.

Results: The newly developed methodology adequately assessed the relationship between claim outcomes (duration and medical incurred) and adherence to EBM guidelines, controlling for medical complexity, distinct number of International Classification of Diseases (ICD)-9 codes, and other confounding factors.

Effect of physician-dispensed medication on workers' compensation claim outcomes in the state of Illinois.

Objective: To evaluate differences between physician-dispensed and non-physician-dispensed medication with regard to lost time, prescription volume, and pharmaceutical, medical, indemnity costs in the Illinois workers' compensation system.

Methods: We studied a sample of 6824 workers' compensation indemnity claims that were opened and closed between January 1, 2007, and December 31, 2012, by Accident Fund Holdings in the State of Illinois.

Results: The number of prescriptions per claim and pharmaceutical, medical, and indemnity costs, as well as time out from work, were significantly higher in claims where a pharmaceutical was dispensed by the physician within 90 days of injury than in claims where physician dispensing did not occur.

The effect of opioid use on workers' compensation claim cost in the State of Michigan.

Objective: To investigate the association between opioid utilization and catastrophic claim (≥$100,000) cost.

Method: A total of 12,226 workers' compensation indemnity claims that were opened and closed from January 1, 2006 to February 28, 2010 in the State of Michigan were selected for multivariate logistic regression analyses.

Result: Controlling for sex, age, claim duration, number of distinct International Classification of Diseases-Ninth Revision codes per claim, and legal involvement, the presence of short-acting opioids on a claim were 1.

Daily peritoneal administration of sodium pyrophosphate in a dialysis solution prevents the development of vascular calcification in a mouse model of uraemia.

Background: The high rate of cardiovascular mortality in patients with end-stage renal disease (ESRD) is a significant barrier to improved life expectancy. Unique in this population is the marked development and aggressive worsening of vascular calcification (VC). Pyrophosphate (PPi), an endogenous molecule, appears to naturally inhibit soft tissue calcification, but may be depressed in chronic kidney disease (CKD) and ESRD.

Transforming patient and family access to medical information: utilisation patterns of a patient-accessible electronic health record.

Objective: The purpose of this study was to evaluate the utilisation of a web-based multimedia patient-accessible electronic health record, for patients with congenital cardiac disease.

Patients And Methods: This was a prospective analysis of patients undergoing congenital cardiac surgery at a single institution from 1 September, 2006 to 1 February, 2009. After meetings with hospital administration, physicians, nurses, and patients, we configured a subset of the cardiac program's web-based clinical electronic health record for patient and family access.

Patterns of lactate values after congenital heart surgery and timing of cardiopulmonary support.

Background: We sought to determine if postoperative serial lactate determinations follow predictable patterns that could be useful in directing management, especially the initiation of postoperative mechanical cardiopulmonary support (CPS).

Methods: Eight patients undergoing CPS in a 2-year period and 147 patients not requiring postoperative CPS in 6 months of that period were stratified into 6 categories based on short-term risk for mortality (1 being the lowest risk). Lactate values for the first 48 hours postoperatively were retrospectively analyzed.

Internet rounds: a congenital heart surgeon's Web log.

As the complexity of congenital heart care increases, and expectations for improved outcomes grow, the limitations of current medical information management systems are exposed. Despite advances in information management technology, achieving a state of information resonance within a congenital heart team, where comprehensive patient data and real time program performance can be intuitively accessed on demand, remains an elusive goal. The World Wide Web constitutes a potential platform for a medical information management system capable of overcoming the limitations of traditional medical information exchange.

The fenestrated Kawashima operation for single ventricle with interrupted inferior vena cava.

An 8-month-old boy with double outlet right ventricle with hypoplastic left ventricle, heterotaxy, left atrial isomerism, bilateral superior vena cavae without bridging vein, and interruption of the inferior vena cava with azygous continuation to the left superior cava underwent a bilateral bidirectional cavopulmonary anastomosis. A calibrated 3-mm connection between the right pulmonary artery and the common atrium was constructed with the proximal right superior vena cava to allow right to left shunting, analogous to a fenestration in a Fontan operation. We hypothesize that in small young patients undergoing the Kawashima operation a fenestration may improve postoperative hemodynamics.

Agarose-dextran gels as synthetic analogs of glomerular basement membrane: water permeability.

Novel agarose-dextran hydrogels were synthesized and their suitability as experimental models of glomerular basement membrane was examined by measuring their Darcy (hydraulic) permeabilities (kappa). Immobilization of large dextran molecules in agarose was achieved by electron beam irradiation. Composite gels were made with agarose volume fractions (phi(a)) of 0.