Introduction: The Nuss procedure is suitable for prepubertal and early pubertal patients but can also be used in adult patients.
Aim: To determine whether the minimally invasive technique (MIRPE) can also be performed successfully in adults.
Material And Methods: Between July 2006 and January 2016, 836 patients (744 male, 92 female) underwent correction of pectus excavatum with the MIRPE technique at our institution. The mean age was 16.8 years (2-45 years). There were 236 adult patients (28.2%) (> 18 years) - 20 female, 216 male. The mean age among the adult patients was 23.2 years (18-45 years). The recorded data included length of hospital stay, postoperative complications, number of bars used, duration of the surgical procedure and signs of pneumothorax on the postoperative chest X-ray.
Results: The MIRPE was performed in 236 adult patients. The average operative time was 44.4 min (25-90 min). The median postoperative stay was 4.92 ±2.81 days (3-21 days) in adults and 4.64 ±1.58 (2-13) in younger patients. The difference was not statistically significant (p = 0.637). Two or more bars were used in 36 (15.8%) adult patients and in 44 (7.5%) younger patients. The difference was not statistically significant either (p = 0.068). Regarding the overall complications, complication rates among the adult patients and younger patients were 26.2% and 11.8% respectively. The difference was statistically significant (p = 0.007).
Conclusions: MIRPE is a feasible procedure that produces good long-term results in the treatment of pectus excavatum in adults.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4945611 | PMC |
http://dx.doi.org/10.5114/wiitm.2016.60456 | DOI Listing |
Dis Colon Rectum
February 2025
Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Ohio.
Background: Patients with Crohn's disease face an elevated risk of colorectal cancer, in part due to underlying chronic inflammation. Biologic therapy is the mainstay of medical treatment; however, the impact of treatment on colorectal cancer-related outcomes remains unclear.
Objective: To investigate the association between prior exposure to biologic treatment and colorectal cancer-related outcomes in patients with underlying Crohn's disease.
Am J Manag Care
January 2025
RAND, 1776 Main St, Santa Monica, CA 90401. Email:
Objectives: Patient experience surveys are essential to measuring patient-centered care, a key component of health care quality. Low response rates in underserved groups may limit their representation in overall measure performance and hamper efforts to assess health equity. Telephone follow-up improves response rates in many health care settings, yet little recent work has examined this for surveys of Medicare enrollees, including those with Medicare Advantage.
View Article and Find Full Text PDFAm J Manag Care
January 2025
Institute of Health Policy and Management and Master of Public Health Program, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Taipei 100, Taiwan. Email:
Objectives: Patients who revisit the emergency department (ED) shortly after discharge are a high-risk group for complications and death, and these revisits may have been seriously affected by the COVID-19 pandemic. Detecting suspected COVID-19 cases in EDs is resource intensive. We examined the associations of screening workload for suspected COVID-19 cases with in-hospital mortality and intensive care unit (ICU) admission during short-term ED revisits.
View Article and Find Full Text PDFAm J Manag Care
January 2025
Health Economics Resource Center, VA Palo Alto Health Care System, 795 Willow Rd, Menlo Park, CA 94025. Email:
Objectives: Unused medical appointments affect both patient care and clinic operations, and the frequency of cancellations due to clinic reasons is underreported. The prevalence of these unused appointments in primary care in the Veterans Affairs Health Care System (VA) is unknown. This study examined the prevalence of unused primary care appointments and compared the relative frequency of cancellations and no-shows for patient and clinic reasons.
View Article and Find Full Text PDFAm J Manag Care
January 2025
McGovern Medical School at UTHealth Houston, 4513 Teas St, Bellaire, TX 77401.
Objective: To examine the effect of physiologic insulin resensitization (PIR) on the cost of treating patients with diabetes and chronic kidney disease (CKD).
Study Design: The mean 1-year cost of treating 66 Medicare Advantage patients with diabetes and CKD who were receiving PIR was compared with that of treating 1301 Medicare Advantage patients with diabetes and CKD not receiving PIR. Differences in disease severity were compared using mean risk adjustment factor scores.
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