Recurrent spine surgery patients in hospital administrative database.

Introduction: Hospital patient databases are typically used by administrative staff to estimate loss-profit ratios and to help with the allocation of hospital resources. These databases can also be very useful in following rehospitalization. This paper studies the recurrence of spine surgery patients in our hospital population based on administrative data analysis.

Shortfalls in pediatric hydrocephalus clinical outcome analysis.

Background: In this paper, we used search engine technology to study outcome analysis and cost awareness of child hydrocephalus in the literature.

Methods: The aggregate hospital charges of hydrocephalus treatment procedures for patients <18 years old was extracted from the Nationwide Inpatient Sample (NIS) data. Hydrocephalus literature was probed through the PubMed biomedical search engine.

Utility of Analgesic and Anxiolytic Medication Dose during Colonoscopy in Identifying Patients with Irritable Bowel Syndrome.

Research question. This paper was done to answer the question on whether patients with IBS require higher analgesic or anxiolytic doses during colonoscopy. Setting.

Quality improvement and patient care checklists in intrahospital transfers involving pediatric surgery patients.

Background: Intrahospital transfers are necessary but hazardous aspects of pediatric surgical care. Plan-Do-Study-Act processes identify risks during hospitalization and improve care systems and patient safety.

Methods: A multidisciplinary team developed a checklist that documented patient data and handoffs for all intrahospital transfers involving pediatric surgical inpatients.

The role of drains in lumbar spine fusion.

Objective: To study the role of drains in lumbar spine fusions.

Methods: The charts of 402 patients who underwent lumbar decompression and fusion (LDF) were retrospectively reviewed. Patients were classified per International Classification of Diseases, 9th Edition (ICD-9) procedure code as 81.

How medical alumni now see their junior clerkships in surgery.

The purpose of this study is to determine the effectiveness and value of the junior medical student surgical clerkship for physicians now in practice. Questionnaires were sent to all Mercer University School of Medicine alumni (1986-2007) using a five-point Likert scale. One hundred and fifty-seven responses were received from 873 recipients (18%), 71 per cent training in nonsurgical specialties.

Early cardiac pacemaker placement for life-threatening bradycardia in traumatic spinal cord injury.

Background: High cervical spinal cord injury (CSCI) can cause life-threatening bradycardia from autonomic instability that may be resistant to pharmacologic interventions. Placement of a cardiac pacemaker, traditionally reserved for patients refractory to drug therapy, may be lifesaving.

Methods: Our Level I trauma center registry found all patients with CSCI from 2003 to 2009.

Professionalism behind barbed wire: health care in World War II Japanese-American concentration camps.

Physicians and nurses of Japanese ancestry provided health care to 110000 persons incarcerated by the US government during World War II. They faced immense public health challenges created by overcrowding and inadequate resources. Their extraordinary service to their community reflected their professional devotion to their patients and the values of their Japanese homeland.

Hepatic artery aneurysms: evolution from open to endovascular repair techniques.

With the development of endovascular therapy, treatment for hepatic artery aneurysm (HAA) has evolved from open excision and repair to include endovascular approaches. We reviewed our recent experience with HAA to help define the treatment of HAA. From 2002 to 2010, five patients underwent treatment of HAA, all men with a median age of 63.

Translation of the National Institutes of Health Diabetes Prevention Program in African American churches.

Objective: To translate the Diabetes Prevention Program (DPP) for delivery in African American churches.

Methods: Two churches participated in a 6-week church-based DPP and 3 churches participated in a 16-week church-based DPP, with follow-up at 6 and 12 months. The primary outcomes were changes in fasting glucose and weight.

De novo spine surgery as a predictor of additional spine surgery at the same or distant spine regions.

Introduction: Degenerative spine disorders are steadily increasing parallel to the aging of the population with considerable impact on cost and productivity. In this paper we study the prevalence and risk factors for multiple spine surgery and its impact on cost.

Methods: Data on 1,153 spine surgery inpatients operated between October 2005 and September 2008 (index spine surgery) in regard to the number of previous spine surgeries and location of surgeries (cervical or lumbar) were retrospectively collected.

Computational modeling of HHH therapy and impact of blood pressure and hematocrit.

Background: After an aneurysmal subarachnoid hemorrhage, cerebral microcirculatory changes occur as a result cerebral vasospasm. The objective of this study is to investigate, with a computational model, how various degrees of vasospasm are influenced by increasing the mean blood pressure and decreasing the blood viscosity.

Methods: Using ANSYS CFX software, a computational model was constructed to simulate steady-state fully developed laminar blood flow through a rigid wall system consisting of the internal carotid artery (ICA), anterior cerebral artery, posterior cerebral artery, and middle cerebral artery (MCA).

History of spine surgery in older obese patients.

Goal: To study the interaction of obesity and age in patients with multiple spine surgeries.

Methods: Data on the body mass index (BMI) of 956 patients were collected and classified into four groups: non-obese (BMI <30 kg/m(2)), obese-class I (BMI ≥30 kg/m(2)), obese-class II (BMI ≥35 kg/m(2)) and obese-class III (BMI ≥40 kg/m(2)). Patients' age was categorized into the following age groups: ≤40, 41-65 and ≥66.

A novel approach to hospital palliative care: an expanded role for counselors.

Background: A large tertiary hospital in central Georgia has found a novel approach to hospital palliative care.

Approach: It is unique in that the approach has a strong counseling base in providing the palliative service, rather than major reliance on advance practice nurses or palliative physicians. The Medical Center of Central Georgia employs master's prepared counselors who spend the hours needed to assist families in making difficult end-of-life decisions.

Higher comorbidity rates in unemployed patients may significantly impact the cost of spine surgery.

Chronic back pain is commonly associated with physical and mental comorbidities, which create a considerable burden on the healthcare system. We examined the differences in comorbidity rates of 619 spinal surgery patients of employment age, and the impact of comorbidity rates on length of hospital stay and cost. The charts of patients aged >25 years and <65 years were reviewed retrospectively.

The effect of age and body mass index on cost of spinal surgery.

Complex shifts in demography combined with drastic advancements in spinal surgery have led to a steep increase in often expensive spinal interventions in older and obese patients. A cost analysis, based on hospital charges, was performed retrospectively on the spinal surgery of 787 randomly selected patients who were operated at The Medical Center of Central Georgia, a large urban hospital in Central Georgia. The types of surgery included anterior cervical decompression and fusion (ACDF), lumbar decompression and fusion (LDF), and lumbar microdiscectomy (LMD).

Postoperative fever discharge guidelines increase hospital charges associated with spine surgery.

Background: Postoperative fever is a common sequel of spine surgery. In the presence of rigid nationally mandated clinical guidelines, fever management may consume more health care resources than is reasonably appropriate.

Objective: To study the relationship between postoperative fever, infection rate, and hospital charges in a cohort of spine surgery patients.

Economic impact of comorbidities in spine surgery.

Object: Comorbidities in patients undergoing spine surgery may reasonably be factors that increase health care costs. To verify this hypothesis, the authors conducted the following study.

Methods: Major comorbidities and age-adjusted Charlson Comorbidity Index scores were retrospectively analyzed for 816 patients who underwent spine surgery at the authors' institutions between 2005 and 2008, and treatment costs (hospital charges) were assessed with the help of statistical software.

Single payer health insurance in pediatric surgery: US impressions and Canadian experience.

Context: Some advocate single payer national health insurance, present in Canada, as a solution to problems in US health care.

Method: Pediatric surgeons in the US and Canada were surveyed regarding their attitudes (US) and experience (Canada) under a single payer by electronic mail regarding features of a single payer using a Likert scale (1-strongly disagree to 5-strongly agree) on quality, administration, organization, and economics.

Results: Overall response rate of 22% (175/835), 153 US, 22 Canadian.

Case report of a cervical lipoleiomyoma with an incidentally discovered ovarian granulosa cell tumor - imaging and minimal-invasive surgical procedure.

Uterine lipoleiomyomas are rare benign tumors that mostly affect the uterine corpus. We are reporting the imaging and operative procedure of a very rare case of a large lipoleiomyoma of the uterine cervix combined with an occult adult ovarian granulosa cell tumor. The patient was treated with minimal invasive surgery.

Total laparoscopic hysterectomy for uteri over one kilogram.

Introduction: Laparoscopic hysterectomy for large fibroid uteri is technically a difficult procedure. In this article, we report our experience with fibroid uteri >1 kg in weight.

Materials And Methods: An intent-to-treat study.