Squamous Cell Carcinoma of the Pancreas: A Case Report.

Primary squamous cell carcinoma (PSCC) of the pancreas is a rare malignancy with poor prognosis and unclear management. Here, we present the case of a patient with PSCC, review the literature, identify areas of therapeutic uncertainty, and conclude that more clinical and molecular data are needed to improve the prognosis of this rare malignancy.

Cost-effectiveness of dietary supplement ingredients versus generic statins for LDL reduction.

Background: While statin therapy is the preferred treatment for hyperlipidemia, literature supports the low-density lipoprotein (LDL) lowering effects associated with red yeast rice, berberine, and . Dietary supplements may be perceived as a more affordable alternative to prescription medication.

Objective: We determined cost-effectiveness of generic pravastatin versus single-ingredient dietary supplements in relation to LDL lowering effect.

Decreased Cerebral Perfusion Under Anesthesia During Radiation Treatment: A Case Report.

Radiation therapy allows patients to receive focused radiation to a tumor. Some patients require anesthesia for their daily treatments. For head and neck tumors, a thermoplastic mask is created to minimize movement.

Resting-state functional connectivity predictors of treatment response in schizophrenia - A systematic review and meta-analysis.

We aimed to systematically synthesize and quantify the utility of pre-treatment resting-state functional magnetic resonance imaging (rs-fMRI) in predicting antipsychotic response in schizophrenia. We searched the PubMed/MEDLINE database for studies that examined the magnitude of association between baseline rs-fMRI assessment and subsequent response to antipsychotic treatment in persons with schizophrenia. We also performed meta-analyses for quantifying the magnitude and accuracy of predicting response defined continuously and categorically.

Assessment of Diaphragm Function and Pleural Pressures During Thoracentesis.

Background: This prospective observational study reports on diaphragm excursion, velocity of diaphragm contraction, and changes in pleural pressure that occur with thoracentesis.

Methods: Twenty-eight patients with pleural effusion underwent therapeutic thoracentesis. Diaphragm excursion and velocity of diaphragm contraction were measured with M-mode ultrasonography of the affected hemidiaphragm.

Intermediate Megavoltage Photon Beams for Improved Lung Cancer Treatments.

The goal of this study is to evaluate the effects of intermediate megavoltage (3-MV) photon beams on SBRT lung cancer treatments. To start with, a 3-MV virtual beam was commissioned on a commercial treatment planning system based on Monte Carlo simulations. Three optimized plans (6-MV, 3-MV and dual energy of 3- and 6-MV) were generated for 31 lung cancer patients with identical beam configuration and optimization constraints for each patient.

Effect of a Brief Massage on Pain, Anxiety, and Satisfaction With Pain Management in Postoperative Orthopaedic Patients.

Background: The majority of massage therapy studies have evaluated 20- to 45-minute interventions in nonsurgical patients. Studies are needed to evaluate the effects of a brief massage intervention that would be more clinically feasible for bedside clinicians to administer as an adjunct to pharmacologic pain management in acutely ill surgical patients.

Purpose: To evaluate the impact of a brief massage intervention in conjunction with analgesic administration on pain, anxiety, and satisfaction with pain management in postoperative orthopaedic inpatients.

Diagnostic carotid and cerebral angiography: a historical summary of the evolving changes in coding and reimbursement in a complex procedure family.

Carotid and cerebral angiography have been a mainstay of neurointerventional and neuroradiologic practice for years. Centers for Medicare and Medicaid Services (CMS) and Relative Value Scale Update Committee (RUC) initiatives have compelled the professional societies to bundle component codes under threat of unilateral CMS revision and revaluation. Code bundling usually results in a decrease in the professional Relative Value Unit (RVU) valuation, and thus the MD reimbursement.

Disaster neurology: A new practice opportunity and challenge for the neurologist.

Headlines are filled with stories of the physical disability and loss of life that results from both natural and man-made disasters. The role of a neurologist as part of the response to these tragedies has moved from a supportive role to the front line. Recent earthquakes in Haiti and Japan as well as military conflicts in Iraq and Afghanistan have demonstrated an increased need for nonsurgical neurologic care.

Radiology stewardship and quality improvement: the process and costs of implementing a CT radiation dose optimization committee in a medium-sized community hospital system.

Purpose: The aims of this study were to measure the effectiveness of a multidisciplinary CT dose optimization committee and estimate its costs and to describe a radiation stewardship quality improvement initiative in one CT department at a medium-sized community hospital system that used a participatory design committee methodology.

Methods: A CT dose optimization committee was conceived, funded, and formed, consisting of the following stakeholders: radiologists, technologists, consultant medical physicists, and an administrator. Volume CT dose index (CTDIvol) and repeat rate were monitored for 1 month, for one scan type, during which iterative protocol adjustments were made through committee interaction.

Can nurses trust nurses in recovery reentering the workplace?

Objective: To examine the ability of working direct care nurses to trust nurses in recovery from substance use (or abuse) disorders (SUDs) reentering the workplace.

Methods: A researcher-designed quantitative survey was used to gather data.

Findings: Nurses said that they've worked with a nurse with SUD at some time in their career.

The resource-based relative value scale and neuroradiology: ASNR's history at the RUC.

The Resource-Based Relative Value Scale (RBRVS) has been the defining algorithm for professional reimbursement of medical services since its introduction in 1992. This article reviews the history of the RBRVS, with an emphasis on the integral involvement of the radiology and neuroradiology communities. Appropriate reimbursement of radiology procedures has been chaperoned by physician volunteers and society staff attending Current Procedural Terminology Panel meetings and American Medical Association/Specialty Society RVS Update Committee (RUC) meetings.

SU-E-T-289: On the Use of a Diode Array for the Commissioning of Dynamically-Wedged Asymmetric Fields Generated by Varian EDW's in the Pinnacle Treatment Planning System.

Purpose: To present a validation study of enhanced dynamic wedges (EDWs) implemented into Pinnacle3 treatment planning system (TPS) using a diode array, Monte Carlo (MC) simulation, and measurements.

Method And Materials: Modeling of EDW dose distribution in the Pinnacle3 TPS is based on a combination of open-field beam data and the Varian 'Golden Segmented Treatment Table' (GSTT) unique to each photon beam. To validate the EDW models, dose profiles of 6- and 10-MV photon beams from a Clinac 2100C/D were measured in virtual water at depths from near- surface to 30 cm for a wide range of asymmetric field sizes and wedge angles using the Profiler-2 diode array system.

Implementing AORN recommended practices for prevention of retained surgical items.

Retention of a surgical item is a preventable event that can result in patient injury. AORN's "Recommended practices for prevention of retained surgical items" emphasizes the importance of using a multidisciplinary approach for prevention. Procedures should include counts of soft goods, needles, miscellaneous items, and instruments, and efforts should be made to prevent retention of fragments of broken devices.

What is the RUC?

We describe a crucial but little-known constituent of the Medicare payment system.

Toward cultural competence.

One hospital's efforts to create a culturally sensitive health care community.

Weight-based heparin protocol using antifactor Xa monitoring.

Purpose: The performance of a weight-based dosing protocol for unfractionated heparin (UFH) infusions using antifactor Xa monitoring was evaluated.

Methods: The first 50 patients to receive a UFH infusion per the new protocol for over 24 hours, regardless of indication, were included in the analysis. All patients received a bolus dose of 26 units/kg, followed by an i.