Agenda ICD-10 Coordination and Maintenance Committee
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The Use of Bone Age in Clinical Practice – Part 2
Mini Review HORMONE Horm Res Paediatr 2011;76:10–16 Received: March 25, 2011 RESEARCH IN DOI: 10.1159/000329374 Accepted: May 16, 2011 PÆDIATRIC S Published online: June 21, 2011 The Use of Bone Age in Clinical Practice – Part 2 a d f e b David D. Martin Jan M. Wit Ze’ev Hochberg Rick R. van Rijn Oliver Fricke g h j c George Werther Noël Cameron Thomas Hertel Stefan A. Wudy i k a a Gary Butler Hans Henrik Thodberg Gerhard Binder Michael B. Ranke a b Pediatric Endocrinology and Diabetology, University Children’s Hospital, Tübingen , Children’s Hospital, c University of Cologne, Cologne , and Paediatric Endocrinology and Diabetology, Justus Liebig University, Giessen , d e Germany; Department of Pediatrics, Leiden University Medical Center, Leiden , and Department of Radiology, f Emma Children’s Hospital/Academic Medical Center Amsterdam, Amsterdam , The Netherlands; Meyer Children’s g Hospital, Rambam Medical Center, Haifa , Israel; Department of Endocrinology, Royal Children’s Hospital h Parkville, Parkville, Vic. , Australia; Centre for Global Health and Human Development, Loughborough University, i Loughborough , and Institute of Child Health, University College London and University College London Hospital, j k London , UK; H.C. Andersen Children’s Hospital, Odense University Hospital, Odense , and Visiana, Holte , Denmark Key Words ness and cortical thickness should always be evaluated in -Skeletal maturity ؒ Bone age ؒ Tall stature ؒ relation to a child’s height and BA, especially around puber Precocious puberty ؒ Congenital adrenal hyperplasia ؒ ty. The use of skeletal maturity, assessed on a radiograph Bone mineral density alone to estimate chronological age for immigration author- ities or criminal courts is not recommended. -
Successful Aortocoronary Bypass in Osteogenesis Imperfecta
View metadata, citation and similar papers at core.ac.uk brought to you by CORE 960 provided bylACC Elsevier Vol. - Publisher 9. No.4 Connector April 1987:960-3 CASE REPORTS Successful Aortocoronary Bypass in Osteogenesis Imperfecta JOHN MURRAH PASSMORE, MD, WILLIAM EASTON WALKER, MD, PHD , FRANCISCO FUENTES, MD, FACC Houston, Texas Cardiovascular abnormalities are infrequently docu anastomoses. Although successfulaortocoronary bypass mented in osteogenesis imperfecta, one of a group of surgery had not been previouslyreported in osteogenesis hereditary, generalized connective tissue disorders. A imperfecta, this patient received such surgery with ther patient with osteogenesis imperfecta is described with apeutic benefit. Therefore, coronary artery vascularl mitral valve prolapse, significantcoronary artery disease zation should be considered as a safe and effective treat and a coronary artery aneurysm. The latter two cardiac ment modality for patients with osteogenesis imperfecta defects are apparently rare in this disease. The option and coexistingcoronary atherosclerosis. of surgery was carefully considered with regard to tech (J Am Coll CardioI1987,'9:960-3) nical feasibility and potential deterioration of the graft Osteogenesis imperfecta is one of the group of hereditary , disorders, including pseudoxanthoma elasticum (4) and Eh generalized disorders of connective tissue including Mar lers-Danlos syndrome (5). fan's syndrome, pseudoxanthoma elasticum, Ehlers-Danlos We present a patient with osteogenesis imperfecta who syndrome and Hurler's syndrome. Significant cardiovas had significant multivessel disease that was treated with cular abnormalities are a recognized feature of the latter four coronary artery bypass grafting. The results indicate that conditions (I ). Although the primary clinical manifestations such surgery is worthy of consideration and feasible in pa of osteogenesis imperfecta include skeletal, ocular, cuta tients with this connective tissue disorder. -
Computer-Aided Patient-Specific Coronary Artery Graft Design
Cardiovascular Engineering and Technology, Vol. 2, No. 1, March 2011 (Ó 2010) pp. 35–47 DOI: 10.1007/s13239-010-0029-z Computer-Aided Patient-Specific Coronary Artery Graft Design Improvements Using CFD Coupled Shape Optimizer 1 2 3 4 ONUR DUR, SINAN TOLGA COSKUN, KASIM OGUZ COSKUN, DAVID FRAKES, 5 1,5 LEVENT BURAK KARA, and KEREM PEKKAN 1Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA; 2Department of Vascular Surgery, Horst Schmidt Kliniken, Wiesbaden, Germany; 3Department of Thoracic Cardiovascular Surgery, University of Go¨ttingen, Go¨ttingen, Germany; 4School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, USA; and 5Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA (Received 29 June 2010; accepted 1 November 2010; published online 18 November 2010) Associate Editor Peter McHugh oversaw the review of this article. Abstract—This study aims to (i) demonstrate the efficacy of a coronary bypass surgery procedures based on acute hemo- new surgical planning framework for complex cardiovascular dynamic readjustments of aorta-CA flow. This methodology reconstructions, (ii) develop a computational fluid dynamics may provide a rational to aid surgical decision making in (CFD) coupled multi-dimensional shape optimization meth- time-critical, patient-specific CA bypass operations before in od to aid patient-specific coronary artery by-pass graft vivo execution. (CABG) design and, (iii) compare the hemodynamic effi- ciency of the sequential CABG, i.e., raising a daughter Keywords—Surgical planning, Coronary artery, Bypass parallel branch from the parent CABG in patient-specific 3D graft, CFD, Hemodynamics, Shape optimization, Sequential settings. Hemodynamic efficiency of patient-specific complete revascularization scenarios for right coronary artery (RCA), graft, WSS, WSSG, Surgical design. -
Viewed at a Minimum Follow-Up of 2 Years (Maximum of 3 Years and 9 Months)
J Orthopaed Traumatol (2012) 13 (Suppl 1):S57–S89 DOI 10.1007/s10195-012-0210-2 12 NOVEMBER 2012 In-Depth Oral Presentations and Oral Communications IN-DEPTH ORAL PRESENTATIONS achieve a stable synthesis and an early mobilization of the MP and IP joints. However, if a malunion is present, it has to be corrected sur- gically as soon as possible. AT05–HAND AND WRIST Radio-distal epiphysis fractures: treatment with angular stability Treatment of malunion of the proximal phalangeal fractures plate of latest generation of the hand R. Di Virgilio*, E. Coppari, E. Condarelli, M. Rendine V. Potenza*, S. Bisicchia, R. Caterini, A. Fichera, P. Farsetti, E. Ippolito (Rome, IT) Universita` di Roma Tor Vergata (Rome, IT) Introduction Distal radius fractures are the most common fractures of the upper limb and coincide with 17 % of all fractures treated in Introduction It is difficult to treat fractures of the phalanges of the emergency rooms. The incidence of these fractures is greater in hand because they can cause complications such as deformity and patients aged 6 to 10 years, and in those between 60 and 70 years. joint limitation with a reduction in the grasping function. The most In older patients the incidence is higher in females. In the articular frequent complications are malunion of the fracture and joint limi- fractures, displaced, dislocated and highly unstable is indicated tation. The greatest incidence of complications can be found in open internal fixation (ORIF) to restore the congruity of the joint transverse fractures of the base of the proximal phalanx, in articular surface, to restore the correct length of the radius, its inclination fractures, comminuted fractures, and in those associated with lesions and palmar tilt. -
Knee Surgery-Arthroscopic and Open Procedures Version 1.0 Effective February 14, 2020
CLINICAL GUIDELINES CMM-312: Knee Surgery-Arthroscopic and Open Procedures Version 1.0 Effective February 14, 2020 Clinical guidelines for medical necessity review of Comprehensive Musculoskeletal Management Services. © 2019 eviCore healthcare. All rights reserved. Comprehensive Musculoskeletal Management Guidelines V1.0 CMM-312: Knee Surgery-Arthroscopic and Open Procedures CMM-312.1: Definitions 3 CMM-312.2: General Guidelines 5 CMM-312.3: Indications and Non-Indications 5 CMM-312.4: Experimental, Investigational, or Unproven 15 CMM-312.5: Procedure (CPT®) Codes 16 CMM-312.6: Procedure (HCPCS) Codes 19 CMM-312.7: References 20 ______________________________________________________________________________________________________ ©2020 eviCore healthcare. All Rights Reserved. Page 2 of 25 400 Buckwalter Place Boulevard, Bluffton, SC 29910 (800) 918-8924 www.eviCore.com Comprehensive Musculoskeletal Management Guidelines V1.0 CMM -312.1: Definitions The Modified Outerbridge Classification is a system that has been developed for judging articular cartilage injury to the knee. This system allows delineation of varying areas of chondral pathology, based on the qualitative appearance of the cartilage surface, and can assist in identifying those injuries that are suitable for repair techniques. The characterization of cartilage in this system is as follows: Grade I – Softening with swelling Grade II – Fragmentation and fissuring less than one square centimeter (1 cm2) Grade III – Fragmentation and fissuring greater than one square centimeter -
Pediatric Ankle Fractures
CHAPTER 26 PEDIATRIC ANKLE FRACTURES Sofi e Pinney, DPM, MS INTRODUCTION stronger than both the physis and bone. As a result, there is a greater capacity for plastic deformation and less chance of The purpose of this review is to examine the current intra-articular fractures, joint dislocation, and ligamentous literature on pediatric ankle fractures. I will discuss the disruptions. However, ligamentous injury may be more anatomic considerations of a pediatric patient, how to common than originally believed (1). A case-control study evaluate and manage these fractures, and when to surgically by Zonfrillo et al found an association between an increased repair them. Surgical techniques and complications will be risk of athletic injury in obese children, and concluded a briefl y reviewed. higher body mass index risk factor for ankle sprains (4). Ankle fractures are the third most common fractures in Secondary ossifi cation centers are located in the children, after the fi nger and distal radial physeal fracture. epiphysis. The distal tibial ossifi cation center appears at 6-24 Approximately 20-30% of all pediatric fractures are ankle months of age and closes asymmetrically over an 18-month fractures. Most ankle fractures occur at 8-15 years old. The period fi rst central, then medial and posterior, with the peak injury age is 11-12 years, and is relatively uncommon anterolateral portion closing last at 15 and 17 years of age for under the age 5. This injury is more common in boys. females and males, respectively. The distal fi bula ossifi cation The most common cause of pediatric ankle fractures is a center appears at 9-24 months of age and closes 1-2 years rotational force, and is often seen in sports injuries associated after the distal tibial. -
Patients with Positive Preoperative Stress Tests Undergoing Vascular Surgery
Patients With Positive Preoperative Stress Tests Undergoing Vascular Surgery Kyung W. Tim Park, MD, Kathirvel Subramaniam, MD, Feroze Mahmood, MD, Fred Shapiro, MD, Selina Long, MD, and David Napoli, MD Objective: To examine the perioperative cardiac morbidity Cardiology and 7 had a left ventricular ejection fraction and mortality in patients undergoing major vascular surgery <40%. Twenty-three patients had been on a -blocker and with -blockade after a positive stress test or cardiac cath- continued on it, while the remainder started on it de novo eterization. perioperatively. None of the patients suffered from myocar- Design: Retrospective review of a quality assurance data- dial infarction, congestive heart failure, or cardiac death base. perioperatively. Setting: A university teaching hospital. Conclusions: This case series reports on the authors’ ex- Participants: A consecutive series of 31 patients undergo- perience with patients undergoing high-risk vascular sur- ing peripheral vascular or aortic surgery after a positive gery after a positive stress test or catheterization, but with- stress test or catheterization between November 2001 and out an intervening coronary intervention. All patients received perioperative -blockade and had a very low ad- September 2003. verse cardiac event rate. With reduction of adverse events Intervention: None. by -blockade, the likelihood of a positive event may be Measurements and Main Results: All 31 patients had a reduced and the utility of the test in risk stratification may preoperative positive stress test and/or cardiac catheteriza- be questioned. tion, with 12 having multiple areas at risk for myocardial © 2005 Elsevier Inc. All rights reserved. ischemia. None had an intervening coronary revasculariza- tion. -
Mechanical Optimization of Vascular Bypass Grafts A
MECHANICAL OPTIMIZATION OF VASCULAR BYPASS GRAFTS A Thesis Presented to The Academic Faculty By Luc Felden In Partial Fulfillment Of the Requirements for the Degree Master of Science in Mechanical Engineering Georgia Institute of Technology May 2005 MECHANICAL OPTIMIZATION OF VASCULAR BYPASS GRAFTS Approved by: Dr. David N. Ku, Advisor The George W. Woodruff School of Mechanical Engineering Georgia Institute of Technology Dr. Alexander Rachev, Co-Advisor The George W. Woodruff School of Mechanical Engineering Georgia Institute of Technology Dr. Elliot L. Chaikof Department of Surgery Emory University School of Medicine Date Approved: March 28, 2005 ACKNOWLEDGEMENTS I wish to express my genuine gratitude to my advisor Dr. Ku, for offering me an opportunity to work in his lab and for his guidance in my research. I particularly wish to thank Dr. Rachev for his daily assistance on this project. I sincerely thank Dr. Chaikof for his review and comments. I thank you all for your help and friendship along this year. My heartfelt appreciation goes to all my lab mates from whom I learned more about the American way of life. I am deeply grateful to my family and friends for the support and love they have provided me while I was abroad. iii TABLE OF CONTENTS ACKNOWLEDGEMENTS...............................................................................................iii LIST OF TABLES............................................................................................................vii LIST OF FIGURES...........................................................................................................ix -
Commercial Musculoskeletal Codes
Updated January 2018 Commercial Musculoskeletal Codes Investigational or Non-Covered Spine Surgery Pain Management Joint Surgery Codes associated with an Arthrogram CPT Description Commercial Notes Partial excision of posterior vertebral component (eg, spinous 22100 process, lamina or facet) for intrinsic bony lesion, single vertebral segment; cervical 22101 Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; thoracic 22102 Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; lumbar Partial excision of posterior vertebral component (eg, spinous process, 22103 lamina or facet) for intrinsic bony lesion, single vertebral segment; each additional segment (List separately in addition to code for primary procedure) Partial excision of vertebral body, for intrinsic bony lesion, without 22110 decompression of spinal cord or nerve root(s), single vertebral segment;cervical Partial excision of vertebral body, for intrinsic bony lesion, without 22112 decompression of spinal cord or nerve root(s), single vertebral segment; thoracic Partial excision of vertebral body, for intrinsic bony lesion, without 22114 decompression of spinal cord or nerve root(s), single vertebral segment; lumbar each additional vertebral segment (list separately in addition to code 22116 for primary procedure) Osteotomy of spine, posterior or posterolateral approach, 3 columns, 22206 1 vertebral -
EACTS Adult Cardiac Database Quality Improvement Programme
EACTS Adult Cardiac Database Quality Improvement Programme Database Dictionary Version 1.1, 15 May 2014 QUIP Adult Cardiac Database Database Dictionary Contents 4 Patient demographics and other identifiers Patient identifier Race Age at operation Country code Gender Hospital code 5 Hospitalisation Date of admission Date of discharge / death Date of surgery 6 Cardiac history Angina Type of most recent MI Dyspnoea Most recent MI Symptomatic status at admission Congestive heart failure Number of previous MIs 9 Previous interventions Previous PCI Previous cardiac surgery Date of last PCI Date of last cardiac surgery 10 Pre-operative risk factors Weight Extra-cardiac arteriopathy Height Peripheral vascular disease details Smoking history Type of cerebrovascular disease Diabetes treatment CVA when Hypertension TIA when Hypercholesterolaemia Neurological dysfunction Renal disease Poor mobility due to any non-cardiac reason Last pre-operative creatinine Carotid bruits Chronic lung disease Pre-operative heart rhythm Degree of COPD 14 Pre-operative haemodynamics and catheterisation Left main stem disease Ejection fraction category Coronary artery disease - LAD Ejection fraction value Coronary artery disease - Circumflex PA systolic Coronary artery disease - Right Pulmonary Hypertension Carotid artery disease AV gradient mean Endocarditis AV gradient peak Left- or right-heart catheterisation LVEDP Date of last catheterisation Mean PAWP / LA 16 Pre-operative status and support IV nitrates Cardiogenic shock IV inotropes Immunosuppressive therapy within -
Appendix H Miscellaneous Tables
Appendix H Miscellaneous Tables Release Notes: Bleeding Inclusion Table Table 1.1 Bleeding Inclusion Table Version 1.0 Gastrointestinal (GI) Genitourinary (GU) Intracranial Other Types of Bleeding • anemia due to • blood in urine, • cerebral hemorrhage or • bleeding which occurred gastrointestinal unless noted only as bleeding as a result of trauma or bleeding laboratory or • hemorrhagic injury ONLY if medical • bleeding diverticulum dipstick finding cerebrovascular intervention required • bleeding from a peptic, • hematuria described accident (CVA) • epistaxis ONLY if gastric, esophageal, or as gross • hemorrhagic infarct of medical intervention duodenal ulcer the brain required • bleeding from colon • intracerebral • hematoma requiring • bleeding from gastritis Pulmonary bleeding/hemorrhage transfusion, stoppage of • bleeding hemorrhoid • bloody tinged • intracranial heparin or other ONLY if medical sputum bleeding/hemorrhage anticoagulant (e.g., Integrilin, Eptifibatide, intervention required • bloody sputum • ruptured intracranial Coumadin, Levonox), or • blood in vomitus, • coughing up blood aneurysm surgical intervention emesis, or stool • hemoptysis • subarachnoid • coffee ground emesis hemorrhage (SAH) (e.g., incision and • esophageal bleeding • subdural hematoma drainage) varices • post-procedure bleeding • hematemesis noted as abnormal or which required medical • hematochezia intervention • heme/guaiac positive vomitus, emesis, or • retinal hemorrhage/ bleeding stool • retroperitoneal (bleeding • hemoccult/occult into the abdomen) -
Towards Mri-Guided Cardiovascular Interventions
TOWARDS MRI-GUIDED CARDIOVASCULAR INTERVENTIONS A Dissertation Presented to The Academic Faculty By Christina Elena Saikus In Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the School of Biomedical Engineering Georgia Institute of Technology / Emory University Atlanta, Georgia August 2011 TOWARDS MRI-GUIDED CARDIOVASCULAR INTERVENTIONS Approved by: Ajit P. Yoganathan, PhD John N. Oshinski, PhD Department of Biomedical Engineering Department of Biomedical Engineering Georgia Institute of Technology and Georgia Institute of Technology and Emory University Emory University Robert J. Lederman, MD W. Robert Taylor, MD, PhD National Heart, Lung, and Blood Institute Department of Biomedical Engineering National Institutes of Health Georgia Institute of Technology and Emory University Elliot R. McVeigh, PhD Department of Biomedical Engineering Johns Hopkins University Date Approved: January 19, 2011 ACKNOWLEDGEMENTS I am indebted to the many people who provided amazing opportunities and support throughout my graduate training. My thesis committee members were all willing mentors and provided critical insight during this process in addition to serving as role models for their expertise and contributions in the fields of cardiovascular disease, biomedical engineering, and MRI. Dr. Yoganathan and my time in the CFM lab fostered a strong research foundation and work ethic while also providing continual guidance and support to pursue different research and professional opportunities. Dr. Lederman gave me the freedom to pursue a wide range of projects and continue my development as a physician scientist through the incredible experience at the NIH/NHLBI intramural research program. Dr. McVeigh’s contributions in real-time cardiac MRI provided the foundation for much of this work and he continually offered important perspective and mentorship along the way.