Log of ICD-9-CM and DRG Coding Updates and Revisions to IQI Documentation and Software
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Surgical Advances in Heart and Lung Transplantation
Anesthesiology Clin N Am 22 (2004) 789–807 Surgical advances in heart and lung transplantation Eric E. Roselli, MD*, Nicholas G. Smedira, MD Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Desk F25, 9500 Euclid Avenue, Cleveland, OH 44195, USA The first heart transplants were performed in dogs by Alexis Carrel and Charles Guthrie in 1905, but it was not until the 1950s that attempts at human orthotopic heart transplant were reported. Several obstacles, including a clear definition of brain death, adequate organ preservation, control of rejection, and an easily reproducible method of implantation, slowed progress. Eventually, the first successful human to human orthotopic heart transplant was performed by Christian Barnard in South Africa in 1967 [1]. Poor healing of bronchial anastomoses hindered early progress in lung transplantation, first reported in 1963 [2]. The first successful transplant of heart and both lungs was accomplished at Stanford University School of Medicine (Stanford, CA) in 1981 [3]. The introduction of cyclosporine to immunosuppres- sion protocols, with lower doses of steroids, led to the first successful isolated lung transplant, performed at Toronto General Hospital in 1983 [4]. Since these early successes at thoracic transplantation, great progress has been made in the care of patients with end-stage heart and lung disease. Although only minor changes have occurred in surgical technique for heart and lung transplantation, the greatest changes have been in liberalizing donor criteria to expand the donor pool. This article focuses on more recent surgical advances in donor selection and management, procurement and implantation, and the impact these advances have had on patient outcome. -
Association Between Gastric Myoelectric Activity Disturbances and Dyspeptic T Symptoms in Gastrointestinal Cancer Patients ⁎ Aneta L
Advances in Medical Sciences 64 (2019) 44–53 Contents lists available at ScienceDirect Advances in Medical Sciences journal homepage: www.elsevier.com/locate/advms Original research article Association between gastric myoelectric activity disturbances and dyspeptic T symptoms in gastrointestinal cancer patients ⁎ Aneta L. Zygulskaa, , Agata Furgalab, Krzysztof Krzemienieckia,c,1, Beata Wlodarczykb, Piotr Thorb a Department of Oncology, University Hospital in Cracow, Cracow, Poland b Department of Pathophysiology, Jagiellonian University Medical College, Cracow, Poland c Department of Oncology, Jagiellonian University Medical College, Cracow, Poland ARTICLE INFO ABSTRACT Keywords: Purpose: Dyspeptic symptoms present a severe problem in gastrointestinal (GI) cancer patients. The aim of the Gastrointestinal carcinoma study was to analyze an association between gastric myoelectric activity changes and dyspeptic symptoms in Gastric motility gastrointestinal cancer patients. Gastric myoelectric activity Material and Methods: The study included 80 patients (37 men and 43 women, mean age 61.2 ± 7.8 years) Electrogastrography diagnosed with GI tract malignancies: colon (group A), rectal (group B) and gastric cancers (group C). Gastric Dyspeptic symptoms myoelectric activity in a preprandial and postprandial state was determined by means of a 4-channel electro- gastrography. Autonomic nervous system was studied based on heart rate variability analysis. The results were compared with the data from healthy asymptomatic controls. Results: In a fasted state, GI cancer patients presented with lesser percentages of normogastria time (A:44.23 vs. B:46.5 vs. C:47.10 vs. Control:78.2%) and average percentage slow wave coupling (ACSWC) (A:47.1 vs. B:50.8 vs. C:47.2 vs. Control:74.9%), and with higher values of dominant power (A:12.8 vs. -
Hysteroscopy and Endometrial Ablation Using Novasure
Hysteroscopy and Endometrial Ablation Using Novasure What is a hysteroscopy and endometrial ablation using Novasure? This is a procedure where a doctor uses a thin tube with a tiny camera to look inside the uterus. There are no incisions. Saline solution is used to expand the uterus in order to look at the inside of the uterus. The Novasure device is then used to burn the lining of the uterus. When is this surgery used? To evaluate and or treat diseases of the uterus • Painful periods. • Heavy or irregular vaginal bleeding. How do I prepare for surgery? • Before surgery, a pre-op appointment will be scheduled with your doctor at their office or with a nurse practitioner or physician assistant at Domino Farms. • Depending on your health, we may ask you to see your primary doctor, a specialist, and/or an anesthesiologist to make sure you are healthy for surgery. • The lab work for your surgery must be done at least 3 days before surgery. • Some medications need to be stopped before the surgery. A list of medications will be provided at your pre-operative appointment. • Smoking can affect your surgery and recovery. Smokers may have difficulty breathing during the surgery and tend to heal more slowly after surgery. If you are a smoker, it is best to quit 6-8 weeks before surgery. If you are unable to stop smoking before surgery, your doctor can order a nicotine patch while you are in the hospital. Department of Obstetrics and Gynecology (734) 763-6295 - 1 - • You will be told at your pre-op visit whether you will need a bowel prep for your surgery and if you do, what type you will use. -
Laparoscopic Gastropexy As a Preventative Measure for Gastric Dilation Volvulus in Canines
Laparoscopic Gastropexy as a Preventative Measure for Gastric Dilation Volvulus in Canines By: Erin O’Brien Advisors: Dr. Kimberly Boswell Board Certified Surgeon Southwest Michigan Animal Emergency Hospital Kalamazoo, MI Dr. Diane R. Kiino Ph.D. Kalamazoo College Health Science A paper submitted in partial fulfillment of the requirements for the degree of Bachelor of Arts at Kalamazoo College. 2010 ii ACKNOWLEDGEMENTS Over the summer I was able to intern at the Southwest Michigan Animal Emergency Hospital in Kalamazoo, MI. It was there that I was exposed to the emergency setting in veterinary medicine but also had the chance to observe surgeries done by Board Certified Surgeon, Dr. Kimberly Boswell. I would like to thank the entire staff at SWMAEH for teaching me a tremendous amount about veterinary medicine and allowing me to get as much hands on experience as possible. It was such a privilege to complete my internship at a hospital where I was able to learn so much about veterinary medicine in only ten weeks. I would also like to thank Dr. Boswell in particular, it was a gastropexy surgery I saw her perform during my internship that inspired the topic of this paper. Additionally I would like to acknowledge my advisor Dr. Diane Kiino for providing the direction I needed in choosing my paper topic. iii ABSTRACT Gastric Dilation Volvulus (GDV) is a fatal condition in canines especially those that are large or giant breeds. GDV results from the stomach distending and twisting on itself which when left untreated causes shock and ultimately death. The only method of prevention for GDV is a gastropexy, a surgical procedure that sutures the stomach to the abdominal wall to prevent volvulus or twisting. -
Laparoscopic Truncal Vagotomy and Gatrojejunostomy for Pyloric Stenosis
ORIGINAL ARTICLE pISSN 2234-778X •eISSN 2234-5248 J Minim Invasive Surg 2015;18(2):48-52 Journal of Minimally Invasive Surgery Laparoscopic Truncal Vagotomy and Gatrojejunostomy for Pyloric Stenosis Jung-Wook Suh, M.D.1, Ye Seob Jee, M.D., Ph.D.1,2 Department of Surgery, 1Dankook University Hospital, 2Dankook University School of Medicine, Cheonan, Korea Purpose: Peptic ulcer disease (PUD) remains one of the most prevalent gastrointestinal diseases and Received January 27, 2015 an important target for surgical treatment. Laparoscopy applies to most surgical procedures; however Revised 1st March 9, 2015 its use in elective peptic ulcer surgery, particularly in cases of pyloric stenosis, has not been popular. 2nd March 28, 2015 The aim of this study was to describe the role of laparoscopic surgery and an easily performed Accepted April 20, 2015 procedure for pyloric stenosis. We accordingly performed laparoscopic truncal vagotomy with gastrojejunostomy in 10 consecutive patients with pyloric stenosis. Corresponding author Ye Seob Jee Methods: Data were collected prospectively from all patients who underwent laparoscopic truncal Department of Surgery, Dankook vagotomy with gastrojejunostomy from August 2009 to May 2014 and reviewed retrospectively. University Hospital, Dankook Results: A total of 10 patients underwent laparoscopic trucal vagotomy with gastrojejunostomy for University School of Medicine, 119, peptic ulcer obstruction from August 2009 to May 2014 in ○○ university hospital. The mean age was Dandae-ro, Dongnam-gu, Cheonan 62.6 (±16.4) years old and mean BMI was 19.3 (±2.5) kg/m2. There were no conversions to open 330-714, Korea surgery and no occurrence of intra-operative complications. -
Signal Processing Techniques for Phonocardiogram De-Noising and Analysis
-3C).1 CBME CeaEe for Bionedio¡l Bnginocdng Adelaide Univenity Signal Processing Techniques for Phonocardiogram De-noising and Analysis by Sheila R. Messer 8.S., Urriversity of the Pacific, Stockton, California, IJSA Thesis submitted for the degree of Master of Engineering Science ADELAIDE U N IVERSITY AUSTRALIA Adelaide University Adelaide, South Australia Department of Electrical and Electronic Faculty of Engineering, Computer and Mathematical Sciences July 2001 Contents Abstract vi Declaration vll Acknowledgement vul Publications lx List of Figures IX List of Tables xlx Glossary xxii I Introduction I 1.1 Introduction 2 t.2 Brief Description of the Heart 4 1.3 Heart Sounds 7 1.3.1 The First Heart Sound 8 1.3.2 The Second Heart Sound . 8 1.3.3 The Third and Fourth Heart Sounds I I.4 Electrical Activity of the Heart I 1.5 Literature Review 11 1.5.1 Time-Flequency and Time-Scale Decomposition Based De-noising 11 I CO]VTE]VTS I.5.2 Other De-noising Methods t4 1.5.3 Time-Flequency and Time-Scale Analysis . 15 t.5.4 Classification and Feature Extraction 18 1.6 Scope of Thesis and Justification of Research 23 2 Equipment and Data Acquisition 26 2.1 Introduction 26 2.2 History of Phonocardiography and Auscultation 26 2.2.L Limitations of the Hurnan Ear 26 2.2.2 Development of the Art of Auscultation and the Stethoscope 28 2.2.2.L From the Acoustic Stethoscope to the Electronic Stethoscope 29 2.2.3 The Introduction of Phonocardiography 30 2.2.4 Some Modern Phonocardiography Systems .32 2.3 Signal (ECG/PCG) Acquisition Process .34 2.3.1 Overview of the PCG-ECG System .34 2.3.2 Recording the PCG 34 2.3.2.I Pick-up devices 34 2.3.2.2 Areas of the Chest for PCG Recordings 37 2.3.2.2.I Left Ventricle Area (LVA) 37 2.3.2.2.2 Right Ventricular Area (RVA) 38 oaooe r^fr /T ce a.!,a.2.{ !v¡u Ãurlo¡^+-;^l ¡rr!o^-^^ \!/ ^^\r¡ r/ 2.3.2.2.4 Right Atrial Area (RAA) 38 2.3.2.2.5 Aortic Area (AA) 38 2.3.2.2.6 Pulmonary Area (PA) 39 ll CO]VTE]VTS 2.3.2.3 The Recording Process . -
Caesarean Section Or Vaginal Delivery in the 21St Century
CAESAREAN SECTION OR VAGINAL DELIVERY IN THE 21ST CENTURY ntil the 20th Century, caesarean fluid embolism. The absolute risk of trans-placentally to the foetus, prepar- section (C/S) was a feared op- death with C/S in high and middle- ing the foetus to adopt its mother’s Ueration. The ubiquitous classical resource settings is between 1/2000 and microbiome. C/S interferes with neonatal uterine incision meant high maternal 1/4000 (2, 3). In subsequent pregnancies, exposure to maternal vaginal and skin mortality from bleeding and future the risk of placenta previa, placenta flora, leading to colonization with other uterine rupture. Even with aseptic surgi- accreta and uterine rupture is increased. environmental microbes and an altered cal technique, sepsis was common and These conditions increase maternal microbiome. Routine antibiotic exposure lethal without antibiotics. The operation mortality and severe maternal morbid- with C/S likely alters this further. was used almost solely to save the life of ity cumulatively with each subsequent Microbial exposure and the stress of a mother in whom vaginal delivery was C/S. This is of particular importance to labour also lead to marked activation extremely dangerous, such as one with women having large families. of immune system markers in the cord placenta previa. Foetal death and the use blood of neonates born vaginally or by of intrauterine foetal destructive proce- Maternal Benefits C/S after labour. These changes are absent dures, which carry their own morbidity, C/S has a modest protective effect against in the cord blood of neonates born by were often preferable to C/S. -
Thoracoscopic Truncal Vagotomy Versus Surgical Revision of the Gastrojejunal Anastomosis for Recalcitrant Marginal Ulcers
Surgical Endoscopy (2019) 33:607–611 and Other Interventional Techniques https://doi.org/10.1007/s00464-018-6386-7 2018 SAGES ORAL DYNAMIC Thoracoscopic truncal vagotomy versus surgical revision of the gastrojejunal anastomosis for recalcitrant marginal ulcers Alicia Bonanno1 · Brandon Tieu2 · Elizabeth Dewey1 · Farah Husain3 Received: 1 May 2018 / Accepted: 10 August 2018 / Published online: 21 August 2018 © Springer Science+Business Media, LLC, part of Springer Nature 2018 Abstract Introduction Marginal ulcer is a common complication following Roux-en-Y gastric bypass with incidence rates between 1 and 16%. Most marginal ulcers resolve with medical management and lifestyle changes, but in the rare case of a non-healing marginal ulcer there are few treatment options. Revision of the gastrojejunal (GJ) anastomosis carries significant morbidity with complication rates ranging from 10 to 50%. Thoracoscopic truncal vagotomy (TTV) may be a safer alternative with decreased operative times. The purpose of this study is to evaluate the safety and effectiveness of TTV in comparison to GJ revision for treatment of recalcitrant marginal ulcers. Methods A retrospective chart review of patients who required surgical intervention for non-healing marginal ulcers was performed from 1 September 2012 to 1 September 2017. All underwent medical therapy along with lifestyle changes prior to intervention and had preoperative EGD that demonstrated a recalcitrant marginal ulcer. Revision of the GJ anastomosis or TTV was performed. Data collected included operative time, ulcer recurrence, morbidity rate, and mortality rate. Results Twenty patients were identified who underwent either GJ revision (n = 13) or TTV (n = 7). There were no 30-day mortalities in either group. -
OT Resource for K9 Overview of Surgical Procedures
OT Resource for K9 Overview of surgical procedures Prepared by: Hannah Woolley Stage Level 1 2 Gynecology/Oncology Surgeries Lymphadenectomy (lymph node dissection) Surgical removal of lymph nodes Radical: most/all of the lymph nodes in tumour area are removed Regional: some of the lymph nodes in the tumour area are removed Omentectomy Surgical procedure to remove the omentum (thin abdominal tissue that encases the stomach, large intestine and other abdominal organs) Indications for omenectomy: Ovarian cancer Sometimes performed in combination with TAH/BSO Posterior Pelvic Exenteration Surgical removal of rectum, anus, portion of the large intestine, ovaries, fallopian tubes and uterus (partial or total removal of the vagina may also be indicated) Indications for pelvic exenteration Gastrointestinal cancer (bowel, colon, rectal) Gynecological cancer (cervical, vaginal, ovarian, vulvar) Radical Cystectomy Surgical removal of the whole bladder and proximal lymph nodes In men, prostate gland is also removed In women, ovaries and uterus may also be removed Following surgery: Urostomy (directs urine through a stoma on the abdomen) Recto sigmoid pouch/Mainz II pouch (segment of the rectum and sigmoid colon used to provide anal urinary diversion) 3 Radical Vulvectomy Surgical removal of entire vulva (labia, clitoris, vestibule, introitus, urethral meatus, glands/ducts) and surrounding lymph nodes Indication for radical vulvectomy Treatment of vulvar cancer (most common) Sentinel Lymph Node Dissection (SLND) Exploratory procedure where the sentinel lymph node is removed and examined to determine if there is lymph node involvement in patients diagnosed with cancer (commonly breast cancer) Total abdominal hysterectomy/bilateral saplingo-oophorectomy (TAH/BSO) Surgical removal of the uterus (including cervix), both fallopian tubes and ovaries Indications for TAH/BSO: Uterine fibroids: benign growths in the muscle of the uterus Endometriosis: condition where uterine tissue grows on structures outside the uterus (i.e. -
Laparoscopic Fundoplication with Double Sided Posterior Gastropexy: a Different Surgical Technique
View metadata, citation and similar papers at core.ac.uk ORIGINAL RESEARCH brought to you by CORE provided by Elsevier - Publisher Connector International Journal of Surgery 10 (2012) 532e536 Contents lists available at SciVerse ScienceDirect International Journal of Surgery journal homepage: www.theijs.com Original research Laparoscopic fundoplication with double sided posterior gastropexy: A different surgical technique Fahri Yetis¸ira,*, A. Ebru Salman b,Dogukan Durak a, Mehmet Kiliç c a Ataturk Research and Training Hospital, General Surgery Department, Turkey b Ataturk Research and Training Hospital, Anesthesiology and Reanimation Department, Turkey c Yildirim Beyazit University, General Surgery Department, Turkey article info abstract Article history: Background: Laparoscopic Nissen Fundoplication has become the gold standard surgical procedure for Received 18 April 2012 management of gastroesophageal reflux disease. Nissen fundoplication provides an effective barrier Received in revised form against reflux. The aim of this study was to evaluate early postoperative outcomes of a different surgical 3 August 2012 technique, laparoscopic fundoplication with double sided posterior gastropexy. Accepted 6 August 2012 Methods: Data of 46 patients who underwent laparoscopic fundoplication with double sided posterior Available online 21 August 2012 gastropexy between February 2010 and December 2011 were collected. Surgically, after Nissen fundoplication was completed, 2e4 sutures were passed through the uppermost parts of the posterior Keywords: Gastropexy and anterior wall of the gastric wrap and then passed gently 1 cm above the celiac artery from the denser fi Nissen fundoplication bers of uppermost part of the arcuate ligament. Demographic data, preoperative and postoperative Gastroesophageal reflux assesments of sympthomatic and functional outcomes of patients were recorded. -
Intestine Transplant Manual
Intestine Transplant Manual Toronto Intestine Transplant Program TRANSPLANT MANUAL E INTESTIN This manual is dedicated to our donors, our patients and their families Acknowledgements Dr. Mark Cattral, MD, (FRCSC) Dr. Yaron Avitzur, MD Andrea Norgate, RN, BScN Sonali Pendharkar, BA (Hons), BSW, MSW, RSW Anna Richardson, RD We acknowledge the contribution of previous members of the team and to Cheryl Beriault (RN, BScN) for creating this manual. 2 TABLE OF CONTENTS Dedications and Acknowledgements 2 Welcome 5 Our Values and Philosophy of Care Our Expectations of You Your Transplant Team 6 The Function of the Liver and Intestines 9 Where are the abdominal organs located and what do they look like? What does your Stomach do? What does your Intestine do? What does your Liver do? What does your Pancreas do? When Does a Patient Need an Intestine Transplant? 12 Classification of Intestine Failure Am I Eligible for an Intestine Transplant? Advantages and Disadvantages of Intestine Transplant The Transplant Assessment 14 Investigations Consultations Active Listing for Intestine Transplantation (Placement on the List) 15 Preparing for the Intestine Transplant Trillium Drug Program Other Sources of Funding for Drug Coverage Financial Planning Insurance Issues Other Financial Considerations Related to the Hospital Stay Legal Considerations for Transplant Patients Advance Care Planning Waiting for the Intestine Transplant 25 Your Place on the Waiting List Maintaining Contact with the Transplant Team Coping with Stress Maintaining your Health While -
AAGL Practice Report: Practice Guidelines for Management of Intrauterine Synechiae
Special Article AAGL Practice Report: Practice Guidelines for Management of Intrauterine Synechiae AAGL ADVANCING MINIMALLY INVASIVE GYNECOLOGY WORLDWIDE Background The search was not restricted to English language literature; committee members fluent in languages other than English re- Intrauterine adhesions (IUAs) have been recognized as viewed relevant articles and provided the committee with rel- a cause of secondary amenorrhea since the end of the 19th ative information translated into English. Because of the century [1], and in the mid-20th century, Asherman further paucity of data in this area, all published works were included described the eponymous condition occurring after preg- for the electronic database searches, and relevant articles not nancy [2]. The terms ‘‘Asherman syndrome’’ and IUAs are available in electronic sources (e.g., published before the be- often used interchangeably, although the syndrome requires ginning of electronic database commencement) were cross- the constellation of signs and symptoms (in this case, pain, referenced from hand-searched bibliographies and included menstrual disturbance, and subfertility in any combination) in the literature review. When necessary, authors were con- and the presence of IUAs [2]. The presence of IUAs in the tacted directly for clarification of points published. absence of symptoms may be best referred to as asymptom- atic IUAs or synechiae. Diagnosis Identification and Assessment of Evidence In women with suspected IUAs, physical examination usually fails to reveal abnormalities [3,4]. Blind transcervical This AAGL Practice Guideline was produced after elec- sounding of the uterus may reveal cervical obstruction at or tronic resources including Medline, PubMed, CINAHL, the near the level of the internal os [3].