2021 Compilation of Inpatient Only Lists by Specialty
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Femoral Shaft Fractures Andrew Chen, MD University of North Carolina
Femoral Shaft Fractures Andrew Chen, MD University of North Carolina Core Curriculum V5 Disclosure All figures belong to Andrew Chen, MD unless otherwise indicated Core Curriculum V5 Objectives • Review initial management of femoral shaft fractures and possible concomitant injuries • Discuss multiple options with intramedullary nailing • Antegrade/retrograde • Starting point • Reaming • Patient positioning • Understand commonly associated complications Core Curriculum V5 Femoral Shaft Fractures • Bimodal distribution • Young patients after high-energy trauma • Elderly patients after falls from standing secondary to osteopenia/osteoporosis • MVC, MCC, pedestrian struck, fall from height, and gunshot wounds most common mechanisms • Intramedullary nail as “gold standard” treatment, which has continued to evolve since introduction by Gerhard Küntscher around World War II Core Curriculum V5 Anatomy • Largest and strongest bone in body • Anterior bow with radius of curvature ~120 cm1 • Blood supply from primary nutrient vessel through linea aspera and small periosteal vessels • Deformity pattern dependent on attached musculature • Proximal fragment • Flexed (gluteus medius/minimus on greater trochanter) • Abducted (iliopsoas on lesser trochanter) • Distal fragment • Varus (adductors inserting on medial aspect distal femur) • Extension (gastrocnemius attaching on distal aspect of posterior femur) Courtesy of Rockwood and Green’s Fracture in Adults2 Core Curriculum V5 Femur Fracture Classification: AO/OTA • Bone Segment 32 • Type A • Simple • -
30Th Annual Meeting “Rapid Evolution in the Healthcare Ecosystem: Become Frontiers”
2020 FINAL PROGRAM North American Skull Base Society 30th Annual Meeting “Rapid Evolution in the Healthcare Ecosystem: Become Frontiers” February 7-9, 2020 La Cantera Resort & Spa, San Antonio, TX Pre-Meeting Dissection Course: February 5-6, 2020 PRESIDENT: Ricardo Carrau, MD, MBA PROGRAM CHAIRS: Adam Zanation, MD & Daniel Prevedello, MD PRE-MEETING COURSE CHAIRS: Paul Gardner, MD & Arturo Solares, MD SCIENTIFIC PROGRAM COMMITTEE: Ricardo Carrau, MD, MBA, President, Adam Zanation, MD, MBA, Program Co-Chair, Daniel Prevedello, MD, Program Co-Chair, Paul Gardner, MD, Arturo Solares, MD, FACS, James Evans, MD, FACS, FAANS, Shaan Raza, MD, Brian Thorp, MD, Deanna Sasaki-Adams, MD, Chris Rassekh, MD, Christine Klatt-Cromwell, MD, Tonya Stefko, MD, Moises Arriaga, MD, Jamie Van Gompel, MD, Kibwei McKinney, MD, Derrick Lin, MD, FACS, Carlos Pinheiro-Neto, MD, PhD Dear friends and colleagues, Welcome to the 30th Annual Meeting of the North American Skull Base Society! This event will be held at La Cantera Resort in San Antonio, Texas; February 7-9, 2020 with a pre-meeting hands-on dissection course February 5-6, 2020. La Cantera is a beautiful resort, full of family- oriented amenities, located just 20 minutes from San Antonio’s downtown, The Alamo historical site and the world renowned Riverwalk. The meeting theme, Rapid Evolution in the Healthcare Ecosystem: Ricardo Carrau, MD, MBA Becoming Frontiers, will present the opportunity to discuss technological, technical, societal and economic changes affecting the way we deliver care to our patients and how our frontier horizon changes faster than our ability to adapt to these changes (“becoming frontiers”). -
Partial Nephrectomy for Renal Cancer: Part I
REVIEW ARTICLE Partial nephrectomy for renal cancer: Part I BJUIBJU INTERNATIONAL Paul Russo Department of Surgery, Urology Service, and Weill Medical College, Cornell University, Memorial Sloan Kettering Cancer Center, New York, NY, USA INTRODUCTION The Problem of Kidney Cancer Kidney Cancer Is The Third Most Common Genitourinary Tumour With 57 760 New Cases And 12 980 Deaths Expected In 2009 [1]. There Are Currently Two Distinct Groups Of Patients With Kidney Cancer. The First Consists Of The Symptomatic, Large, Locally Advanced Tumours Often Presenting With Regional Adenopathy, Adrenal Invasion, And Extension Into The Renal Vein Or Inferior Vena Cava. Despite Radical Nephrectomy (Rn) In Conjunction With Regional Lymphadenectomy And Adrenalectomy, Progression To Distant Metastasis And Death From Disease Occurs In ≈30% Of These Patients. For Patients Presenting With Isolated Metastatic Disease, Metastasectomy In Carefully Selected Patients Has Been Associated With Long-term Survival [2]. For Patients With Diffuse Metastatic Disease And An Acceptable Performance Status, Cytoreductive Nephrectomy Might Add Several Additional Months Of Survival, As Opposed To Cytokine Therapy Alone, And Prepare Patients For Integrated Treatment, Now In Neoadjuvant And Adjuvant Clinical Trials, With The New Multitargeted Tyrosine Kinase Inhibitors (Sunitinib, Sorafenib) And Mtor Inhibitors (Temsirolimus, Everolimus) [3,4]. The second groups of patients with kidney overall survival. The explanation for this cancer are those with small renal tumours observation is not clear and could indicate (median tumour size <4 cm, T1a), often that aggressive surgical treatment of small incidentally discovered in asymptomatic renal masses in patients not in imminent patients during danger did not counterbalance a population imaging for of patients with increasingly virulent larger nonspecific abdominal tumours. -
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. -
2021 – the Following CPT Codes Are Approved for Billing Through Women’S Way
WHAT’S COVERED – 2021 Women’s Way CPT Code Medicare Part B Rate List Effective January 1, 2021 For questions, call the Women’s Way State Office 800-280-5512 or 701-328-2389 • CPT codes that are specifically not covered are 77061, 77062 and 87623 • Reimbursement for treatment services is not allowed. (See note on page 8). • CPT code 99201 has been removed from What’s Covered List • New CPT codes are in bold font. 2021 – The following CPT codes are approved for billing through Women’s Way. Description of Services CPT $ Rate Office Visits New patient; medically appropriate history/exam; straightforward decision making; 15-29 minutes 99202 72.19 New patient; medically appropriate history/exam; low level decision making; 30-44 minutes 99203 110.77 New patient; medically appropriate history/exam; moderate level decision making; 45-59 minutes 99204 165.36 New patient; medically appropriate history/exam; high level decision making; 60-74 minutes. 99205 218.21 Established patient; evaluation and management, may not require presence of physician; 99211 22.83 presenting problems are minimal Established patient; medically appropriate history/exam, straightforward decision making; 10-19 99212 55.88 minutes Established patient; medically appropriate history/exam, low level decision making; 20-29 minutes 99213 90.48 Established patient; medically appropriate history/exam, moderate level decision making; 30-39 99214 128.42 minutes Established patient; comprehensive history exam, high complex decision making; 40-54 minutes 99215 128.42 Initial comprehensive -
Rare Combination of Ipsilateral Acetabular Fracture-Dislocation and Pertrochanteric Fracture
A Case Report & Literature Review Rare Combination of Ipsilateral Acetabular Fracture-Dislocation and Pertrochanteric Fracture Kevin M. Kuhn, CDR, MC, USN, John A. Boudreau, MD, and J. Tracy Watson, MD oral fractures. Other case reports have described acetabular Abstract fracture-dislocations associated with femoral neck fractures.1-3 Acetabular fracture-dislocations are severe This case report describes an acetabular fracture-dislocation injuries that require urgent closed reduction associated with an ipsilateral pertrochanteric fracture and sub- of the hip and often require surgery to restore trochanteric extension. hip stability. Other authors have described We propose a staged treatment strategy consisting of early acetabular fracture-dislocations associated minimally invasive reduction of the hip and delayed reduction with femoral neck fractures, but to our knowl- and fixation of the fractures. This strategy may be useful in edge, this case report is the first to describe an managing a polytraumatized patient who may not be stable acetabular fracture-dislocation in association enough to undergo early definitive management, or a patient with an ipsilateral pertrochanteric fracture and who requires prolonged transfer to receive definitive care. subtrochanteric extension. The patient provided written informed consent for print The polytraumatized patient initially was not and electronic publication of this case report. stable enough for prolonged surgery. Through a 3-cm anterolateral hip incision, a 5-mmAJO Schanz Case Report screw was introduced percutaneously into the A 44-year-old man was involved in a head-on motor vehicle femoral head through the primary fracture site collision at highway speed. He was taken to a local hospital, under fluoroscopic guidance. -
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 -
Agreement Between Endocervical Brush and Endocervical Curettage in Patients Undergoing Repeat Endocervical Sampling
Agreement Between Endocervical Brush and Endocervical Curettage in Patients Undergoing Repeat Endocervical Sampling Meredith J. Alston MD David W. Doo MD Sara E. Mazzoni MD MPH Elaine H. Stickrath MD Denver Health Medical Center University of Colorado Department of Obstetrics and Gynecology Background • Women with abnormal Pap tests referred for colposcopy frequently require sampling of the endocervix • ASCCP deems both the endocervical brush (ECB) and the endocervical currette (ECC) appropriate means of collecting endocervical samples (1) • Both have advantages and disadvantages, and it is unclear if one modality is superior Background • ECB has good sensitivity for endocervical lesions, it has poor specificity, ranging from 26- 38%2,3 • ECC has an excellent negative predictive value of 99.4% in women who had a satisfactory colposcopy • ECB is better tolerated by the patient, but runs the risk of contamination from the ectocervix • ECC is less likely to obtain an adequate sample Background • The results from the endocervical sample may influence clinical management after colposcopy. • Certain treatment options for high grade squamous intraepithelial neoplasia are available only to women with negative endocervical sampling. ▫ Ablative techniques ▫ Expectant management Background • Over concerns related to potential complications of excisional treatments, as well as over- treatment, there has been a push to re-introduce ablative techniques and, in appropriate clinical circumstances, expectant management, into the routine treatment of patients with cervical cancer precursors (12). Background • At our institution, it is our concern that due to the possibility of contamination from the ectocervix, a positive ECB may not represent a true positive endocervical sample. • We do not use a sleeve • Positive ECBs return for ECC if otherwise a candidate for ablative therapy or expectant management Objective • To describe the agreement between these two modalities of endocervical sampling. -
Fearful Symmetries: Essays and Testimonies Around Excision and Circumcision. Rodopi
Fearful Symmetries Matatu Journal for African Culture and Society ————————————]^——————————— EDITORIAL BOARD Gordon Collier Christine Matzke Frank Schulze–Engler Geoffrey V. Davis Aderemi Raji–Oyelade Chantal Zabus †Ezenwa–Ohaeto TECHNICAL AND CARIBBEAN EDITOR Gordon Collier ———————————— ]^ ——————————— BOARD OF ADVISORS Anne V. Adams (Ithaca NY) Jürgen Martini (Magdeburg, Germany) Eckhard Breitinger (Bayreuth, Germany) Henning Melber (Windhoek, Namibia) Margaret J. Daymond (Durban, South Africa) Amadou Booker Sadji (Dakar, Senegal) Anne Fuchs (Nice, France) Reinhard Sander (San Juan, Puerto Rico) James Gibbs (Bristol, England) John A. Stotesbury (Joensuu, Finland) Johan U. Jacobs (Durban, South Africa) Peter O. Stummer (Munich, Germany) Jürgen Jansen (Aachen, Germany) Ahmed Yerma (Lagos, Nigeria)i — Founding Editor: Holger G. Ehling — ]^ Matatu is a journal on African and African diaspora literatures and societies dedicated to interdisciplinary dialogue between literary and cultural studies, historiography, the social sciences and cultural anthropology. ]^ Matatu is animated by a lively interest in African culture and literature (including the Afro- Caribbean) that moves beyond worn-out clichés of ‘cultural authenticity’ and ‘national liberation’ towards critical exploration of African modernities. The East African public transport vehicle from which Matatu takes its name is both a component and a symbol of these modernities: based on ‘Western’ (these days usually Japanese) technology, it is a vigorously African institution; it is usually -
Pituitary Pathology in Traumatic Brain Injury: a Review
Pituitary (2019) 22:201–211 https://doi.org/10.1007/s11102-019-00958-8 Pituitary pathology in traumatic brain injury: a review Aydin Sav1 · Fabio Rotondo2 · Luis V. Syro3 · Carlos A. Serna4 · Kalman Kovacs2 Published online: 29 March 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract Purpose Traumatic brain injury most commonly afects young adults under the age of 35 and frequently results in reduced quality of life, disability, and death. In long-term survivors, hypopituitarism is a common complication. Results Pituitary dysfunction occurs in approximately 20–40% of patients diagnosed with moderate and severe traumatic brain injury giving rise to growth hormone defciency, hypogonadism, hypothyroidism, hypocortisolism, and central diabe- tes insipidus. Varying degrees of hypopituitarism have been identifed in patients during both the acute and chronic phase. Anterior pituitary hormone defciency has been shown to cause morbidity and increase mortality in TBI patients, already encumbered by other complications. Hypopituitarism after childhood traumatic brain injury may cause treatable morbidity in those survivors. Prospective studies indicate that the incidence rate of hypopituitarism may be ten-fold higher than assumed; factors altering reports include case defnition, geographic location, variable hospital coding, and lost notes. While the precise pathophysiology of post traumatic hypopituitarism has not yet been elucidated, it has been hypothesized that, apart from the primary mechanical event, secondary insults such as hypotension, hypoxia, increased intracranial pressure, as well as changes in cerebral fow and metabolism may contribute to hypothalamic-pituitary damage. A number of mechanisms have been proposed to clarify the causes of primary mechanical events giving rise to ischemic adenohypophysial infarction and the ensuing development of hypopituitarism. -
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. -
IPEG's 25Th Annual Congress Forendosurgery in Children
IPEG’s 25th Annual Congress for Endosurgery in Children Held in conjunction with JSPS, AAPS, and WOFAPS May 24-28, 2016 Fukuoka, Japan HELD AT THE HILTON FUKUOKA SEA HAWK FINAL PROGRAM 2016 LY 3m ON m s ® s e d’ a rl le o r W YOU ASKED… JustRight Surgical delivered W r o e r l ld p ’s ta O s NL mm Y classic 5 IPEG…. Now it’s your turn RIGHT Come try these instruments in the Hands-On Lab: SIZE. High Fidelity Neonatal Course RIGHT for the Advanced Learner Tuesday May 24, 2016 FIT. 2:00pm - 6:00pm RIGHT 357 S. McCaslin, #120 | Louisville, CO 80027 CHOICE. 720-287-7130 | 866-683-1743 | www.justrightsurgical.com th IPEG’s 25 Annual Congress Welcome Message for Endosurgery in Children Dear Colleagues, May 24-28, 2016 Fukuoka, Japan On behalf of our IPEG family, I have the privilege to welcome you all to the 25th Congress of the THE HILTON FUKUOKA SEA HAWK International Pediatric Endosurgery Group (IPEG) in 810-8650, Fukuoka-shi, 2-2-3 Jigyohama, Fukuoka, Japan in May of 2016. Chuo-ku, Japan T: +81-92-844 8111 F: +81-92-844 7887 This will be a special Congress for IPEG. We have paired up with the Pacific Association of Pediatric Surgeons International Pediatric Endosurgery Group (IPEG) and the Japanese Society of Pediatric Surgeons to hold 11300 W. Olympic Blvd, Suite 600 a combined meeting that will add to our always-exciting Los Angeles, CA 90064 IPEG sessions a fantastic opportunity to interact and T: +1 310.437.0553 F: +1 310.437.0585 learn from the members of those two surgical societies.