Surgical procedures – Rhinoplasty Digest http://rhinoplastydigest.com/ Sat, 19 Nov 2022 23:41:37 +0000 en-US hourly 1 https://wordpress.org/?v=5.9.3 https://rhinoplastydigest.com/wp-content/uploads/2021/07/icon-2021-07-08T154233.528.png Surgical procedures – Rhinoplasty Digest http://rhinoplastydigest.com/ 32 32 Spina Bifida Has Distorted My Body But It Can’t Stop Me From Reaching My Goals – University Times https://rhinoplastydigest.com/spina-bifida-has-distorted-my-body-but-it-cant-stop-me-from-reaching-my-goals-university-times/ Sat, 19 Nov 2022 22:22:38 +0000 https://rhinoplastydigest.com/spina-bifida-has-distorted-my-body-but-it-cant-stop-me-from-reaching-my-goals-university-times/ Over 15 years ago, I trained in the gym four days a week, two hours a day. Despite moving around in a wheelchair, my arms and upper body were so strong that I could easily get in and out of my mother’s Chevrolet Suburban SUV. But when I was 24, I faced the lowest point […]]]>

Over 15 years ago, I trained in the gym four days a week, two hours a day. Despite moving around in a wheelchair, my arms and upper body were so strong that I could easily get in and out of my mother’s Chevrolet Suburban SUV.

But when I was 24, I faced the lowest point of my life. I spent over a month in the hospital. I needed three surgeries and even spent over a week in intensive care.

I was born with Spina bifida which is a Latin word meaning “split spine”, and because my spine was split, it damaged most of the nerves in my spine.

When I was born at Garfield Hospital, my mother did not realize the seriousness of my condition.

“I was scared, but…the hospital made me feel like Children’s Hospital Los Angeles was going to treat you.” Then I could take my baby home,” she recalls.

Last effects of hospital stay

In December 2007 I had a problem with urination which required the doctor to drill a hole under my navel and they quickly discovered other issues with me requiring more surgeries.

After my stay in the hospital, I had lost a lot of weight, muscle mass and strength.

It’s been almost 15 years and I’m still trying to get over it.

I managed to regain most of my weight. I’m still struggling to regain my strength, and it’s something I’ve worked for every day of my life.

But, at almost 40, I’ve slowed down quite a bit.

I am classified as a paraplegic and as I got older I have accepted that there are things I need help with, however frustrating they may be. It’s just part of my life.

Types of spina bifida, prevention and treatment

Last month was Spina Bifida Awareness Month, so I thought sharing my story would help raise awareness about this, including the signs, treatments, and preventative measures.

There are three different types of Spina Bifida: occult, meningocele and myelomeningocele.

Myelomeningocele is the most common and severe form of Spina bifida – and that’s what I was born with.

Spina Bifida is a Latin term meaning split spine. When I was born my spine was exposed or open and because this happened most of the nerves in my spine were damaged.

Famous people like musician John Mellencamp and actor Rene Kirby were both born with milder forms of Spina Bifida.

Early 1980s technology and modern medicine were not as advanced as they are today.

Future parents now have the option of knowing whether or not their baby will be born with a birth defect thanks to a amniocentesis procedure, in which a doctor sticks a needle into a woman’s belly through the amniotic sac and extracts a sample of fluid.

When I was born in the early 1980s, my mother didn’t have that option.

By the time she was pregnant with my brother, Jake, in 1997, this procedure was available.

He was fine.

Today, spina bifida can be corrected by surgery while the fetus is still in the womb. A doctor enters through the amniotic sac and closes the back of the fetus with sutures.

Now it is also known that the condition can be prevented by consuming 400 micrograms per day of folic acidnow available in many prenatal pills.

Another way to get folic acid is to eat lots of dark green or leafy vegetables like broccoli or spinach.

“I just knew about prenatal vitamins. I found out about folic acid after the fact,” my mum recently said, adding that she was only 19 when she had me.

educational goals

My condition has seen me undergo two dozen surgeries and other non-surgical procedures, numerous hospital visits and doctor’s appointments.

Despite having the most severe form of this chronic condition, I walked using a walker and leg braces for a few years as a child.

I have been a wheelchair user for thirty-three years full time.

My brother, Jake, said he was scared the first few times I was in the hospital, but eventually “got used to it” — kind of like having a disabled brother doesn’t not seem unusual to him.

“I was born after you, so it’s always been my normal life. I remember when I thought everyone had a sibling in a wheelchair. ‘Cause the first time I went to [my childhood friend] At Jeremy’s when I was a kid, I thought it was weird that his brother wasn’t in a wheelchair,” Jake said.

I graduated from high school in 2001 and spent a few years at Mt. SAC before my cousin told me college wasn’t for me.

Discouraged, I took some time off before deciding to return to college, this time to Chaffey College.

I spent seventeen years there. I was determined to graduate and I finally did, earning an Associate of Arts degree in Journalism in May 2022.

My educational goals don’t stop there. I was hoping to transfer to a four-year college.

I was at home when I received the email that made me realize I was on my way.

He was from Cal State Northridge and said I had been accepted.

“Mom, I think I’m going to cry,” I said. She came into my room and I told her the news.

She smiled proudly and gave me a big hug. Little did I know that I would also be accepted into four other schools, including the one I chose, Cal State LA.

Some days are tough. I prefer to use a manual wheelchair to keep my arms strong, but had to use an electric wheelchair to get around campus, including going up a steep hill hill for one of my TV, Film and Media Studies courses.

Unfortunately, people like me who were born with spina bifida aren’t expected to make it past high school because of learning. disabled it can come with chronic illness.

Despite my physical difficulties, I am determined to prove that anyone can do anything they want.

In my case, it’s earning my bachelor’s degree in journalism and a minor in creative writing — with my determination and with the big guy upstairs by my side.

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DOJ Joins A Qui Tam False Claims Act Lawsuit Against Fresenius and Azura Vascular Care https://rhinoplastydigest.com/doj-joins-a-qui-tam-false-claims-act-lawsuit-against-fresenius-and-azura-vascular-care/ Thu, 17 Nov 2022 11:07:21 +0000 https://rhinoplastydigest.com/doj-joins-a-qui-tam-false-claims-act-lawsuit-against-fresenius-and-azura-vascular-care/ On August 12, 2022, the Department of Justice (“DOJ”) filed its Amended Intervenor Complaint (the “Intervener Complaint”), intervening in a qui tam action originally filed in 2014 by two nephrologists who referred patients at Fresenius Vascular Care d/ b/a Azura Vascular Care Clinics (“Azura”), Dr John Pepe and Dr Richard Sherman (“Relators”). The Relators filed […]]]>

On August 12, 2022, the Department of Justice (“DOJ”) filed its Amended Intervenor Complaint (the “Intervener Complaint”), intervening in a qui tam action originally filed in 2014 by two nephrologists who referred patients at Fresenius Vascular Care d/ b/a Azura Vascular Care Clinics (“Azura”), Dr John Pepe and Dr Richard Sherman (“Relators”). The Relators filed their Fourth Amended Complaint (“Amended Complaint”)1 against Fresenius Medical Care North America (“FMCNA”), Azura, and several other FMCNA-affiliated entities on August 7, 2020, alleging violations of the Federal False Claims Act ( “FCA”) and the Federal Anti-Kickback Statute (“AKS”).2 The U.S. District Court for the Eastern District of New York unsealed the action on May 9, 2022. FMCNA is one of the two most major dialysis providers in the United States, operates more than 2,500 dialysis units nationwide, and treats more than 200,000 dialysis patients each year.Azura operates more than 60 vascular care facilities nationwide.

In the intervenor’s complaint, the DOJ alleges that Azura: (i) repeatedly performed and billed Medicare, Medicaid, and other government health care programs for medically unnecessary vascular access procedures, and ( ii) falsified referrals to give the impression that the patients’ nephrologists referred the patients for these unnecessary procedures. On April 18, 2022, the Department of Justice (“DOJ”) elected to intervene in the FCA claims, but declined to intervene in the AKS claims. The AKS claims have since been voluntarily denied.

Medically Unnecessary Vascular Access Procedures The DOJ’s primary allegations relate to the performance of medically unnecessary dialysis vascular access procedures provided to patients with end-stage renal disease (ESRD). In its intervener complaint, the DOJ alleges that the defendants engaged in a scheme to receive government payments for unnecessary surgical procedures and tests. Patients with ESRD usually require a surgically created access point in the patient’s arm or abdomen. The DOJ further asserts that under Medicare program rules, a patient’s dialysis clinic is responsible for monitoring the patient’s fistula and overall vascular access, and is responsible for making referrals for diagnostic procedures to determine if a fistula is working effectively or if the patient has a condition or blockage interfering with its functioning.

The DOJ alleges that during the period from 2012 to 2018, after a patient’s treating nephrologist referred the patient to an Azura clinic to treat a clinically significant stenosis, Azura would routinely schedule follow-up appointments or so-called “timed clinical evaluations” (“CTE”) every two to four months without consulting the patient’s dialysis clinic or referring nephrologist.

The DOJ also claims that during these appointments, Azura staff performed a brief visual examination and documented a pretext indication of impaired vascular access, justifying the fistula, which was then often followed by angioplasty, for which Azura staff exaggerated the degree of vascular narrowing or stenosis. The DOJ further alleges that Azura did not request any information regarding a patient’s recent dialysis treatment from that patient’s treating nephrologist or the dialysis clinic responsible for administering the patient’s dialysis. The DOJ asserts that, in many cases, records documenting the administration of dialysis at the patient’s clinic in the days prior to a CTE have demonstrated with quantifiable and objective measures that the patient was on dialysis without any problems. The DOJ estimates that these practices accounted for approximately seventy percent of all fistulas performed by Azura Clinics.

According to the DOJ, as a result of these medically unnecessary procedures, Azura Clinics would document the observation of patients with stenosis ranging from sixty to eighty percent blockage and, based on this observation alone and against guidelines professionals from the Kidney Disease Outcomes Quality Initiative (KDOQI).3 According to the responder’s complaint, Azura would recommend additional follow-up, thereby referring every patient indefinitely for follow-up appointments and additional procedures at the Access Center. During these follow-up appointments, the DOJ alleges that Azura’s providers performed inappropriate angiograms on patients, as well as invasive surgical procedures called angioplasties, without evidence that these procedures were medically necessary and without a recommendation for treatment. a nephrologist. Accordingly, the DOJ alleges that the defendants had no reasonable basis to perform these proceedings, and that the defendants were submitting or causing to be submitted fraudulent claims for government reimbursement.

In their amended complaint, the Relators previously argued that Dr. William Rodino, an interventionist at Azura, admitted to performing “surveillance angiograms,” stating that these procedures would identify issues missed by routine monitoring. However, Relators argued that under Medicare program rules, “vascular studies are not covered as a separately billable service if used to monitor a patient’s vascular access site,” and that Access site monitoring is included in ESRD’s Prospective Payment System (PPS) bundled payments. 4 Thus, by charging for these services separately from the bundled payment, Relators alleged that Azura Clinics were billing Medicare and Medicaid for these medically unnecessary procedures in violation of the FCA.

Download – DOJ Joins Qui Tam Misrepresentation Act Lawsuit Against Fresenius and Azura Vascular Care

Footnotes

1 United States ex rel. Pepe and Sherman c. Fresenius Medical Holdings, Inc., et al., No. 14-CV-3505 (ED New York).

2 The FCA allows individuals to bring qui tam actions on behalf of the federal government to recover funds it has paid through government reimbursement based on misrepresentation. See 31 USC § 3730. The reporter may receive between fifteen and twenty-five percent of the recovered amount if the federal government pursues the action. Since 1986, lawsuits have recovered billions of dollars on behalf of the federal government.

3 The complaint cites KDOQI guidelines, noting that fistula surgery should only be performed if the stenosis is “hemodynamically significant,” including “both greater than 50% narrowing and other clinical symptoms of support, abnormal physical results and throughput measurements”.

4 The reviewers cite the Medicare Benefit Policy Manual, ch. 11, § 40.H.

The content of this article is intended to provide a general guide on the subject. Specialist advice should be sought regarding your particular situation.

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2 Best Stocks to Buy in November and Hold Forever https://rhinoplastydigest.com/2-best-stocks-to-buy-in-november-and-hold-forever/ Sun, 13 Nov 2022 11:00:00 +0000 https://rhinoplastydigest.com/2-best-stocks-to-buy-in-november-and-hold-forever/ Earnings reports can be an investor’s best friend. They don’t just tell us about recent revenue and earnings. They also offer us clues about the future of a business. These reports do not have to be 100% positive. But if some major points are bright, we might consider a buying opportunity. This is the case […]]]>

Earnings reports can be an investor’s best friend. They don’t just tell us about recent revenue and earnings. They also offer us clues about the future of a business. These reports do not have to be 100% positive. But if some major points are bright, we might consider a buying opportunity.

This is the case for both AbbVie (ABVV 0.29%) and Intuitive surgery (ISRG 2.80%). Businesses are each facing specific challenges right now. But they also gave us very good reasons to be optimistic about the future. Let’s take a closer look at these top two stocks to buy this month and hold forever.

1. AbbVie

I’m going to brush off the bad news first. AbbVie’s super blockbuster immunological drug, Humira, is expected to face US competition from next year. Humira’s international sales are already down as rivals outside the United States take market share.

But here’s why I’m optimistic about AbbVie. The company’s two new immunology drugs – Skyrizi and Rinvoq – are on track to make up for the loss. In the third-quarter earnings report, AbbVie said the two drugs are expected to generate $7.5 billion in revenue this year. And their combined revenue is expected to eventually exceed Humira’s.

AbbVie also has a strong and diversified portfolio. Besides immunology, it includes products in the areas of neuroscience, oncology, aesthetics and other fields. In fact, the company is on track to become the world’s No. 1 in prescription drug market share by 2026, according to data from Evaluate.

AbbVie has a track record of growing profits over time. Of course, Humira is a key contributor. But Skyrizi and Rinvoq seem poised to keep this growing positive trend going. During the quarter, they accounted for nearly 15% of the company’s total revenue.

You will also like AbbVie for its dividend. The company is a dividend king. This means that it has increased its dividend payout at least over the past 50 years. This shows that dividend growth is important to AbbVie. And that’s great news for you as an investor.

AbbVie shares are trading today at 10 times forward earnings estimates, up from more than 12 earlier this year. This seems like a reasonable entry point given the company’s growth prospects and its dividend policy.

2. Intuitive surgery

Intuitive’s main problem during the pandemic has to do with hospitals postponing surgeries with its surgical robots. This happened at times when coronavirus hospitalizations peaked.

Why does it hurt Intuitive? Because Intuitive actually makes more revenue from selling the instruments and accessories needed for each surgery than it does from selling its million-dollar robots.

Postponement of surgeries remains a risk. But as we move into a post-pandemic world, that risk might be lower than it has been lately. Things seem to be on the right track. In the third quarter, global procedures using the flagship Da Vinci robot increased by 20%. Revenue grew by double digits.

And, most importantly, Intuitive repurchased $1 billion of its own common stock. It is a sign of confidence in the future of the company.

Like AbbVie, Intuitive has a track record of growing profits over time. Importantly, Intuitive is also a market leader. The company has nearly 80% of the robotic surgery market, according to BIS Research. Given the price of surgical robots, hospitals are unlikely to easily switch to a rival. So, Intuitive might stay ahead for a while.

Intuitive trading at 54 times forward earnings estimates. That’s down from over 72 in January. At the same time, income increases. So right now seems like the right time to embark on this exciting long-term story.

Adria Cimino has no position in the stocks mentioned. The Motley Fool fills positions and recommends Intuitive Surgical. The Motley Fool has a disclosure policy.

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CSAs turn to high-acuity service lines as operating costs soar https://rhinoplastydigest.com/csas-turn-to-high-acuity-service-lines-as-operating-costs-soar/ Thu, 10 Nov 2022 22:31:23 +0000 https://rhinoplastydigest.com/csas-turn-to-high-acuity-service-lines-as-operating-costs-soar/ As procedures, especially orthopedic and cardiology cases, migrate to the outpatient setting, many ASC leaders are looking to add high-acuity service lines to meet margins as operating costs soar. “As CMS enables more procedures to be performed at centers, it gives centers the ability to be open for more procedures,” said Catherine Retzbach, BSN, RN, […]]]>

As procedures, especially orthopedic and cardiology cases, migrate to the outpatient setting, many ASC leaders are looking to add high-acuity service lines to meet margins as operating costs soar.

“As CMS enables more procedures to be performed at centers, it gives centers the ability to be open for more procedures,” said Catherine Retzbach, BSN, RN, director of ASC operations at Marlton-based Virtua Health. , N.J. Becker’s. “Cardiology and spine procedures provide patients with more options for procedures to be performed in a high-quality, low-cost environment.”

Jeany Dunaway, RN, administrator at Effingham, Illinois, Ambulatory Surgical Center and her team launched a total joint program in 2021. Although the ramp-up has been slow, she is excited to see it continue because “surgeons and our staff become more comfortable with the processes,” she said Becker’s.

“It’s exciting to see the great results our patients are getting and how happy they are with our services,” she added.

Large ASC chains are turning to high-acuity procedures to encourage growth. At the end of the third quarter, orthopedic and spinal procedures represented 20% of the volume of the ASC United Surgical Partners International channel.

During an Oct. 20 earnings call, Saum Sutaria, MD, CEO of Tenet Healthcare, USPI’s parent company, said the chain was doubling down on its high-acuity growth strategy. He cited the growth of an ASC in Tennessee, where the center increased revenue by 46% by replacing high-volume, low-acuity procedures with high-acuity orthopedic cases.

UnitedHealth Group’s Optum, parent company of ASC chain SCA Health, is also considering higher-acuity surgical procedures to drive growth, Chief Financial Officer John Rex said in an Oct. 14 earnings call.

The growth strategy for small CSAs also includes service line additions. Shannon Parisi O’Leary, regulatory compliance manager for Mason-based Southwest Ohio Pain Management, runs a “very small” center focused on “a very efficient day-to-day operation,” said she declared. Becker’s.

“With the addition of new service lines, this will provide more opportunities for growth as CHWs and as employees, which is most exciting of all,” she said.

But adding service lines in an unstable economy isn’t always the best option, and CSA leaders need to weigh the costs before committing to the investment, Ms. Retzbach said.

“Adding service lines takes research and commitment. Plus sometimes tough decisions have to be made, like reducing days of service if the volume doesn’t justify being open every day,” she said. “If you want to add a new range of services, will you perform enough procedures to cover the costs? »

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SIUT Hosts Nation’s First-Ever Robotic Surgery Symposium – Journal https://rhinoplastydigest.com/siut-hosts-nations-first-ever-robotic-surgery-symposium-journal/ Sat, 05 Nov 2022 02:30:25 +0000 https://rhinoplastydigest.com/siut-hosts-nations-first-ever-robotic-surgery-symposium-journal/ KARACHI: Experts at a two-day international symposium held at Sindh Institute of Urology and Transplantation (SIUT) discussed various aspects and benefits of robotic surgery and the need to make it more popular as it speeds up the recovery process and helps minimize complications. The event – the first-ever robotic surgery symposium in Pakistan – brought […]]]>

KARACHI: Experts at a two-day international symposium held at Sindh Institute of Urology and Transplantation (SIUT) discussed various aspects and benefits of robotic surgery and the need to make it more popular as it speeds up the recovery process and helps minimize complications.

The event – the first-ever robotic surgery symposium in Pakistan – brought together eminent surgeons from the US and UK, as well as Pakistani professionals.

It also marked the milestone of more than 1,200 successful interventions at the SIUT robotics unit, which opened this year.

Speaking at a session, SIUT Director Prof. Adib Rizvi said robotic surgery was another step forward by dedicated local experts, who not only successfully perform state-of-the-art surgical procedures, but also trained professional colleagues across the country and region.

He reiterated SIUT’s desire to keep abreast of the latest technologies and ensure its availability to those who need it. “The robotic unit is in line with SIUT’s philosophy of providing free health coverage without any discrimination,” he said.

The opening session was followed by a round table of international and national experts during which they shared the evolution of surgery and robotic techniques in their respective countries.

Professor Babar Hasan from SIUT spoke about the diagnosis and prognosis of the Pakistani population through significant collaboration with international partners. He also highlighted how SIUT facilitated the transformation of healthcare practice.

The institution, he said, has maintained simulation labs to provide training in new surgical techniques for staff members as well as professionals across Pakistan.

Taking part in a panel discussion, Dr. Khursheed Guru from the United States said that the next generation of surgeons could embrace robotic surgery and achieve better results in prostate and lower urinary tract surgeries.

Dr. Mark Slack from the UK completed SIUT by pioneering this new area of ​​medical technology.

Others who also spoke included Dr. Rehan Mohsin, Dr. Arsalan Khan, Dr. Riaz Leghari, Dr. Shadab Khan and Junaid Khan, all from SIUT.

Posted in Dawn, November 5, 2022

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Planned Parenthood’s first abortion clinic on wheels is a fully operational medical facility https://rhinoplastydigest.com/planned-parenthoods-first-abortion-clinic-on-wheels-is-a-fully-operational-medical-facility/ Wed, 02 Nov 2022 15:15:45 +0000 https://rhinoplastydigest.com/planned-parenthoods-first-abortion-clinic-on-wheels-is-a-fully-operational-medical-facility/ Planned parenthood announcement last month, it will open its first mobile abortion clinic: a fully operational medical facility that will be stationed in southern Illinois. The idea is to facilitate access to abortion for patients from neighboring states that have banned the procedure. “Our priority is to ensure voters who have been left behind in […]]]>

Planned parenthood announcement last month, it will open its first mobile abortion clinic: a fully operational medical facility that will be stationed in southern Illinois. The idea is to facilitate access to abortion for patients from neighboring states that have banned the procedure.

“Our priority is to ensure voters who have been left behind in these states have access to basic health care,” said Dr. Colleen McNicholas, chief medical officer for Planned Parenthood of the St. Louis area. and southwestern Missouri.

The RV is equipped with two examination rooms, a waiting room and a laboratory. Medical abortions will be administered there by the pill by the end of the year, and next year, by surgical interventions, specifies the non-profit organization.

Planned Parenthood employees are calling the mobile center an act of activism in response to the Supreme Court’s June decision to overturn Roe v. Wade. Since then, the organization has seen a 370% increase in abortion procedures at its southern Illinois clinic among patients traveling beyond Illinois and Missouri.

“We really are at a critical time, a public health crisis where we need people to think differently, work together, act boldly and take risks,” McNicholas said.

The motorhome is equipped with cameras – and will initially have a security guard.

“We really thought about the safety and security of the unit,” McNicholas said.

But some are against it.

Lobbyist Sam Lee of anti-abortion rights group Campaign Life Missouri called Planned Parenthood’s mobile medical facility “very irresponsible” and said the group was “trying to solicit the women of Missouri.”

“When a woman has a complication, where can you go back for help when that abortion van is gone?” he told CBS News.

Instead, Lee said he wants more resources to go into alternatives for pregnant women in Missouri, such as pregnancy centers and housing assistance.

It “always comes down to women who are unsure of their decision or pressured to make their decision being offered real choices,” he said.

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The “Himchan” Center at Sharjah University Hospital uses the latest techniques in shoulder joint replacement surgery https://rhinoplastydigest.com/the-himchan-center-at-sharjah-university-hospital-uses-the-latest-techniques-in-shoulder-joint-replacement-surgery/ Fri, 28 Oct 2022 00:13:52 +0000 https://rhinoplastydigest.com/the-himchan-center-at-sharjah-university-hospital-uses-the-latest-techniques-in-shoulder-joint-replacement-surgery/ Emirates-Sharjah – October 27, 2022 – Himchan Joint and Spine Center at Sharjah University Hospital has announced the provision of Complete Shoulder Replacement Surgery with modern technology in the United Arab Emirates. Total shoulder replacement, also known as total shoulder arthroplasty, is a highly effective surgical procedure for relieving severe shoulder pain and helping to […]]]>

Emirates-Sharjah – October 27, 2022 – Himchan Joint and Spine Center at Sharjah University Hospital has announced the provision of Complete Shoulder Replacement Surgery with modern technology in the United Arab Emirates.

Total shoulder replacement, also known as total shoulder arthroplasty, is a highly effective surgical procedure for relieving severe shoulder pain and helping to restore mobility, strength and shoulder function. the shoulder. More than 95% of patients who have undergone this surgery do not suffer from pain after it. Most can also return to participating in their usual activities and light sports.

Dr. Seong Joon Park, Consultant Orthopedic Surgeon at Himchan Center – for Joints and Spine – with 25 years of medical experience, recommended total shoulder replacement surgery to relieve arthritis pain that usually occurs due to fractures, rheumatic diseases and torn tendons. Noting that if non-surgical treatments such as medication and physiotherapy are no longer helpful in relieving pain, then; Joint replacement is a good option to consider.

He added: “The human shoulder is a kneecap and a handle. The rounded head (ball) of the humerus fits into the shallow socket of the shoulder, and the soft cartilage covering the bones of the shoulder allows the bones to slide comfortably against each other. When these cartilaginous surfaces degenerate or disintegrate, bone comes into direct contact, increasing friction and making bone-to-bone movement extremely painful. During a shoulder replacement, damaged areas of the shoulder joint are removed and replaced with artificial parts for completely normal shoulder movement.

He continued: “The technique of shoulder replacement surgery is very complex. It must be performed by an experienced and highly qualified surgical team. The surgeon will need to carefully assess the patient’s condition and discuss the appropriate type of replacement, as shoulder implants come in different shapes and sizes, and the surgeon replaces the damaged joint with a polished metal ball. It rolls in its smooth bowl.

Park explained, “Instead of using artificial pieces that resemble the natural shape of the shoulder joint, it is better to use a new type that can be attached backwards to the bones of the arm and of the shoulder to prevent slipping again and reduce potential side effects. . This technology is recommended for people who have completely torn tendons with acute arm muscle weakness or unsuccessful traditional shoulder replacement surgery. With this technique we also avoid the restriction of arm movements after surgery as patients often cannot fully lift their arms which means they have difficulty which can affect daily tasks and life activities like combing hair or washing face or eating with cutlery. In these cases, the inverted design gives more stability as it allows the patient to use the strong deltoid muscle instead of the rotator cuff to lift the arm, and it is recommended for patients with a partial rotator cuff tear prevent shoulder movement.

He went on to say, “Most patients stay in the hospital for three to five days after surgery, and physical therapy begins one day after, the patient also begins to move their fingers, wrist, and elbow, and can start some shoulder movements the next day. surgery, they can officially return to work 2 to 3 weeks after surgery. They may need an additional 2-3 weeks if their job requires physical exertion.

He added, “We are proud of the scientific benchmark work, which has increased patient confidence in the Himchan Center internationally and in the UAE in particular. Every patient who underwent shoulder replacement surgery at the University Hospital Himchan Center is very satisfied and enjoying a normal life again. Physiotherapists specialized in post-surgical treatments are available to achieve the best result after surgery. Therefore, the Himchan team at Sharjah University Hospital constantly strives to improve the quality of life of every patient. They provide excellent medical care to elderly patients who can easily develop shoulder arthritis as well as younger patients with acute shoulder diseases and injuries. »

Media Contact
Company Name: Company Promosanté
Contact person: Dr Diaa Salah
E-mail: Send an email
Call: +971 55 755 0422
Country: United Arab Emirates
Website: https://www.uhs.ae/

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Abortion access weighs on medical residency applications https://rhinoplastydigest.com/abortion-access-weighs-on-medical-residency-applications/ Wed, 19 Oct 2022 06:40:19 +0000 https://rhinoplastydigest.com/abortion-access-weighs-on-medical-residency-applications/ COLUMBIA, SC (AP) — Students of obstetrics and gynecology and family medicine — two of the most popular medical residencies — face tough choices about where to advance their training in a landscape where legal access abortion varies from state to state. Abortions are typically performed by OB-GYNs or family physicians, and training usually involves […]]]>

COLUMBIA, SC (AP) — Students of obstetrics and gynecology and family medicine — two of the most popular medical residencies — face tough choices about where to advance their training in a landscape where legal access abortion varies from state to state.

Abortions are typically performed by OB-GYNs or family physicians, and training usually involves observing and assisting with the procedure, often in outpatient clinics. Many doctors and students now worry about non-existent or poor training in states where clinics closed or abortion laws were tightened after the Supreme Court struck down Roe v. Wade.

In some cases, applicants who wish to perform abortions as part of their career pursue residencies in states with more liberal reproductive laws and perhaps pursue their careers there as well – potentially creating less permissive states for a shortage of OB-GYNs, observers said. .

“Choosing a state where I will be limited or where I won’t have full access is essentially depriving myself and my future patients of the quality of care that I can provide,” said Deborah Fadoju, a student. in fourth-year medicine from Ohio State who said she looked at programs along the East Coast, where many states have laws protecting abortion.

As an OB-GYN, Fadoju said, she should be able to “do all the work.”

On the other hand, students who oppose abortion may find more accommodations in residency programs in states that broadly ban the procedure.

Dr. Christina Francis, board member and CEO-elect of the Pro-Life American Association of Obstetricians and Gynecologists, said her organization has already received requests from students seeking information about residencies in which they would not have to make an abortion referral.

“Now we see residents and medical students who don’t want to participate in abortions saying, ‘We’re going to seek residency positions in places where abortion might be restricted’ because – theoretically and I think it will play out – there should be less pressure on them.

OB-GYN residency programs must provide education on abortions, according to the Accreditation Council for Higher Medical Education, although residents with religious or moral objections can opt out. A Sept. 17 update said programs where abortions are illegal must provide that experience elsewhere. There are no similar requirements for family medicine programs.

Doctors need the ‘muscle memory’ that only hands-on education can give, especially for abortions, said Pamela Merritt, executive director of Medical Students for Choice, which promotes access to abortion education. .

“How many surgical hours do you want a liver specialist to have before trying to do a biopsy?” Merritt said. “We would never debate how to educate people without physical interaction with the patient about any other major health issue.”

A research team led by Emory University in Atlanta is interviewing third- and fourth-year medical students across the country and in all specialties about their residency application decisions after the ruling that overturned Roe.

The team is still analyzing the data, but early results show many candidates are wondering where to continue their training, according to Emory medical students Nell Mermin-Bunnell and Ariana Traub, who also co-founded an advocacy group that supports the right to abortion.

“There are a lot of unknowns, and it’s scary for people applying for residency,” Mermin-Bunnell said. “There really are a lot of question marks, and the way health care is practiced is changing rapidly.”

More than three-quarters of about 490 respondents said access to abortion is likely or very likely to influence decisions about where they live, the researchers said. The survey did not directly ask respondents for their position on abortion, to avoid introducing bias.

Connor McNamee, a third-year family medicine resident at the University of Toledo, began exploring abortion training outside of Ohio last summer. A state law bans most abortions after heart activity is detected, but a judge has blocked it while a challenge is pending.

McNamee is now exploring options in Virginia, where abortions are more widely available. He was open to eventually returning to Ohio, but now says abortion limits are “the final nail in the coffin” for him.

“I can’t really be an abortion provider in Ohio, and that’s a huge part of my career,” McNamee said.

The majority of medical residents end up practicing in the state where they completed their residency, according to a 2021 report from the Association of American Medical Colleges — and some doctors worry that fewer interns means fewer OB-GYNs in states with strict abortion restrictions.

In South Carolina, student fears about access to reproductive health education (for their careers) and abortion services (for themselves) have hampered recruitment of medical residents and fellows said Dr. Elizabeth Mack, president of the South Carolina chapter of the American Academy of Pediatrics, who testified in August before lawmakers for tougher abortion restrictions.

Francis, of the anti-abortion obstetricians group, said she hopes new restrictions could open the door for students otherwise interested in OB-GYN but opposed to abortion to enter the field.

Nearly 44% of the 6,007 OB-GYN residents were in a state deemed certain or likely to ban abortion if the Supreme Court overturns Roe, according to an article published online in April by the journal Obstetrics & Gynecology.

President Joe Biden vowed on Tuesday to codify abortion rights if Democrats retain enough congressional seats — but while such federal protections remain elusive, medical education officials are considering ways for residents of Restrictive states to continue abortion training, including allowing travel to more permissive states.

Such “travel rotations” have been proposed by the American College of Obstetricians and Gynecologists, but the sheer volume of need makes it difficult to bridge the gap, according to the Obstetrics & Gynecology article.

The Ryan Program, based at the University of California, San Francisco, piloted travel rotations for students to train outside of Texas last year, according to its director, Dr. Jody Steinauer.

Steinauer suggests the programs work together to help fund travel rotations and guide residents through the process of obtaining medical licensing in new states. She also suggests strengthening simulation abortion training to teach basic skills.

She fears the legal changes will jeopardize training in emergency skills like safely emptying a uterus after a miscarriage or abortion.

Surgical procedures for miscarriages and abortions are the same — which Francis said should allow residents to be trained without participating in the abortion.

Residents could still learn a lot from miscarriage care, Steinauer said, but routine abortion training correlates with greater preparedness in all early pregnancy loss management, including counseling and complications. And, she said, residents need to see enough patients to feel competent — which restrictions make difficult.

“Not having comprehensive, integrated abortion education often leaves people with skill deficits,” Steinauer said. “Programs are really going to have to help their learners, who are able, to travel to other states for training.”

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James Pollard is a member of the Associated Press/Report for America Statehouse News Initiative. Report for America is a national, nonprofit service program that places reporters in local newsrooms to report on underreported issues.

Copyright 2022 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without permission.

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Government seeks to strengthen emergency care services | Latest India News https://rhinoplastydigest.com/government-seeks-to-strengthen-emergency-care-services-latest-india-news/ Sun, 16 Oct 2022 17:51:31 +0000 https://rhinoplastydigest.com/government-seeks-to-strengthen-emergency-care-services-latest-india-news/ As the Covid-19 pandemic highlights the importance of having a robust critical healthcare system, the central government is focusing on strengthening emergency care services in its hospitals across the country to save lives. . “Not just the infrastructure, the goal is also to create adequately trained human resources so that all kinds of emergency cases […]]]>

As the Covid-19 pandemic highlights the importance of having a robust critical healthcare system, the central government is focusing on strengthening emergency care services in its hospitals across the country to save lives. .

“Not just the infrastructure, the goal is also to create adequately trained human resources so that all kinds of emergency cases are treated in a standardized way in our hospitals,” said a government official, speaking on condition of anonymity. “At the moment intensive care is a weak point, especially in tier 2-3 cities, but we know it is an essential service, as we have seen in the time of Covid how intensivists were in high demand because of the care that was needed for patients admitted to intensive care (intensive care unit)”.

An intensivist is a physician who provides special care to critically ill patients.

The Ministry of Health recently launched national emergency resuscitation courses for doctors, nurses and paramedics, specifically keeping the demand for intensive care in mind.

In addition to the training modules, the program also includes the development of a training infrastructure in all States and Union Territories to implement the courses under the program, and the creation of a cadre of trainers to train doctors, nurses and paramedics working in emergency departments of public hospitals and ambulance services. .

“The fact that anesthesiologists have many roles and responsibilities, apart from anesthesia, is less known to the general public. Very few are aware that anesthesia is a highly specialized and advanced field and that intensive training of at least six years after graduation from medicine is required to independently administer anesthesia to a healthy patient,” said Dr. Babita Gupta, a professor in the Department of Anesthesia at JPN Apex. Trauma Center, All India Institute of Medical Sciences, New Delhi.

“A patient with multiple illnesses requiring surgery can be an easy operation from a surgical perspective, but very difficult for anesthesiologists, as they are responsible for managing perioperative medical issues as well as managing intraoperative and postoperative complications, which sometimes also include surgical complications. said Dr. Gupta. “Therefore, anesthesiologists are also called perioperative physicians.”

Anaesthesiologists have been working extensively as intensive care doctors during the Covid-19 pandemic, not only in India but globally.

A good knowledge of respiratory and cardiovascular physiology, expert skills in invasive procedures and experience in managing ventilators make them resuscitators by default, according to Dr. Gupta.

To recognize their efforts and celebrate the discovery of anesthesia which helped patients feel free from physical pain during surgeries, October 16 is observed annually as World Anesthesia Day.

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Stabilization of macular, peripapillary and papillary vascular parameters after XEN and trabeculectomy visualized by optical coherence tomography angiography https://rhinoplastydigest.com/stabilization-of-macular-peripapillary-and-papillary-vascular-parameters-after-xen-and-trabeculectomy-visualized-by-optical-coherence-tomography-angiography/ Fri, 14 Oct 2022 15:03:33 +0000 https://rhinoplastydigest.com/stabilization-of-macular-peripapillary-and-papillary-vascular-parameters-after-xen-and-trabeculectomy-visualized-by-optical-coherence-tomography-angiography/ Filtering IOP-lowering surgery (XEN or TE stent) did not significantly alter vascular parameters in the papillary, peripapillary, and macular region in preoperative eyes with moderately elevated IOP. Comparing the two treatments, the TE-treated patients showed slightly higher results in VAD (SVC, DVC, and Optic Disc) than the XEN stent group after 6 months. Both filtering […]]]>

Filtering IOP-lowering surgery (XEN or TE stent) did not significantly alter vascular parameters in the papillary, peripapillary, and macular region in preoperative eyes with moderately elevated IOP. Comparing the two treatments, the TE-treated patients showed slightly higher results in VAD (SVC, DVC, and Optic Disc) than the XEN stent group after 6 months.

Both filtering surgeries, the XEN stent and the TE, significantly reduce IOP12,14,15,16,17. Similar to previous results, the decrease in glaucoma eye drops was comparable between the two procedures, but the IOP lowering effect was stronger in the TE group than in the XEN stent group.14,15,16,17.

To our knowledge, this is the first report that has comprehensively analyzed VAD by exploring the SVC, DVC, CL, CCL and optic disc layer in filtering glaucoma surgery and thus advances the concepts of glaucoma treatment. Analyzing the influence of lowering IOP on the microvasculature, we found no significant changes in VAD over time in all perfusion regions, except the CCL layer in patients with VAD. a XEN stent. Comparable to these results, Zéboulon et al.29 detected no change in the VAD of the superficial peripapillary layer 1 month after TE. With similar results 6 months after surgery, Lommatzsch et al.25 also did not detect changes in the papillary and peripapillary layer. However, a significant increase in VAD of the peripapillary layer after 3 months after TE surgery was reported by Shin et al.23In et al.24 and Miraftabi et al.30. Kim et al.21 could detect an increase in papillary VAD 3 months after ET but not in the peripapillary layer.

Considering these irregular postoperative follow-up intervals found in the current literature, we inferred that the time period selected to detect VAD changes could be crucial due to influential factors like postoperative inflammation (e.g. reaction of the anterior chamber or corneal oedema) which can influence image quality. For example, we hypothesize that the significantly lower retinal thickness observed 3 days after XEN (p=0.018) compared to patients treated with TE, is due to the significantly lower image quality (p=0.028) during this period. For our study, we tried to include all intervals that seemed significant for the investigation, but as mentioned above, we could not detect significant changes or specific trends in VAD at any follow-up interval. .

Regarding the FAZ results, Shoji et al.31 and Park et al.32 were able to detect significant change and reduction 3 months after glaucoma surgery, while we could not. This could be related to a lack of precision of our method. Shoji et al.31 used the same OCT-A but different external software for their study which allowed for a magnified view and specific color coding making tracing potentially more suitable for detecting changes in FAZ. In contrast, our results of no FAZ change match our VAD results. Unlike In et al.24who found significantly increased VAD after TE treatment, and Park et al.32, which showed increased VAD in the optic disc and decreased FAZ after glaucoma surgery, our patients had moderately high preoperative glaucoma (about 20 mmHg). IOP amplitude was significantly lower compared to their study where IOP amplitude was high and preoperative IOP was poorly regulated (approximately 30 mmHg)24. It is possible that the effect of lowering IOP in preoperative moderately IOP-controlled glaucoma is not as influential on changes in VAD. This is further supported by our correlation analysis where none of the vessel complexes are significantly correlated with changes in IOP. The influence of higher preoperative baseline IOP values ​​has already been discussed and it is hypothesized that “lower pressure range autoregulation can compensate for changes” in VAD adequately, as reported by Lommatzsch et al.25. Another potential influence could be the initial severity of glaucoma as measured, for example, by the MD visual field. Miraftabi et al.30, which had patients with slightly more pronounced visual field loss from the higher baseline MD values, observed a significant increase in VAD after TE. Once again, it could be argued that the severity of glaucoma could influence vascular architecture.

Kim et al.21 linked their improved diagnostic outcome of vascular parameters more to reduction in lamina cribrosa depth (LCD) rather than reduction in IOP. LCD changes were not analyzed in this study.

Glaucoma filtering surgery has diversified in recent years and, as mentioned above, offers the best IOP reduction alternative. XEN stent has less IOP lowering effect than TE treatment. Additionally, we see a slight decrease in RNFL after 6 months for the XEN group. No significant increase in VAD could be detected, but VAD also did not decrease. This allows us to infer or at least assume that in addition to lowering IOP, filtering surgery might also stabilize the vascular architecture of eyes with glaucoma. Comparing the two procedures with each other, eyes treated with TE showed significantly higher VAD values ​​in the SVC, DVC and optic disc after 6 months. These better results, and the more effective reduction of IOP after TE treatment, could indicate that a sufficiently lowered long-term IOP could potentially better stabilize RNFL and VAD. The positive influence of the type of glaucoma surgery on VAD is probably an additional reason, besides the higher preoperative IOP levels, for the significant differences in VAD after filtering surgery, as reported by In et al.24 and Park et al.32where the majority of patients received trabeculectomy and only a different small fraction shunt implantation.

On the other hand, the preoperative RNFL was also higher in the TE group than in the XEN group without significant difference. To get more information about the long-term effects after filtering surgery, longer follow-up periods would be needed.

Early hypotonia, occurring in four patients in this study, also did not show a significant influence on VAD in the overall outcome.

Although VAD analysis may not have been as indicative of detecting a change in postoperative vascular architecture, our correlation analysis showed a significant correlation between the extent of glaucomatous damage , given in the functional parameters, and the VAD. Specifically, MD and RNFL were significantly correlated with multiple layers of perfusion before and after surgery. Our results are in line with previous proposals made by Yarmohammadi et al.4.33 where the extent of glaucomatous damage could be associated with microvasculature. OCT-A, on its own, could therefore be useful in complementing and offering a broader spectrum of glaucomatous damage. Specifically, through the detection of early changes in the microvasculature that could potentially be seen before irreversible RNFL or visual field loss. These changes, along with classic parameters like IOP, could offer an improvement in the current management and potential screening of patients with glaucoma.

The results of this study are evaluable to some extent. Systemic vascular diseases such as diabetes and high blood pressure should be excluded from future studies. On the other hand, these comorbidities are also very common in patients with glaucoma. Thus, we show real data after glaucoma surgery. The intra-statistical analysis of the patients, also carried out in our study, makes it possible to reduce this bias compared to the inter-statistical analysis. The influence and impact of image quality on the results should also be considered as it is known to significantly influence the results.34. We have tried to minimize the risk of influence by setting a minimum to the signal strength index (not below 20). Czakó et al.34 indicate that the repeatability of OCTA parameters increased with increasing image quality. Additionally, we also did not find a significant difference in image quality between the two groups, except 3 days after surgery, as previously reported. The size of the study sample could also influence the statistical significance of the results. Due to the number of patients and the ratio of TE to XEN patients, it should be emphasized that a lack of statistically significant difference does not directly imply that the two treatment groups are the same or similar in terms of results. Additionally, the analysis and anatomical definition of the perfusion layer varies slightly depending on the OCT-A device used and is therefore defined differently in other studies. A more standardized definition and classification of the perfusion layer is needed in the future, ideally with a standardized method for VAD analysis. However, we find significant correlations comparable to the results of the current literature.

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