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10. 6. Breast Flap Neurotization After Autologous Free Flap Breast Reconstruction: A Prospective Trial

Author

Tecce, Michael G., primary, Desai, Abhishek A., additional, Christopher, Adrienne, additional, Cunning, Jessica, additional, Rios-Diaz, Arturo J., additional, Morris, Martin P., additional, Nathan, Shelby L., additional, McAuliffe, Phoebe B., additional, Talwar, Ankoor A., additional, Broach, Robyn B., additional, Percec, Ivona, additional, and Serletti, Joseph M., additional

Published
2022
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12. PC21. BREAST FLAP NEUROTIZATION FOLLOWING AUTOLOGOUS BREAST RECONSTRUCTION: A PROSPECTIVE TRIAL

Author

Desai, Abhishek A., primary, Tecce, Michael G., additional, Christopher, Adrienne, additional, Cunning, Jessica, additional, Morris, Martin P., additional, Rios-Diaz, Arturo J., additional, Nathan, Shelby L., additional, Talwar, Ankoor A., additional, McAuliffe, Phoebe B., additional, Broach, Robyn B., additional, and Serletti, Joseph M., additional

Published
2022
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15. A multi-institutional analysis of sternoclavicular joint coverage following osteomyelitis

Author

Othman, Sammy, primary, Elfanagely, Omar, additional, Azoury, Saïd C., additional, Kozak, Geoffrey M., additional, Cunning, Jessica, additional, Rios-Diaz, Arturo J., additional, Palvannan, Prashanth, additional, Greaney, Patrick, additional, Jenkins, Matthew P., additional, Jarrar, Doraid, additional, Kovach, Stephen J., additional, and Fischer, John P., additional

Published
2020
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18. Abstract 77

Author

Azoury, Said, primary, Rios-Diaz, Arturo J., additional, Cunning, Jessica R., additional, Whitely, Cutler, additional, Broach, Robyn B., additional, Serletti, Joseph M., additional, and Fosnot, Joshua, additional

Published
2020
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19. Abstract 116

Author

Tecce, Michael, primary, Cunning, Jessica R., additional, Tecce, Michael, additional, Nathan, Shelby L., additional, Rios-Diaz, Arturo J., additional, Whitely, Cutler, additional, Broach, Robyn B., additional, and Serletti, Joseph M., additional

Published
2020
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22. Impact of public release of performance data on the behaviour of healthcare consumers and providers.

Author

Metcalfe D, Rios Diaz AJ, Olufajo OA, Massa MS, Ketelaar NA, Flottorp SA, and Perry DC

Subjects
Canada, Clinical Decision-Making, Evaluation Studies as Topic, Health Maintenance Organizations standards, Health Services Needs and Demand standards, Humans, Medicaid, Organizational Innovation, Randomized Controlled Trials as Topic, Reproducibility of Results, Treatment Outcome, United States, Consumer Health Information methods, Hospitals standards, Information Dissemination, Quality Assurance, Health Care methods, Quality Improvement
Abstract

Background: It is becoming increasingly common to publish information about the quality and performance of healthcare organisations and individual professionals. However, we do not know how this information is used, or the extent to which such reporting leads to quality improvement by changing the behaviour of healthcare consumers, providers, and purchasers., Objectives: To estimate the effects of public release of performance data, from any source, on changing the healthcare utilisation behaviour of healthcare consumers, providers (professionals and organisations), and purchasers of care. In addition, we sought to estimate the effects on healthcare provider performance, patient outcomes, and staff morale., Search Methods: We searched CENTRAL, MEDLINE, Embase, and two trials registers on 26 June 2017. We checked reference lists of all included studies to identify additional studies., Selection Criteria: We searched for randomised or non-randomised trials, interrupted time series, and controlled before-after studies of the effects of publicly releasing data regarding any aspect of the performance of healthcare organisations or professionals. Each study had to report at least one main outcome related to selecting or changing care., Data Collection and Analysis: Two review authors independently screened studies for eligibility and extracted data. For each study, we extracted data about the target groups (healthcare consumers, healthcare providers, and healthcare purchasers), performance data, main outcomes (choice of healthcare provider, and improvement by means of changes in care), and other outcomes (awareness, attitude, knowledge of performance data, and costs). Given the substantial degree of clinical and methodological heterogeneity between the studies, we presented the findings for each policy in a structured format, but did not undertake a meta-analysis., Main Results: We included 12 studies that analysed data from more than 7570 providers (e.g. professionals and organisations), and a further 3,333,386 clinical encounters (e.g. patient referrals, prescriptions). We included four cluster-randomised trials, one cluster-non-randomised trial, six interrupted time series studies, and one controlled before-after study. Eight studies were undertaken in the USA, and one each in Canada, Korea, China, and The Netherlands. Four studies examined the effect of public release of performance data on consumer healthcare choices, and four on improving quality.There was low-certainty evidence that public release of performance data may make little or no difference to long-term healthcare utilisation by healthcare consumers (3 studies; 18,294 insurance plan beneficiaries), or providers (4 studies; 3,000,000 births, and 67 healthcare providers), or to provider performance (1 study; 82 providers). However, there was also low-certainty evidence to suggest that public release of performance data may slightly improve some patient outcomes (5 studies, 315,092 hospitalisations, and 7502 providers). There was low-certainty evidence from a single study to suggest that public release of performance data may have differential effects on disadvantaged populations. There was no evidence about effects on healthcare utilisation decisions by purchasers, or adverse effects., Authors' Conclusions: The existing evidence base is inadequate to directly inform policy and practice. Further studies should consider whether public release of performance data can improve patient outcomes, as well as healthcare processes.

Published
2018
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23. "Countersinking" of reservoir in an irradiated patients can decrease tension on scalp closure.

Author

Singh M, Rios Diaz AJ, Golby AJ, and Caterson EJ

Abstract

Background: Subcutaneous reservoirs are used to provide therapy by establishing access to cerebrospinal fluid. However, it is associated with complications such as hemorrhage, infection, malfunction, and malpositioning. In an irradiated field with thin skin, use of reservoir can result in wound dehiscence, wound infection, and device extrusion., Case Description: We introduced a "countersinking" technique for the reservoir placement which involves the creation of bony recess in the skull to effectively accommodate the reservoir and decrease the protrusion. "Countersinking" of the reservoir can result in tension-free closure of the scalp and allow durable coverage of the reservoir. In the representative case, the incisional wound healed completely without any concern for wound dehiscence and the countersink technique may have contributed to effective healing of the radiated scalp., Conclusion: Countersinking of the reservoir can be a strategy to prevent complications such as wound dehiscence, and device extrusion in any patient, but in irradiated patients with very thin skin it also enables tension-free closure of the wound.

Published
2015
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24. Intraoperative Development of Tension Pneumocephalus in a Patient Undergoing Repair of a Cranial-Dural Defect Under Nitrous Oxide Anesthesia.

Author

Singh M, Vasudeva VS, Rios Diaz AJ, Dunn IF, and Caterson EJ

Abstract

Rapid buildup of gas within the cranial vault can result in a life-threatening condition known as "tension pneumocephalus," necessitating immediate surgical intervention. Nitrous oxide (N2O), a commonly used inhaled anesthetic, is associated with the development of tension pneumocephalus and its role in neurosurgical procedures has been debated in the literature. We present a case of tension pneumocephalus with preexisting pneumocephalus secondary to the usage of N2O as an inhaled anesthetic. Included is a literature review of studies discussing the role of N2O in the development of tension pneumocephalus. N2O is associated with tension pneumocephalus especially in the setting of preexisting pneumocephalus. Tension pneumocephalus can manifest as Cushing response and immediate decompression is life-saving. Nitrous oxide should be used cautiously in neurosurgical procedures, especially with preexisting pneumocephalus.

Published
2015
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