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Study Design: A retrospective, observational study.Objective: The aim of this study was to determine the utilization of various treatment modalities in the management of degenerative spondylolisthesis within Medicare beneficiaries.Summary Of Background Data: Degenerative lumbar spondylolisthesis is a condition often identified in symptomatic low back pain. A variety of treatment algorithms including physical therapy and interventional techniques can be used to manage clinically significant degenerative spondylolisthesis.Methods: This study utilized the 5% national sample of Medicare carrier claims from 2000 through 2011. A cohort of beneficiaries with a new International Classification of Diseases 9th edition (ICD-9) diagnosis code for degenerative lumbar spondylolisthesis was identified. Current procedural terminology codes were used to identify the number of procedures performed each year by specialty on this cohort.Results: A total of 95,647 individuals were included in the analysis. Average age at the time of initial diagnosis was 72.8 ± 9.8 years. Within this study cohort, spondylolisthesis was more prevalent in females (69%) than males and in Caucasians (88%) than other racial demographics. Over 50% of beneficiaries underwent at least one injection, approximately one-third (37%) participated in physical therapy, one in five (21%) underwent spinal surgery, and one-third (36%) did not utilize any of these interventions. Greater than half of all procedures (124,280/216,088) occurred within 2 years of diagnosis. The ratio of focal interventions (transforaminal and facet interventions) to less selective (interlaminar) procedures was greater for the specialty of Physical Medicine and Rehabilitation than for the specialties of Anesthesiology, Interventional Radiology, Neurosurgery, and Orthopedic Surgery. The majority of physical therapy was dedicated to passive treatment modalities and range of motion exercises rather than active strengthening modalities within this cohort.Conclusion: Interventional techniques and physical therapy are frequently used treatment modalities for symptomatic degenerative spondylolisthesis. Understanding utilization of these techniques is important to determine relative clinical efficacies and to optimize future health care expenditures.Level Of Evidence: N/A. [ABSTRACT FROM AUTHOR]

The fundamental biodiversity number, θ, as proposed by Hubbell, should be positively correlated with province area. Because θ can be calculated from preserved relative abundance distributions, this correlation can be tested in the fossil record for regions with known provinces. Late Ordovician (443-458 Ma) strata of Laurentia are divided into four geochemically and biologically distinct regions that reflect provinces in the epicontinental sea. We use existing and newly obtained bed-level census data to test whether Hubbell's θ is positively correlated with the area of these four regions, corresponding roughly to the Appalachian Basin, Cincinnati Arch, Upper Mississippi Valley, and western United States and Canada. Results indicate a positive relationship between province area and θ that suggests the influence of provincial area, among other factors, on diversity. This correlation highlights the inherent link between diversity and abundance structure at local and regional scales, such that changes at one scale will necessarily affect the other. Since diversity at these smaller spatial scales is an important component of global biodiversity, determining the nature of this relationship in the fossil record has implications for understanding how diversity is assembled globally throughout the Phanerozoic. [ABSTRACT FROM AUTHOR]

In the article, the authors discuss about health care safety. They cite the voluntary Safety Certification in Outpatient Practice Excellence (SCOPE) for Women's Health scheme of the American Congress of Obstetricians and Gynecologists to assess and recognize work in the outpatient setting. They present the requirements for an office-safety program including surgical safety, medication safety and communication and teamwork.

Focuses on the aligned educational system in Texas that contributes to student achievement. Alignment of curriculum standards and accountability; Criticisms of the Texas education system; Direction for school districts.

A prospective study of the use of realtime and store-and-forward teleconsulting was carried out in patients who presented to the New York Eye and Ear Infirmary for otolaryngology care. Forty-five patients were seen in the study. There were no significant differences between local and remote otolaryngologists when interpreting the examinations, indicating that transmission did not affect the ability of a qualified physician to make an accurate diagnosis. In the store-and-forward examinations only 62 of the electronic records provided sufficient information for a confident diagnosis. Records were judged inadequate primarily due to poor selection, or an insufficient number of stored images. The study demonstrates that both interactive and store-and-forward techniques can be used to provide accurate clinical consultations in nasopharyngolaryngoscopic examinations. However, since store-and-forward consultations include less information and do not provide immediate feedback, a well defined clinical protocol for assembling the electronic consultation is needed. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the safety and efficacy of a 2.5% polyacrylamide hydrogel in the aesthetic enhancement of nasolabial folds., Methods and Materials: The safety and efficacy of a polyacrylamide hydrogel were compared with those of nonanimal stabilized hyaluronic acid (NASHA) in 315 subjects in a double-blind, randomized, multicenter, noninferiority trial with a 12-month follow-up. The primary efficacy end point was mean change in Wrinkle Assessment Scale (WAS) scores at 6 months. The primary safety end point was rate of serious adverse events (AEs) through 12 months after treatment., Results: Polyacrylamide hydrogel was as effective as NASHA, and effectiveness persisted throughout the 12-month follow-up. Treatment-related AEs occurred with equal incidence; most were mild to moderate, transient, and related to injection procedure. One serious AE (infection) was thought to be related to treatment with polyacrylamide hydrogel; it resolved within 5 days after appropriate treatment., Conclusion: This 2.5% polyacrylamide hydrogel offers promise as a long-lasting soft tissue filler. It is well tolerated, as effective as NASHA in correction of nasolabial folds, and persistent. Longer evaluation is required to evaluate longer-term safety and demonstrate duration of effect beyond 12 months. This, (© 2010 by the American Society for Dermatologic Surgery, Inc.)