BRTO vs PARTO for gastric variceal bleeding using sodium tetradecyl sulfate (STS) in a single U.S. medical center

2017 ◽  
Vol 28 (2) ◽  
pp. S165-S166
Author(s):  
R Charalel ◽  
N Saad ◽  
S Kim
Keyword(s):  
Variceal Bleeding ◽  
Medical Center ◽  
Sodium Tetradecyl Sulfate

Predictive Power of Liver Maximum Function Capacity Test in Transjugular Intrahepatic Portosystemic Shunt Patients: A Pilot Study

2019 ◽  
Vol 38 (3) ◽  
pp. 251-258 ◽  
Author(s):  
Matthias Christian Reichert ◽  
Antje Schulz ◽  
Alexander Massmann ◽  
Arno Buecker ◽  
Matthias Glanemann ◽  
...  
Keyword(s):  
Pilot Study ◽  
Liver Failure ◽  
Variceal Bleeding ◽  
Multivariate Regression ◽  
Bacterial Infections ◽  
Medical Center ◽  
Test Methods ◽  
Refractory Ascites ◽  
Maximum Function ◽  
Before And After

Background: Transjugular intrahepatic shunt (TIPSS) is placed in patients with variceal bleeding, refractory ascites, and for other indications. Postprocedural liver function-associated complications (LFAC), including hepatic encephalopathy (HE) and liver failure, represent a major setback. Current methods to predict complications are insufficient. Objectives: We investigated in a pilot study of patients prior TIPSS placement whether the risk of LFAC correlates with the functional reserve of the liver, as assessed by liver maximum function capacity (LiMAx) test. Methods: Prospectively we included patients prior TIPSS placement between June 2016 and November 2017 at Saarland University Medical Center. LiMAx was conducted before and after TIPSS placement. Patients with HE prior TIPSS, as well as other factors predisposing to HE, including concomitant sedative drugs, current bacterial infections and sepsis, were excluded. Overt HE (OHE), LiMAx, and laboratory values were assessed before and after TIPSS placement. Data were analyzed in multivariate regression and AUROC models. Results: Mean age was 60 ± 8 years. Patients (n = 20) were mainly men (65%), and presented predominantly with Child-Pugh class B (90%). Indications for TIPSS were most commonly refractory ascites or recurrent variceal bleeding. In total, 40% of the patients developed LFAC after TIPSS placement. Expectedly, LiMAx decreased and serum bilirubin increased after TIPSS. LiMAx drop ≥20% was the only parameter predicting the development of LFAC after TIPSS in multivariate regression and AUROC analysis. Conclusions: In multivariate regression models and AUROC analysis, a drop in LiMAx predicted the development of LFAC after TIPSS placement. Additional larger studies assessing OHE and early liver failure separately are warranted.

Medicaid & Medicare: D.C. Appellate Court Denies Claim for Medicare Reimbursement of GME Cost

1999 ◽  
Vol 27 (2) ◽  
pp. 205-205
Author(s):  
choeffel Amy
Keyword(s):  
Medical Center ◽  
Federal District ◽  
Federal Court ◽  
University Of Pennsylvania ◽  
District Court ◽  
Appellate Court ◽  
Court Of Appeals ◽  
Department Of Health ◽  
Administrative Proceedings ◽  
Summary Judgment

The U.S. Court of Appeals for the District of Columbia upheld, in Presbyterian Medical Center of the University of Pennsylvania Health System v. Shalala, 170 F.3d 1146 (D.C. Cir. 1999), a federal district court ruling granting summary judgment to the Department of Health and Human Services (DHHS) in a case in which Presbyterian Medical Center (PMC) challenged Medicare's requirement of contemporaneous documentation of $828,000 in graduate medical education (GME) expenses prior to increasing reimbursement amounts. DHHS Secretary Donna Shalala denied PMC's request for reimbursement for increased GME costs. The appellants then brought suit in federal court challenging the legality of an interpretative rule that requires requested increases in reimbursement to be supported by contemporaneous documentation. PMC also alleged that an error was made in the administrative proceedings to prejudice its claims because Aetna, the hospital's fiscal intermediary, failed to provide the hospital with a written report explaining why it was denied the GME reimbursement.

Too Much to Bear

Crisis ◽  
2016 ◽  
Vol 37 (1) ◽  
pp. 59-67 ◽  
Author(s):  
Nicole J. Peak ◽  
James C. Overholser ◽  
Josephine Ridley ◽  
Abby Braden ◽  
Lauren Fisher ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Concurrent Validity ◽  
Medical Center ◽  
Psychiatric Patients ◽  
Preliminary Evidence ◽  
Diagnostic Interview ◽  
Veterans Affairs ◽  
Self Report ◽  
Perceived Burdensomeness ◽  
Scale Method

Abstract. Background: People who feel they have become a burden on others may become susceptible to suicidal ideation. When people no longer feel capable or productive, they may assume that friends and family members would be better off without them. Aim: The present study was designed to assess preliminary psychometric properties of a new measure, the Perceived Burdensomeness (PBS) Scale. Method: Depressed psychiatric patients (N = 173) were recruited from a veterans affairs medical center. Patients were assessed with a structured diagnostic interview and self-report measures assessing perceived burdensomeness, depression severity, hopelessness, and suicidal ideation. Results: The present study supported preliminary evidence of reliability and concurrent validity of the PBS. Additionally, perceived burdensomeness was significantly associated with higher levels of hopelessness and suicidal ideation. Conclusion: It is hoped that with the aid of the PBS clinicians may be able to intervene more specifically in the treatment of suicidality.

Incidence of Completed and Attempted Suicide in Trabzon, Turkey

Crisis ◽  
2002 ◽  
Vol 23 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Mustafa Bilici ◽  
Mehmet Bekaroğlu ◽  
Çiçek Hocaoğlu ◽  
Serhat Gürpınar ◽  
Cengiz Soylu ◽  
...  
Keyword(s):  
Suicide Risk ◽  
Attempted Suicide ◽  
Medical Center ◽  
Study Data ◽  
Public Prosecutor ◽  
Suicide Method ◽  
Hospital Data ◽  
State Institute ◽  
The Public ◽  
Completed Suicide

Summary: Objective: Studies of completed and attempted suicide in Turkey are based on data of State Institute of Statistics (SIS) and emergency clinics of the large hospitals. This study seeks (1) to find, independent of the SIS and hospital data, the annual incidences of completed and attempted suicide in Trabzon, Turkey; (2) to examine the associated factors between the incidence of completed and attempted suicide. Method: The data are derived by using a method specially designed for this study. Data sources include emergency clinics in all hospitals, village clinics, the Forensic Medical Center of Trabzon, the Governorship of Trabzon, “mukhtars” (local village representatives) of neighborhoods, the Office of the Public Prosecutor of Trabzon, the Police Headquarters and Gendarmerie, and the local press organs. Results: The incidences of completed and attempted suicide per 100,000 inhabitants turned out to be 2.60 and 31.5, respectively, whereas the SIS reported the incidence of completed suicide to be 1.11 per 100,000 inhabitants in Trabzon in 1995. Conclusion: Our results demonstrate that SIS data are inadequate for suicide research in Turkey. Our findings show that the risk of completed and attempted suicide is high in young, unmarried, and unemployed persons, and that these groups must be carefully evaluated for suicide risk. The study highlights the need for culture-specific research on suicidal behavior in Turkey.

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