Journal of vascular surgery
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Comparative Study
Management of early (<30 day) vascular groin infections using vacuum-assisted closure alone without muscle flap coverage in a consecutive patient series.
Vacuum-assisted closure (VAC) therapy without muscle flap coverage is our primary approach for graft preservation in early, deep groin infections with and without exposed grafts; however, concerns exist regarding its safety. We report our experience in a consecutive series of patients with early groin infections managed without muscle flap closure. ⋯ Management of early, deep groin wound infections with debridement, antibiotics, and VAC treatment is safe and enables graft preservation in the majority of patients with minimal morbidity, no perioperative limb loss, or mortality.
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Comparative Study
Sustained cognitive benefit 5 years after carotid endarterectomy.
This study investigated the long-term effect of carotid endarterectomy (CEA) on cognitive brain function by means of P300 evoked potentials. ⋯ CEA improves previously impaired cognitive brain function as shown by P300 measurements similar to normal cognitive brain function of age- and sex-matched healthy individuals. This beneficial effect is sustained up to 5 years after treatment.
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Electronic medical records are gathering significant attention with the recent State and Federal initiatives, Medicare Physician Quality Reporting Initiatives (PQRI), and stimulus funds. The conversion to an electronic environment from the comfortable but inefficient paper record can be confusing, difficult, and costly if the practice does not complete the proper analysis and planning for the transformation. Significant monetary assistance is available for practices during this process, with resultant increased practice efficiency and patient safety. To be successful, the practice must fully understand the expected benefits and must evaluate each of the options to be sure the entire practice workflow is considered.
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Comparative Study
Effects of ethnicity and insurance status on outcomes after thoracic endoluminal aortic aneurysm repair (TEVAR).
Thoracic endoluminal aortic aneurysm repair (TEVAR) is associated with improved outcomes compared with open thoracic aortic aneurysm repair. This study was designed to better characterize TEVAR outcomes in a large population, and to determine if outcomes are independently influenced by patient ethnicity and insurance status. ⋯ Mortality after TEVAR remains high in the US, although this may be associated with its early introduction during the study period. Nonetheless, the incidence of spinal cord ischemia is very low. Ethnicity and insurance type do not appear to influence TEVAR outcomes.