Bonner G.L.,Baylor Scott and White |
Nagy A.J.,Texas A&M University |
Jupiter D.C.,Texas A&M University |
Rodriguez J.A.,Texas A&M University |
And 2 more authors.
American Journal of Surgery | Year: 2014
Background Bariatric surgery reduces the prevalence of diabetes and improves lipid profiles. Low-density lipoprotein particle (LDL-P) is a more accurate predictor of cardiovascular events than high-density lipoprotein (HDL) and LDL cholesterol. The effects of bariatric procedures on LDL-P have not been previously reported.Methods Two hundred thirty patients undergoing bariatric surgery, including gastric bypass, sleeve gastrectomy, and laparoscopic adjustable gastric band placement at a single institution were included. HDL, LDL, hemoglobin A1c, and LDL-P were measured preoperatively and at 3, 6, and 12 months postoperatively. Weight was recorded at baseline and after 1 year.Results There was a decrease in serum LDL-P levels, averaging 472.58 (P <.0001) over 1 year. HDL levels increased. Hemoglobin A1c and LDL levels declined. On average, patients lost 58% of excess weight.Conclusion LDL-P significantly decreased after bariatric surgery in relation to weight loss. It may be inferred that bariatric surgery decreases the risk of cardiovascular events. © 2014 Elsevier Inc.All rights reserved.
Czerwinski M.,Baylor Scott and White |
Gronet E.M.,Baylor Scott and White
Journal of Craniofacial Surgery | Year: 2016
Reconstruction of combined nose, cheek, and/or inferior eyelid defects is facilitated by stable anchorage at the nasal-cheek junction. The previously reported techniques of drill holes and Mitek anchors are not without disadvantages. The authors present a simple means of anchoring soft tissue flaps at the nasal-cheek junction: a titanium miniplate secured with a screw at each end. Our case report describes successful, lasting, and complication-free anchorage of cheek, forehead, and eyelid flaps to a single miniplate placed along the piriform aperture. Copyright © 2015 by Mutaz B. Habal, MD.
McFaddin C.,Baylor Scott and White |
McFaddin C.,Medical University of South Carolina |
Sirohi D.,University of Texas Health Science Center at San Antonio |
Castro-Echeverry E.,Baylor Scott and White |
And 2 more authors.
Journal of Cutaneous Pathology | Year: 2015
We report three cases of desmoplastic trichoepithelioma (DTE) with overlying pseudocarcinomatous hyperplasia. All three cases developed on the face of patients in their second decade. In spite of their young age, a diagnosis of squamous cell carcinoma was considered for each case, given the unusual juxtaposition of these two well-known simulators of malignancy. Awareness of this potential association may avert a misdiagnosis of malignancy. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Frazee R.C.,Baylor Scott and White |
Matejicka A.V.,Barnabas Health System |
Abernathy S.W.,Baylor Scott and White |
Davis M.,Baylor Scott and White |
And 5 more authors.
Journal of the American College of Surgeons | Year: 2015
Background Case mix index (CMI) is calculated to determine the relative value assigned to a Diagnosis-Related Group. Accurate documentation of patient complications and comorbidities and major complications and comorbidities changes CMI and can affect hospital reimbursement and future pay for performance metrics. Study Design Starting in 2010, a physician panel concurrently reviewed the documentation of the trauma/acute care surgeons. Clarifications of the Centers for Medicare and Medicaid Services term-specific documentation were made by the panel, and the surgeon could incorporate or decline the clinical queries. A retrospective review of trauma/acute care inpatients was performed. The mean severity of illness, risk of mortality, and CMI from 2009 were compared with the 3 subsequent years. Mean length of stay and mean Injury Severity Score by year were listed as measures of patient acuity. Statistical analysis was performed using ANOVA and t-test, with p < 0.05 for significance. Results Each year demonstrated an increase in severity of illness, risk of mortality, and CMI compared with baseline values (p < 0.05). Length of stay was not significantly different, reflecting similar patient populations throughout the study. Injury Severity Score decreased in 2011 and 2012 compared with 2009, reflecting a lower level of injury in the trauma population. Conclusions A concurrent documentation review significantly increases severity of illness, risk of mortality, and CMI scores in a trauma/acute care service compared with pre-program levels. These changes reflect more accurate key word documentation rather than a change in patient acuity. The increased scores might impact hospital reimbursement and more accurately stratify outcomes measures for care providers. © 2015 American College of Surgeons.