Oluseyi Aliu

A 5-year interval evaluation of function after pollicization for congenital thumb aplasia using multiple outcome measures.

Background: The authors aimed to determine the functional improvement rate over a 5-year interval among patients who had undergone index finger pollicization for isolated thumb absence compared with age-matched controls. They also investigated suggestions in previous reports that tissue remodeling in reconstructed thumbs causes improvements in function outpacing normal development. Methods: Five patients (seven hands) evaluated 5 years earlier with grip, lateral pinch, and tripod pinch strength tests; the pegboard Functional Dexterity Test; the Jebsen Hand Function Test; standard radiographs; and parent questionnaires on appearance, social interactions, and functionality were reevaluated. Percentage changes were compared with expected changes from published norms. Results: Regarding grip strength, patients showed a 148 percent increase compared with 102 percent in controls. Regarding lateral and tripod pinch, patients had 99 and 125 percent increases compared with 78 and 69 percent in controls, respectively; the differences were not significant between groups. Functional dexterity outcomes showed the same trend. Controls improved in the five administered subtests of the Jebsen tests. In three Jebsen subtests, patients accomplished the tasks in 40 to 45 percent less time than 5 years previously. Parent perspectives were comparable to 5 years previously. Previously, 60 percent of responses were in the best category and 4 percent were in the worst category. Those percentages were 58 and 6 percent, respectively, in this study. Conclusions: Although this was a small study group, it seems that children who have undergone index finger pollicization have changes in function comparable to normal development. Parents still have positive perspectives of the reconstructed thumb. There is no evidence that tissue remodeling causes improvement outpacing normal development.

Readability of ASPS and ASAPS educational web sites: An analysis of consumer impact

BACKGROUND Patients use the Internet to educate themselves about health-related topics, and learning about plastic surgery is a common activity for enthusiastic consumers in the United States. How to educate consumers regarding plastic surgical procedures is a continued concern for plastic surgeons when faced with the growing portion of the American population having relatively low health care literacy. The usefulness of health-related education materials on the Internet depends largely on their comprehensibility and understandability for all who visit the Web sites. METHODS The authors studied the readability of patient education materials related to common plastic surgery procedures from the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) Web sites and compared them with materials on similar topics from 10 popular health information-providing sites. RESULTS The authors found that all analyzed documents on the ASPS and ASAPS Web sites targeted to the consumers were rated to be more difficult than the recommended reading grade level for most American adults, and these documents were consistently among the most difficult to read when compared with the other health information Web sites. CONCLUSIONS The Internet is an increasingly popular avenue for patients to educate themselves about plastic surgery procedures. Patient education material provided on ASPS and ASAPS Web sites should be written at recommended reading grade levels to ensure that it is readable and comprehensible to the targeted audience.

Variation in inpatient tonsillectomy costs within and between US hospitals attributable to postoperative complications

Background:Tonsillectomy is the second most common inpatient procedure in US children. However, the factors that influence tonsillectomy-related costs are unknown. Objective:The objective of the study was to describe variation in US inpatient tonsillectomy costs and examine whether postoperative complications contribute to these disparities in costs. Research Design:This is a retrospective cohort study of the 2009 Nationwide Inpatient Sample. Hierarchical, mixed-effects linear regression modeling was used to analyze the association between postoperative complications and cost, controlling for clinically relevant characteristics such as age, number of chronic comorbidity indicators, and hospital mean complication rates. We also estimated the variance in cost attributable to the treating hospital using the intraclass correlation coefficient. Subjects:The study cohort comprised 12,512 adult and pediatric patients undergoing tonsillectomy or adenotonsillectomy in the inpatient setting. Measures:Cost, posttonsillectomy hemorrhage, and mechanical ventilator use at the individual encounter and at hospital level were evaluated. Results:The aggregate cost of tonsillectomies in the cohort was

The effect of pre-Affordable Care Act (ACA) Medicaid eligibility expansion in New York State on access to specialty surgical care.

94.2 million. The median cost per encounter across all hospitals was

The Effect of Medicaid Expansion in New York State on Use of Subspecialty Surgical Procedures by Medicaid Beneficiaries and the Uninsured

4393 (interquartile range,

Surgical Treatment of Cubital Tunnel Syndrome: Trends and the Influence of Patient and Surgeon Characteristics.

3279–

Assessing strength of evidence in diagnostic tests.

6981), whereas the mean cost was

Qualitative Analysis of the Perspectives of Volunteer Reconstructive Surgeons on Participation in Task-Shifting Programs for Surgical-Capacity Building in Low-Resource Countries

7525 (95% confidence interval,

Building surgical capacity in low-resource countries: a qualitative analysis of task shifting from surgeon volunteers' perspectives.

6453–

Reconstruction of the Irradiated Breast: A National Claims-Based Assessment of Postoperative Morbidity

8597). Mechanical ventilation was associated with an adjusted increase of