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rural surgery

Dayron Rodriguez, Kai Li, Michel Apoj, Ricardo Munarriz
INTRODUCTION: The epidemiology of penile fractures in the emergency setting is not well described. AIM: Examine the incidence, evaluation, management, risk factors predicting surgical repair or hospital transfer, and use of financial resources in patients presenting with penile fractures to the emergency departments (ED) nationwide in the Unites States. METHODS: ED visits with a primary diagnosis of penile fractures (International Classification of Diseases, Ninth Edition codes) between 2010-2014 were abstracted from the Nationwide Emergency Department Sample...
February 2019: Journal of Sexual Medicine
Gareth D Mercer, Penny Lyons, Ken Bassett
PURPOSE: Women bear an inequitable burden of blinding conditions compared to men primarily because they have more limited access to eye care services. This systematic review sought evidence regarding interventions to increase gender equity in eye care. METHODS: We searched MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, and EBSCO CINAHL, and contacted experts to identify studies in low- and middle-income countries of health services interventions for age-related cataract, childhood cataract, and trachoma...
February 15, 2019: Ophthalmic Epidemiology
Martin Májovský, David Netuka, Vladimír Beneš, Pavel Kučera
Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions. Despite ongoing efforts, recurrence and reoperation rates after surgical treatment remain high. We synthesize scientific evidence on the treatment of CSDH with biophysical principles and then propose a simple and effective surgical technique aiming to reduce the recurrence rate. Under local anesthesia, one burr hole is placed in the area above the maximum hematoma thickness. One drain is inserted into the dorsal direction to the deepest point of the hematoma cavity, and a second drain is inserted frontally into the highest point...
January 2019: Journal of Neurosciences in Rural Practice
O E Konovalov, J M Beisenbaieva
The article presents the results of analysis of indices of morbidity and mortality of diseases of blood circulation system of population of the Southern Kazakhstan oblast in 2004-2015. The analysis was applied to annual activities reports of the Regional cardiologic Center in 2013-2016. Thus, in 2016 the Center accepted 4237 patients and 80.7% out of them in emergence order. In overall, treatment in the Regional cardiologic Center was applied to 59.4% of respondents. All respondents were residents of municipal center an only 25...
November 2018: Problemy Sot︠s︡ialʹnoĭ Gigieny, Zdravookhranenii︠a︡ i Istorii Medit︠s︡iny
Rhea Liang, Tim Dornan, Debra Nestel
BACKGROUND: Women are under-represented in surgery and leave training in higher proportions than men. Studies in this area are without a feminist lens and predominantly use quantitative methods not well suited to the complexity of the problem. METHODS: In this qualitative study, a researcher interviewed women who had chosen to leave surgical training. Women were recruited using a purposive snowball strategy through the routine communications of the Royal Australasian College of Surgeons and Royal Australasian College of Surgeons Trainee Association over a 3-week period, and were interviewed over the following 4 months in the past 4 years in person or by telephone...
February 9, 2019: Lancet
Rafeh Ahmed, Asad Iqbal Mian
The increasing disparity in healthcare access in Pakistan requires immediate intervention in the form of informed policy and appropriate implementation of such a policy. The implementation of a global surgery framework in Pakistan has the potential to improve healthcare access and parity in rural areas. Benefitting from the lessons learned through previous attempts at implementing centrally planned health programmes, This paper makes the case for a decentralised approach in facilitating the implementation of a Global Surgery framework in Pakistan...
February 2019: JPMA. the Journal of the Pakistan Medical Association
N Latchana, L Davis, N G Coburn, A Mahar, Y Liu, A Hammad, D Kagedan, M Elmi, M Siddiqui, C C Earle, J Hallet
Background: Pancreatic cancer surgery is increasingly regionalized in high-volume centres. Provision of adjuvant chemotherapy in the same institution can place a burden on patients, whereas receiving adjuvant chemotherapy at a different institution closer to home may create disparities in care. This study compared long-term outcomes of patients with pancreatic adenocarcinoma receiving adjuvant chemotherapy at the institution where they had undergone surgery with outcomes for those receiving chemotherapy at a different institution...
February 2019: BJS open
Association Of Rural Surgeons Of India-Lancet Commission On Global Surgery Arsi-LCoGS Consensus Committee
In India, 90% of the rural population is estimated to lack access to safe, affordable, and timely surgical care. Surgical care in these settings is often characterized by limited resources. Provision of rural surgical care often requires novel approaches as compared to those in higher income urban sectors, specifically in areas of infrastructure, workforce, and blood. This consensus statement draws upon the wealth of experience held by India's rural surgeons to identify key problems and lay forth actionable solutions in the areas of surgical infrastructure, workforce, and blood supply...
January 29, 2019: Healthcare
Charles Everett Wilkins, Tammie Lynn Herrera, Monica Kwai Nagahiro, Luther Basil Weathers, Sudhakar Virendra Girotra, Faraz Sandhu
AIMS: Impella 2.5 and Impella CP (Abiomed) are percutaneous left ventricular assist devices that can be easily deployed in the cardiac catheterization laboratory without need for surgery and provide effective hemodynamic support. The utility of Impella devices for management of acute myocardial infarction complicated by cardiogenic shock (AMI-CS) at a rural community hospital without on-site surgical back-up has not been reported. METHODS: We retrospectively reviewed all consecutive patients who underwent percutaneous coronary intervention (PCI) with Impella support between 2012 and 2017 for AMI-CS at our institution...
February 2019: Journal of Invasive Cardiology
Ramy Behman, Avery B Nathens, Stephanie Mason, James P Byrne, Nicole Look Hong, Petros Pechlivanoglou, Paul Karanicolas
Importance: Adhesive small-bowel obstruction (aSBO) is a potentially chronic, recurring surgical illness. Although guidelines suggest trials of nonoperative management, the long-term association of this approach with recurrence is poorly understood. Objective: To compare the incidence of recurrence of aSBO in patients undergoing operative management at their first admission compared with nonoperative management. Design, Setting, and Participants: This longitudinal, propensity-matched, retrospective cohort study used health administrative data for the province of Ontario, Canada, for patients treated from April 1, 2005, through March 31, 2014...
January 30, 2019: JAMA Surgery
Rafeh Ahmed, Asad Iqbal Mian
The increasing disparity in healthcare access in Pakistan requires immediate intervention in the form of informed policy and appropriate implementation of such a policy. The implementation of a global surgery framework in Pakistan has the potential to improve healthcare access and parity in rural areas. Benefitting from the lessons learned through previous attempts at implementing centrally planned health programmes, This paper makes the case for a decentralised approach in facilitating the implementation of a Global Surgery framework in Pakistan...
February 2019: JPMA. the Journal of the Pakistan Medical Association
James D O'Leary, Hannah Wunsch, Anne-Marie Leo, David Levin, Asad Siddiqui, Mark W Crawford
BACKGROUND: Healthcare interventions on weekends have been associated with increased mortality and adverse clinical outcomes, but these findings are inconsistent. We hypothesized that patients admitted to hospital on weekends who have surgery have an increased risk of death compared with patients who are admitted and have surgery on weekdays. METHODS AND FINDINGS: This matched cohort study included 318,202 adult patients from Ontario health administrative and demographic databases, admitted to acute care hospitals from 1 January 2005 to 31 December 2015...
January 2019: PLoS Medicine
Matthew Shew, Jacob New, Andrés M Bur
OBJECTIVE: To apply a novel methodology with machine learning (ML) to a large national cancer registry to help identify patients who are high risk for delayed adjuvant radiation. STUDY DESIGN: Observational cohort study. SETTING: National Cancer Database (NCDB). SUBJECTS AND METHODS: A total of 76,573 patients were identified from the NCDB who had invasive head and neck cancer and underwent surgery, followed by radiation...
January 29, 2019: Otolaryngology—Head and Neck Surgery
Richard A Iles
Government doctor absenteeism from their public posts is a sizable problem across developing economies. The consumer demand estimation for outpatient fever treatment presented in this paper investigates the interrelationship between government doctor absenteeism and the large informal healthcare sector. Using a counterfactual framework, this paper estimates treatment effect of eliminating government doctor absenteeism. The effects are measured by changes to the market share of government Bachelor of Medicine and Bachelor of Surgery (MBBS) providers and resulting own-price elasticities of demand for government MBBS providers and unqualified providers...
January 28, 2019: Health Economics
Rajesh S Joshi, Sonali V Singanwad
Purpose: To study the frequency and intraoperative difficulties associated with pseudoexfoliation (PXF) syndrome at a tertiary eye care center in a rural central India. Methods: This study included patients scheduled for cataract surgery who were diagnosed with PXF syndrome. All patients underwent a complete ophthalmologic evaluation, including slit-lamp examination, tonometry, gonioscopy, and ophthalmoscopy before the surgery. Cataract surgeries were performed by a single surgeon who reported the intraoperative difficulties...
February 2019: Indian Journal of Ophthalmology
Susan Barnason, Lani Zimmerman, Paula Schulz, Carol Pullen, Sue Schuelke
AIMS AND OBJECTIVES: To determine if a weight management intervention (WMI) plus cardiac rehabilitation (CR) compared to CR alone improves outcomes for overweight and obese cardiac revascularization patients. BACKGROUND: Despite participating in cardiac rehabilitation (CR), few cardiac patients lose enough weight to achieve clinically significant cardiovascular disease risk reduction. DESIGN: A randomized controlled design was used with measurements at baseline, 4 and 6 months; guided by the CONSORT checklist, see Supplementary File 1...
January 22, 2019: Journal of Clinical Nursing
Shraddha Vidyadhar Naik, Vithal Krishna Dhulkhed, Rewa Hemant Shinde
Background: The operation theater (OT) complex is a costly component of a hospital budget expenditure. This area of hospital activity requires maximum utilization to ensure optimum cost benefit. To achieve a high level of utilization in the OT, it is necessary to efficiently coordinate number of activities and personnel. Methods: This study was conducted in a 1000-bedded tertiary care teaching hospital in rural maharashtra over aperiod of two months. The OT complex consists of eight major OTs...
October 2018: Anesthesia, Essays and Researches
Julia Neily, Christina Soncrant, Peter D Mills, Douglas E Paull, Lisa Mazzia, Yinong Young-Xu, William Nylander, Marilyn M Lynn, William Gunnar
Importance: Reducing wrong-site surgery is fundamental to safe, high-quality care. This is a follow-up study examining 8 years of reported surgical adverse events and root causes in the nation's largest integrated health care system. Objectives: To provide a follow-up description of incorrect surgical procedures reported from 2010 to 2017 from US Veterans Health Administration (VHA) medical centers, compared with the previous studies of 2001 to 2006 and 2006 to 2009, and to recommend actions for future prevention of such events...
November 2, 2018: JAMA network open
Marco Raftopulos, Eugene H Wong, Thomas E Stewart, R Niell Boustred, Richard J Harvey, Raymond Sacks
OBJECTIVES: Surgical trainee burnout has gained attention recently as a significant factor leading to poorer quality of patient care, decreased productivity, and personal dysfunction. As a result, we aimed to determine the prevalence and associated risk factors for burnout among otolaryngology-head and neck surgery (OHNS) trainees in Australia. STUDY DESIGN: Cross-sectional survey. SETTING: National cohort of accredited OHNS trainees in Australia...
January 15, 2019: Otolaryngology—Head and Neck Surgery
Yen-Yi Juo, Yas Sanaiha, Usah Khrucharoen, Bickey H Chang, Erik Dutson, Peyman Benharash
BACKGROUND: Recent trends toward regionalization of complex surgical procedures may increase the risk for care fragmentation during readmissions. Conflicting conclusions have been reported regarding risk factors and consequences of nonindex readmissions (ie, readmission to a separate hospital than the one where surgery was originally performed). We seek to perform a comprehensive review of existing literature. METHODS: Four electronic databases were searched to identify all eligible studies examining the risk factors and outcomes of postoperative nonindex readmission...
January 9, 2019: Surgery
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