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Neurosurgical Focus

Michael C Dewan, Justin Onen, Hansen Bow, Peter Ssenyonga, Charles Howard, Benjamin C Warf
There is inadequate pediatric neurosurgical training to meet the growing burden of disease in low- and middle-income countries (LMIC). Subspecialty expertise in the management of hydrocephalus and spina bifida-two of the most common pediatric neurosurgical conditions-offers a high-yield opportunity to mitigate morbidity and avoid unnecessary death. The CURE Hydrocephalus and Spina Bifida (CHSB) fellowship offers an intensive subspecialty training program designed to equip surgeons from LMIC with the state-of-the-art surgical skills and equipment to most effectively manage common neurosurgical conditions of childhood...
October 2018: Neurosurgical Focus
D Ryan Ormond, Joseph Kahamba, Kevin O Lillehei, Nicephorus Rutabasibwa
Tanzania sits on the Indian Ocean in East Africa and has a population of over 53 million people. While the gross domestic product has been increasing in recent years, distribution of wealth remains a problem, and challenges in the distribution of health services abound. Neurosurgery is a unique case study of this problem. The challenges facing the development of neurosurgery in Tanzania are many and varied, built largely out of the special needs of modern neurosurgery. Task shifting (training nonphysician surgical providers) and 2-tiered systems (fast-track certification of general surgeons to perform basic neurosurgical procedures) may serve some of the immediate need, but these options will not sustain the development of a comprehensive neurosurgical footprint...
October 2018: Neurosurgical Focus
James L West, Kyle M Fargen, Wesley Hsu, Charles L Branch, Daniel E Couture
Global access to neurosurgical care is still a work in progress, with many patients in low-income countries not able to access potentially lifesaving neurosurgical procedures. "Big Data" is an increasingly popular data collection and analytical technique predicated on collecting large amounts of data across multiple data sources and types for future analysis. The potential applications of Big Data to global outreach neurosurgery are myriad: from assessing the overall burden of neurosurgical disease to planning cost-effective improvements in access to neurosurgical care, and collecting data on conditions which are rare in developed countries...
October 2018: Neurosurgical Focus
Charles L Branch, Frederick Boop, Michael M Haglund, Robert J Dempsey
No abstract text is available yet for this article.
October 2018: Neurosurgical Focus
Ashish H Shah, Ernest Barthélemy, Yudy Lafortune, Joanna Gernsback, Ariel Henry, Barth Green, John Ragheb
Given Haiti's longstanding socioeconomic burden and recent environmental and epidemiological catastrophes, the capacity for neurosurgery within Haiti has been limited, and outcomes for patients with neurosurgical conditions have remained poor. With few formally trained neurosurgeons (4) in a country of 10.5 million inhabitants, there is a significant need for the development of formal structured neurosurgical training. To mitigate the lack of neurosurgical care within Haiti, the authors established the first neurosurgical residency program within the country by creating an integrated model that uniquely fortifies existing Haitian neurosurgery with government sponsorship (Haitian Ministry of Health and National Medical School) and continual foreign support...
October 2018: Neurosurgical Focus
Ahmed E Helal, Heba Abouzahra, Ahmed Abdelaziz Fayed, Tarek Rayan, Mahmoud Abbassy
Healthcare spending has become a grave concern to national budgets worldwide, and to a greater extent in low-income countries. Brain tumors are a serious disease that affects a significant percentage of the population, and thus proper allocation of healthcare provisions for these patients to achieve acceptable outcomes is a must. The authors reviewed patients undergoing craniotomy for tumor resection at their institution for the preceding 3 months. All the methods used for preoperative planning, intraoperative management, and postoperative care of these patients were documented...
October 2018: Neurosurgical Focus
Christopher Carr, Lora Kahn, Mansour Mathkour, Erin Biro, Cuong J Bui, Aaron S Dumont
OBJECTIVE: The Global Burden of Disease (GBD) is an international collaboration and the largest comprehensive investigation of global health disease burden ever conducted. It has been particularly insightful for understanding disease demographics in middle-income nations undergoing rapid development, such as Vietnam, where 6 of the top 10 causes of death are relevant to the neurosurgeon. The burden of stroke-the number one cause of death in Vietnam-is particularly impressive. Likewise, road injuries, with a disproportionate rate of traumatic brain injury, continue to increase in Vietnam following economic development...
October 2018: Neurosurgical Focus
Dagoberto Estevez-Ordonez, Matthew C Davis, Betsy Hopson, Msha, Anastasia Arynchyna, Brandon G Rocque, Graham Fieggen, Gail Rosseau, Godfrey Oakley, Mspm, Jeffrey P Blount
Neural tube defects (NTDs) are one of the greatest causes of childhood mortality and disability-adjusted life years worldwide. Global prevalence at birth is approximately 18.6 per 10,000 live births, with more than 300,000 infants with NTDs born every year. Substantial strides have been made in understanding the genetics, pathophysiology, and surgical treatment of NTDs, yet the natural history remains one of high morbidity and profound impairment of quality of life. Direct and indirect costs of care are enormous, which ensures profound inequities and disparities in the burden of disease in countries of low and moderate resources...
October 2018: Neurosurgical Focus
David Kitya, Maria Punchak, Jihad Abdelgadir, Oscar Obiga, Derek Harborne, Michael M Haglund
OBJECTIVE: Causes, clinical presentation, management, and outcomes of chronic subdural hematoma (CSDH) in low- and middle-income countries are not well characterized in the literature. Knowledge regarding these factors would be beneficial in the development and implementation of effective preventive and management measures for affected patients. The authors conducted a study to gain a better understanding of these factors in a low-income setting. METHODS: This prospective study was performed at Mbarara Regional Referral Hospital (MRRH) in Uganda between January 2014 and June 2017...
October 2018: Neurosurgical Focus
Frederick A Boop
No abstract text is available yet for this article.
October 2018: Neurosurgical Focus
Andreas Leidinger, Pablo Extremera, Eliana E Kim, Mahmood M Qureshi, Paul H Young, José Piquer
OBJECTIVE: The objective of this study was to describe the experience of a volunteering neurosurgeon during an 18-week stay at the Neurosurgery Education and Development (NED) Institute and to report the general situation regarding the development of neurosurgery in Zanzibar, identifying the challenges and opportunities and explaining the NED Foundation's model for safe practice and sustainability. METHODS: The NED Foundation deployed the volunteer neurosurgeon coordinator (NC) for an 18-week stay at the NED Institute at the Mnazi Mmoja Hospital, Stonetown, Zanzibar...
October 2018: Neurosurgical Focus
Brandon G Rocque, Matthew C Davis, Samuel G McClugage, Dang Anh Tuan, Donald T King, Nguyen Thi Huong, Nguyen Thi Bich Van, Pongkiat Kankirawatana, Cao Vu Hung, Le Nam Thang, James M Johnston, Nguyen Duc Lien
OBJECTIVE: The purpose of this report was to describe an international collaboration model to facilitate the surgical treatment of children with epilepsy in Vietnam. METHODS: This model uses three complementary methods to achieve a meaningful expansion in epilepsy surgery capacity: US-based providers visiting Hanoi, Vietnam; Vietnamese providers visiting the US; and ongoing telecollaboration, including case review and real-time mentorship using internet-based communication platforms...
October 2018: Neurosurgical Focus
Federico Nicolosi, Zefferino Rossini, Ismail Zaed, Angelos G Kolias, Maurizio Fornari, Franco Servadei
OBJECTIVE: Neurosurgical training is usually based on traditional sources of education, such as papers, books, direct surgical experience, and cadaveric hands-on courses. In low-middle income countries, standard education programs are often unavailable, mainly owing to the lack of human and economic resources. Introducing digital platforms in these settings could be an alternative solution for bridging the gap between Western and poor countries in neurosurgical knowledge. METHODS: The authors identified from the Internet the main digital platforms that could easily be adopted in low-middle income countries...
October 2018: Neurosurgical Focus
Carolyn Quinsey, Jessica Eaton, Weston Northam, Matt Gilleskie, Anthony Charles, Eldad Hadar
Global health research can transform clinical and surgical practice worldwide. Partnerships between US academic centers and hospitals in low- and middle-income counties can improve clinical care at the host institution hospital and give the visiting institution access to a large volume of valuable research data. Recognizing the value of these partnerships, the University of North Carolina (UNC) formed a partnership with Kamuzu Central Hospital (KCH) in Lilongwe, Malawi. The Department of Neurosurgery joined the partnership with KCH and designed a Head Trauma Surveillance Registry...
October 2018: Neurosurgical Focus
Jihad Abdelgadir, Cyrus Elahi, Jacquelyn Corley, Kevin C Wall, Josephine N Najjuma, Alex Muhindo, Joao Ricardo Nickenig Vissoci, Michael M Haglund, David Kitya
OBJECTIVE: In addition to the rising burden of surgical disease globally, infrastructure and human resources for health remain a great challenge for low- and middle-income countries, especially in Uganda. In this study, the authors aim to explore the trends of neurosurgical care at a regional referral hospital in Uganda and assess the long-term impact of the institutional collaboration between Mulago National Referral Hospital and Duke University. METHODS: An interrupted time series is a quasi-experimental design used to evaluate the effects of an intervention on longitudinal data...
October 2018: Neurosurgical Focus
Michael C Dewan, Ronnie E Baticulon, Abbas Rattani, James M Johnston, Benjamin C Warf, William Harkness
OBJECTIVE: The presence and capability of existing pediatric neurosurgical care worldwide is unknown. The objective of this study was to solicit the expertise of specialists to quantify the geographic representation of pediatric neurosurgeons, access to specialist care, and equipment and training needs globally. METHODS: A mixed-question survey was sent to surgeon members of several international neurosurgical and general pediatric surgical societies via a web-based platform...
October 2018: Neurosurgical Focus
Gail Rosseau, Walter D Johnson, Kee B Park, Miguel Arráez Sánchez, Franco Servadei, Kerry A Vaughan
Since the creation of the World Health Organization (WHO) in 1948, the annual World Health Assembly (WHA) has been the major forum for discussion, debate, and approval of the global health agenda. As such, it informs the framework for the policies and budgets of many of its Member States. For most of its history, a significant portion of the attention of health ministers and Member States has been given to issues of clean water, vaccination, and communicable diseases. For neurosurgeons, the adoption of WHA Resolution 68...
October 2018: Neurosurgical Focus
Linda W Xu, Silvia D Vaca, Joy Q He, Juliet Nalwanga, Christine Muhumuza, Joel Kiryabwire, Hussein Ssenyonjo, John Mukasa, Michael Muhumuza, Gerald Grant
OBJECTIVE: Children with neural tube defects (NTDs) require timely surgical intervention coupled with long-term management by multiple highly trained specialty healthcare teams. In resource-limited settings, outcomes are greatly affected by the lack of coordinated care. The purpose of this study was to characterize outcomes of spina bifida patients treated at Mulago National Referral Hospital (MNRH) through follow-up phone surveys. METHODS: All children presenting to MNRH with NTDs between January 1, 2014, and August 31, 2015, were eligible for this study...
October 2018: Neurosurgical Focus
Joao Paulo Almeida, Carlos Velásquez, Claire Karekezi, Miguel Marigil, Mojgan Hodaie, James T Rutka, Mark Bernstein
OBJECTIVE: International collaborations between high-income (HICs) and low- and middle-income countries (LMICs) have been developed as an attempt to reduce the inequalities in surgical care around the world. In this paper the authors review different models for international surgical education and describe projects developed by the Division of Neurosurgery at the University of Toronto in this field. METHODS: The authors conducted a review of models of international surgical education reported in the literature in the last 15 years...
October 2018: Neurosurgical Focus
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