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rural surgery

Stuart Iglesias, Jude Kornelsen
CONTEXT: Over the past 25 years, the attrition of small volume rural surgery programs across Western Canada has been significant and sustained. The 'Joint position paper on rural surgery and operative delivery' (JPP) offers a consensus policy framework for the sustainability of rural surgical programs by nesting them within larger regional programs. The many recommendations in the JPP coalesce around the recognition that surgical care should be provided as close to home as possible. To achieve this, surgical care should be delivered within rural and regional surgical programs integrated into well-functioning networks staffed by generalist specialist surgeons trained across surgical disciplines and family physicians with enhanced surgical skills (FPESS)...
December 2018: Rural and Remote Health
Taylor R Cushman, Sherif G Shaaban, Amy C Moreno, Chi Lin, Vivek Verma
PURPOSE: Patients with unresectable cT4b esophageal cancer (EC) are rare and largely excluded from prospective trials. As a result, current treatment recommendations are based on limited evidence. This study sought to evaluate national practice patterns and outcomes for this population and evaluated 3 primary cohorts: patients receiving chemotherapy (CT) with or without subtherapeutic radiotherapy (RT), definitive chemoradiotherapy (CRT), or CT with or without RT followed by definitive surgery...
November 28, 2018: American Journal of Clinical Oncology
Muhammed Zübeyr Üçüncü, Merve Müge Üçüncü, Dilek Toprak
Background: Breast cancer is the most frequently diagnosed cancer among women in Turkey and worldwide, and is ranked as the second-leading cause of death in women after lung cancer. Early diagnosis of breast cancer is possible, and breast cancer is included in cancer-screening programs in Turkey. The aim of this study was to evaluate the knowledge, attitude, and behaviour of young women (older than 20 years of age) on breast self-examination and breast cancer screening methods, and to determine the effect of sociodemographic characteristics...
November 29, 2018: Asian Pacific Journal of Cancer Prevention: APJCP
Manoj Kumar, Siddharth Pandey, Apul Goel, Deepanshu Sharma, Gaurav Garg, Ajay Aggarwal
OBJECTIVE: To analyze the patterns of presentation and management for urologic complications of obstetrics and gynecology in the form of genitourinary fistulas at a tertiary referral center and highlight the social issues associated with them. MATERIAL AND METHODS: We conducted this retrospective study analyzing 311 patients with genitourinary fistulas after obstetric and gynecologic surgeries between January 2005 and January 2018. We recorded the patients' characteristics and area of residence and then analyzed the etiology, surgical management and success rates by grouping the patients into four types of genitourinary fistulas...
November 26, 2018: Turkish Journal of Urology
S J W Kent, R Morrison
We have previously identified differences in the presentation and treatment of cancer between patients who live in rural compared with urban areas, but have not yet seen differences in those treated by orthognathic surgery. We hypothesised that patients from areas further away from the hospital face higher costs to attend and may not present with minor problems as often as those who live nearby. We therefore retrospectively reviewed all those (n=216) who had presented for orthognathic surgery over a six-year period (May 2011 to May 2017)...
October 25, 2018: British Journal of Oral & Maxillofacial Surgery
Irma Corral, Hope Landrine
BACKGROUND: Although African-Americans have a higher prevalence of severe obesity than Whites, they are less likely to have bariatric surgery. Demographic, healthcare, and knowledge variables contribute to this racial disparity but have not been examined separately by race. OBJECTIVES: Examine the role of demographic, healthcare, and knowledge variables in African-Americans' versus Whites' interest in bariatric surgery. METHODS: A random sample of 293 African-American and 259 White adults were surveyed door-to-door in the rural south...
November 26, 2018: Journal of Racial and Ethnic Health Disparities
Edith E Holloway, Marios Constantinou, Jing Xie, Eva K Fenwick, Eric A Finkelstein, Ryan E K Man, Michael Coote, Jonathan Jackson, Gwyn Rees, Ecosse L Lamoureux
BACKGROUND: Older adults in residential aged care facilities have unnecessarily high levels of vision impairment (VI) which are largely treatable or correctable. However, no current comprehensive eye health service model exists in this setting in Australia. We aimed to determine the clinical, person-centered, and economic effectiveness of a novel eye care model, the Residential Ocular Care (ROC). METHODS/DESIGN: This protocol describes a multicentered, prospective, randomized controlled trial...
November 26, 2018: Trials
Shreya Tocaciu, Jayaraman Thiagarajan, Guy J Maddern, Matthias W Wichmann
OBJECTIVE: Emergency abdominal surgery has poorer outcomes and higher mortality rates, compared with elective surgery. Serious morbidity or mortality occurs in up to 40% of patients. No information is available with regard to the outcome of patients undergoing emergency abdominal surgery in rural Australia. METHODS: Patients undergoing emergency abdominal surgery in a 110-bed rural surgical centre in South Australia over a 5 year period (January 2010-December 2014) were included in the study...
November 25, 2018: Australian Journal of Rural Health
Emily Mary O'Brien, David Law, David Celermajer, Peter Watson Grant, Jon Waites
OBJECTIVE: The number of adults with congenital heart disease has increased with improvements in surgical and medical management, posing a challenge for regional and rural settings, which might have difficulties accessing specialised professionals with congenital heart disease services. This study aims to ascertain the demographics and management of adults with congenital heart disease seen by a cardiology practice in regional Australia to better understand the needs of regional adults with congenital heart disease...
November 19, 2018: Australian Journal of Rural Health
Kenza Baline, Fouzia Hali
We report the case of a 13-year old female patient from rural areas presenting with papulonodular lesion of 4/3cm in the lower third of the right leg, evolving over the last two years. Skin biopsy showed papillomatous hyperplasia with neutrophilic microabscess and spores. Direct mycological examination showed fumagoid bodies and Fonsecaea pedrosoi was isolated from culture. The patient underwent medico-surgical treatment (terbinafine 250mg/day for 6 months + resection and then skin graft) with good evolution and a follow-up period of 2 years without recurrences...
2018: Pan African Medical Journal
Ramesh Kumar, Namrata Choudhary
No abstract text is available yet for this article.
January 1, 2018: American Surgeon
Alexander Morzycki, Helene Retrouvey, Becher Alhalabi, Johnny Ionut Efanov, Sarah Al-Youha, Jamil Ahmad, David T Tang
Background: Projecting the demand for plastic surgeons has become increasingly important in a climate of scarce public resource within a single payer health-care system. The goal of this study is to provide a comprehensive workforce update and describe the perceptions of the workforce among Canadian Plastic Surgery residents and surgeons. Methods: Two questionnaires were developed by a national task force under the Canadian Plastic Surgery Research Collaborative...
November 2018: Plastic Surgery
Ilsley B Colton, Mayo H Fujii, Thomas P Ahern, Charles D MacLean, Julie E Lahiri, Matthew Alef, Andrew C Stanley, Georg Steinthorsson, Daniel J Bertges
The aim of this study was to assess postoperative opioid prescribing patterns, usage, and pain control after common vascular surgery procedures in order to develop patient centered best-practice guidelines. We performed a prospective review of opioid prescribing after seven common vascular surgeries at a rural, academic medical center from December 2016 to July 2017. A standardized telephone questionnaire was prospectively administered to patients ( n = 110) about opioid use and pain management perceptions...
November 18, 2018: Vascular Medicine
Tiffany J Zens, Randi Cartmill, Bridget L Muldowney, Sara Fernandes-Taylor, Peter Nichol, Jonathan E Kohler
OBJECTIVE: To evaluate and better understand variations in practice patterns, we analyzed ambulatory surgery claims data from 3 demographically diverse states to assess the relationship between age at umbilical hernia repair and patient, hospital, and geographic characteristics. STUDY DESIGN: We performed a cross-sectional descriptive study of uncomplicated hernia repairs performed as a single procedure in 2012-2014, using the State Ambulatory Surgery and Services Database for Wisconsin, New York, and Florida...
November 15, 2018: Journal of Pediatrics
Lisa P Spees, Stephanie B Wheeler, Mahesh Varia, Morris Weinberger, Christopher D Baggett, Xi Zhou, Victoria M Petermann, Wendy R Brewster
OBJECTIVE: Urban-rural health disparities are often attributed to the longer distances rural patients travel to receive care. However, a recent study suggests that distance to care may affect urban and rural cancer patients differentially. We examined whether this urban-rural paradox exists among patients with cervical cancer. METHODS: We identified individuals diagnosed with cervical cancer from 2004 to 2013 using a statewide cancer registry linked to multi-payer, insurance claims...
November 12, 2018: Gynecologic Oncology
Yousaf Ali, Muhammad Waseem Khan, UbaidUllah Mumtaz, Aneel Salman, Noor Muhammad, Muhammad Sabir
PURPOSE: The rate of cesarean sections has been rapidly increased in the last few decades in all the developing as well as developed countries. The rate of cesarean sections determined by the World Health Organization has been crossed by many countries, like Brazil, India, China, USA, Australia, etc. Similarly, this rate has also increased in Pakistan. The purpose of this paper is to explore and identify the factors that are responsible for the rising rate of cesarean sections in Pakistan...
October 8, 2018: International Journal of Health Care Quality Assurance
Leon Bijlmakers, Dennis Cornelissen, Mweene Cheelo, Mzaza Nthele, John Kachimba, Henk Broekhuizen, Jakub Gajewski, Ruairí Brugha
The lack of access to quality-assured surgery in rural parts of sub-Saharan Africa, where the numbers of trained health workers are often insufficient, presents challenges for national governments. The case for investing in scaling up surgical systems in low-resource settings is 3-fold: the potential beneficial impact on a large proportion of the global burden of disease; better access for rural populations who have the greatest unmet need; and the economic case. The economic losses from untreated surgical conditions far exceed any expenditure that would be required to scale up surgical care...
November 6, 2018: Health Policy and Planning
Ramesh Kumar, Namrata Choudhary
No abstract text is available yet for this article.
January 1, 2018: American Surgeon
K Keano Pavlosky, John D Vossler, Sarah M Murayama, Marilyn A Moucharite, Kenric M Murayama, Dean J Mikami
BACKGROUND: Inguinal hernia repair (IHR) is among the most common general surgery procedures. Multiple studies have examined costs and benefits of laparoscopic approach versus open repair. This study aimed to identify patient, surgeon, and hospital demographic predictors of laparoscopic versus open IHR. METHODS: We conducted a retrospective analysis of 342,814 IHRs (241,669 open; 101,145 laparoscopic) performed in adults (age ≥ 18) from 2010 to 2015 using the Premier Hospital Database...
October 29, 2018: Surgical Endoscopy
Saeed Hesam, Mahmood Mahmoudi, Abbas Rahimi Foroushani, Mehdi Yaseri, Mohammad Ali Mansournia
Background: Gastrointestinal cancer is one of the common causes of death from cancer in Iran. Survival analysis is usually used to detect prognostic factors of time to death from gastrointestinal cancers. The use of ordinary survival models, in the presence of competing risks and/or when data is collected within geographic areas, may lead to distorting the results. Therefore, the aim of this study is to use the spatial survival models in the presence of competing risks to assess the risk factors affecting the survival time of gastrointestinal cancer patients...
October 26, 2018: Asian Pacific Journal of Cancer Prevention: APJCP
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