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rural surgery

Zhamak Khorgami, Wei T Li, Theresa N Jackson, C Anthony Howard, Guido M Sclabas
BACKGROUND: Robotic-assisted surgery (RAS) with its advantages continues to gain popularity among surgeons. This study analyzed the increased costs of RAS in common surgical procedures using the National Inpatient Sample. METHODS: Retrospective analysis of the 2012-2014 Healthcare Cost and Utilization Project-NIS was performed for the following laparoscopic/robotic procedures: cholecystectomy, ventral hernia repair, right and left hemicolectomy, sigmoidectomy, abdominoperineal resection, and total abdominal hysterectomy (TAH)...
October 16, 2018: Surgical Endoscopy
Thomas R Freeman, Leslie Boisvert, Eric Wong, Stephen Wetmore, Heather Maddocks
OBJECTIVE: To determine the range of services and procedures offered by family physicians who define themselves as comprehensive practitioners and compare responses across 3 generations of alumni of a single family practice program. DESIGN: Cross-sectional survey. SETTING: Western University in London, Ont. PARTICIPANTS: All graduates of the family medicine program between 1985 and 2012. MAIN OUTCOME MEASURES: Self-reported provision of the following types of care: in-office care, in-hospital care, intrapartum obstetrics, housecalls, palliative care, after-hours care, nursing home care, minor surgery, emergency department care, sport medicine, and walk-in care...
October 2018: Canadian Family Physician Médecin de Famille Canadien
S Rabiou, M Lakranbi, Y Ouadnouni, D Benajah, M Smahi
INTRODUCTION: The biliobronchial fistula of hydatic origin is a rare complication and the left localization is exceptional. OBSERVATION: We report the case of a 26-year-old patient from the rural area who was referred to us for treatment of biliptysis. The thoracic and abdominal computed tomography diagnosed a left biliobronchial fistula was. Management consisted of primary endoscopic sphincterotomy, followed by left exclusive thoracotomy surgery to treat pulmonary, hepatic and diaphragmatic repair...
October 8, 2018: Revue de Pneumologie Clinique
Eli Raneses, Eric S Secrist, Kevin B Freedman, David H Sohn, Thomas B Fleeter, Christopher M Aland
INTRODUCTION: Opioids are widely used after orthopaedic procedures. Nonmedical opioid use is a growing public health issue. METHODS: An anonymous online survey was distributed by e-mail to the orthopaedic societies of all 50 states and several large private practices to assess practicing orthopaedic surgeons' opioid prescribing practices. RESULTS: A total of 555 orthopaedic surgeons practicing in 37 states responded. The most commonly prescribed opioid for both teenagers and adults was hydrocodone/acetaminophen...
October 5, 2018: Journal of the American Academy of Orthopaedic Surgeons
Eric Anderson, Matthew Glogoza, Aaron Bettenhausen, Rory Guenther, Dylan Dangerfield, Rick Jansen, Roxanne Newman, Donald Warne, Cornelius Dyke
Objectives: Heart disease is the leading cause of death in American Indians (AIs). For AI patients with severe coronary artery disease requiring coronary artery bypass graft (CABG) surgery, little data exist. The purpose of this study was to evaluate short-term outcomes of Northern Plains AI undergoing CABG and identify variations in patient presentation. Methods: All patients undergoing isolated CABG between June 2012 and June 2017 were studied. Seventy-four AI and 1236 non-American Indian (non-AI) patients were identified...
2018: Health Equity
Phillip J Mercier, Steven J Skube, Samantha L Leonard, Ashley N McElroy, Tyler G Goettl, Melissa M Najarian, Paula M Termuhlen, Jeffrey G Chipman
OBJECTIVE: The objective of this study was to present the process of developing a rural surgery training track within an established residency program and review the current rural surgery training programs in the nation. DESIGN: This study reviews current rural surgery training opportunities at Accreditation Council for Graduate Medical Education accredited surgical residencies in the United States and presents the process of creating the University of Minnesota's rural surgery training track...
September 29, 2018: Journal of Surgical Education
Stephanie Treffert Lumpkin, Paula Strassle, Nicole Chaumont
BACKGROUND: Rates of readmission after colorectal surgery (CRS) range from 9% to 25% and cost the US $300 million annually. The aim of this study was to identify risk factors for 30-d readmission after CRS. Our hypothesis was that transfer from an outside hospital before CRS increases incidence of 30-d readmission. METHODS: Using the Healthcare Cost and Utilization Project Nationwide Readmissions Database, a retrospective analysis of surviving adult patients who underwent inpatient colon and/or rectal resection from 2010 to 2014 was performed...
November 2018: Journal of Surgical Research
Ahmed Hassan Fahal, Suliman Hussein Suliman, Roderick Hay
Mycetoma is a chronic infection, newly designated by the World Health Organization (WHO) as a neglected tropical disease, which is endemic in tropical and subtropical regions. It follows implantation of infectious organisms, either fungi (eumycetomas) or filamentous bacteria (actinomycetomas) into subcutaneous tissue, from where infection spreads to involve skin, bone and subcutaneous sites, leading to both health related and socioeconomic problems. In common with other NTDs, mycetoma is most often seen in rural areas amongst the poorest of people who have less access to health care...
September 4, 2018: Tropical Medicine and Infectious Disease
Tyler Carson, Hammad Ghanchi, Marc Billings, Vladimir Cortez, Raed Sweiss, Dan Miulli
Introduction: Intracranial hemorrhage (ICH) accounts for significant morbidity and mortality in the United States. Many studies have looked at the benefits of surgical intervention for ICH. Recent results for Minimally Invasive Surgery Plus Recombinant Tissue-type Plasminogen Activator for Intracerebral Hemorrhage-II trials have shown promise for a minimally invasive clot evaluation on improving perihematomal edema. Often rural or busy county medical centers may not have the resources available for immediate operative procedures that are nonemergent...
October 2018: Journal of Neurosciences in Rural Practice
Jennifer N Cooper, Charles A Elmaraghy
OBJECTIVE: To determine whether privately owned ambulatory surgery centers (ASCs) increase pediatric tympanostomy tube use in their surrounding communities. STUDY DESIGN: We studied children <5 years of age who underwent outpatient tympanostomy tube placement in New York or Florida in 2010-2014. Data came from the Healthcare Cost and Utilization Project State Ambulatory Surgery Databases, which include all outpatient surgeries in these states. Population characteristics came from the US Census' American Community Survey...
September 26, 2018: Journal of Pediatrics
John H Kempen, Redda Tekle-Haimanot, Lelisa Hunduma, Menilik Alemayehu, Maxwell Pistilli, Aida Abashawl, Scott D Lawrence, Wondu Alemayehu
PURPOSE: To assess the hypothesis that fluorometholone 0.1% eye drops are safe and effective as adjunctive therapy for trachomatous trichiasis (TT) surgery; determining the most promising dose. DESIGN: Randomized, placebo-controlled, double-masked parallel dose-ranging clinical trial. METHODS: Patients undergoing upper lid TT surgery at a rural Ethiopian hospital were randomized to fluorometholone 0.1% twice daily for four weeks, four times daily for four weeks, four times daily for eight weeks, or matching frequency placebo in a 3:1:3:1:3:1 ratio for one eye...
September 26, 2018: American Journal of Ophthalmology
Sunil V Patel, Sulaiman Nanji, Susan B Brogly, Katherine Lajkosz, Patti A Groome, Shaila Merchant
BACKGROUND: Appendectomy is a common emergency procedure. The risks have been reported in previous studies but often are limited to inpatient complications. The purpose of this study was to describe inpatient and outpatient rates of complications associated with appendectomy in a contemporary population-based cohort and explore factors associated with these complications. METHODS: We conducted a retrospective study using linked data for Ontario within Institute for Clinical Evaluative Sciences databases...
October 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
S Cheddie, C G Manneh, B Pillay
BACKGROUND: Primary amputation (stump closure) for diabetic foot sepsis is perceived to have a higher re-amputation rate due to stump sepsis. A guillotine amputation with elective stump closure is widely practised due to the lower risk of stump sepsis and re-amputation. AIMS: To provide an epidemiological analysis of the spectrum of disease and outcomes of primary amputation for diabetic foot sepsis in a regional rural hospital. METHODS: A prospective cohort study of 100 patients who underwent surgery for diabetic foot sepsis over a 5-year period was undertaken at Madadeni Provincial Hospital, in northern KwaZulu-Natal...
September 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
Sharnie Wu, Kong Chan Tang
PURPOSE: Ocular regional blocks generally require blind instrumentation to the posterior orbit, leading to rare but serious complications. However, topical anesthesia does not suppress eye or lid movements and may lead to more surgical complications. Advanced subconjunctival anesthesia (ASCAN) is a technique developed to provide reliable akinesia and anesthesia without anterior dissection or blind intrusion into the posterior orbit, while allowing visualization of the needle-tip position...
September 2018: Asia-Pacific Journal of Ophthalmology
Hannah O'Brien, David Mc Conaghy, Declan Brennan, Sarah Meaney
BACKGROUND: The incidence of anaphylaxis appears to be increasing worldwide with cases in the community outnumbering those in the hospital setting. General practice (GP) surgeries and pharmacies, based in the community, are often the first point of contact for many patients suffering from anaphylaxis. OBJECTIVES: To determine if studied GP surgeries and pharmacies have an anaphylaxis protocol on site and have access to an anaphylaxis kit; to explore GP's and pharmacists' personal experiences with management of anaphylaxis...
December 2018: European Journal of General Practice
Arya Amini, Tyler P Robin, Priscilla K Stumpf, Chad Rusthoven, Tracey E Schefter, Ashwin Shinde, Yi-Jen Chen, Scott M Glaser, Bradley R Corr, Christine M Fisher
OBJECTIVE: In this study, we analyzed patterns of care for patients with locally advanced cervical cancer to identify predictors for upfront surgery compared with definitive chemoradiation (CRT). METHODS: The National Cancer Database was queried for patients aged 18 years or older with Federation of Gynecology and Obstetrics IB2-IIB cervical cancer. All patients underwent either upfront hysterectomy with or without postoperative radiation therapy versus definitive CRT...
October 2018: International Journal of Gynecological Cancer
Daniel S O'Neil, Nancy L Keating, Jean Marie V Dusengimana, Vedaste Hategekimana, Aline Umwizera, Tharcisse Mpunga, Lawrence N Shulman, Lydia E Pace
PURPOSE: As breast cancer incidence and mortality rise in sub-Saharan Africa, it is critical to identify strategies for delivery of high-quality breast cancer care in settings with limited resources and few oncology specialists. We investigated the quality of treatments received by a cohort of patients with breast cancer at Butaro Cancer Center of Excellence (BCCOE), Rwanda's first public cancer center. PATIENTS AND METHODS: We reviewed medical records of all female patients diagnosed with invasive breast cancer at BCCOE between July 2012 and December 2013...
September 2018: Journal of Global Oncology
Akef El-Maghraby, Amin elMaghraby, Mutasim Alireza, Daniel E Etya'ale, William C Felch, Tamer Makary, Henry E Nkumbe, David E I Pyott, Serge Resnikoff, Alfred Sommer, Bruce E Spivey, Bradley R Straatsma, Hugh R Taylor
PURPOSE: To report establishment of the Magrabi ICO Cameroon Eye Institute at Yaoundé, Cameroon, as an ophthalmology subspecialty patient care and training center in Central Africa. DESIGN: Perspective METHODS: Assessment of unpublished and published material. RESULTS: To improve, preserve and restore eye health and vision in a region with world-high prevalence of functional vision impairment and blindness, the Africa Eye Foundation established the Magrabi ICO Cameroon Eye Institute as an ophthalmology subspecialty patient care center for all in need and a training center for ophthalmologists, ophthalmology subspecialists and allied personnel...
September 18, 2018: American Journal of Ophthalmology
C Michael Honey, Armaan K Malhotra, Mandeep S Tamber, Michel Prud'homme, Ivar Mendez, Christopher R Honey
BACKGROUND: The Canada Health Act requires reasonable access to all medically necessary therapies. No information is available to assess the current access to neuromodulation across Canada. This study quantifies the current rate of deep brain stimulation (DBS) for the entire country of Canada. Analyses were performed to determine whether there were differences in access based on provincial or territorial location, rural or non-rural region, or socioeconomic status. METHODS: All implanted DBS devices in Canada over a 2-year epoch (January 2015 to December 2016) were supplied by either Boston Scientific or Medtronic...
September 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Lalit Kant, Nobhojit Roy, Sanjay P Zodpey
The burden of surgical conditions is large, though unrecognized. Surgical interventions are cost - effective, but thought to be otherwise. Investments aimed at including surgery at primary care level are affordable. Globally, a momentum is being created to strengthen surgery infrastructure especially for the poor in the low and middle income countries - who bear the burden most. In India, the Association of Rural Surgeons of India, and a body for implementing Lancet Commission of Global Surgery, India are taking lead...
July 2018: Indian Journal of Public Health
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