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General surgery, urology,plastic surgery

Iain M Goodhart, John C Andrzejowski, Georgina L Jones, Mireille Berthoud, Andy Dennis, Gary H Mills, Stephen C Radley
BACKGROUND: Worldwide, guidelines support the routine use of anaesthetic preoperative assessment (POA), a process that is frequently supported by pro formas and unvalidated questionnaires. Electronic questionnaires can provide reliable data. A local initiative has seen the development of a computerised electronic Personal Assessment Questionnaire (ePAQ). OBJECTIVE: To develop and validate a novel electronic instrument for POA. DESIGN: The content and face validity were evaluated in 30 patients...
April 2017: European Journal of Anaesthesiology
N F M CorrĂȘa, M J A de Brito, M M de Carvalho Resende, M F P Duarte, F S Santos, G M SalomĂ©, L M Ferreira
OBJECTIVE: To assess the impact of surgical wound dehiscence on health-related quality of life and mental health. Dehiscence of surgical wounds is a serious postoperative complication associated with high morbidity and mortality. METHOD: Sixty-one adult patients, who had undergone neurological, general, colorectal, orthopaedic, gynaecological, plastic, cardiovascular, urological or neurological surgery in a university hospital in Brazil, were assessed between 30 and 180 days after surgery...
October 2, 2016: Journal of Wound Care
Kathryn E Ford, Lilli R L Cooper
INTRODUCTION: Medico-legal claims are a drain on NHS resources and promote defencive practice. The litigious burden of surgery in England has not been previously described. This paper describes trends over ten years of claims made against the NHS across 11 surgical specialities. MATERIALS AND METHODS: Data were requested for all claims received by the NHS Litigation Authority (NHSLA) from 2004 to 2014. Surgical specialities included cardiothoracic, general, neurosurgery, obstetric, oral and maxillofacial (OMFS), orthopaedic, otorhinolaryngology, paediatric, plastic, urology and vascular surgery...
May 6, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Lauren A Cadish, Vicki Fung, Felicia L Lane, Eric G Campbell
OBJECTIVE: The Accreditation Council for Graduate Medical Education measures surgical residents' experience in the United States by mandating that residents log each procedure in which they have participated. This system is the primary mechanism by which breadth and depth of surgical training are documented, and data are used for program accreditation and by individual program directors to assess resident preparedness. The study objective was to learn from residents across surgical specialties how this system is being used, and whether they believe these data are reliable...
May 2016: Journal of Surgical Education
O N Ekeke, K E Okonta, P O Igwe
BACKGROUND: There is paucity of literatures on audit of mortality in the surgical units of tertiary hospitals in the country. This has made the spectrum of mortality not to been known in some of the centers and therefore, there is a great disparity and dearth in apportioning health care services appropriately. AIM: The determination of the pattern of mortality in a surgical unit helps in planning, provision of quality surgical care and prioritizing of limited resources in developing countries...
May 2016: Nigerian Journal of Clinical Practice
Charles S Day, David J Park, Frederick S Rozenshteyn, Nana Owusu-Sarpong, Aldebarani Gonzalez
BACKGROUND: The U.S. Food and Drug Administration (FDA) evaluates medical devices by two main pathways. The more stringent Premarket Approval (PMA) review requires clinical trials, and the Premarket Notification 510(k) process generally exempts devices from clinical trials if they prove to be substantially equivalent to existing devices. We hypothesized that orthopaedic devices are more likely to be cleared through the 510(k) process and thus are more susceptible to being recalled. METHODS: Using the FDA's public database, we searched for the following: PMA and 510(k) clearances for orthopaedics and non-orthopaedic specialties, including General & Plastic Surgery, Gastroenterology/Urology, Obstetrics/Gynecology, and Ear Nose & Throat, from 1992 to 2012...
March 16, 2016: Journal of Bone and Joint Surgery. American Volume
Jerry Godfrey Makama, Ibrahim Mohammed Okeme, Elizabeth Jerry Makama, Emmanuel Adoyi Ameh
BACKGROUND: The risk of exposure of either the patient or the surgeon to communicable disease when the surgical glove is perforated is important. Both patients and the surgical team need to be protected from this risk. Therefore, we intended to determine the efficacy of double gloving in our center. METHODS: This was a prospective cohort study, involving (randomly selected) surgeons, who wore single or double latex surgical gloves during procedures. Gloves were collected and evaluated for perforations (using air insufflation and water leak methods)...
August 2016: Surgical Infections
Natalia O Glebova, Michael Bronsert, Caitlin W Hicks, Mahmoud B Malas, Karl E Hammermeister, James H Black, Mark R Nehler, William G Henderson
OBJECTIVE: Administrative data show that among surgical patients, readmission rates are highest in vascular surgery. Herein we analyze the contribution of planned readmissions and patient comorbidities to high readmission rates in vascular surgery. METHODS: The 2012 to 2014 American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data set was analyzed for overall and unplanned readmissions. Bivariable and multivariable risk adjustment analyses were performed using patient comorbidities to compare risks of overall and unplanned readmissions in vascular surgery compared with other specialties...
March 2016: Journal of Vascular Surgery
Anne M Stey, Charles D Vinocur, R Lawrence Moss, Bruce L Hall, Mark E Cohen, Kari Kraemer, Clifford Y Ko, Brian D Kenney
BACKGROUND: Intraoperative and postoperative red blood cell (RBC) transfusions are relatively frequent events tracked in the American College of Surgeons' National Surgical Quality Improvement Program-Pediatric (ACS-NSQIP-P). This study sought to quantify variation in RBC transfusion practices among hospitals. STUDY DESIGN AND METHODS: This is an observational study of children older than 28 days who underwent a general, neurologic, urologic, otolaryngologic, plastic, or orthopedic operation at 50 hospitals in participating in the ACS-NSQIP-P during 2011 to 2012...
March 2016: Transfusion
Amanda Chung, Henry Woo
BACKGROUND: Over recent years, Twitter has demonstrated an expanding role in scientific discussion, surgical news and conferences. This study evaluates the role of Twitter in urological conferences, with comparison to other surgical specialties. METHODS: A retrospective analysis of Twitter metrics during the two largest recent English-speaking conferences for each surgical specialty was performed. Using, all 'tweets' under the official conference hashtag from 0000 hour the first day to 24...
April 2016: ANZ Journal of Surgery
Xinli Li, Mark Wilson, William Nylander, Tracy Smith, Marilyn Lynn, William Gunnar
IMPORTANCE: This study analyzes and reports Clostridium difficile infection (CDI) rates, risk factors, and associations with postoperative outcomes in the Veterans Health Administration (VHA). OBJECTIVE: To report 30-day postoperative CDI rates and outcomes and identify associated risks by surgical procedures and preoperative patient demographics in a large integrated health care system. DESIGN, SETTING, AND PARTICIPANTS: In a retrospective observational study conducted from September 2014 to April 2015, the Veterans Affairs Surgical Quality Improvement Program database and the Decision Support System pharmacy database were linked to analyze the association of postoperative CDI with patients' demographics, preoperative comorbidities, operative characteristics, and preoperative medications...
April 2016: JAMA Surgery
Benedict F DiGiovanni, Leigh T Sundem, Richard D Southgate, David R Lambert
BACKGROUND: Musculoskeletal (MSK) conditions are common, and their burden on the healthcare system is increasing as the general population ages. It is essential that medical students be well prepared to evaluate and treat MSK disorders in a confident manner as they enter the workforce. Recent studies and the American Association of Medical Colleges have raised concern that medical schools may not give sufficient instruction on this topic. Other authors have shown that preclinical instruction has increased over the past decade; however, it is unclear if required clinical instruction also has followed that trend...
April 2016: Clinical Orthopaedics and related Research
Loretta B Chou, Lori B Lerner, Alex H S Harris, Ashley J Brandon, Sabine Girod, Lesley M Butler
BACKGROUND: Exposure to ionizing radiation from fluoroscopy performed during surgery, although low and within established limits, remains a health concern among surgeons. Estimates of breast cancer prevalence among women across surgery specialties with different patterns of fluoroscopy use are needed to evaluate this concern. METHODS: Female U.S. surgeons in urology, plastics, and orthopedics were identified using national directories and mailed surveys to collect information on occupational and medical history, including cancer diagnoses...
September 2015: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Yoshinori Nakata, Yuichi Watanabe, Hiroshi Otake, Toshihito Nakamura, Giichiro Oiso, Tomohiro Sawa
The goal of this study was to examine the current Japanese surgical payment system from the viewpoint of resource utilization. We collected data from surgical records in Teikyo University's electronic medical record system from April 1 through September 30, 2013. We defined the decision-making unit as a surgeon with the highest academic rank in the surgery. Inputs were defined as: 1) the number of medical doctors who assisted surgery and 2) the time of operation from skin incision to closure. An output was defined as the surgical fee...
2015: International Journal of Health Services: Planning, Administration, Evaluation
Dan Poenaru, Julia Pemberton, Brian H Cameron
BACKGROUND: Disability-adjusted life years (DALYs) have become the standard metric for estimating burden of disease (BoD), but have not yet been applied to delayed access to surgical procedures. This study estimates the DALYs accrued from delayed access to surgical care in two pediatric surgical units in Kenya and Canada. METHODS: Records of operations for 13 congenital health states in a Kenyan and a Canadian hospital were prospectively collected for 2012. DALYs caused by delayed presentation were estimated using disability weights and ideal and actual age at surgery...
May 2015: Journal of Pediatric Surgery
Shane Jensen, Matthew D Tadlock, Trent Douglas, Matthew Provencher, Romeo C Ignacio
OBJECTIVE: To describe how the US Navy integrates surgical resident training during hospital ship-based humanitarian activities and discuss the potential operative and educational benefits during these missions. DESIGN: Retrospective review of predeployment surgical plans, operative case logs, and after-action reports from United States Naval Ship (USNS) Mercy humanitarian deployments from 2006 to 2012. SETTING: The USNS Mercy hospital ship...
September 2015: Journal of Surgical Education
Imran Haruna Abdulkareem
The concept of surgical waiting time initiative (SWAT) was introduced in developed countries to reduce elective surgery waiting lists and increase efficiency of care. It was supplemented by increasing popularity of day surgery, which shortens elective waiting lists and minimises cancellations. It is established in Western countries, but not in developing countries like Nigeria where it is still evolving. A search was carried out in Pub Med, Google, African journals online (AJOL), Athens and Ovid for relevant publications on elective surgery waiting list in Nigeria, published in English language...
November 2014: Nigerian Medical Journal: Journal of the Nigeria Medical Association
Rashna F Ginwalla, Rudolph B Rustin
OBJECTIVE: "Global surgery" is becoming an increasingly popular concept not only for new trainees, but also for established surgeons. The need to provide surgical care in low-resource settings is laudable, but the American surgical training system currently does not impart the breadth of skills required to provide quality care. We propose one possible model for a surgical fellowship program that provides those trainees who desire to practice in these settings a comprehensive experience that encompasses not only broad technical skills but also the opportunity to engage in policy and programmatic development and implementation...
July 2015: Journal of Surgical Education
Tiffany E Chao, Pratik B Patel, Michael Kikubaire, Michelle Niescierenko, Lars Hagander, John G Meara
BACKGROUND: Situational needs of health care facilities inform the optimal allocation of resources and quality improvement efforts. This study examines surgical care delivery metrics at a tertiary care institution in Liberia. METHODS: We retrospectively reviewed operative and ward logbooks from January 1 to December 31, 2012. Data parameters included patients' age, diagnosis, procedure, mortality, and perioperative provider information. RESULTS: In 2012, 1,036 operations were performed...
September 2015: World Journal of Surgery
C Iavazzo, K Johnson, H Savage, S Gallagher, M Datta, B A Winter-Roach
BACKGROUND/AIM: According to recent studies up to 80% of patients would like to receive more information about how cancer treatments can affect their sexual functioning. Moreover, 75 % of them would not feel comfortable being the first to bring up the subject. Our Gynaecological Advice Clinic was established in 2006 at the Christie Hospital and offers support to cancer patients who face sexuality issues. A previous evaluation established that the service sees approximately, 200 patients per year...
March 2015: Archives of Gynecology and Obstetrics
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