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Effect of specialization on surgery Quality

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https://www.readbyqxmd.com/read/29115962/bridging-the-human-resource-gap-in-surgical-and-anesthesia-care-in-low-resource-countries-a-review-of-the-task-sharing-literature
#1
REVIEW
Tigistu Ashengo, Alena Skeels, Elizabeth J H Hurwitz, Eric Thuo, Harshad Sanghvi
Task sharing, the involvement of non-specialists (non-physician clinicians or non-specialist physicians) in performing tasks originally reserved for surgeons and anesthesiologists, can be a potent strategy in bridging the vast human resource gap in surgery and anesthesia and bringing needed surgical care to the district level especially in low-resource countries. Although a common practice, the idea of assigning advanced tasks to less-specialized workers remains a subject of controversy. In order to optimize its benefits, it is helpful to understand the current task sharing landscape, its challenges, and its promise...
November 7, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28981957/the-role-of-high-frequency-oscillations-in-epilepsy-surgery-planning
#2
REVIEW
David Gloss, Sarah J Nevitt, Richard Staba
BACKGROUND: Epilepsy is a serious brain disorder characterized by recurrent unprovoked seizures. Approximately two-thirds of seizures can be controlled with antiepileptic medications (Kwan 2000). For some of the others, surgery can completely eliminate or significantly reduce the occurrence of disabling seizures. Localization of epileptogenic areas for resective surgery is far from perfect, and new tools are being investigated to more accurately localize the epileptogenic zone (the zone of the brain where the seizures begin) and improve the likelihood of freedom from postsurgical seizures...
October 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28953522/use-of-fat-grafts-in-facial-reconstruction-on-the-wounded-soldiers-from-the-first-world-war-wwi-by-hippolyte-morestin-1869-1919
#3
Nadia Benmoussa, Kevin Hansen, Philippe Charlier
INTRODUCTION: During the Great War of 1914 to 1918, spectacular progress was made in the field of facial reconstruction. The sheer number and severity of facial lesions inflicted during the fighting obliged French and German surgeons to take a close interest in the treatment of patients wounded in such a manner. As head surgeon of the fifth division "blessés de la face" at the hospital of Val-de-Grace, Hippolyte Morestin was responsible for one of the largest surgical departments specializing in facial surgery and reconstruction during the war...
November 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28902026/chemical-peels-indications-and-special-considerations-for-the-male-patient
#4
REVIEW
Jeave Reserva, Amanda Champlain, Seaver L Soon, Rebecca Tung
BACKGROUND: Chemical peels are a mainstay of aesthetic medicine and an increasingly popular cosmetic procedure performed in men. OBJECTIVE: To review the indications for chemical peels with an emphasis on performing this procedure in male patients. MATERIALS AND METHODS: Review of the English PubMed/MEDLINE literature and specialty texts in cosmetic dermatology, oculoplastic, and facial aesthetic surgery regarding sex-specific use of chemical peels in men...
November 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28845050/preservation-of-fertility-or-ovarian-function-in-patients-with-breast-cancer-or-gynecologic-and-internal-malignancies
#5
Angrit Stachs, Steffi Hartmann, Bernd Gerber
Because of the efficacy of systemic therapies, neoplasias which occur in pediatric and adolescent patients and in young adults have high cure rates. This means that fulfilling their wish to have children has become a more pressing concern, particularly among young women with malignant tumors. Premature ovarian failure is also a not insignificant problem as it has a lasting detrimental effect on quality of life. Every oncology patient who may potentially wish to have children should be informed about their options for preserving fertility prior to starting treatment...
August 2017: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/28757835/pain-relief-following-thoracic-surgical-procedures-a-literature-review-of-the-uncommon-techniques
#6
REVIEW
Tariq Alzahrani
Thoracic surgical procedures can be either thoracotomy or thoracoscopy. In thoracotomy, the incision could be either muscle-cutting or muscle-sparing incision. The posterolateral thoracotomy incision is used for most general thoracic surgical procedures. This incision, which involves division of the latissimus dorsi and serratus anterior muscles, affords excellent exposure of the thoracic cavity. However, it is associated with significant morbidity, including impaired pulmonary function, postoperative chest pain, and restricted arm and shoulder movement...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28719707/community-triage-of-otology-patients-using-a-store-and-forward-telemedicine-device-a-feasibility-study
#7
Nishi Gupta, Neeraj Chawla, Digant Gupta, Nidhi Dhawan, Vidya R Janaki
Chronic otitis media is a major contributor to acquired hearing loss in developing countries. Developing countries such as India, with huge populations and poor health infrastructures, have always felt the shortage of trained specialists who can provide quality care to meet the enormous demand for treatment of this disease. This pilot study assessed the feasibility of empowering trained health workers equipped with ENTraview, a store-and-forward telemedicine device that integrates a camera- enabled smart phone with an otoscope...
July 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28718878/deep-brain-and-cortical-stimulation-for-epilepsy
#8
REVIEW
Mathieu Sprengers, Kristl Vonck, Evelien Carrette, Anthony G Marson, Paul Boon
BACKGROUND: Despite optimal medical treatment, including epilepsy surgery, many epilepsy patients have uncontrolled seizures. Since the 1970s interest has grown in invasive intracranial neurostimulation as a treatment for these patients. Intracranial stimulation includes both deep brain stimulation (DBS) (stimulation through depth electrodes) and cortical stimulation (subdural electrodes). This is an updated version of a previous Cochrane review published in 2014. OBJECTIVES: To assess the efficacy, safety and tolerability of DBS and cortical stimulation for refractory epilepsy based on randomized controlled trials (RCTs)...
July 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28708753/effectiveness-of-preoperative-intranasal-dexmedetomidine-compared-with-oral-midazolam-for-the-prevention-of-emergence-delirium-in-the-pediatric-patient-undergoing-general-anesthesia-a-systematic-review
#9
James FitzSimons, Laura S Bonanno, Stephanie Pierce, Jennifer Badeaux
BACKGROUND: Emergence delirium is defined as a cognitive disturbance during emergence from general anesthesia resulting in hallucinations, delusions and confusion manifested by agitation, restlessness, involuntary physical movement and extreme flailing in bed. Postoperative emergence delirium develops in 12% to 18% of all children undergoing general anesthesia for surgery. This post-anesthetic phenomenon changes cognitive and psychomotor behavior, and puts pediatric patients and health care personnel at risk of injury...
July 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28700011/how-does-practice-improve-the-skills-of-medical-students-during-consecutive-training-courses
#10
Erzsebet Vanyolos, Istvan Furka, Iren Miko, Aida Viszlai, Norbert Nemeth, Katalin Peto
Purpose: To follow-up the development of medical students in taking a stitch using two different bench models, and to assess their performance with regards to gender, handedness, prior recreational activities and interest in surgery. Methods: The study was performed during the compulsory basic (n=152) and the consecutive elective course (n=27). Students took simple interrupted stitches into synthetic and biopreprate models in the classroom and in the operating room...
June 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28662010/-the-impact-of-dynamic-platform-exercises-on-knee-joint-muscle-strength-in-patients-with-gonarthrosis-treated-with-microfracture-method
#11
Kamil Klupiński, Jakub Krochmalski, Marta Woldańska-Okońska
Osteoarthritis is the most common joint disease. Gonarthrosis is one of the most serious diseases the highly developed modern medicine must face. The number of patients suffering from joint pain and progressive disability is growing, especially in economically developed countries. Over the years, the disease has been considered merely as a symptom of aging and the effect of "wear and tear" of the cartilage. At present it is known that the degenerative joint disease is of chronic and progressive nature and its pathogenesis is complex...
June 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28657533/-the-ametrop%C3%A3-as-updated-review-for-non-ophthalmologists-physicians
#12
REVIEW
Virgilio Galvis, Alejandro Tello, Oscar Blanco, Andrea N Laiton, Marion R Dueñas, Priscila Alejandra Hidalgo
Refractive errors are caused by a decoupling of the power of convergence of the eye lens, the cornea and lens, which make the rays reaching the eye to focus and generate an image, and the retina, which is the biological photosensitive screen where the image will be transformed into a nerve impulse. These defects include myopia, hyperopia and astigmatism. Presbyopia can also be considered a refractive defect, but of special features, since only affects near vision in patients older than 40 years. By altering the quality of the focused image on the most sensitive area of the retina (the macula), they decrease visual acuity...
2017: Revista de la Facultad de Ciencias Médicas
https://www.readbyqxmd.com/read/28612105/-polytrauma-and-concomitant-traumatic-brain-injury-the-role-of-the-trauma-surgeon
#13
REVIEW
A Antoni, T Heinz, J Leitgeb
BACKGROUND: Concomitant traumatic brain injury (TBI) increases mortality and reduces quality of life of polytrauma patients. These facts demand effective treatment strategies while the growing specialization of medicine is questioning the role of the trauma surgeon in the management of these patients. OBJECTIVES: Which factors influence outcome of polytrauma with concomitant TBI? Who should be responsible for the management of these patients and what is the limit of management? MATERIALS AND METHODS: A literature search using Medline via PubMed was performed with Medical Subject Headings and text word search...
June 13, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28609794/-destruction-of-microsurgical-devices-by-sterilisation
#14
Raphaela Berto, Jürgen Strutz
Hospital facilities issue numerous risk announcements on corrosion, deformation or premature wearout of medical devices every year. As there is yet little data on the impact of reprocessing on the quality and durability of microsurgical instruments, this paper aims at evaluating the effects of the reprocessing on microsurgical instruments. Material and Methods 22 brand new microsurgical instruments for stapes surgery were being reprocessed 30 times without being used for surgery or other purposes in the interim time...
November 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28560229/is-there-a-rationale-for-structural-quality-assurance-in-esophageal-surgery
#15
REVIEW
Torben Glatz, Jens Höppner
BACKGROUND: Advances regarding perioperative mortality rates and oncological outcomes after esophagectomy have been reported extensively by specialized high-volume centers in Europe and the USA over the last decade. However, recent database analyses reveal that the perioperative mortality of esophagectomy remains high in these countries, indicating a discrepancy between surgical quality in baseline hospitals and specialized centers. METHODS: This article provides an overview over the existing literature on the correlation between structural quality, procedural volume, and surgical outcome in e- sophageal surgery...
May 2017: Visceral Medicine
https://www.readbyqxmd.com/read/28556124/uterine-adenomyosis-and-infertility-review-of-reproductive-outcome-after-in%C3%A2-vitro-fertilization-and-surgery
#16
REVIEW
Margit Dueholm
This review includes an analysis of the clinical studies evaluating reproductive outcome and adenomyosis, and a review of studies on reproductive outcome and surgical treatment options for adenomyosis. Strict diagnostic criteria and classification of disease are needed for an image diagnosis of adenomyosis. Studies of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) populations and women with surgically treated deep endometriosis have suggested that adenomyosis has a negative impact on reproductive outcome, although there are substantial variations between studies...
June 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28549765/improving-patient-centered-transitional-care-after-complex-abdominal-surgery
#17
Alexandra W Acher, Stephanie A Campbell-Flohr, Maria Brenny-Fitzpatrick, Kristine M Leahy-Gross, Sara Fernandes-Taylor, Alexander V Fisher, Suresh Agarwal, Amy J Kind, Caprice C Greenberg, Pascale Carayon, Sharon M Weber
BACKGROUND: Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. STUDY DESIGN: The intervention includes in-person enrollment of patients...
August 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28508384/endoscopic-management-of-benign-esophageal-ruptures-and-leaks
#18
REVIEW
Milena Di Leo, Roberta Maselli, Elisa Chiara Ferrara, Laura Poliani, Sameer Al Awadhi, Alessandro Repici
Esophageal leaks (EL) and ruptures (ER) are rare conditions associated with a high risk of mortality and morbidity. Historically, EL and ER have been surgically treated, but current treatment options also include conservative management and endoscopy. Over the last decades, interventional endoscopy has evolved as an effective and less invasive alternative to primary surgery in these cases. A variety of techniques are currently available to re-establish the continuity of the digestive tract, prevent or treat infection related to the leak/rupture, prevent further contamination, drain potential collections, and provide nutritional support...
June 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28405807/management-and-outcomes-of-acute-surgical-patients-at-a-district-hospital-in-uganda-with-non-physician-emergency-clinicians
#19
Caleb Dresser, Usha Periyanayagam, Brad Dreifuss, Robert Wangoda, Julius Luyimbaazi, Mark Bisanzo
INTRODUCTION: Acute surgical care services in rural Sub-Saharan Africa suffer from human resource and systemic constraints. Developing emergency care systems and task sharing aspects of acute surgical care addresses many of these issues. This paper investigates the degree to which specialized non-physicians practicing in a dedicated Emergency Department contribute to the effective and efficient management of acute surgical patients. METHODS: This is a retrospective review of an electronic quality assurance database of patients presenting to an Emergency Department in rural Uganda staffed by non-physician clinicians trained in emergency care...
September 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28383117/an-alternative-prosthetic-approach-for-rehabilitation-of-two-edentulous-maxillectomy-patients-clinical-report
#20
Murat Yenisey, Şafak Külünk, Necati Kaleli
Obturator prosthesis is a common treatment method for maxillectomy patients for maintaining their oronasal separation and resuming their social lives. After tumor resection, the remaining anatomical structures have a significant effect on prosthesis retention. The present study describes the rehabilitation of two maxillectomy patients after cancer surgery using a prosthesis consisting of a denture and a special retentive obturator that is positioned in the anatomical undercuts of the nasal cavity. These patients have undergone total and subtotal maxillectomy surgery after the diagnosis of squamous cell carcinoma...
April 6, 2017: Journal of Prosthodontics: Official Journal of the American College of Prosthodontists
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