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Surgical inequality

Hamlet A Peterson, William J Shaughnessy, Anthony A Stans
Premature partial physeal arrest without the formation of an osseous bar - physeal bar equivalent (PBE) - is uncommon. Four children with a PBE had an infection near the distal femoral physis before the age of 11 months. Some growth was achieved after resection of the PBE in each case. Of two cases diagnosed and treated early, one required only contralateral physeal arrests to achieve limb-length equality at maturity. The other, currently 8 years and 4 months old, has a 1.1-cm limb-length discrepancy 6 years after PBE resection and will require observation until maturity...
September 29, 2016: Journal of Pediatric Orthopedics. Part B
P Niclas Broer, Hillary E Jenny, Joshua S Ng-Kamstra, Sabrina Juran
In September 2015, the international community came together to agree on the 2030 Agenda for Sustainable Development, a plan of action for people, the planet, and prosperity. Ambitious and far-reaching as they are, they are built on three keystones: the elimination of extreme poverty, fighting climate change, and a commitment to fighting injustice and inequality. Critical to the achievement of the Agenda is the global realization of access to safe, affordable surgical and anesthesia care when needed. The landmark report by the Lancet Commission on Global Surgery estimated that between 28 and 32 percent of the global burden of disease is amenable to surgical treatment...
May 2016: World Journal of Plastic Surgery
Marina R Makarov, Samuel H Dunn, Dustin E Singer, Karl E Rathjen, Brandon A Ramo, Chukwudi K Chukwunyerenwa, John G Birch
BACKGROUND: Epiphysiodesis is well-established surgical treatment for the management of leg length discrepancy (LLD) in children; however, a variety of complications may occur. This study evaluates the nature, rate, and potential risk factors of complications associated with epiphysiodesis in a large patient population treated in 1 institution. METHODS: We evaluated the medical and radiographic records of 863 children who had lower extremity epiphysiodesis to manage LLD between 1980 and 2011...
August 19, 2016: Journal of Pediatric Orthopedics
Matthew Beard, Joseph F Orlando, Saravana Kumar
INTRODUCTION: There is consistent evidence to indicate people living in rural and remote regions have limited access to healthcare and poorer health outcomes. One way to address this inequity is through innovative models of care such as telehealth. The aim of this pilot trial was to determine the feasibility, appropriateness and access to a telehealth clinic. In this pilot trial, the telehealth clinic outcomes are compared with the outreach clinic. Both models of care are commonly utilised means of providing healthcare to meet the needs of people living in rural and remote regions...
August 17, 2016: Journal of Telemedicine and Telecare
Peter D Baade, Paramita Dasgupta, Philippa H Youl, Christopher Pyke, Joanne F Aitken
The uptake of breast conserving surgery (BCS) for early stage breast cancer varies by where women live. We investigate whether these geographical patterns have changed over time using population-based data linkage between cancer registry records and hospital inpatient episodes. The study cohort consisted of 11,631 women aged 20 years and over diagnosed with a single primary invasive localised breast cancer between 1997 and 2011 in Queensland, Australia who underwent either BCS (n = 9223, 79%) or mastectomy (n = 2408, 21%)...
2016: International Journal of Environmental Research and Public Health
S Clough, Z Shehabi, C Morgan
Background There remains significant inequality in health and healthcare in people with learning disabilities (LD). A lack of coordination and the episodic nature of care provision are contributory factors. Recognising the need to improve outcomes for this group, we evaluate a multi-disciplinary team (MDT) approach to care whereby additional medical procedures are carried out under the same episode of general anaesthesia (GA) as dental treatment for people with severe LD. This is the first published evaluation of its kind in the UK...
May 27, 2016: British Dental Journal
Ruoran Li, Rhian Daniel, Bernard Rachet
Substantial socioeconomic inequalities in breast cancer survival persist in England, possibly due to more advanced cancer at diagnosis and differential access to treatment. We aim to disentangle the contributions of differential stage at diagnosis and differential treatment to the socioeconomic inequalities in cancer survival. Information on 36,793 women diagnosed with breast cancer during 2000-2007 was routinely collected by an English population-based cancer registry. Deprivation was determined for each patient according to her area of residence at the time of diagnosis...
June 2016: European Journal of Epidemiology
Mohammed M Ahmed, Thomas J Otto, Berton R Moed
BACKGROUND: Limited-incision total hip arthroplasty (THA) preserves hip abductors, posterior capsule, and external rotators potentially diminishing dislocation risk. However, potential complications also exist, such as component malposition. Specific implants have been manufactured that enhance compatibility with this technique, while preserving metaphyseal bone; however, little data exists documenting early complications and component position. The purpose was to evaluate primary THA using a curved, bone-sparing stem inserted through the anterior approach with respect to component alignment and early complications...
2016: Journal of Orthopaedic Surgery and Research
Bruce Rosen, Ruth Waitzberg, Sherry Merkur
Israel is a small country, with just over 8 million citizens and a modern market-based economy with a comparable level of gross domestic product per capita to the average in the European Union. It has had universal health coverage since the introduction of a progressively financed statutory health insurance system in 1995. All citizens can choose from among four competing, non-profit-making health plans, which are charged with providing a broad package of benefits stipulated by the government. Overall, the Israeli health care system is quite efficient...
2015: Health Systems in Transition
Yao Cyril Kudjawu, Gilles Chatellier, Elsa Decool, Florence de Maria, Nathalie Beltzer, Isabelle Grémy, Guy Meyer, Daniel Eilstein
BACKGROUND: Time-to-treatment of cancer is becoming a serious political and social issue. A greater understanding of the timeframes involved in cancer care is needed to reduce inequalities in access to care caused by delays. OBJECTIVE: To describe time delays in each phase of lung cancer treatment after bronchoscopy. METHOD: Using the international classification of diseases and medical procedures codes, from national hospital discharge database we selected patients newly diagnosed for Lung cancer in 2009-2010 who had undergone treatment...
May 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
A J Kuryba, N A Scott, J Hill, J H van der Meulen, K Walker
AIM: The rate of ileostomy reversal was estimated in patients undergoing an elective anterior resection for rectal cancer and factors associated with reversal were identified. METHOD: The records of 4879 rectal patients who had an ileostomy created during anterior resection between 2009 and 2012 were identified in the National Bowel Cancer Audit database and linked to administrative records of the Hospital Episode Statistics. Patients were followed from surgery...
June 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Clare E Gilbert, Nathalie Lepvrier-Chomette
PURPOSE: Cataract is a common cause of avoidable blindness in children globally. Gender differences in service access among children are reported for several conditions, but not for surgery for bilateral cataract. In this review we compared the proportion of children undergoing surgery for bilateral, nontraumatic cataract who were girls, using data from high-income, gender-neutral countries as the reference. DESIGN: Systematic review. METHODS: A systematic review of MEDLINE was undertaken in November 2014...
June 2016: Ophthalmology
Frances M Doran, Julie Hornibrook
INTRODUCTION: Little is known about Australian rural women's overall experiences of accessing an abortion service and the barriers they encounter. Approximately one in three Australian women access an abortion at some time in their lives. Most abortions are undertaken during the first trimester of pregnancy in private clinics. Although both medical and surgical abortions are uncomplicated medical procedures, abortion remains a contentious area of women's health. Whilst it is clear that rural women experience disparities in relation to access to health care, there is a gap in the evidence on rural women's experiences of accessing an abortion...
January 2016: Rural and Remote Health
Adil H Haider, Irene Dankwa-Mullan, Allysha C Maragh-Bass, Maya Torain, Cheryl K Zogg, Elizabeth J Lilley, Lisa M Kodadek, Navin R Changoor, Peter Najjar, John A Rose, Henri R Ford, Ali Salim, Steven C Stain, Shahid Shafi, Beth Sutton, David Hoyt, Yvonne T Maddox, L D Britt
Health care disparities (differential access, care, and outcomes owing to factors such as race/ethnicity) are widely established. Compared with other groups, African American individuals have an increased mortality risk across multiple surgical procedures. Gender, sexual orientation, age, and geographic disparities are also well documented. Further research is needed to mitigate these inequities. To do so, the American College of Surgeons and the National Institutes of Health-National Institute of Minority Health and Disparities convened a research summit to develop a national surgical disparities research agenda and funding priorities...
June 1, 2016: JAMA Surgery
Cheryl K Zogg, Wei Jiang, Muhammad Ali Chaudhary, John W Scott, Adil A Shah, Stuart R Lipsitz, Joel S Weissman, Zara Cooper, Ali Salim, Stephanie L Nitzschke, Louis L Nguyen, Lorens A Helmchen, Linda Kimsey, Samuel T Olaiya, Peter A Learn, Adil H Haider
BACKGROUND: Racial disparities in surgical care are well described. As many minority patients are also uninsured, increasing access to care is thought to be a viable solution to mitigate inequities. The objectives of this study were to determine whether racial disparities in 30-/90-/180- day outcomes exist within a universally insured population of military-/civilian-dependent emergency general surgery (EGS) patients and ascertain whether differences in outcomes differentially persist in care received at military versus civilian hospitals and among sponsors who are enlisted service members versus officers...
May 2016: Journal of Trauma and Acute Care Surgery
A Aggarwal, J Nossiter, P Cathcart, J van der Meulen, J Rashbass, N Clarke, H Payne
AIMS: The National Prostate Cancer Audit (NPCA) started in April 2013 with the aim of assessing the process of care and its outcomes in men diagnosed with prostate cancer in England and Wales. One of the key aims of the audit was to assess the configuration and availability of specialist prostate cancer services in England. MATERIALS AND METHODS: In 2014, the NPCA undertook an organisational survey of all 143 acute National Health Service (NHS) Trusts and 48 specialist multidisciplinary team (MDT) hubs cross England...
August 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
Norma I Cruz, Fernando Rivera, Elvis Santiago
OBJECTIVE: To determine whether the number of women accepted to the University of Puerto Rico (UPR) general surgery residency program has increased in recent years. METHODS: We examined the gender distribution of residents accepted in their first postgraduate year (PGY-1) by the UPR Surgery Department from 1958 to 2014. This information was obtained from the database of graduate residents, which collects information on gender, medical school from which they graduated, the years in which they were in the residency program, and, their specialty...
March 2016: Puerto Rico Health Sciences Journal
Jonathan C Riboh, Annemarie K Tilton, Gregory L Cvetanovich, Kirk A Campbell, Brian J Cole
PURPOSE: To report the results of meniscal allograft transplantation (MAT) with minimum 2-year follow-up in an active adolescent population. METHODS: After institutional review board approval, all patients aged 16 years or younger who underwent MAT and had more than 2 years' clinical follow-up were identified from a prospectively collected database. Demographic data were collected and summary statistics calculated. Functional outcome scores were collected preoperatively and at 6 months, 1 year, 2 years, and final follow-up...
February 19, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Kae Okoshi, Kyoko Nomura, Fumiaki Taka, Kayo Fukami, Yasuko Tomizawa, Koichi Kinoshita, Ryuji Tominaga
BACKGROUND: In Japan, gender inequality between males and females in the medical profession still exists. We examined gender gaps in surgeons' incomes. METHODS: Among 8,316 surgeons who participated in a 2012 survey by the Japan Surgical Society, 546 women and 1,092 men within the same postgraduation year were selected randomly with a female-to-male sampling ratio of 1:2 (mean age, 36 years; mean time since graduation, 10.6 years). RESULTS: Average annual income was 9...
May 2016: Surgery
Yao Cyril Kudjawu, Daniel Eilstein, Elsa Decool, Florence De Maria, Nathalie Beltzer, Gilles Chatellier
BACKGROUND: Time to treatment of cancer is becoming a serious political and social issue. A greater understanding of the timeframes involved in cancer care is needed to reduce inequalities in access to care caused by delays. OBJECTIVE: To describe indicators of time to first treatment after colonoscopy in colon cancer (CC) and rectum cancer (RC) patients in France. METHOD: Using the international classification of diseases and medical procedures codes, from national hospital discharge and long term illness databases we selected patients newly diagnosed for CC or RC in 2009-2010 who had undergone treatment...
December 2015: Cancer Epidemiology
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