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Perioperative medecine

Miguel Trelles, Barclay T Stewart, Hamayoun Hemat, Masood Naseem, Sattar Zaheer, Mutallib Zakir, Edris Adel, Catherine Van Overloop, Adam L Kushner
BACKGROUND: On October 3, 2015, a United States airstrike hit Médecins Sans Frontières (Doctors Without Borders) Trauma Centre in Kunduz, Afghanistan. Our aim was to describe the care provided and estimate the health burden averted by surgical care at the hospital. We also report the benefit rendered by the Trauma Centre to the health of the local population prior to its destruction. METHODS: All operations performed in an operating theater at the Trauma Centre from its opening on August 30, 2011, to August 31, 2015, were described...
July 9, 2016: Surgery
Jessica F Davies, Annick Lenglet, Marten van Wijhe, Cono Ariti
BACKGROUND: The African continent has the greatest burden of surgical disability-adjusted life years, yet the least is known about operative care here. This analysis describes the surgical patients admitted to 7 hospitals supported by the Médécins Sans Frontières (MSF) over 3 years in 3 conflict-affected countries-Eastern Democratic Republic of Congo, Central African Republic, and South Sudan. METHODS: A standardized operative data collection tool was used for routine collection of operative inpatient data between 2011 and 2013 at 7 MSF surgical facilities...
May 2016: Surgery
Promise Ariyo, Miguel Trelles, Rahmatullah Helmand, Yama Amir, Ghulam Haidar Hassani, Julien Mftavyanka, Zenon Nzeyimana, Clemence Akemani, Innocent Bagura Ntawukiruwabo, Adelin Charles, Yanang Yana, Kalla Moussa, Mustafa Kamal, Mohamed Lamin Suma, Mowlid Ahmed, Mohamed Abdullahi, Evan G Wong, Adam Kushner, Asad Latif
BACKGROUND: Anesthesia is integral to improving surgical care in low-resource settings. Anesthesia providers who work in these areas should be familiar with the particularities associated with providing care in these settings, including the types and outcomes of commonly performed anesthetic procedures. METHODS: The authors conducted a retrospective analysis of anesthetic procedures performed at Médecins Sans Frontières facilities from July 2008 to June 2014. The authors collected data on patient demographics, procedural characteristics, and patient outcome...
March 2016: Anesthesiology
Davina Sharma, Kate Hayman, Barclay T Stewart, Lynette Dominguez, Miguel Trelles, Sanaulhaq Saqeb, Cheride Kasonga, Theophile Kubuya Hangi, Jerome Mupenda, Aamer Naseer, Evan Wong, Adam L Kushner
BACKGROUND: Surgical infections represent a substantial yet undefined burden of disease in low-income and middle-income countries (LMICs). Médecins Sans Frontières (MSF) provides surgical care in LMICs and collects data useful to describe the operative epidemiology of surgical need that would otherwise be unmet by national health services. We aimed to describe the experience of MSF Operations Centre Brussels surgery for infections during crisis; aid effective resource allocation; prepare humanitarian surgical staff; and further characterise unmet surgical needs in LMICs...
April 27, 2015: Lancet
Maeve O'Neill Trudeau, Emmanuel Baron, Patrick Hérard, Amy S Labar, Xavier Lassalle, Carrie Lee Teicher, David H Rothstein
IMPORTANCE: Little is known about the scope of practice and outcomes in pediatric surgery performed by humanitarian organizations in resource-poor settings and conflict zones. This study provides the largest report to date detailing such data for a major nongovernmental organization providing humanitarian surgical relief support in these settings. OBJECTIVE: To characterize pediatric surgical care provision by a major nongovernmental organization in specialized humanitarian settings and conflict zones...
November 2015: JAMA Surgery
Kathryn Chu, Rebecca Maine, Miguel Trelles
BACKGROUND: Surgical site infections (SSI) are a significant cause of post-surgical morbidity and mortality and can be an indicator of surgical quality. The objectives of this study were to measure post-operative SSI after cesarean section (CS) at four sites in three sub-Saharan African countries and to describe the associated risk factors in order to improved quality of care in low and middle income surgical programs. METHODS: This study included data from four emergency obstetric programs supported by Medecins sans Frontieres, from Burundi, the Democratic Republic of Congo (DRC), and Sierra Leone...
February 2015: World Journal of Surgery
Frederick M Burkle, Jason W Nickerson, Johan von Schreeb, Anthony D Redmond, Kelly A McQueen, Ian Norton, Nobhojit Roy
Following large-scale disasters and major complex emergencies, especially in resource-poor settings, emergency surgery is practiced by Foreign Medical Teams (FMTs) sent by governmental and non-governmental organizations (NGOs). These surgical experiences have not yielded an appropriate standardized collection of data and reporting to meet standards required by national authorities, the World Health Organization, and the Inter-Agency Standing Committee's Global Health Cluster. Utilizing the 2011 International Data Collection guidelines for surgery initiated by Médecins Sans Frontières, the authors of this paper developed an individual patient-centric form and an International Standard Reporting Template for Surgical Care to record data for victims of a disaster as well as the co-existing burden of surgical disease within the affected community...
December 2012: Prehospital and Disaster Medicine
(no author information available yet)
Around 50,000 cardiac arrests (CA) occur each year in France and survival remains as low as 3 to 5%. Cardiopulmonary resuscitation (CPR) includes several treatment techniques for CA that are regularly updated in French, European, and international guidelines. Extracorporeal life support (ECLS) has been suggested as a therapeutic option in refractory CA since 1976. However, the use of this technique has remained limited to hypothermic CA and to CA occurring during the perioperative period of cardiothoracic surgery, mainly because the results of the initial trials were deceptive...
February 2009: Annales Françaises D'anesthèsie et de Rèanimation
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