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African surgery

Olivier Barbier, Maelle Racle
Introduction: The current evolution of surgical practices is increasingly trending toward hyper-specialization. For military surgeons, their practice in France does not differ from their civilian counterparts. In contrast, in external operations, they have to deal with specific war injuries in austere conditions. They are also required to take care of local populations. Therefore, specific training is necessary, and the French Military Health Service Academy (Ecole du Val-de-Grâce) Paris has set up a specific training called Advanced Course for Deployment Surgery (ACDS) in 2007...
March 14, 2018: Military Medicine
Cary L Klemmer, Sean Arayasirikul, Henry F Raymond
Psychological processes may mediate the relationship between minority stress and mental health though limited data exist showing this pathway among trans women. Trans women's degree of satisfaction with their body is associated with mental health outcomes. This study used a model of minority stress to explore for indirect effects on the association between transphobia-based victimization and anxiety and depression through one's degree of body satisfaction. Analysis also explored for racial differences. Transgender women ( N = 233) were recruited in 2013 using respondent-driven sampling...
March 1, 2018: Journal of Interpersonal Violence
Michael A Mahr, David O Hodge, Jay C Erie
PURPOSE: To determine racial/ethnic differences in rates of complex cataract surgery among United States Medicare beneficiaries. SETTING: Departments of Ophthalmology and Health Science Research, Mayo Clinic, Rochester, Minnesota, USA. DESIGN: Retrospective case series. METHODS: The U.S. Medicare 5% Limited Data Set, representing a 5% sample of over 28 million fee-for-service Medicare beneficiaries predominantly aged 65 years and older, were analyzed for rates of complex cataract surgery (Current Procedural Terminology [CPT] code 66982) among all beneficiaries who had cataract surgery (CPT codes 66982, 66984), stratified by race/ethnicity between January 1, 2014, and December 31, 2014...
March 7, 2018: Journal of Cataract and Refractive Surgery
Julius C Mwita, Sajini Souda, Mgaywa Gmd Magafu, Amos Massele, Brian Godman, Michael Mwandri
OBJECTIVES: Antibiotic prophylaxis in surgery is known to reduce the rate of surgical site infections (SSI) as well as shorten hospital stay. However, there is currently a scarcity of data on antibiotic prophylaxis and SSIs among African countries including Botswana. Consequently, this study aimed to address this. METHODS: A prospective study involving 400 patients was carried out at a leading tertiary hospital in Botswana from 2014-2015. Patients' demographic information, type of surgery performed and peri-operative use of antibiotics were documented...
March 9, 2018: Hospital Practice (Minneapolis)
Keila M Maher, Kwadwo Owusu-Akyaw, Jingzhu Zhou, Mary Cooter, Allison K Ross, Robert K Lark, Brad M Taicher
INTRODUCTION: Surgical correction of pediatric scoliosis is associated with significant blood loss. Minimizing estimated blood loss and blood transfusion is beneficial as transfusions have been associated with increased morbidity, including risk of surgical site infections, longer hospitalizations, and increased cost. Although there is evidence that African-American or Black adults are more likely to require intraoperative blood transfusion compared with Caucasian or White adults, the reasons for this difference are unclear...
March 9, 2018: Paediatric Anaesthesia
Benedetta Allegranzi, Alexander M Aiken, Nejla Zeynep Kubilay, Peter Nthumba, Jack Barasa, Gabriel Okumu, Robert Mugarura, Alexander Elobu, Josephat Jombwe, Mayaba Maimbo, Joseph Musowoya, Angèle Gayet-Ageron, Sean M Berenholtz
BACKGROUND: Surgical site infections (SSIs) are the most frequent health-care-associated infections in developing countries. Specific prevention measures are highly effective, but are often poorly implemented. We aimed to establish the effect of a multimodal intervention on SSIs in Africa. METHODS: We did a before-after cohort study, between July 1, 2013, and Dec 31, 2015, at five African hospitals. The multimodal intervention consisted of the implementation or strengthening of multiple SSI prevention measures, combined with an adaptive approach aimed at the improvement of teamwork and the safety climate...
March 5, 2018: Lancet Infectious Diseases
Faith Jelagat Lelei-Mailu, Charles Muriuki Mariara
This case report is of a 32-year-old woman of African descent on follow-up for pregnancy in the background of portal hypertension due to liver cirrhosis. She had initially been treated for chronic hepatitis B infection with lamivudine and tenofovir, complicated by portal hypertension and variceal bleeding that thrice required banding. Her pregnancy was uneventful until 31 weeks gestation when she presented with dyspnoea. On examination and investigation, she had oedema, bilateral pleural effusions and ascites...
March 5, 2018: BMJ Case Reports
Johannes J Fagan
Surgeons in sub-Saharan Africa face different challenges than those in developed countries: extreme shortages of otolaryngologists, speech pathologists, and audiologists; lack of training opportunities; and a paucity of otolaryngology services aggravated by population growth and aging. In addition to common Western diseases, patients have otolaryngology complications related to the human immunodeficiency virus, tuberculosis, malaria, and trauma. Less than 5% of the population has access to timely, safe, affordable surgery; 29 out of 52 African countries have no radiotherapy services...
February 27, 2018: Otolaryngologic Clinics of North America
Blake S Raggio, Blair M Barton, Emad Kandil, Paul L Friedlander
Importance: No evidence exists to direct the management of preoperative aspirin (acetylsalicylic acid) use in patients undergoing thyroid surgery. Nevertheless, a considerable number of patients interrupt receiving aspirin therapy during the preoperative period to minimize bleeding complications despite the increased risk of experiencing major adverse cardiac events. Objective: To determine whether aspirin therapy continued preoperatively increases bleeding complications in patients undergoing thyroid surgery...
March 1, 2018: JAMA Otolaryngology—Head & Neck Surgery
Arif Hussain, Candice Yong, Katherine H R Tkaczuk, Yi Qian, Jorge Arellano, C Daniel Mullins, Eberechukwu Onukwugha
OBJECTIVE: Real-world data regarding patient factors associated with the occurrence of spinal cord compression (SCC) or pathological fracture (PF), or need for bone surgery (BS), or use of radiation therapy (RAD) (i.e. skeletal complications and radiation therapy; SCRT) are limited for women with metastatic breast cancer (BCa). Given the substantial clinical and economic burden of these events in advanced BCa, we conducted the present study to understand the prevalence and identify the risk factors associated with these events among elderly women presenting with de novo metastatic BCa...
2018: PloS One
Eric Sven Kroeber, Assefa Mathewos, Tigeneh Wondemagegnehu, Abreha Aynalem, Tufa Gemechu, Swantje Piszczan, Genebo Timotewos, Adamu Addissie, Andreas Wienke, Susanne Unverzagt, Christoph Thomssen, Ahmedin Jemal, Eva Johanna Kantelhardt
Vulvar cancer (VC) is strongly associated with human papilloma virus (HPV) infections and immunosuppression (e.g., HIV). However, there is limited information on VC patient characteristics and survival in parts of sub-Saharan Africa, including Ethiopia, where chronic HPV and HIV infections are prevalent. The aim of this study is to provide a first view on VC patient characteristics in a sub-Saharan African setting.We present a retrospective analysis of records of 86 VC patients diagnosed between January 2010 and October 2015 at Addis Ababa University Hospital and other major health facilities in Ethiopia...
March 2018: Medicine (Baltimore)
Tatjana Ramich, Anne Asendorf, Katrin Nickles, Gerhard M Oremek, Ralf Schubert, Luigi Nibali, Martin Wohlfeil, Peter Eickholz
AIM: The aim of the study is to assess the long-term effect of active periodontal therapy on serum inflammatory parameters in patients with aggressive (AgP) and chronic (ChP) periodontitis in a non-randomised clinical study. METHODS: Twenty-five ChP and 17 AgP were examined clinically prior to (baseline), 12 weeks and 60 months after subgingival debridement of all pockets within 2 days. Systemic antibiotics were prescribed if Aggregatibacter actinomycetemcomitans was detected (10 AgP, 8 ChP), flap surgery was rendered if required...
February 27, 2018: Clinical Oral Investigations
A Benjamin Srivastava, Alex T Ramsey, Leslie D McIntosh, Thomas C Bailey, Sherri L Fisher, Louis Fox, Mario Castro, Yinjiao Ma, Timothy B Baker, Li-Shiun Chen, Laura J Bierut
Introduction: Effective smoking cessation medications are readily available but may be underutilized in hospital settings. In our large, tertiary care hospital, we aimed to: 1) characterize patient tobacco use prevalence across medical specialties, 2) determine smoking cessation pharmacotherapy prescription variation across specialties, and 3) identify opportunities for improvement in practice. Methods: Using electronic health records at Barnes Jewish Hospital (BJH), we gathered demographic data, admitting service, admission route, length of stay, self-reported tobacco use, and smoking cessation prescriptions over a 6-year period, from 2010 to 2016...
February 22, 2018: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
Mia-Michaela Beetge, Vladimir S Todorovic, Anna Oettlé, Jakobus Hoffman, Andre W van Zyl
The greater palatine foramen (GPF) is an important anatomical landmark and has substantial clinical relevance in dental surgery. Knowledge of its precise location and dimensions is required for proper planning of surgical procedures involving the posterior maxilla. We used microfocus computed tomography to determine the location and dimensions of the GPF, and any sex and race variations in those measurements, in 77 human skulls scanned at the South African Nuclear Energy Corporation. Specialized software was used for three-dimensional rendering, segmentation, and visualization of the reconstructed volume data...
February 26, 2018: Journal of Oral Science
Suresh Subramanian, K V Vimalnath, Ashutosh Dash
Hepatocellular carcinoma (HCC) or liver cancer is an increasingly prevalent and highly morbid disease with critical significance in the Asian and African sub-continents. Among the various therapies currently employed in the clinic to combat the global menace of HCC, radio-embolization with suitable therapeutic isotopes is an effective targeted approach. In the Indian context, the significant cost and logistical disadvantage of imported radio-embolic formulations for HCC therapy make it essential to develop more feasible indigenous alternatives - using locally available radioisotopes and microspheric carriers - that can serve the nuclear medicine community...
February 20, 2018: Journal of Labelled Compounds & Radiopharmaceuticals
Michael Held, Sophie Castelein, Marie-Fien Bruins, Maritz Laubscher, Robert Dunn, Marius Keel, Sufian Ahmad, Sven Hoppe
Study Design: Bibliometric review of the literature. Objective: This bibliometric analysis aims to give an overview of the most influential academic literature written on spinal tuberculosis. Methods: All databases included in the Thomson Reuters Web of Knowledge were searched for the most influential publications in spinal tuberculosis. The most cited articles published between 1950 and 2015, with the main focus on orthopedic surgery, were identified using a multistep approach, and a total of 100 articles were included...
February 2018: Global Spine Journal
Nabil Wasif, David Etzioni, Elizabeth B Habermann, Amit Mathur, Barbara A Pockaj, Richard J Gray, Yu-Hui Chang
BACKGROUND: Although major cancer surgery at a high-volume hospital is associated with lower postoperative mortality, the use of such hospitals may not be equally distributed. OBJECTIVE: Our aim was to study socioeconomic and racial differences in cancer surgery at Commission on Cancer (CoC)-accredited high-volume hospitals. METHODS: The National Cancer Database (NCDB) was used to identify patients undergoing surgery for colon, esophageal, liver, and pancreatic cancer from 2003 to 2012...
February 15, 2018: Annals of Surgical Oncology
Olusola Olawoye, Tarela Sarimiye, Adeyinka Ashaye, Young Hoon Hwang, Jong Chul Han, Byung Heon Ahn
Purpose: The aim of this study was to report the safety and efficacy of the membrane-tube (MT)-type glaucoma shunt device (Finetube MT) in the management of refractory glaucoma in indigenous West Africans. Methods: The Finetube MT was implanted into 25 eyes of 25 West African patients with refractory glaucoma. These patients had inadequate intraocular pressure (IOP) control despite maximum tolerable IOP-lowering medications with or without previous ocular surgeries...
2018: Clinical Ophthalmology
Tomi F Akinyemiju, Gurudatta Naik, Kemi Ogunsina, Daniel T Dibaba, Neomi Vin-Raviv
BACKGROUND: This study examines whether racial disparities in hospitalization outcomes persist between African-American and White women with ovarian cancer after matching on demographic, presentation, and treatment factors. METHODS: Using data from the Nationwide Inpatient Sample database, 5,164 African-American ovarian cancer patients were sequentially matched with White patients on demographic (e.g., age, income), presentation (e.g., stage, comorbidities), and treatment (e...
February 10, 2018: Cancer Causes & Control: CCC
Andrew J Schoenfeld, Daniel J Sturgeon, Justin B Dimick, Christopher M Bono, Justin A Blucher, Lauren B Barton, Joel S Weissman, Adil H Haider
OBJECTIVE: To assess the effect of Accountable Care Organizations (ACOs) on the use of surgical services among racial and ethnic minorities. BACKGROUND: Health reform efforts were expected to reduce healthcare disparities. The impact of ACOs on existing disparities in access to surgical care remains unknown. METHODS: We used national Medicare data (2009-2014) to compare rates of surgery among white, African American, Hispanic, and Asian Medicare beneficiaries for coronary artery bypass grafting, colectomy, total hip arthroplasty, hip fracture repair, and lumbar spine surgery...
February 7, 2018: Annals of Surgery
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