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https://www.readbyqxmd.com/read/28216396/estimating-the-cost-of-neurosurgical-procedures-in-a-low-income-setting-an-observational-economic-analysis
#1
Jihad Abdelgadir, Tu Tran, Alex Muhindo, Doomwin Obiga, John Mukasa, Hussein Ssenyonjo, Michael Muhumza, Joel Kiryabwire, Michael M Haglund, Frank A Sloan
BACKGROUND: There are no data on cost of neurosurgery in low- and middle-income countries. This study's objective was to estimate the cost of neurosurgical procedures in a low-resource setting to better inform resource allocation and health sector planning. METHODS: In this observational economic analysis, micro-costing was used to estimate the direct and indirect costs of neurosurgical procedures at Mulago National Referral Hospital (Kampala, Uganda). RESULTS: During the study period, October 2014-September 2015, a total of 1,440 charts were reviewed...
February 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28188941/association-between-breast-reconstruction-surgery-and-quality-of-life-in-iranian-breast-cancer-patients
#2
Farnaz Sinaei, Kazem Zendehdel, Mahsa Adili, Atefeh Ardestani, Ali Montazeri, Mohammad Ali Mohagheghi
Breast reconstruction (BR) surgery is not common for the treatment of breast cancer in low- and middle-income countries, including Iran. We evaluated the quality of life (QoL) in Iranian breast cancer patients who underwent BR at the Cancer Institute of Iran. We compared patients who had BR with breast cancer patients who had a radical mastectomy as the control group, matched for age, and time since surgery. We interviewed the cases and controls and collected data about QoL using EORTC-Q30 and EORTC-Q23 questionnaires...
January 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28138364/practice-training-and-safety-of-laparoscopic-surgery-in-low-and-middle-income-countries
#3
REVIEW
Maryam Alfa-Wali, Samuel Osaghae
Surgical management of diseases is recognised as a major unmet need in low and middle-income countries (LMICs). Laparoscopic surgery has been present since the 1980s and offers the benefit of minimising the morbidity and potential mortality associated with laparotomies. Laparotomies are often carried out in LMICs for diagnosis and management, due to lack of radiological investigative and intervention options. The use of laparoscopy for diagnosis and treatment is globally variable, with high-income countries using laparoscopy routinely compared with LMICs...
January 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28138304/radiation-therapy-and-cancer-control-in-developing-countries-can-we-save-more-lives
#4
REVIEW
Rajamanickam Baskar, Koji Itahana
Globally, morbidity and mortality due to cancer are predicted to increase in both men and women in the coming decades. Furthermore, it is estimated that two thirds of these cancer-related deaths will occur in low-and middle-income countries (LMIC). In addition to morbidity and mortality, cancer also causes an enormous economic burden, especially in developing countries. There are several treatment and management options for cancer including chemotherapy, radiation therapy, surgery, and palliative care. Radiotherapy or radiation therapy (RT) can be an effective treatment, especially for localized or solid cancers; about half of cancer patients receive radiation as a curative or palliative treatment...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28105528/cost-effectiveness-in-global-surgery-pearls-pitfalls-and-a-checklist
#5
REVIEW
Mark G Shrime, Blake C Alkire, Caris Grimes, Tiffany E Chao, Dan Poenaru, Stéphane Verguet
INTRODUCTION: Cost-effectiveness analysis can be a powerful policy-making tool. In the two decades since the first cost-effectiveness analyses in global surgery, the methodology has established the cost-effectiveness of many types of surgery in low- and middle-income countries (LMICs). However, with the crescendo of cost-effectiveness analyses in global surgery has come vast disparities in methodology, with only 15% of studies adhering to published guidelines. This has led to results that have varied up to 150-fold...
January 19, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28097413/when-surgical-resources-are-severely-constrained-who-receives-care-determinants-of-access-to-orthopaedic-trauma-surgery-in-uganda
#6
Trina Stephens, Alexander Mezei, Nathan N O'Hara, Jeffrey Potter, Rodney Mugarura, Piotr A Blachut, Peter J O'Brien, Tito Beyeza, Gerard P Slobogean
BACKGROUND: In low- and middle-income countries, the volume of traumatic injuries requiring orthopaedic intervention routinely exceeds the capacity of available surgical resources. The objective of this study was to identify predictors of surgical care for lower extremity fracture patients at a high-demand, resource-limited public hospital in Uganda. METHODS: Skeletally mature patients admitted with the intention of definitive surgical treatment of an isolated tibia or femur fractures to the national referral hospital in Uganda were recruited to participate in this study...
January 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28007223/a-hidden-opportunity-within-surgery-in-low-and-middle-income-countries
#7
Allison Silverstein, Sristi Sharma, Swagoto Mukhopadhyay, Salim Afshar
No abstract text is available yet for this article.
December 2016: Healthcare
https://www.readbyqxmd.com/read/28002848/multidisciplinary-approach-to-neoadjuvant-endocrine-therapy-in-breast-cancer-a-comprehensive-review
#8
Tomás Reinert, Susana Ramalho, Rodrigo Gonçalves, Carlos Henrique Barrios, Marcia Silveira Graudenz, José Bines
Breast cancer is the most common type of cancer and the leading cause of cancer-related death among women worldwide. Hormone receptor-positive (HR+) tumors represent the most common form of this disease, with more than 70% of breast cancers expressing these receptors. Response and benefit to neoadjuvant chemotherapy (NCT) varies according to HR expression, with lower responses in luminal tumors as compared with hormone receptor-negative (HR-) and human epidermal growth factor receptor 2-positive (HER2+) tumors...
December 2016: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28002378/global-forum-spine-research-and-training-in-underserved-low-and-middle-income-culturally-unique-communities-the-world-spine-care-charity-research-program-s-challenges-and-facilitators
#9
O'Dane Brady, Margareta Nordin, Maria Hondras, Geoff Outerbridge, Deborah Kopansky-Giles, Pierre Côté, Sophia da Silva, Timothy Ford, Stefan Eberspaecher, Emre Acaroğlu, Tiro Mmopelwa, Eric L Hurwitz, Scott Haldeman
The World Spine Care (WSC), established by volunteers from 5 continents, is dedicated to providing sustainable, evidence-based spine care to individuals and communities in low and middle-income countries consistent with available health-care resources and integrated within the local culture. The research committee approves and oversees the WSC's collaborative research and training projects worldwide and serves to create a sustainable research community for underserved populations focused on preventing disability from spinal disorders...
December 21, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27986236/surgical-management-and-reconstruction-training-smart-course-for-international-orthopedic-surgeons
#10
Hao-Hua Wu, Kushal R Patel, Amber M Caldwell, R Richard Coughlin, Scott L Hansen, Joseph N Carey
BACKGROUND: The burden of complex orthopedic trauma in low- and middle-income countries (LMICs) is exacerbated by soft-tissue injuries, which can often lead to amputations. This study's purpose was to create and evaluate the Surgical Management and Reconstruction Training (SMART) course to help orthopedic surgeons from LMICs manage soft-tissue defects and reduce the rate of amputations. METHODS: In this prospective observational study, orthopedic surgeons from LMICs were recruited to attend a 2-day SMART course taught by plastic surgery faculty in San Francisco...
July 2016: Annals of Global Health
https://www.readbyqxmd.com/read/27986232/the-need-for-formal-surgical-global-health-programs-and-improved-mission-trip-coordination
#11
Sar Medoff, Jeffrey Freed
BACKGROUND: There is a dire need for more surgical services as part of improving global health. Conditions treatable with surgery account for 11% of the global burden of disease, with a disproportionate burden affecting low- and middle-income countries (LMICs). Less than 6% of the world's operations are performed in LMICs, with relief organizations performing nearly 250,000 operations annually in LMICs in addition to each country's domestic surgical capacity. Currently, surgical needs are not adequately met by the existing patchwork of federal and nongovernmental organizations' surgical services and surgical mission trips...
July 2016: Annals of Global Health
https://www.readbyqxmd.com/read/27986230/barriers-to-global-health-training-in-obstetrics-and-gynecology
#12
Rachel Pope, Maria Shaker, Prakash Ganesh, Margaret Larkins-Pettigrew, Stephanie Deter Pickett
BACKGROUND: The Lancet Commission on Global Surgery includes obstetrics and gynecology as an area needing international strengthening in low- and middle-income countries. Despite interest, a majority of participants in US residency programs graduate with little exposure to global health or preparation to work abroad. OBJECTIVE: The aim of this study was to determine the level of interest of obstetrics and gynecology (Ob/Gyn) residents in gaining global health training and to identify perceived barriers to receiving training...
July 2016: Annals of Global Health
https://www.readbyqxmd.com/read/27986227/global-surgical-ecosystems-a-need-for-systems-strengthening
#13
Catherine R deVries, Jenna S Rosenberg
BACKGROUND: As surgery is gaining recognition as a critical component of universal health care worldwide, surgical communities have come together with unprecedented unity to advocate for systems to support surgical care. This community has long believed that much care could be performed in a cost-effective manner even in low resource settings, despite skepticism voiced by many in public health. To do so will require the development of new systems and re-vamping of old systems that are not effective...
July 2016: Annals of Global Health
https://www.readbyqxmd.com/read/27979787/worrisome-high-frequency-of-extended-spectrum-beta-lactamase-producing-escherichia-coli-in-community-acquired-urinary-tract-infections-a-case-control-study
#14
Franco Castillo-Tokumori, Claudia Irey-Salgado, Germán Málaga
OBJECTIVES: There has been a sustained and dramatic increase in community-acquired urinary tract infections (CA-UTI) caused by extended-spectrum beta-lactamase (ESBL)-producing bacteria over recent years. Despite this, no studies have been performed in low- or middle-income countries. The main objective of this case-control study was to describe ESBL CA-UTI and its risk factors. METHODS: Outpatients with CA-UTI seen at the Hospital Cayetano Heredia during 2015 were identified...
December 12, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27978578/cost-and-expected-visual-effect-of-interventions-to-improve-follow-up-after-cataract-surgery-prospective-review-of-early-cataract-outcomes-and-grading-precog-study
#15
Mirjam E Meltzer, Nathan Congdon, Steven M Kymes, Xixi Yan, Van C Lansingh, Alemayehu Sisay, Andreas Müller, Ving Fai Chan, Ling Jin, Sasipriya M Karumanchi, Chunhong Guan, Quy Vuong, Nelson Rivera, Joan McCleod-Omawale, Mingguang He
Importance: Some experts recommend increasing low rates of follow-up after cataract surgery in low- and middle-income countries using various interventions. However, little is known about the cost and effect of such interventions. Objective: To examine whether promoting follow-up after cataract surgery creates economic value. Design, Setting, and Participants: The Prospective Review of Early Cataract Outcomes and Grading (PRECOG) is a cohort study with data from patients undergoing cataract surgery from January 19, 2010, to April 18, 2012...
December 15, 2016: JAMA Ophthalmology
https://www.readbyqxmd.com/read/27918334/challenges-of-anesthesia-in-low-and-middle-income-countries-a-cross-sectional-survey-of-access-to-safe-obstetric-anesthesia-in-east-africa
#16
Isabella Epiu, Jossy Verel Bahe Tindimwebwa, Cephas Mijumbi, Thomas M Chokwe, Edwin Lugazia, Francois Ndarugirire, Theogene Twagirumugabe, Gerald Dubowitz
BACKGROUND: The United Nations 2015 Millennium Development Goals targeted a 75% reduction in maternal mortality. However, in spite of this goal, the number of maternal deaths per 100,000 live births remains unacceptably high across Sub-Saharan Africa. Because many of these deaths could likely be averted with access to safe surgery, including cesarean delivery, we set out to assess the capacity to provide safe anesthetic care for mothers in the main referral hospitals in East Africa. METHODS: A cross-sectional survey was conducted at 5 main referral hospitals in East Africa: Uganda, Kenya, Tanzania, Rwanda, and Burundi...
January 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27905020/laparoscopic-versus-open-cholecystectomy-a-cost-effectiveness-analysis-at-rwanda-military-hospital
#17
Allison Silverstein, Ainhoa Costas-Chavarri, Mussa R Gakwaya, Joseph Lule, Swagoto Mukhopadhyay, John G Meara, Mark G Shrime
BACKGROUND: Laparoscopic cholecystectomy is first-line treatment for uncomplicated gallstone disease in high-income countries due to benefits such as shorter hospital stays, reduced morbidity, more rapid return to work, and lower mortality as well-being considered cost-effective. However, there persists a lack of uptake in low- and middle-income countries. Thus, there is a need to evaluate laparoscopic cholecystectomy in comparison with an open approach in these settings. METHODS: A cost-effectiveness analysis was performed to evaluate laparoscopic and open cholecystectomies at Rwanda Military Hospital (RMH), a tertiary care referral hospital in Rwanda...
November 30, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27904844/cardiothoracic-surgical-experience-in-ghana
#18
REVIEW
Mark Tettey, Martin Tamatey, Frank Edwin
Ghana is one of the few low-to-middle-income countries in sub-Saharan Africa able to consistently sustain a cardiothoracic program with locally trained staff for more than two decades. Cardiothoracic surgery practice in Ghana started in 1964 but faltered from a combination of political and the economic problems. In 1989, Dr. Kwabena Frimpong-Boateng, a Ghanaian cardiothoracic surgeon trained in Hannover, rekindled interest in cardiothoracic surgery and in establishing a National Cardiothoracic Centre. His vision and leadership has brought cardiothoracic surgery practice in Ghana to its current high level...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27893012/surgeons-and-trauma-care-physicians-perception-of-the-impact-of-the-globalization-of-medical-education-on-quality-of-care-in-lima-peru
#19
Lacey N LaGrone, Leah N Isquith-Dicker, Eduardo Huaman Egoavil, Manuel J A Rodriguez Castro, Alfredo Allagual, Fernando Revoredo, Charles N Mock
Importance: The globalization of medical education-the process by which trainees in any region gain access to international training (electronic or in-person)-is a growing trend. More data are needed to inform next steps in the responsible stewardship of this process, from the perspective of trainees and institutions at all income levels, and for use by national and international policymakers. Objective: To describe the impact of the globalization of medical education on surgical care in Peru from the perspective of Peruvian surgeons who received international training...
November 23, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27890315/global-surgery-a-view-from-the-south
#20
Nobhojit Roy
: This article is based on the Hugh Greenwood Lecture delivered at the 2016 Congress of the British Association of Paediatric Surgeons. It presents the view of the global surgery movement from the bottom of the surgical food chain and proposes what HICs (high-income countries) can do for global surgery in a coordinated fashion. From the LMIC (low- and middle-income countries) surgeon perspective, global surgery is transitioning from the charity-based surgery model to codevelopment with multiple stakeholders...
February 2017: Journal of Pediatric Surgery
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