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https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#1
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29322309/the-global-spine-care-initiative-a-summary-of-guidelines-on-invasive-interventions-for-the-management-of-persistent-and-disabling-spinal-pain-in-low-and-middle-income-communities
#2
REVIEW
Emre Acaroğlu, Margareta Nordin, Kristi Randhawa, Roger Chou, Pierre Côté, Tiro Mmopelwa, Scott Haldeman
PURPOSE: The purpose of this study was to synthesize recommendations on the use of common elective surgical and interventional procedures for individuals with persistent and disabling non-radicular/axial with or without myelopathy, radicular back pain, cervical myelopathy, symptomatic spinal stenosis, and fractures due to osteoporosis. This review was to inform a clinical care pathway on the patient presentations where surgical interventions could reasonably be considered. METHODS: We synthesized recommendations from six evidence-based clinical practice guidelines and one appropriate use criteria guidance for the surgical and interventional management of persistent and disabling spine pain...
January 10, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29290072/operations-for-suspected-neoplasms-in-a-resource-limited-setting-experience-and-challenges-in-the-eastern-democratic-of-congo
#3
Luc Malemo Kalisya, Jacques Fadhili Bake, Richard Bigabwa, David H Rothstein, Sarah B Cairo
INTRODUCTION: Surgery is an essential component of a functional health system, with surgical conditions accounting for nearly 11-15% of world disability. While communicable diseases continue to burden low- and low-middle-income countries, non-communicable diseases, such as cancer, are an important cause of morbidity and mortality worldwide. Preliminary data on malignancies in low- and middle-income countries, specifically in Africa, suggest a higher mortality compared to other regions of the world, a difference partially explained by limited availability of screening and early detection systems as well as poorer access to treatment...
December 31, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29261548/prospective-observational-study-of-intraoperative-anesthetic-events-in-district-hospitals-in-namibia
#4
Andrew J Ottaway, Leonard Kabongo
BACKGROUND: Access to safe surgery and anesthesia care is grossly inadequate in low- and middle-income countries, with a shortage of anesthesia providers contributing to this crisis. In Namibia, medical officers typically receive no >3 months of informal training in anesthesia. This study sought to determine the prevalence, currently unknown, of intraoperative adverse anesthetic events in this setting. Further, we assessed surgical volume, complications, and mortality outcomes at the district hospital level...
December 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29246560/transvaginal-natural-orifice-transluminal-endoscopic-surgery-a-new-approach-to-ovarian-cystectomy
#5
Jan Baekelandt
OBJECTIVE: To demonstrate a new approach for performing an ovarian cystectomy via transvaginal natural orifice transluminal endoscopic surgery (vNOTES) as an alternative for a laparoscopic ovarian cystectomy. DESIGN: Stepwise explanation of the technique using original video footage. SETTING: Department of Obstetrics and Gynaecology, Imelda Hospital, Belgium. PATIENT(S): Fourteen patients who provided informed consent and were treated transvaginally to remove a benign ovarian cyst...
December 12, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29239197/maintaining-quality-in-lower-volume-cardiac-surgery-a-blueprint-from-a-military-program
#6
Jared L Antevil, Philip S Mullenix, Junewai L Reoma, Paul S Massimiano, Frederick C Lough, Eric A Elster
Although there is a clear volume-outcome relationship in the field of cardiac surgery, the existence of high-performing programs with relatively low case volumes is well established. This report describes the programmatic and institutional processes in place at a lower volume cardiac surgery center in a US military hospital, which have been executed to optimally leverage available resources in the delivery of exemplary patient care. By implementing a highly collaborative practice, rigorous outcomes review, evidence-based standardized care pathways, consistent attending surgeon oversight for care delivery, careful case selection, and a mechanism for support from highly experienced outside cardiac surgeons, the cardiac surgery program at the authors' institution delivers care on par with its higher volume counterparts...
December 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29225959/effect-of-removing-the-barrier-of-transportation-costs-on-surgical-utilisation-in-guinea-madagascar-and-the-republic-of-congo
#7
Mark G Shrime, Mirjam Hamer, Swagoto Mukhopadhyay, Lauren M Kunz, Nathan H Claus, Kirsten Randall, Joannita H Jean-Baptiste, Pierre H Maevatombo, Melissa P S Toh, Jasmin R Biddell, Ria Bos, Michelle White
Background: 81 million people face impoverishment from surgical costs every year. The majority of this impoverishment is attributable to the non-medical costs of care-for transportation, for food and for lodging. Of these, transportation is the largest, but because it is not viewed as an actual medical cost, it is frequently unaddressed. This paper examines the effect on surgical utilisation of paying for transportation. Methods: A hierarchical logistic regression was performed on 2692 patients presenting for surgical care to a non-governmental organisation operating in the Republic of the Congo, Guinea and Madagascar...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29225957/limited-sterile-processing-capabilities-for-safe-surgery-in-low-income-and-middle-income-countries-experience-in-the-republic-of-congo-madagascar-and-benin
#8
REVIEW
Olive Fast, Christina Fast, Dan Fast, Suzanne Veltjens, Zouliha Salami, Michelle C White
It is highly difficult to perform safe surgery without sterile instruments, yet the capacity to adequately clean, disinfect and sterilise surgical instruments in low-income and middle-income countries is largely unknown. Sterile Processing Education Charitable Trust developed an assessment tool and, in partnership with Mercy Ships, evaluated the sterile processing capacity in 59 facilities in Madagascar, Benin and the Republic of Congo. This data-driven analysis paper illustrates how lack of sterile processing capacity acts as a barrier to safe surgical care...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29223665/guidelines-and-checklists-for-short-term-missions-in-global-pediatric-surgery-recommendations-from-the-american-academy-of-pediatrics-delivery-of-surgical-care-global-health-subcommittee-american-pediatric-surgical-association-global-pediatric-surgery-committee
#9
REVIEW
Marilyn Butler, Elizabeth Drum, Faye M Evans, Tamara Fitzgerald, Jason Fraser, Ai-Xuan Holterman, Howard Jen, J Matthew Kynes, Jenny Kreiss, Craig D McClain, Mark Newton, Benedict Nwomeh, James O'Neill, Doruk Ozgediz, George Politis, Henry Rice, David Rothstein, Julie Sanchez, Mark Singleton, Francine S Yudkowitz
INTRODUCTION: Pediatric surgeons, anesthesia providers, and nurses from North America and other high-income countries (HICs) are increasingly engaged in resource-limited areas, with short-term missions (STMs) as the most common form of involvement. However, consensus recommendations currently do not exist for STMs in pediatric general surgery and associated perioperative care. METHODS: The American Academy of Pediatrics (AAP) Delivery of Surgical Care Subcommittee and American Pediatric Surgical Association (APSA) Global Pediatric Surgery Committee, with the American Pediatric Surgical Nurses Association, Inc...
November 15, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29210045/surgery-or-in-vitro-fertilization-the-simplicity-of-this-question-belies-its-complexity
#10
Anusch Yazdani
Unlike surgery, assisted reproduction, particularly in vitro fertilisation (IVF), requires a low skill base, is largely practitioner independent, is highly effective, quality controlled, reproducible and consistent in the management of endometriosis-associated infertility. Ultimately, however, the decision to proceed to IVF or surgery is dependent on the woman, her reproductive expectations, her specific disease pattern, her support and family network and the resources available in a given health care setting...
December 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29198261/inter-hospital-transport-of-the-child-with-critical-cardiac-disease
#11
Padmanabhan Ramnarayan, Zafurallah Intikhab, Neil Spenceley, Ilias Iliopoulos, Alana Duff, Johnny Millar
Centralisation of services such as cardiology, cardiac surgery, and intensive care in many parts of the world has resulted in the need to safely transport children with critical cardiac disease from local hospitals to specialist centres for diagnostic, surgical, and/or critical care intervention. The transport of this cohort of children, whether locally or internationally, can present specific clinical and logistical challenges. An international group of clinicians with expertise in cardiac care and critical care transport worked together to summarise current clinical practice relating to key areas of transport...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29173776/out-of-africa-insights-from-a-prospective-pediatric-surgery-database
#12
REVIEW
Stephen W Bickler
In this year's Robert E. Gross lecture, I describe how experiences early in my career at a government referral hospital in Banjul, The Gambia, influenced my research. Collecting prospective data on all children presenting to the hospital with surgical problems allowed me to gain an understanding of the epidemiology of childhood surgical conditions in sub-Saharan Africa and an appreciation for the inherent challenges of delivering surgical care in settings of limited resources. Based on findings from this database, my research over the past 20years has focused on developing strategies for improving surgical care in low-income countries and better understanding the geographical variations that occur in some of the most common surgical conditions in high-income countries (e...
October 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#13
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29147893/high-elective-surgery-cancellation-rate-in-malawi-primarily-due-to-infrastructural-limitations
#14
Meghan Prin, Jessica Eaton, Onias Mtalimanja, Anthony Charles
BACKGROUND: The provision of safe and timely surgical care is essential to global health care. Low- and middle-income countries have a disproportionate share of the global surgical disease burden and struggle to provide care with the given resources. Surgery cancellation worldwide occurs for many reasons, which are likely to differ between high-income and low-income settings. We sought to evaluate the proportion of elective surgery that is cancelled and the associated reasons for cancellation at a tertiary hospital in Malawi...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29133167/patterns-of-lymph-node-sampling-and-the-impact-of-lymph-node-density-in-favorable-histology-wilms-tumor-an-analysis-of-the-national-cancer-database
#15
A F Saltzman, A Carrasco, A Amini, J H Aldrink, R Dasgupta, K W Gow, R D Glick, P F Ehrlich, N G Cost
INTRODUCTION: There is controversy about the role of lymph node (LN) sampling or dissection in the management of favorable histology (FH) Wilms tumor (WT), specifically how it performed and how it may impact survival. OBJECTIVE: The objective of this study was to analyze factors affecting LN sampling patterns and the impact of LN yield and density (number of positive LNs/LNs examined) on overall survival (OS) in patients with advanced-stage favorable histology Wilms tumor (FHWT)...
October 31, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29129378/transvaginal-natural-orifice-transluminal-endoscopic-surgery-a%C3%A2-new-approach-to-myomectomy
#16
Jan Baekelandt
OBJECTIVE: To demonstrate a new approach for performing a myomectomy via transvaginal natural-orifice transluminal endoscopic surgery (vNOTES) as an alternative to laparoscopic myomectomy. DESIGN: Stepwise explanation of the technique with the use of original video footage. SETTING: Hospital. PATIENT(S): Eight patients were treated transvaginally for intramural, subserosal, and pedunculated myomas. INTERVENTION(S): In case of a posterior myoma, a 2...
January 2018: Fertility and Sterility
https://www.readbyqxmd.com/read/29103149/preoperative-pulmonary-function-tests-before-low-risk-surgery-in-japan-a-retrospective-cohort-study-using-a-claims-database
#17
Hiroshi Yonekura, Kazuki Ide, Kahori Seto, Yohei Kawasaki, Shiro Tanaka, Isao Nahara, Chikashi Takeda, Koji Kawakami
PURPOSE: Routine preoperative pulmonary function tests (PFTs) are not recommended prior to low-risk surgery because their prognostic value is limited. However, only a few studies have assessed the utilization of healthcare resources regarding preoperative PFTs in a real-world setting. Here, we aimed to assess the prevalence and determinant factors of preoperative PFTs before low-risk surgery in Japan. METHODS: In this retrospective cohort study, we used the nationwide insurance claims databases...
November 4, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29081317/evaluation-of-a-low-fidelity-ear-surgery-simulator-in-a-low-resource-setting
#18
K Luu, L Straatman, D Nakku, B Westerberg, N Carter, M Clark
OBJECTIVE: The provision of healthcare education in developing countries is a complex problem that simulation has the potential to help. This study aimed to evaluate the effectiveness of a low-cost ear surgery simulator, the Ear Trainer. METHODS: The Ear Trainer was assessed in two low-resource environments in Cambodia and Uganda. Participants were video-recorded performing four specific middle-ear procedures, and blindly scored using a validated measurement tool...
October 30, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/29077728/corneal-transplantation-at-tenwek-hospital-kenya-east-africa-analysis-of-outcomes-and-associated-patient-socioeconomic-characteristics
#19
Michael C Chen, Allen R Kunselman, Christy M Stetter, Sadeer B Hannush, Benjamin W Roberts
PURPOSE: To review the graft survival rate, visual outcomes, and patient demographics of primary penetrating keratoplasty performed at Tenwek Hospital, a mission hospital in rural Kenya. METHODS: A retrospective review was performed of the clinical records of patients who underwent primary penetrating keratoplasty for optical purposes from January 2012 to October 2014. The graft survival rates were constructed using the Kaplan-Meier method, and the effect of clinical and socioeconomic characteristics on time to graft failure were examined using Cox regression models...
2017: PloS One
https://www.readbyqxmd.com/read/29075071/low-dose-rituximab-in-chronic-itp-still-an-option-in-resource-limited-settings
#20
Rajan Kapoor, Rajiv Kumar, M Mahapatra, H P Pati, Suman Kumar Pramanik
The etiology of ITP remains unknown but its pathogenesis consists of loss of tolerance to platelet antigens. There is a complex dysregulation of the immune system involving both the B cells and the T cells. Splenectomy is the standard second line option in steroid refractory chronic ITP patients. However, costs of surgery and reluctance for surgery in severely thrombocytopenic patients on part of surgeons are major obstacles in resource limited settings. Rituximab has been used in both the standard doses of 375 mg/m(2) and low doses of 100 mg/m(2) with similar results...
December 2017: Indian Journal of Hematology & Blood Transfusion
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