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Surgery in rural

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https://www.readbyqxmd.com/read/28330802/orofacial-trauma-in-rural-india-a-clinical-study
#1
Sunita Malik, Gurdarshan Singh, Gagandeep Kaur, Sunil Yadav, Hitesh C Mittal
PURPOSE: Orofacial trauma is becoming a leading medical problem worldwide. Most of the studies pertaining to orofacial trauma have been done in urban areas but very little scientific literature is available for rural areas. METHODS: A prospective medical institute-based study of orofacial injury patients was carried out from May 2013 to April 2016 (36 Months). Data regarding incidence, age and sex distribution, causes, types and site of injury, treatment modalities and trauma associated complications were collected and analysed...
February 24, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28328635/a-systematic-review-of-the-use-of-telemedicine-in-plastic-and-reconstructive-surgery-and-dermatology
#2
Krishna S Vyas, H Rhodes Hambrick, Afaaf Shakir, Shane D Morrison, Duy C Tran, Keon Pearson, Henry C Vasconez, Samir Mardini, Amanda A Gosman, Marek Dobke, Mark S Granick
BACKGROUND: Telemedicine, the use of information technology and telecommunication to provide healthcare at a distance, is a burgeoning field with applications throughout medicine. Given the visual nature of plastic surgery and dermatology, telemedicine has a myriad of potential applications within the field. METHODS: A comprehensive literature review of articles published on telemedicine since January 2010 was performed. Articles were selected for their relevance to plastic and reconstructive surgery and dermatology, and then reviewed for their discussion of the applications, benefits, and limitations of telemedicine in practice...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28327960/geographic-and-hospital-variation-in-cost-of-lumbar-laminectomy-and-lumbar-fusion-for-degenerative-conditions
#3
Corinna C Zygourakis, Caterina Y Liu, Glenn Wakam, Christopher Moriates, Christy Boscardin, Christopher P Ames, Praveen V Mummaneni, John Ratliff, R Adams Dudley, Ralph Gonzales
BACKGROUND: Spinal surgery costs vary significantly across hospitals and regions, but there is insufficient understanding of what drives this variation. OBJECTIVE: To examine the factors underlying the cost variation for lumbar laminectomy/discectomy and lumbar fusions. METHODS: We obtained patient information (age, gender, race, severity of illness, risk of mortality, population of county of residence, median zipcode income, insurance status, elective vs nonelective admission, length of stay) and hospital data (region, hospital type, bed size, wage index) for all patients who underwent lumbar laminectomy/discectomy (n = 181 267) or lumbar fusions (n = 433 364) for degenerative conditions in the 2001 to 2013 National Inpatient Sample database...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28325240/cancer-care-access-and-outcomes-for-american-indian-populations-in-the-united-states-challenges-and-models-for-progress
#4
REVIEW
B Ashleigh Guadagnolo, Daniel G Petereit, C Norman Coleman
Low socioeconomic and health care access realities of being American Indian/Alaskan Native (AI/AN) in the United States combined with decades of data documenting poor cancer outcomes for this population provide a population nested within the United States that is analogous to the cancer care landscape of low- and middle-income countries internationally. We reviewed the medical literature with respect to cancer prevention, access to cancer treatment, and access to effective supportive and palliative care for AI/AN populations in the United States...
April 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28319582/trends-in-the-purchase-of-surgical-care-in-the-community-by-the-veterans-health-administration-va
#5
Amy K Rosen, William O'Brien, Qi Chen, Michael Shwartz, Kamal F M Itani, William Gunnar
BACKGROUND: The 2014 implementation of the Veterans Choice Program increased opportunities for Veterans to receive care in the community. Although surgical care is a Veterans Health Administration (VA) priority, little is known about the types of surgeries provided in the VA versus those referred to community care (CC), and whether Veterans are increasing their use of surgical care through CC with these additional opportunities. OBJECTIVES: To examine national trends across VA facilities in the frequencies and types of surgeries provided in the VA and through CC, and explore the association between facilities' purchase of care with rurality and surgical complexity designation...
March 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28319580/hospital-characteristics-associated-with-risk-standardized-readmission-rates
#6
Leora I Horwitz, Susannah M Bernheim, Joseph S Ross, Jeph Herrin, Jacqueline N Grady, Harlan M Krumholz, Elizabeth E Drye, Zhenqiu Lin
BACKGROUND: Safety-net and teaching hospitals are somewhat more likely to be penalized for excess readmissions, but the association of other hospital characteristics with readmission rates is uncertain and may have relevance for hospital-centered interventions. OBJECTIVE: To examine the independent association of 8 hospital characteristics with hospital-wide 30-day risk-standardized readmission rate (RSRR). DESIGN: This is a retrospective cross-sectional multivariable analysis...
March 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28301555/risk-factors-for-delay-of-adjuvant-chemotherapy-in-non-metastatic-breast-cancer-patients-a-systematic-review-and-meta-analysis-involving-186982-patients
#7
Xiaofang He, Fen Ye, Bingcheng Zhao, Hailin Tang, Jin Wang, Xiangsheng Xiao, Xiaoming Xie
PURPOSE: Delay performance of adjuvant chemotherapy (AC) after surgery has been presented to affect survival of breast cancer patients adversely, but the risk factors for delay in initiation remain controversial. Therefore, we conducted this systematic review of the literature and meta-analysis aiming at identifying the risk factors for delay of adjuvant chemotherapy (DAC) in non-metastatic breast cancer patients. METHODS: The search was performed on PubMed, Embase, Chinese National Knowledge Infrastructure and Wanfang Database from inception up to July 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28288068/emergency-surgery-for-medicare-beneficiaries-admitted-to-critical-access-hospitals
#8
Andrew M Ibrahim, Scott E Regenbogen, Jyothi R Thumma, Justin B Dimick
OBJECTIVE: The aim of this study was to compare the surgical outcomes of emergency operations performed at critical access and non-critical access hospitals. BACKGROUND: Critical access hospitals are often the only source of surgical care for rural populations. Previous studies have demonstrated that patients undergoing common, elective operations at these rural hospitals have similar outcomes to their urban counterparts. Little is known, however, about the quality of care these hospitals provide for emergency operations for which they are most essential...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28280507/fine-needle-aspiration-of-thyroid-nodules-using-the-bethesda-system-for-reporting-thyroid-cytopathology-an-institutional-experience-in-a-rural-setting
#9
Aili Guo, Yuuki Kaminoh, Terra Forward, Frank L Schwartz, Scott Jenkinson
Background. Fine needle aspiration (FNA) remains the first-line diagnostic in management of thyroid nodules and reduces unnecessary surgeries. However, it is still challenging since cytological results are not always straightforward. This study aimed to examine the results of thyroid FNA using the Bethesda system for reporting thyroid cytopathology (TBSRTC) to establish the level of accuracy of FNA procedures in a rural practice setting. Method. A retrospective chart review was conducted on existing thyroid FNA performed in a referral endocrine center between December 2011 and November 2015...
2017: International Journal of Endocrinology
https://www.readbyqxmd.com/read/28276273/comparative-analysis-of-length-of-stay-hospitalization-costs-opioid-use-and-discharge-status-among-spine-surgery-patients-with-postoperative-pain-management-including-intravenous-versus-oral-acetaminophen
#10
Ryan N Hansen, An T Pham, Elaine A Böing, Belinda Lovelace, George J Wan, Timothy E Miller
BACKGROUND: Recovery from spine surgery is oriented toward restoring functional health outcomes while reducing resource use. Optimal pain management is a key to reaching these objectives. We compared outcomes of spine surgery patients who received standard pain management including intravenous (IV) acetaminophen (APAP) vs. oral APAP. METHODS: We performed a retrospective analysis of the Premier database (January 2012 to September 2015) comparing spine surgery patients who received pain management with IV APAP to those who received oral APAP, with no exclusions based on additional pain management...
March 9, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28244473/pattern-of-care-in-operable-endometrial-cancer-treated-at-a-rural-based-tertiary-care-cancer-center
#11
S B Dessai, D Adrash, M Geetha, S Arvind, J Bipin, S Nayanar, K Sachin, M S Biji, S Balasubramanian
PURPOSE: An audit was planned to study the demographics, staging, treatment details, and outcomes of operable endometrial cancers. METHODOLOGY: All operable endometrial cancers treated between January 2009 and October 2014 were included in the study. The details regarding demographics, staging, surgical procedure, pathological staging, adjuvant treatment, and outcomes were extracted from the case records. Descriptive statistics was performed. The time-to-event analysis was done by Kaplan-Meier method...
July 2016: Indian Journal of Cancer
https://www.readbyqxmd.com/read/28242434/rural-general-surgery-a-38-year-experience-with-a-regional-network-established-by-an-integrated-health-system-in-the-midwestern-united%C3%A2-states
#12
Thomas H Cogbill, Marilu Bintz
BACKGROUND: General surgeon (GS) workforce shortages are predicted to worsen, particularly in rural areas. We report on a sustainable model for delivery of GS services within a large rural region that includes an integrated health system. STUDY DESIGN: We conducted a longitudinal study of a rural GS network from 1978 to 2016. Employment data and rural GS survey results were reviewed to document methods of recruitment, retention, and case-volume development. RESULTS: During the 38-year study period, 19 rural GSs were employed by the health system...
February 24, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28238592/frequency-of-carcinoid-syndrome-at-neuroendocrine-tumour-diagnosis-a-population-based-study
#13
Daniel M Halperin, Chan Shen, Arvind Dasari, Ying Xu, Yiyi Chu, Shouhao Zhou, Ya-Chen Tina Shih, James C Yao
BACKGROUND: Neuroendocrine tumours (NETs) can secrete bioactive amines into the bloodstream, causing carcinoid syndrome, with symptoms including flushing and diarrhoea. However, carcinoid syndrome frequency in the NET population has never been rigorously assessed, nor has its relationship to presenting clinicopathological characteristics. This analysis assessed the proportion of patients with NETs and carcinoid syndrome in the USA and associated clinical factors. METHODS: We identified patients (≥65 years of age) from the Surveillance, Epidemiology, and End Results-Medicare database, excluding those with pancreatic tumours or small-cell or large-cell lung cancer, as well as those without complete data...
February 23, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28219124/our-experience-in-using-telehealth-for-paediatric-plastic-surgery-in-western-australia
#14
Debesh Rimal, Ju Hui Huang Fu, David Gillett
BACKGROUND: Western Australia accounts for one-third of Australia's total land mass. Princess Margaret Hospital is the only dedicated plastic surgery tertiary referral centre providing services to over 500 000 children across the state. The aim of this study is to share our experience using telehealth for service provision and delivery of care in a geographically challenging setting. METHODS: A retrospective review was conducted, and data were extracted from patients' notes...
February 20, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28209185/health-literacy-in-a-community-with-low-levels-of-education-findings-from-chakaria-a-rural-area-of-bangladesh
#15
Susmita Das, Mohammad Nahid Mia, Syed Manzoor Ahmed Hanifi, Shahidul Hoque, Abbas Bhuiya
BACKGROUND: Health literacy (HL) helps individuals to make effective use of available health services. In low-income countries such as Bangladesh, the less than optimum use of services could be due to low levels of HL. Bangladesh's health service delivery is pluralistic with a mix of public, private and informally trained healthcare providers. Emphasis on HL has been inadequate. Thus, it is important to assess the levels of HL and service utilization patterns. The findings from this study aim to bridge the knowledge gap...
February 16, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28209160/odontogenic-tumors-in-ethiopia-eight-years-retrospective-study
#16
Bruktawit Kebede, Dawit Tare, Birke Bogale, Fessahaye Alemseged
BACKGROUND: Odontogenic tumor (OT) comprises a large heterogeneous group of lesions arising from tooth producing tissues or its remnants. Studies on OTs are scarce in Ethiopia. Thus, the present study aimed to assess the pattern of OTs in Ethiopia. METHODS: An 8 years retrospective study was conducted at the Dental and Maxillofacial Department, St. Paul's referral hospital, Addis Ababa, Ethiopia. Data were collected by reviewing the medical records of patients who visited the Department from September 2008 to August 2015...
February 16, 2017: BMC Oral Health
https://www.readbyqxmd.com/read/28208923/long-term-outcome-in-patients-with-esophageal-stenting-for-cancer-esophagus-our-experience-at-a-rural-hospital-of-punjab-india
#17
Parvinder Singh, Abhitesh Singh, Anantbir Singh, Ghansham Sharma, Parmod Kumar Bhatia, Amarjeet Singh Grover
INTRODUCTION: Cancer of the esophagus is among the leading cause of cancer deaths in Punjab, India. Patients generally present with dysphagia as their first symptom and more often they have advanced disease at the time of presentation to a tertiary care centre. Palliative procedures have important roles in this setting. Stenting is the best option to palliate the symptoms of dysphagia, from which patient is suffering the most. AIM: To know the success rate, early and long term complications and mortality in esophageal stenting, when it was done in malignant esophageal stricture patients...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28206929/disparities-in-mangement-of-patients-with-benign-colorectal-disease-impact-of-urbanization-and-specialized-care
#18
Viraj Pandit, Mazhar Khalil, Bellal Joseph, Jana Jandova, Tahereh Orouji Jokar, Ansab Abbas Haider, Bardiya Zangbar, Asad Asim, Ahmed Hassan, Valentine Nfonsam
Disparities in the management of patients with various medical conditions are well established. Colorectal diseases continue to remain one of the most common causes for surgical intervention. The aim of this study was to assess disparities (rural versus urban) in the surgical management of patients with noncancerous benign colorectal diseases. We hypothesized that there is no difference among rural versus urban centers (UC) in the surgical management for noncancerous benign colorectal diseases. The national estimates of surgical procedures for benign colorectal diseases from the National Inpatient Sample database 2011 representing 20 per cent of all in-patient admissions were abstracted...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28190366/predictors-of-remote-practice-location-in-the-first-seven-cohorts-of-james-cook-university-mbbs-graduates
#19
Torres Woolley, Tarun Sen Gupta, Maria Bellei
INTRODUCTION: This article describes factors predicting James Cook University (JCU) medical graduates undertaking at least 1 year of remote practice. The cross-sectional design involved point-in-time (2015) analysis of the JCU medical school's ongoing longitudinal graduate tracking database. Participants were the first seven cohorts of graduates from the JCU medical school who had completed at least their postgraduate year (PGY) 4 in Australia (<i>n</i>=529); that is, PGY 4 to PGY 10 graduates...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28179175/-to-operate-versus-not-to-operate-in-low-resource-settings-an-example-of-aneurysm-surgery-in-rural-iran-and-the-impact-of-mastery-of-neurosurgical-anatomy
#20
Dylan Griswold, Arnau Benet, Halima Tabani, Michael T Lawton, Ali Tayebi Meybodi
Subarachnoid hemorrhage (SAH) has a global incidence of 9/100,000. In low-resource settings, where neurosurgical capacity is diminished through fewer human and technological resources, neurosurgeons may not be prepared to operate on aneurysmal SAH. Through a case illustration of an Iranian neurosurgeon faced with a decision to operate on a patient presenting with aneurysmal SAH in a low-resource setting, we highlight the importance of mastery of neurosurgical anatomy, which was critical in achieving a favorable patient outcome...
February 4, 2017: World Neurosurgery
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