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Surgery in rural

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https://www.readbyqxmd.com/read/28424776/socially-responsible-surgery-building-recognition-and-coalition
#1
Tyler D Robinson, Thiago M Oliveira, Theresa R Timmes, Jacqueline M Mills, Nichole Starr, Matthew Fleming, Megan Janeway, Diane Haddad, Feroze Sidhwa, Ryan D Macht, Douglas F Kauffman, Tracey A Dechert
IMPORTANCE: Socially responsible surgery (SRS) integrates surgery and public health, providing a framework for research, advocacy, education, and clinical practice to address the social barriers of health that decrease surgical access and worsen surgical outcomes in underserved patient populations. These patients face disparities in both health and in health care, which can be effectively addressed by surgeons in collaboration with allied health professionals. OBJECTIVE: We reviewed the current state of surgical access and outcomes of underserved populations in American rural communities, American urban communities, and in low- and middle-income countries...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28422552/rapid-assessment-of-avoidable-blindness-and-diabetic-retinopathy-in-gilan-province-iran
#2
Marzieh Katibeh, Hassan Behboudi, Siamak Moradian, Yousef Alizadeh, Ramin Beiranvand, Hamideh Sabbaghi, Hamid Ahmadieh
PURPOSE: To conduct an assessment of avoidable blindness and diabetic retinopathy (DR) in Gilan, 2014. METHODS: A cross-sectional population-based survey was performed on a representative sample of urban and rural individuals aged ≥50 years of the province. Blindness was defined as presenting visual acuity (PVA) <3/60 in the better eye. Moderate visual impairment (MVI) and severe visual impairment (SVI) were defined as 6/60 ≤ PVA <6/18 and 3/60 ≤ PVA <6/60 in the better eye, respectively...
April 19, 2017: Ophthalmic Epidemiology
https://www.readbyqxmd.com/read/28414114/why-do-long-distance-travelers-have-improved-pancreatectomy-outcomes
#3
Manila Jindal, Chaoyi Zheng, Humair S Quadri, Chukwuemeka U Ihemelandu, Young K Hong, Andrew K Smith, Vikas Dudeja, Nawar M Shara, Lynt B Johnson, Waddah B Al-Refaie
BACKGROUND: Centralization of complex surgical care has led patients to travel longer distances. Emerging evidence suggested a negative association between increased travel distance and mortality after pancreatectomy. However, the reason behind this association remains largely unknown. We sought to unravel the relationships among travel distance, receiving pancreatectomy at high volume hospitals (HVH), delayed surgery, and operative outcomes. STUDY DESIGN: We identified 44,476 patients who underwent pancreatectomy for neoplasms between 2004 and 2013 at the reporting facility from the National Cancer Data Base...
April 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28405807/management-and-outcomes-of-acute-surgical-patients-at-a-district-hospital-in-uganda-with-non-physician-emergency-clinicians
#4
Caleb Dresser, Usha Periyanayagam, Brad Dreifuss, Robert Wangoda, Julius Luyimbaazi, Mark Bisanzo
INTRODUCTION: Acute surgical care services in rural Sub-Saharan Africa suffer from human resource and systemic constraints. Developing emergency care systems and task sharing aspects of acute surgical care addresses many of these issues. This paper investigates the degree to which specialized non-physicians practicing in a dedicated Emergency Department contribute to the effective and efficient management of acute surgical patients. METHODS: This is a retrospective review of an electronic quality assurance database of patients presenting to an Emergency Department in rural Uganda staffed by non-physician clinicians trained in emergency care...
April 12, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28404468/assessing-the-impact-of-a-program-for-late-surgical-intervention-in-early-blind-children
#5
A Kalia, T Gandhi, G Chatterjee, P Swami, H Dhillon, S Bi, N Chauhan, S D Gupta, P Sharma, S Sood, S Ganesh, U Mathur, P Sinha
OBJECTIVE: Many blind children in the developing world are unable to obtain timely treatment due to lack of financial and medical resources. Can public health programs that identify and treat such children several years after the onset of blindness enhance their quality of life? The notion that visual development is subject to an early 'critical period' argues against this possibility. However, there are inadequate empirical data from humans on this issue. To address this need, we examined the quality of life of children living in India and who were treated for early-onset blindness (before one year of age), due to cataracts or corneal opacities...
February 1, 2017: Public Health
https://www.readbyqxmd.com/read/28397253/are-women-s-needs-being-met-by-specialist-health-services-managing-urinary-incontinence-in-the-remote-top-end-nt
#6
Alexandra Bonner, Jacqueline Boyle
BACKGROUND: Urinary incontinence (UI) is likely to be high in Aboriginal women in rural Australia due to risk factors including high body mass index, parity and diabetes. However, UI appears to be under-reported with limited information on whether women access appropriate care. AIMS: To assess whether women who access specialist gynaecological services in rural and remote Top End Northern Territory (NT) through the specialist outreach program (SONT) are receiving care for UI aligned with best practice...
April 10, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28376581/esperance-pica-study
#7
Kuroush A Ardeshirian, Donald A Howarth
BACKGROUND: Pica, the eating of non-foods, occurs particularly in children and pregnant women. It has been observed in communities all over the world. Pica is associated with iron deficiency and, in some environments, lead poisoning. This is the first time a study has assessed the prevalence of pica in Australia. METHODS: The study assessed the prevalence of pica in an Australian rural community, using a questionnaire given to parents of 223 children aged 2-10 years attending the five general practice surgeries in the shire...
2017: Australian Family Physician
https://www.readbyqxmd.com/read/28338572/the-drivers-of-medicare-reimbursement-for-thoracolumbar-fusion-an-analysis-of-data-from-the-centers-for-medicare-and-medicaid-services
#8
Krishn Khanna, Eric M Padegimas, Benjamin Zmistowski, Michael Howley, Kushagra Vema
STUDY DESIGN: Retrospective observational OBJECTIVE.: The purpose of this study is to examine the variation in Thoracolumbar Fusion (TLF) payment and determine the drivers of this variation. SUMMARY OF BACKGROUND DATA: As healthcare spending continues to increase, variation in surgical procedures reimbursements has come under more scrutiny. TLF is an example of a high-cost, proven-benefit procedure that is often the focus of Centers for Medicare and Medicaid Services (CMS) administrators...
March 23, 2017: Spine
https://www.readbyqxmd.com/read/28337059/cataract-surgical-rate-in-yemen-2012
#9
Saleh A Al-Akily, Mutahar Y AlShaer, Mahfouth A Bamashmus, Abdulmoghni O AlBarrag, Tawfik K Alkhatib, Hisham A Al-Akhlee
OBJECTIVE: To determine cataract surgical rate (CSR) in 2012 (01 January to 31 December 2012) in 22 Governorates of Yemen in order to identify the needs to reduce cataract related blindness. METHODS: A standardized questionnaire was sent to the 184 eye units in governmental, university, military, private and charity clinics and hospitals in Yemen. RESULTS: The response rate to the questionnaire was 80.7%, and the collected data are summarized...
January 2017: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
https://www.readbyqxmd.com/read/28330802/orofacial-trauma-in-rural-india-a-clinical-study
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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...
May 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
#16
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
#17
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
#18
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
#19
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...
May 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
#20
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
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