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Surgery in rural

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https://www.readbyqxmd.com/read/29241339/a-novel-model-for-a-hub-and-spoke-spinal-service-and-improvements-in-the-treatment-of-spinal-pathology-in-a-rural-hospital-setting
#1
Erden Ali, Andrew Macdowell, Thomas Pagonis
INTRODUCTION:   We present a unique pathway for care aimed specifically at spinal patients. As a result of the shift of the spoke direction from the existing hub-and-spoke model, patient care is being redirected successfully with great benefit to a rural department. Within the rural community, it is the spoke that is the main locality to which patients present and at which they are treated. Subspecialty procurement is often more central and located in tertiary referral centres outside of a rural position...
December 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/29238684/a-study-of-clinical-significance-of-the-depth-of-olfactory-fossa-in-patients-undergoing-endoscopic-sinus-surgery
#2
Ashok Murthy V, Bollineni Santosh
The endoscope has revolutionized the diagnosis and treatment of diseases of the nose and paranasal sinuses. Endoscopic sinus surgery (ESS), like all minimally invasive surgery, is designed to combine an excellent outcome with minimal patient discomfort. Successful outcome with minimal complications can only be achieved with good knowledge of the endoscopic anatomy, appropriate training in the procedure and the understanding of the anatomical variations. The intraoperative complications of ESS are bleeding and injury to surrounding structures commonly the orbital structures and fovea ethmoidalis...
December 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/29229152/omission-of-radiotherapy-after-breast-conservation-surgery-in-the-postneoadjuvant-setting
#3
Andrew C Esposito, James Crawford, Elin R Sigurdson, Elizabeth A Handorf, Shelly B Hayes, Marcia Boraas, Richard J Bleicher
BACKGROUND: Breast conservation therapy (BCT) consists of breast conservation surgery (BCS) and radiotherapy (RT). Neoadjuvant chemotherapy (NACT) can downstage tumors, broadening BCS eligibility in patients requiring mastectomy. However, tumor downstaging does not obviate need for RT. This study evaluated factors that predict RT omission after NACT and BCS. METHODS: The National Cancer Database was queried for women with unilateral, clinical stage II-III breast cancer, treated with NACT and BCS between 2008 and 2012...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29209733/quality-of-surgery-in-malawi-comparison-of-patient-reported-outcomes-after-hernia-surgery-between-district-and-central-hospitals
#4
Jakub Gajewski, Ronan Conroy, Leon Bijlmakers, Gerald Mwapasa, Tracey McCauley, Eric Borgstein, Ruairi Brugha
BACKGROUND: District hospitals in Africa could meet the essential surgical needs of rural populations. However, evidence on outcomes is needed to justify investment in this option, given that surgery at district hospitals in some African countries is usually undertaken by non-physician clinicians. METHODS: Baseline and 2-3-month follow-up measurements were undertaken on 98 patients who had undergone hernia repairs at four district and two central hospitals in Malawi, using a modified quality-of-life tool...
December 5, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29209530/teleconsultation-ultrasonography-a-new-weapon-to-combat-cholangiocarcinoma
#5
Nittaya Chamadol, Vallop Laopaiboon, Jiraporn Srinakarin, Watcharin Loilome, Puangrat Yongvanit, Bandit Thinkhamrop, Narong Khuntikeo
Although cholangiocarcinoma (CCA) is usually a rare cancer, in northeast Thailand it kills 20 000 or more people every year. The prognosis is very poor owing to late stage diagnosis, with palliative treatment often representing the only option. In this area of predominantly rural Thailand, CCA is associated with infection with the liver fluke, Opisthorchis viverrini, which is classified as a group 1 carcinogen. Up to 6 million Thais are infected with this fluke. The Cholangiocarcinoma Screening and Care Program (CASCAP) was initiated in 2014 with the aim of detecting early stage CCA, allowing curative surgery, by using ultrasound (US) screening of prospectively 500 000 at risk individuals...
2017: ESMO Open
https://www.readbyqxmd.com/read/29191200/emergency-general-surgery-in-rwandan-district-hospitals-a-cross-sectional-study-of-spectrum-management-and-patient-outcomes
#6
Christophe Mpirimbanyi, Alexandre Nyirimodoka, Yihan Lin, Bethany L Hedt-Gauthier, Jackline Odhiambo, Theoneste Nkurunziza, Joaquim M Havens, Jack Omondi, Emile Rwamasirabo, Faustin Ntirenganya, Gabriel Toma, Joel Mubiligi, Scheilla Bayitondere, Robert Riviello
BACKGROUND: Management of emergency general surgical conditions remains a challenge in rural sub-Saharan Africa due to issues such as insufficient human capacity and infrastructure. This study describes the burden of emergency general surgical conditions and the ability to provide care for these conditions at three rural district hospitals in Rwanda. METHODS: This retrospective cross-sectional study included all patients presenting to Butaro, Kirehe and Rwinkwavu District Hospitals between January 1st 2015 and December 31st 2015 with emergency general surgical conditions, defined as non-traumatic, non-obstetric acute care surgical conditions...
December 1, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29182463/willingness-to-pay-for-cataract-surgery-is-much-lower-than-actual-costs-in-zamfara-state-northern-nigeria
#7
Nazaradden Ibrahim, Jacqueline Ramke, Francisco Pozo-Martin, Clare E Gilbert
PURPOSE: Direct medical and non-medical costs incurred by those undergoing subsidised cataract surgery at Gusau eye clinic, Zamfara state, were recently determined. The aim of this study was to assess the willingness to pay for cataract surgery among adults with severe visual impairment or blindness from cataract in rural Zamfara and to compare this to actual costs. METHODS: In three rural villages served by Gusau eye clinic, key informants helped identify 80 adults with bilateral severe visual impairment or blindness (<6/60), with cataract being the cause in at least one eye...
November 28, 2017: Ophthalmic Epidemiology
https://www.readbyqxmd.com/read/29168577/screening-for-developmental-dysplasia-of-the-hip-in-a-rural-health-district-an-analysis-of-practice
#8
Suzanne Wright, Elizabeth Cotterell, David Schmidt
OBJECTIVE: To describe hip dysplasia screening practices in a local rural health district. DESIGN: Cross-sectional study of hospital birth records, local physiotherapy records, public community health electronic medical record (Community Health Information Management Enterprise database) and a survey of local clinicians who work with infants and children. SETTING: Three rural public hospitals and community health centres in a New South Wales health district...
November 23, 2017: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/29159936/influence-of-socioeconomic-factors-and-distance-to-radiotherapy-on-breast-conserving-surgery-rates-for-early-breast-cancer-in-regional-australia-implications-of-change
#9
Ian M Collins, Caroline Lum, Vincent L Versace
AIMS: Breast conserving surgery rates are affected by many factors including distance to radiotherapy and tumor-related features. Numerous studies have found women who must travel further for radiotherapy are more likely to choose mastectomy and avoid radiotherapy. We examined relationships between socioeconomic group, distance to radiotherapy services and mastectomy rates across a range of rural and metropolitan settings. METHODS: We used a dataset extracted from the Evaluation of Cancer Outcomes Barwon South Western Registry, which captured data on new breast cancer diagnoses in the southwest region of Victoria, Australia...
November 21, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29146756/prevalence-and-factors-associated-with-age-related-macular-degeneration-in-a-southwestern-island-population-of-japan-the-kumejima-study
#10
Ryo Obata, Yasuo Yanagi, Tatsuya Inoue, Miho Yasuda, Yuji Oshima, Shoichi Sawaguchi, Aiko Iwase, Makoto Araie
AIMS: To evaluate the prevalence of and factors associated with age-related macular degeneration (AMD) in a rural population of southwestern Japan. METHODS: This population-based cross-sectional study of all residents aged 40 years or older was conducted on the island of Kumejima, Okinawa, Japan. Of 4632 eligible residents, 3762 completed a comprehensive questionnaire and underwent ocular examination (participant rate, 81.2%). A non-mydriatic fundus photograph was used to grade AMD lesions according to the Wisconsin protocol...
November 16, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29143383/who-performs-colonoscopy-workforce-trends-over-space-and-time
#11
Jan M Eberth, Michele J Josey, Lee R Mobley, Davidson O Nicholas, Donna B Jeffe, Cassie Odahowski, Janice C Probst, Mario Schootman
PURPOSE: With the increased availability of colonoscopy to average risk persons due to insurance coverage benefit changes, we sought to identify changes in the colonoscopy workforce. We used outpatient discharge records from South Carolina between 2001 and 2010 to examine shifts over time and in urban versus rural areas in the types of medical providers who perform colonoscopy, and the practice settings in which they occur, and to explore variation in colonoscopy volume across facility and provider types...
November 16, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/29142871/cavernous-sinus-thrombosis-following-dental-extraction-a-rare-case-report-and-forgotten-entity
#12
Karun Aggarwal, Sanjay Rastogi, Atul Joshi, Ashish Kumar, Archana Chaurasia, Rajat Prakash
Prior to the advent of efficacious antimicrobial agents, the mortality rate from cavernous sinus thrombosis (CST) was effectively 100%. There have been very few reports of CST associated with tooth extraction. A 40-year-old female presented to the emergency room with swelling over the right side of the face and history of extraction in the upper right region by an unregistered dental practitioner. The patient presented with diplopia, periorbital ecchymosis, and chemosis of the right eye. A computed tomography scan revealed venous dilatation of the right superior ophthalmic vein...
October 2017: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/29119547/interventions-to-improve-access-to-cataract-surgical-services-and-their-impact-on-equity-in-low-and-middle-income-countries
#13
REVIEW
Jacqueline Ramke, Jennifer Petkovic, Vivian Welch, Ilse Blignault, Clare Gilbert, Karl Blanchet, Robin Christensen, Anthony B Zwi, Peter Tugwell
BACKGROUND: Cataract is the leading cause of blindness in low- and middle-income countries (LMICs), and the prevalence is inequitably distributed between and within countries. Interventions have been undertaken to improve cataract surgical services, however, the effectiveness of these interventions on promoting equity is not known. OBJECTIVES: To assess the effects on equity of interventions to improve access to cataract services for populations with cataract blindness (and visual impairment) in LMICs...
November 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29110097/geographic-region-socioeconomic-position-and-the-utilisation-of-primary-total-joint-replacement-for-hip-or-knee-osteoarthritis-across-western-victoria-a-cross-sectional-multilevel-study-of-the-australian-orthopaedic-association-national-joint-replacement-registry
#14
Sharon Brennan-Olsen, Sara Vogrin, Kara L Holloway, Richard S Page, Muhammad A Sajjad, Mark A Kotowicz, Patricia M Livingston, Mustafa Khasraw, Sharon Hakkennes, Trish L Dunning, Susan Brumby, Daryl Pedler, Alasdair Sutherland, Svetha Venkatesh, Lana J Williams, Gustavo Duque, Julie A Pasco
Compared to urban residents, those in rural/regional areas often experience inequitable healthcare from specialist service providers. Independent of small between-area differences in utilisation, socially advantaged groups had the greatest uptake of joint replacement. These data suggest low correlation between 'need' vs. 'uptake' of surgery in rural/regional areas. BACKGROUND AND PURPOSE: Compared to urban residents, those in rural and regional areas often experience inequitable healthcare from specialist service providers, often due to geographical issues...
November 6, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/29101617/quality-of-medication-information-in-discharge-summaries-from-hospitals-an-audit-of-electronic-patient-records
#15
Beate Hennie Garcia, Berit Svendsen Djønne, Frode Skjold, Ellen Marie Mellingen, Trine Iversen Aag
Background Low quality of medication information in discharge summaries from hospitals may jeopardize optimal therapy and put the patient at risk for medication errors and adverse drug events. Objective To audit the quality of medication information in discharge summaries and explore factors associated with the quality. Setting Helgelandssykehuset Mo i Rana, a rural hospital in central Norway. Method For each month in 2013, we randomly selected 60 discharge summaries from the Department of Medicine and Surgery (totally 720) and evaluated the medication information using eight Norwegian quality criteria...
December 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29101504/wait-times-for-melanoma-surgery-is-there-an-association-with-overall-survival
#16
Alyson B Crawford, Carolyn Nessim, Joel Weaver, Carl van Walraven
INTRODUCTION: Wait times for access to care have been of increasing interest to public health care officials, health care providers, and the public. There is a paucity of data determining whether extended wait times for melanoma surgery influence patient outcomes. This study measured the association of wait times to surgical treatment with overall survival in patients with melanoma. METHODS: Population-based health administrative databases were used to identify all Ontario adults diagnosed with melanoma between 2004 and 2011, time to various treatment modalities, and death dates...
November 3, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29089737/a-10-year-review-of-urethral-stricture-management-in-irrua-nigeria
#17
Eshiobo Irekpita
BACKGROUND: Several authors have demonstrated regional and temporal changes in the demographics of urethral stricture and its management. OBJECTIVES: To assess the changes in the demographics of the patients and the evolution of the management of urethral stricture in this institution. SUBJECTS AND METHODS: This is a retrospective study. The files of all the men who were diagnosed with urethral stricture from May 2006 to April 2016 were retrieved from the database of the records department of the hospital...
July 2017: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/29079108/reap-what-you-sow-which-rural-surgery-training-programs-currently-exist-and-do-medical-students-know-of-their-existence
#18
Isolina R Rossi, Aaron L Wiegmann, Pat Schou, David C Borgstrom, Matthew B Rossi
BACKGROUND: There exists an acute need to recruit and train general surgeons for rural communities. To assist medical students interested in rural surgery, the American College of Surgeons (ACS) website lists general surgery residencies, which are tailored to train the rural surgeon by providing exposure to endoscopy, gynecology, urology, orthopedics, and otolaryngology. Another available reference is the American Medical Association Fellowship and Residency Electronic Database (FREIDA)...
October 24, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29078599/from-full-thoracotomy-to-uniportal-video-assisted-thoracic-surgery-lessons-learned
#19
REVIEW
Eliseo Passera, Gaetano Rocco
Over the last two decades, conventional video-assisted thoracic surgery (VATS) has established itself as the preferred approach for almost all thoracic surgical procedures. The procedure provides a safe and easy approach with undisputed patient benefit at a cost acceptable to the healthcare system all over the world, in large hospitals as well as underprivileged rural areas. VATS has effectively addressed the patients' right to less scarring, trauma (both of access and intrathoracic manipulation), medication, pain, hospitalization, and early return home and work...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29077728/corneal-transplantation-at-tenwek-hospital-kenya-east-africa-analysis-of-outcomes-and-associated-patient-socioeconomic-characteristics
#20
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
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