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Surgery in rural

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https://www.readbyqxmd.com/read/29456356/the-current-state-of-rural-neurosurgical-practice-an-international-perspective
#1
REVIEW
Pavan S Upadhyayula, John K Yue, Jason Yang, Harjus S Birk, Joseph D Ciacci
Introduction: Rural and low-resource areas have diminished capacity to care for neurosurgical patients due to lack of infrastructure, healthcare investment, and training programs. This review summarizes the range of rural neurosurgical procedures, novel mechanisms for delivering care, rapid training programs, and outcome differences across international rural neurosurgical practice. Methods: A comprehensive literature search was performed for English language manuscripts with keywords "rural" and "neurosurgery" using the National Library of Medicine PubMed database (01/1971-06/2017)...
January 2018: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29433860/surgical-deserts-in-california-an-analysis-of-access-to-surgical-care
#2
Tarsicio Uribe-Leitz, Micaela M Esquivel, Naomi Y Garland, Kristan L Staudenmayer, David A Spain, Thomas G Weiser
BACKGROUND: Areas of minimal access to surgical care, often called "surgical deserts", are of particular concern when considering the need for urgent surgical and anesthesia care. We hypothesized that California would have an appropriate workforce density but that physicians would be concentrated in urban areas, and surgical deserts would exist in rural counties. METHODS: We used a benchmark of six general surgeons, six orthopedists, and eight anesthesiologists per 100,000 people per county to define a "desert"...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29428008/colonoscopy-in-rural-general-surgery-practice-challenges-outcomes-and-quality-measures
#3
Ramesh Kumar, Namrata Choudhary
No abstract text is available yet for this article.
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29420324/conjunctival-autograft-combined-with-either-preoperative-mitomycin-c-injection-or-intraoperative-local-mitomycin-c-over-the-medial-rectus-muscle-tendon-in-primary-pterygium-surgery
#4
Ayman Lotfy, Ahmed A M Gad, Ayman Abdelrahman, Ahmed Samir, Bahaa-Eldin Hasan Abdulhalim
PURPOSE: To evaluate and compare the recurrence rate and complications of conjunctival autograft (CAG) combined with preoperative mitomycin C (MMC) injection versus CAG with intraoperative local MMC over the medial rectus muscle tendon in primary pterygium. STUDY DESIGN: Randomized prospective study. METHODS: This study included 108 eyes of 108 patients with primary fleshy or growing pterygium. All patients were from rural areas and less than 50 years old...
February 7, 2018: Eye & Contact Lens
https://www.readbyqxmd.com/read/29397101/outcomes-for-thoracoscopy-versus-thoracotomy-not-just-technique-dependent-a%C3%A2-study-of-9-787-patients
#5
Andrea Wolf, Bian Liu, Emanuele Leoncini, Daniel Nicastri, Dong-Seok Lee, Emanuela Taioli, Raja Flores
BACKGROUND: Studies reporting the benefits of video-assisted thoracoscopic surgery (VATS) lung cancer resection over thoracotomy have been subject to selection bias. We evaluated patient and hospital characteristics associated with type of surgery and the independent effect of VATS on outcomes. METHODS: The Statewide Planning and Research Cooperative System of New York State database was queried to identify all lung cancer patients undergoing lobectomy or sublobar resection between 2007 and 2012...
January 31, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29396079/review-of-factors-influencing-women-s-choice-of-mastectomy-versus-breast-conserving-therapy-in-early-stage-breast-cancer-a-systematic-review
#6
REVIEW
Jeffrey Gu, Gary Groot, Catherine Boden, Angela Busch, Lorraine Holtslander, Hyun Lim
We have performed a narrative synthesis. A literature search was conducted between January 2000 and June 2014 in 7 databases. The initial search identified 2717 articles; 319 underwent abstract screening, 67 underwent full-text screening, and 25 final articles were included. This review looked at early stage breast cancer in women only, excluding ductal carcinoma in situ and advanced breast cancer. A conceptual framework was created to organize the central constructs underlying women's choices: clinicopathologic factors, physician factors, and individual factors with subgroups of sociodemographic, geographic, and personal beliefs and preferences...
January 3, 2018: Clinical Breast Cancer
https://www.readbyqxmd.com/read/29389793/complications-in-patients-undergoing-spinal-fusion-after-tha
#7
Bassel G Diebo, George A Beyer, Preston W Grieco, Shian Liu, Louis M Day, Roby Abraham, Qais Naziri, Peter G Passias, Aditya V Maheshwari, Carl B Paulino
INTRODUCTION: Patients with lumbar spine and hip disorders may, during the course of their treatment, undergo spinal fusion and THA. There is disagreement among prior studies regarding whether patients who undergo THA and spinal fusion are at increased risk of THA dislocation and other hip-related complications. QUESTIONS / PURPOSES: Is short or long spinal fusion associated with an increased rate of postoperative complications in patients who underwent a prior THA? PATIENTS AND METHODS: A retrospective study of New York State's Department of Health database (SPARCS) was performed...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29386183/follow-up-patterns-and-associated-risk-factors-after-paediatric-cataract-surgery-observation-over-a-5-year-period
#8
Pratik Chougule, Shamsiya Murat, Ashik Mohamed, Ramesh Kekunnaya
PURPOSE: To study the pattern of compliance to follow-up of children less than 5 years of age undergoing surgery for congenital and developmental cataract over a period of 5 years. METHODS: It is a retrospective study of children less than 5 years of age undergoing cataract surgery between January and December 2010 for congenital or developmental cataract and followed up until 31 December 2015. Age, sex, distance from hospital and urban or rural habitat, delay in presentation, socioeconomic status, laterality, morphology and type of cataract, implantation of intraocular lens and interventions done were noted...
January 31, 2018: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29379266/surgically-induced-astigmatism-after-phacoemulsification-by-temporal-clear-corneal-and-superior-clear-corneal-approach-a-comparison
#9
Archana Sunil Nikose, Dhrubojyoti Saha, Pradnya Mukesh Laddha, Mayuri Patil
Introduction: Cataract surgery has undergone various advances since it was evolved from ancient couching to the modern phacoemulsification cataract surgery. Surgically induced astigmatism (SIA) remains one of the most common complications. The introduction of sutureless clear corneal incision has gained increasing popularity worldwide because it offers several advantages over the traditional sutured limbal incision and scleral tunnel. A clear corneal incision has the benefit of being bloodless and having an easy approach, but SIA is still a concern...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29372083/discrepancies-between-planned-and-actual-operating-room-turnaround-times-at-a-large-rural-hospital-in-germany
#10
Regula Morgenegg, Franziska Heinze, Katharina Wieferich, Ralf Schiffer, Frank Stueber, Markus M Luedi, Dietrich Doll
Objectives: While several factors have been shown to influence operating room (OR) turnaround times, few comparisons of planned and actual OR turnaround times have been performed. This study aimed to compare planned and actual OR turnaround times at a large rural hospital in Northern Germany. Methods: This retrospective study examined the OR turnaround data of 875 elective surgery cases scheduled at the Marienhospital, Vechta, Germany, between July and October 2014...
November 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29350592/geographic-proximity-to-specialized-pediatric-neurosurgical-care-in-the-contiguous-united-states
#11
Abdul-Kareem Ahmed, Ann-Christine Duhaime, Timothy R Smith
OBJECTIVE Absent from an analysis of supply is consideration of the geographic distribution of pediatric neurosurgeons. Several patient socioeconomic metrics are known to be associated with outcome in pediatric neurosurgical diseases, such as hydrocephalus. The purpose of this study was to determine current geographic proximity to pediatric neurosurgical care using professional society databases. This study also sought to establish how socioeconomic factors are related to distance to care, using federal government-collected data...
January 19, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29344622/barriers-to-and-facilitators-of-implementing-enhanced-recovery-pathways-using-an-implementation-framework-a-systematic-review
#12
Alexander B Stone, Christina T Yuan, Michael A Rosen, Michael C Grant, Lauren E Benishek, Elizabeth Hanahan, Lisa H Lubomski, Clifford Ko, Elizabeth C Wick
Importance: Enhanced recovery pathways (ERPs) have the potential to reduce length of hospital stay, costs, and complications following surgery but can be challenging to implement. Objective: To examine the body of literature on ERPs to assess how authors describe barriers and facilitators of ERP implementation and identify, in aggregate, the best practices that should be considered utilizing the Consolidated Framework for Implementation Research (CFIR) to extract these elements and summarize common barriers and facilitators according to its 5 major domains: (1) intervention characteristics, (2) inner setting, (3) outer setting, (4) characteristics of the individuals, and (5) the process of implementation...
January 17, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29333013/comparative-study-of-imprint-cytology-and-histopathology-of-soft-tissue-tumors
#13
Sujit Kumar Dutta, Senjuti Dasgupta, Nirmal Kumar Bhattacharyya, Parul Jain, Debdas Bose, Pranab Kumar Biswas
Background: The components of soft tissue are fibroblasts, collagen, vascular structures, fatty tissue, skeletal muscles, smooth muscles, and neural tissue. The real incidence of soft tissue tumors (STTs) is difficult to estimate because most of them are benign (Benign: Malignant-100:1). Aims: The aim of the present study was undertaken to note the patterns of presentation of patients with STTs and to evaluate the findings of imprint cytology (IC) and histopathological examination (HPE) of STTs...
October 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29325761/trends-in-utilization-of-robotic-and-open-partial-nephrectomy-for-management-of-ct1-renal-masses
#14
Mahmoud Alameddine, Tulay Koru-Sengul, Kevin J Moore, Feng Miao, Luís Felipe Sávio, Bruno Nahar, Nachiketh Soodana Prakash, Vivek Venkatramani, Joshua S Jue, Sanoj Punnen, Dipen J Parekh, Chad R Ritch, Mark L Gonzalgo
BACKGROUND: Partial nephrectomy is widely used for surgical management of small renal masses. Use of robotic (RPN) versus open partial nephrectomy (OPN) among various populations is not well characterized. OBJECTIVE: To analyze trends in utilization of RPN and disparities that may be associated with this procedure for management of cT1 renal masses in the USA. DESIGN, SETTING, AND PARTICIPANTS: Patients who underwent RPN or OPN for clinical stage T1N0M0 renal masses in the USA from 2010 to 2013 were identified in the National Cancer Data Base...
January 8, 2018: European Urology Focus
https://www.readbyqxmd.com/read/29317415/examining-changes-in-the-equity-of-physician-distribution-in-japan-a-specialty-specific-longitudinal-study
#15
Koji Hara, Susumu Kunisawa, Noriko Sasaki, Yuichi Imanaka
OBJECTIVES: In this longitudinal study, we examined changes in the geographical distribution of physicians in Japan from 2000 to 2014 by clinical specialty with adjustments for healthcare demand based on population structure. METHODS: The Japanese population was adjusted for healthcare demand using health expenditure per capita stratified by age and sex. The numbers of physicians per 100 000 demand-adjusted population (DAP) in 2000 and 2014 were calculated for subprefectural regions known as secondary medical areas...
January 8, 2018: BMJ Open
https://www.readbyqxmd.com/read/29310408/case-report-repairing-orbital-skin-defects-using-composite-flaps-after-giant-eyelid-derived-tumor-excision-and-orbital-exenteration
#16
Bin Fan, Jian-Ju Liu, Bei-Fen Wang, Ying-Jian Sun, Guang-Yu Li
RATIONALE: Though giant malignant tumors arising in the eyelid are rare, they often require extensive surgery for removal along with orbital exenteration. Because of this, repairing orbital defects is an important factor in the surgical strategy. PATIENT CONCERNS: Case 1 was a 78-year-old nomad man who presented in the Department of Ophthalmology with a giant tumor in his right eyelid, which had developed over three years. Clinical examination revealed a huge pigmented, nonhealing ulcerated lesion, approximately 52×44×40 mm in size...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29284848/utility-of-acute-normovolemic-hemodilution-in-major-surgeries-in-rural-area-a-prospective-comparative-study-from-north-india
#17
Sujeet Rai, Satyajeet Verma, Pramod Kumar Yadav, Jawed Ahmad, Harikesh Kumar Yadav
Introduction: Easy availability of autologous blood is difficult in rural areas. Acute normovolemic hemodilution (ANH) has been found to be an effective alternative in major surgeries where we are expecting major blood loss. Patients and Methods: A prospective comparative study was designed to evaluate the utility of ANH patients (patients receiving autologous blood) during major operations done at MRA Medical College Ambedkar Nagar, Uttar Pradesh, India. during from September 2015 to September 2016...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29282601/decreased-use-of-sphincter-preserving-procedures-among-african-americans-with-rectal-cancer
#18
Elliot G Arsoniadis, Yunhua Fan, Stephanie Jarosek, Wolfgang B Gaertner, Genevieve B Melton, Robert D Madoff, Mary R Kwaan
BACKGROUND: Improved multimodality rectal cancer treatment has increased the use of sphincter-preserving surgery. This study sought to determine whether African American (AA) patients with rectal cancer receive sphincter-preserving surgery at the same rate as non-AA patients. METHODS: The study used the Nationwide Inpatient Sample for years 1998-2012 to compare AA and non-AA patients with rectal cancer undergoing low anterior resection or abdominoperineal resection...
December 27, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29282582/rural-urban-differences-in-surgical-treatment-regional-lymph-node-examination-and-survival-in-endometrial-cancer-patients
#19
Whitney E Zahnd, Katherine S Hyon, Paula Diaz-Sylvester, Sonya R Izadi, Graham A Colditz, Laurent Brard
PURPOSE: Endometrial cancer (EC) is the most common gynecological malignancy and one of few cancers with an increasing US mortality rate. Rural patients may have less access to specialty care affecting their receipt of surgery and adequate lymphadenectomy (AL). We sought to assess rural-urban differences in EC surgery, lymphadenectomy, and survival. METHODS: We analyzed data from the Surveillance Epidemiology and End Results database on EC patients (2004-2013). We performed univariate analyses to compare rural and urban patients on demographic and clinical characteristics and receipt of nodal examination and AL...
December 27, 2017: Cancer Causes & Control: CCC
https://www.readbyqxmd.com/read/29249273/30-day-all-cause-hospital-readmission-after-cystectomy-no-worse-for-rural-medicare-residents
#20
Daniel J Sadowski, Hayden Warner, Steven Scaife, Kevin T McVary, Shaheen R Alanee
OBJECTIVE: To evaluate rural/urban disparities in 30-day all-cause hospital admission after cystectomy. MATERIALS AND METHODS: We used the SEER-Medicare database to identify all Medicare beneficiaries who underwent radical cystectomy (ICD-9 codes 57.7, 57.71, 57.79, and 68.8) between the years 1991 and 2009, yielding a total sample size of 15,572. Our primary outcome was 30-day hospital readmission rate. Rural Urban Continuum Codes were used to designate county-level rural status based on patient residence...
December 14, 2017: Urologic Oncology
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