Abstract：
BACKGROUND:We sought to assess the status of availability of technology for trauma care in a state in India and to identify factors contributing to both adequate levels of availability and to deficiencies. We also sought to identify potential solutions to deficiencies in terms of health system management and product development. METHODS:Thirty-two technology-related items were selected from the World Health Organization's Guidelines for Essential Trauma Care. The status of these items was assessed at 43 small and large hospitals in Gujarat State. Site visits utilized direct inspection and interviews with administrative, clinical, and bioengineering staff. RESULTS:Many specific individual items could be better supplied, including many that were very low cost (e.g., chest tubes). Many deficiencies arose because of mismatch of resources, such as availability of equipment in the absence of personnel trained to use it. Several locally manufactured items were fairly well supplied: pulse oximetry, image intensification, and X-ray machines. Ventilators were often deficient because of inadequate numbers of units and frequent breakdowns. CONCLUSIONS:Availability of a range of lower-cost items could be improved by better organization and planning, such as: better procurement and stock management; eliminating mismatch of resources, including optimizing training for use of existing resources; and by strengthening service contracts and in-house repair capabilities. From a product development viewpoint, there is a need for lower cost, more durable, and easier to repair ventilators. Promoting increased capacity for local manufacturing should also be considered as a potential method to decrease cost and increase availability of a range of equipment.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Shah MT,Joshipura M,Singleton J,LaBarre P,Desai H,Sharma E,Mock Cdoi
10.1007/s00268-014-2805-7subject
Has Abstractpub_date
2015-02-01 00:00:00pages
363-72issue
2eissn
0364-2313issn
1432-2323journal_volume
39pub_type
杂志文章abstract：BACKGROUND:Owing to an aging society, both the number of operations for patients aged >85 years and the average age of patients admitted to the intensive care unit (ICU) are rapidly increasing. However, mortality is not an appropriate outcome measurement in patients aged >85 years; a more important outcome is home retu...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3830-5
更新日期：2017-04-01 00:00:00
abstract：BACKGROUND:The specific definition of central hepatectomy (CH) (i.e., resection of segments 4-5-8 ± 1) is not uniformly used, resulting in conflicting comparisons with the more commonly performed extended hepatectomy (EH). The study aimed to compare, using propensity score matching (PSM) analysis, the incidence of post...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3584-0
更新日期：2016-11-01 00:00:00
abstract：BACKGROUND:The risk of developing chronic kidney disease (CKD) among living kidney donors (LKDs) is seldom included in evaluations of patients' outcomes. Potential risk factors and new criteria for estimating the glomerular filtration rate (eGFR) indexed for body surface area (BSA) were investigated with a view to prev...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-1906-z
更新日期：2013-04-01 00:00:00
abstract：BACKGROUND:The optimal timing of VTE prophylaxis initiation after blunt solid organ injury is controversial. Retrospective studies suggest initiation ≤48 h is safe. This prospective study examined the safety and efficacy of early VTE prophylaxis initiation after nonoperative blunt solid organ injury. METHODS:All patie...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05096-7
更新日期：2019-11-01 00:00:00
abstract：BACKGROUND:Although various complications after hepatectomy have been reported, there have been no large studies on postoperative portal vein thrombosis (PVT) as a complication. This study evaluated the incidence, risk factors, and clinical outcomes of PVT after hepatectomy. METHODS:The preoperative and postoperative ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2440-8
更新日期：2014-06-01 00:00:00
abstract：:This study aims to examine the frequency of the pheochromocytoma (pheo), defined as a "benign, intra-adrenal, hypertensive, sporadic, unilateral tumor." Three large series amounting to 310 subphrenic chromaffin tumors operated over periods of 17, 23, and 41 years, respectively, have been reviewed. Among those combined...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF00353738
更新日期：1994-07-01 00:00:00
abstract：BACKGROUND:Anal manometry is a useful tool for testing the effectiveness of surgical treatment. However, most techniques for anal pressure measurement are not easily available because of high cost. The aim of the present study was to introduce an easy and reproducible method for measuring anal pressures in testing the ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-006-0365-1
更新日期：2007-02-01 00:00:00
abstract：:Pancreatic endocrine tumors (PETs) may be sporadic or inherited in the multiple endocrine neoplasia type 1 (MEN-1) syndrome. The inherited form is caused by mutations of the MEN-1 gene, which functions as a tumor suppressor gene and maps to chromosome 11q13. These tumors tend to have a better prognosis than their spor...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-002-4062-4
更新日期：2002-07-01 00:00:00
abstract：BACKGROUND:The commonest surgical treatment used for peptic ulcer perforation is omental patching. If, however, the perforation leaks, it rarely heals by itself due to persistence of duodenal fistula (DF). We present our experience with a T-tube placed into the DF for better outcome of the patients. METHODS:All patien...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2196-1
更新日期：2013-11-01 00:00:00
abstract：BACKGROUND:Trauma is the third leading cause of death worldwide after cardiovascular and oncologic diseases. Predominant causes of trauma-related death (TD) are severe traumatic brain injury (sTBI), hemorrhagic shock, and multiple organ failure. An analysis of TD is required in order to review the quality of trauma car...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05347-7
更新日期：2020-04-01 00:00:00
abstract：OBJECTIVE:Mirizzi syndrome (MS) is an uncommon presentation of cholelithiasis. This study aims to find the incidence and analyze the outcome of management of this condition at Riyadh Medical Complex (RMC) with particular reference to diagnostic methods and outcome of surgical treatment. METHODS:Retrospective study on ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-005-0100-3
更新日期：2005-12-01 00:00:00
abstract：:Multiple organ failure (MOF) is considered to be the leading cause of death after severe trauma. Although there is extensive literature on MOF, little is known about the pattern, sequence, and onset of this clinical syndrome. The first goal of this clinical study was to define MOF; the second was to assess the typical...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900067
更新日期：1996-05-01 00:00:00
abstract：BACKGROUND:Although laparoscopic appendectomy (LA) is widely performed in many countries, LA for complicated appendicitis, which includes perforated or gangrenous appendicitis with or without localized or disseminated peritonitis, has not become a common practice yet. METHODS:We retrospectively analyzed the clinical r...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-008-9843-y
更新日期：2009-02-01 00:00:00
abstract：BACKGROUND:Substernal thyroidectomy (ST), as compared to conventional, cervical thyroidectomy, is a technically demanding procedure that is associated with increased morbidity and mortality. We tested the hypothesis that outcomes following ST are improved at centers that perform a high volume of thyroidectomies. METHO...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-007-9347-1
更新日期：2008-05-01 00:00:00
abstract：:There is little information on the pharmacokinetics and pharmacodynamics of doxorubicin (DXR) administered during locoregional treatments of colon carcinoma under hyperthermic conditions. The aim of this study was to evaluate distribution and activity of DXR in healthy tissue and tumor tissues under hyperthermic condi...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-003-6804-3
更新日期：2003-06-01 00:00:00
abstract：BACKGROUND:Single-incision laparoscopic colorectal surgery (SILS) suggests a promising alternative to conventional laparoscopic surgery. In this report we describe our initial experience with SILS for both right hemicolectomies and anterior resections. METHODS:Between June 2009 and May 2010, SILS was performed for 32 ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-011-0989-7
更新日期：2011-04-01 00:00:00
abstract：INTRODUCTION:The decision to perform a relaparotomy in patients with secondary peritonitis is based on "clinical judgment" with inherent variability among surgeons. Our objective was to review the literature on prognostic variables for ongoing abdominal infection. Predictive variables for positive findings at relaparot...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-005-0333-1
更新日期：2006-12-01 00:00:00
abstract：BACKGROUND:Barriers to female surgeons entering the field are well documented in Australia, the USA and the UK, but how generalizable these problems are to other regions remains unknown. METHODS:A cross-sectional survey was developed by the International Federation of Medical Students' Associations (IFMSA)'s Global Su...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05199-1
更新日期：2020-01-01 00:00:00
abstract：BACKGROUND:Binding of the lectin Helix pomatia agglutinin (HPA) has been shown to be associated with poor prognosis in many human cancers, but not in thyroid cancer. The aims of the present study were to assess alteration in cellular glycosylation, detected by HPA binding, in thyroid tumors; to determine if such altere...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-011-1196-2
更新日期：2011-10-01 00:00:00
abstract：:Most neoplasms arising in the parotid gland are benign. Patients with cancer of the parotid gland usually present with normal facial nerve function. In these patients, findings at the time of surgery will guide the management of the facial nerve, with most surgeons preserving the nerve unless it is adherent to, or imb...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-003-7112-7
更新日期：2003-07-01 00:00:00
abstract：BACKGROUND:There are scant studies that have analyzed the prognostic factors for malignant nonfunctioning endocrine tumors of the pancreas. We identified the predictive factors associated with long-term survival after surgical resection for malignant nonfunctioning endocrine tumors. METHODS:Among the 25 patients seen ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-006-0585-4
更新日期：2007-03-01 00:00:00
abstract：BACKGROUND:Over the past decade, assessments of surgical capacity in low- and middle-income countries (LMICs) have contributed to our understanding of barriers to the delivery of surgical services in a number of countries. It is yet unclear, however, how the findings of these assessments have been applied and built upo...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-014-2938-8
更新日期：2015-04-01 00:00:00
abstract：BACKGROUND:Open surgical cricopharyngeal myotomy(CM) is considered standard of care for Zenker's diverticulum(ZD). Trans-oral CM has been described using a rigid stapling device for two decades; however, this remains problematic for severely kyphotic patients. This problem can be overcome with flexible endoscopy utiliz...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3442-0
更新日期：2016-06-01 00:00:00
abstract：:Childhood papillary thyroid carcinoma is associated with more locally aggressive and more frequent distant disease than its adult counterpart. Recurrence rates tend to be higher in children, but cause-specific mortality remains low. Optimal initial treatment of childhood papillary thyroid carcinoma should include tota...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-004-7605-z
更新日期：2004-12-01 00:00:00
abstract：BACKGROUND:Tumor size has been advocated as possible risk factors for occult central lymph node metastases (CNM) in papillary thyroid carcinoma (PTC) patients. This prospective study evaluated factors that could identify patients at higher risk of occult CNM, especially comparing micro-PTC and macro-PTC. METHODS:One h...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4390-z
更新日期：2018-03-01 00:00:00
abstract：:Eighty patients undergoing cholecystectomy were either assigned deliberately (n = 30) or randomized (n = 50) to drainage (n = 38) or nondrainage (n = 42). Subhepatic collections were seen on ultrasonography (US) after 48 to 72 hours in 12 of 35 patients with drainage and 24 of 42 patients without drainage (p < 0.05). ...
journal_title：World journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/BF01655718
更新日期：1993-01-01 00:00:00
abstract：:Organ transplantation continues to be hindered by a limited supply of organs. A significant percentage of potential organ donors are lost to either medical failure or inability to obtain consent for donation. In a surgical intensive care unit (ICU) we have refocused our efforts toward aggressive resuscitation, directe...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/pl00012362
更新日期：1999-07-01 00:00:00
abstract：BACKGROUND:Postoperative liver failure (PHLF) is one of the most common complications following major hepatectomy. The preoperative assessment of future liver remnant (FLR) function is critical to predict the incidence of PHLF. OBJECTIVE:To determine the efficacy of the plasma clearance rate of indocyanine green clear...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3441-1
更新日期：2016-06-01 00:00:00
abstract：BACKGROUND:Nasogastric decompression has been routinely used in most major abdominal operations to prevent the consequences of postoperative ileus. The aim of the present study was to assess the necessity for routine prophylactic nasogastric or nasojejunal decompression after gastrectomy. METHODS:A prospective randomi...
journal_title：World journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00268-006-0430-9
更新日期：2007-01-01 00:00:00
abstract：:The purpose of this study was to evaluate the pattern of recovery of intestinal motility using manometric and clinical assessment in the postoperative ileus following abdominal surgery. We reviewed the charts of 18 patients who underwent partial colectomy for colon cancer (group A, without vagotomy) and compared them ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900310
更新日期：1997-10-01 00:00:00
