Abstract:
BACKGROUND:The traditional tools to assess surgical capacity in low-income countries require significant amounts of time and resources, and have thus not been utilized systematically in this context. Proxy indicators have been suggested as a simpler tool to estimate surgical volume. The aim of this study was to assess caesarean section and inguinal hernia repair as proxy indicators of the total number of surgeries performed per capita in a given region of sub-Saharan Africa. METHODS:Surgical data was compiled from 58 health institutions (96.7%) that performed major surgery in Sierra Leone in 2012. In total, 24,152 operative procedures were included in the study. Validity of proxy indicators was tested by logistic regression analyses with the rate of caesarean sections compared with total operations (%CS), hernia repairs (%HR) or both (%CS&HR) as dependent variables and the operations per 100,000 capita as the covariate. RESULTS:There was significant correlation for each of the proxy indicators, with the estimated odds ratio for %CS being 0.675 (95% CI, 0.520-0.876; P < .01), the estimated odds ratio for %HR being 0.822 (95% CI, 0.688-0.983; P < .05), and the estimated odds ratio for %CS&HR being 0.838 (95% CI, 0.731-0.962; P < .05). CONCLUSION:The unmet need for surgical services in a region of sub-Saharan Africa can be estimated by using any of the 3 proxy indicators. However, it seems that %CS is more sensitive for small changes in operations per 100,000 capita, compared with the %HR. There is no obvious added benefit for using the combined proxy indicator.
journal_name
Surgeryjournal_title
Surgeryauthors
Bjerring AW,Lier ME,Rød SM,Vestby PF,Melf K,Endreseth BH,Salvesen Ø,von Schreeb J,Wibe A,Kamara TB,Bolkan HAdoi
10.1016/j.surg.2014.12.014subject
Has Abstractpub_date
2015-05-01 00:00:00pages
836-42issue
5eissn
0039-6060issn
1532-7361pii
S0039-6060(14)00845-9journal_volume
157pub_type
杂志文章相关文献
SURGERY文献大全abstract::The recent surge in enthusiasm for laparoscopic surgery has created concern that abdominal insufflation with carbon dioxide produces a respiratory acidosis. This may be because of both transperitoneal gas absorption and impaired ventilation with increased dead space from elevated intraabdominal pressure. To examine th...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract::The object of this article is to assess the value of human serum albumin (HSA) in the initial resuscitation of hypotensive trauma victims. Thirty-six patients (mean age = 30 years) in shock from trauma who underwent laparotomies were randomly assigned to either Ringer's lactate solution (RL) resuscitation or 4% HSA in...
journal_title:Surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1981-04-01 00:00:00
abstract::The extrahepatic diversion of essential splanchnic hepatotrophic factors may cause the liver atrophy and insufficiency that follows portacaval shunting. To investigate this, control dogs with end-to-side portacaval shunts (control-PCS, n = 6) were compared with dogs shunted 1 month after intraportal pancreatic islet a...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1989-08-01 00:00:00
abstract:BACKGROUND:The objective of the current study was to define the incidence, as well as time course of mortality within the first year after liver transplantation. METHODS:Data on adult, first-time liver transplant recipients transplanted between February 2002 and June 2016 were obtained from the United Network for Orga...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2018.04.039
更新日期:2018-10-01 00:00:00
abstract::The possibility of vagal reinnervation to intrasplenic islet grafts was examined by measuring portal insulin response to electric stimulation of the dorsal vagus nerve in autografted dogs. Grafted islets responded appropriately to an exogenous cholinergic agent given intravenously. However, no insulin secretory respon...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1986-12-01 00:00:00
abstract:BACKGROUND:Bilateral axillo-breast approach (BABA) robotic thyroidectomy (RoT) has good postoperative and excellent cosmetic outcomes. To assess the surgical completeness of BABA RoT, it was compared to open thyroidectomy (OT) after propensity score matching of the cohorts. METHODS:Between 2008 and 2010, 760 patients ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2011.09.015
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Seeding of vascular grafts with genetically engineered human endothelial cells (hECs) secreting antithrombogenic or fibrinolytic agents has considerable clinical potential. METHODS:An adenoviral vector was used to transfer the human tissue-type plasminogen activator (htPA) gene to hECs, and the ability of t...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(97)90269-5
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND:Polymorphonuclear neutrophil (PMN) sequestration in the lung is a hallmark of acute respiratory distress syndrome (ARDS). We have shown that 25% Albumin (A25) resuscitation attenuates lung injury after hemorrhagic shock and lipopolysaccharide (LPS) exposure by reducing lung leukosequestration. We hypothesize...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2002.126508
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:In animal models of postoperative ileus (POI), inflammation of the intestine plays an important role in the pathogenesis of POI. Changes in alpha(2)-adrenoceptors and nitrergic regulation have been proposed to be implicated. The aim of our study was to investigate the presynaptic alpha(2)-receptor-mediated c...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2008.05.011
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Estimates of the number of firearm-related injuries widely vary. Although focus has been primarily on deaths, the societal cost of caring for victims of these injuries is largely unknown. Our goal was to estimate the economic impact of nonfatal, firearm-related injuries in the United States based on recent, ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2014.02.011
更新日期:2014-05-01 00:00:00
abstract::Until recently, vascular surgeons have had to make judgments based on an impression of their experiences rather than upon the actual facts. Presently, with the simplified and less costly use of computers, the establishment of a computerized data base is feasible. Our goal had been to develop a system suitable for micr...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1980-12-01 00:00:00
abstract::Myocardial high-energy phosphate and glucose-6-phosphate levels were determined in the in vivo pig heart model during ischemic arrest and reperfusion to determine the effectiveness of potassium cardioplegia in myocardial protection. Thirty-five pigs were divided into six experimental groups consisting of 2-hour normot...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1979-07-01 00:00:00
abstract:BACKGROUND:The aim of this prospective study was to elucidate the features, indications, and surgical treatment in patients affected by complications of Crohn's disease. METHODS:Between January 1985 and July 1996, 513 consecutive patients (248 male, 265 female; mean age, 38 years) were operated on for 542 occurrences ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(97)90071-4
更新日期:1997-10-01 00:00:00
abstract::The correct timing of surgery in cases of gallstone pancreatitis is debatable. To delineate more clearly the influence of the timing of surgery in the treatment of the disease, a prospective randomized clinical study of early surgery (less than 48 hours after admission) and delayed surgery (more than 48 hours after ad...
journal_title:Surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1988-10-01 00:00:00
abstract:BACKGROUND:The Lombardy region suffered severely during the acute phase of the coronavirus disease 2019 outbreak in Italy (Mar-Apr 2020) with 16,000 diagnosed coronavirus disease 2019-related deaths (49% of the total coronavirus disease 2019-related deaths in Italy). In the area surrounding Pavia during the critical st...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2020.09.009
更新日期:2020-12-01 00:00:00
abstract::We estimated ambulatory venous pressure (AVP) noninvasively with a new technique of quantitative photoplethysmography (PPG). Postural changes of hydrostatic pressure permitted in vivo calibration of the PPG. We recorded quantitative PPG and AVP in 14 normal subjects and 14 patients with postthrombotic chronic venous i...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1983-11-01 00:00:00
abstract:BACKGROUND:"Take the Volume Pledge" proposes restricting pancreatectomies to hospitals that perform ≥20 per year. Our purpose was to identify those factors that characterize patients at risk for loss of access to pancreatic cancer care with enforcement of volume standards. METHODS:Using the Healthcare Cost and Utiliza...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2016.07.017
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:We have previously reported that vascular inducible nitric oxide synthase (iNOS) gene transfer inhibits injury-induced intimal hyperplasia in vitro and in vivo. One mechanism by which NO may prevent intimal hyperplasia is by preserving the endothelium or promoting its regeneration. To study this possibility ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(97)90016-7
更新日期:1997-08-01 00:00:00
abstract:BACKGROUND:Lung injury in severe acute pancreatitis is mediated by infiltrating leukocytes. Our laboratory has previously demonstrated that acute lung injury in acute pancreatitis results in an up-regulation of vascular adhesion molecule-1 (VCAM-1) cell surface receptor expression on pulmonary vascular endothelium and ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2003.84
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Groin hernia repair occasionally leads to severe chronic pain associated with entrapped or damaged nerves. Conservative treatment is often unsuccessful. Selective neurectomy may be effective, but long-term results are scarce. The authors assessed the long-term efficacy of surgical neurectomy for chronic, pos...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2009.08.008
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Encapsulated follicular variant of papillary thyroid carcinoma has recently been reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features on the basis of its highly indolent behavior, as proposed by an international group of experienced thyroid pathologists. METHODS:All p...
journal_title:Surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.surg.2018.04.089
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Secondary hyperparathyroidism (SHPT) and its associated abnormalities in mineral metabolism increase the risk of cardiovascular morbidity and death in chronic renal failure (CRF). The effect of parathyroidectomy (PTX) on the incidence of major cardiovascular events in CRF patients with SHPT is unknown. We te...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2007.06.015
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:We have previously reported that by means of a breath test with intravenously administered L-[1-13C] phenylalanine (13Cphe), hepatopathy could be quantitatively evaluated by measuring expiratory 13CO2 levels in a short period. It is known that phenylalanine hydroxylase activity (PAHA) plays an important role...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2002.127947
更新日期:2002-11-01 00:00:00
abstract::Heterotopic rat heart allografts were performed in 35 rats. At intervals after transplantation, rats were killed and tissue concentrations of immunoassayable prostaglandin E (PGE) were measured in the native heart, transplanted heart, spleen, and thymus. A significant increase in allograft PGE activity was observed at...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1975-10-01 00:00:00
abstract:BACKGROUND:The present study evaluates 111In-pentetreotide scanning as a method for detection of gastrinomas. Operative findings serve as the benchmark for comparison of the efficacy of 111In-pentetreotide versus conventional imaging studies. METHODS:Twelve patients (seven female and five male; age, 37 to 80 years) wi...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(05)80121-7
更新日期:1995-12-01 00:00:00
abstract::Autologous fibrin glue was evaluated as a sealant of the common bile duct (CBD) with the use of experimental animal models. It proved to be highly effective. Since it is a safe product that can be easily obtained from the patient's own blood, it may find useful application in most biliary tract procedures, liver trans...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1987-03-01 00:00:00
abstract:BACKGROUND:Adhesions to polypropylene mesh used for abdominal wall hernia repair may eventuate in intestinal obstruction or enterocutaneous fistula. A Seprafilm Bioresorbable Membrane translucent adhesion barrier has been shown to inhibit adhesions. This investigation was designed to determine if Seprafilm alters abdom...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2000.106810
更新日期:2000-07-01 00:00:00
abstract::With advances in clinical immunosuppression, results in organ transplantation continue to improve. During a 52-month period, 507 cadaver renal transplants were performed, including 435 primary and 72 nonprimary transplants. All patients were managed with quadruple immunosuppression (prednisone, azathioprine, sequentia...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1988-10-01 00:00:00
abstract:BACKGROUND:Depression has been associated with delayed presentation, inadequate treatment, and poor survival in patients with cancer. METHODS:Using Surveillance, Epidemiology and End Results and Medicare linked data (1992-2005), we identified patients with pancreatic adenocarcinoma (N = 23,745). International classifi...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2012.06.010
更新日期:2012-09-01 00:00:00
abstract::Between July 1978 and February 1987, 177 pancreas transplants were performed. The 1-year patient and graft survival rates for the first 100 transplants up to October 1984 were 88% and 27%, respectively. Since November 1984, duct drainage has been used for 74 of 77 transplants, bladder (BD) in 36 and enteric (ED) in 38...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1987-10-01 00:00:00