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1 Canadian Field Hospital in Haiti: surgical experience in earthquake relief.

https://arctichealth.org/en/permalink/ahliterature122035
Source
Can J Surg. 2012 Aug;55(4):271-4
Publication Type
Article
Date
Aug-2012
Author
Max Talbot
Bethann Meunier
Vincent Trottier
Michael Christian
Tracey Hillier
Chris Berger
Vivian McAlister
Scott Taylor
Author Affiliation
1 Canadian Field Hospital, Canadian Forces, Montreal, QC. max_talbot@hotmail.com
Source
Can J Surg. 2012 Aug;55(4):271-4
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Canada
Disaster Planning - organization & administration
Earthquakes
Female
Haiti
Hospitals, Packaged - organization & administration
Humans
International Cooperation
Male
Multiple Trauma - etiology - surgery
Operating Rooms
Relief Work - organization & administration
Surgical Procedures, Operative - statistics & numerical data
Abstract
The Canadian Forces' (CF) deployable hospital, 1 Canadian Field Hospital, was deployed to Haiti after an earthquake that caused massive devastation. Two surgical teams performed 167 operations over a 39-day period starting 17 days after the index event. Most operations were unrelated to the earthquake. Replacing or supplementing the destroyed local surgical capacity for a brief period after a disaster can be a valuable contribution to relief efforts. For future humanitarian operations/disaster response missions, the CF will study the feasibility of accelerating the deployment of surgical capabilities.
Notes
Cites: Disasters. 2000 Sep;24(3):262-7011026159
Cites: Prehosp Disaster Med. 2003 Oct-Dec;18(4):278-9015310039
Cites: Disaster Manag Response. 2005 Jan-Mar;3(1):11-615627125
Cites: Mil Med. 2007 May;172(5):471-717521092
Cites: Prehosp Disaster Med. 2008 Mar-Apr;23(2):144-51; discussion 152-318557294
Cites: Ann Intern Med. 2010 Jun 1;152(11):733-720197507
Cites: Prehosp Disaster Med. 2009 Jan-Feb;24(1):9-1019557952
Cites: Science. 2010 Feb 5;327(5966):638-920133550
Cites: Nature. 2010 Feb 18;463(7283):878-920164905
Cites: N Engl J Med. 2010 Mar 18;362(11):e3820200362
Cites: Prehosp Disaster Med. 2009 Jan-Feb;24(1):3-819557951
PubMed ID
22854149 View in PubMed
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An analysis of frequencies of surgical procedures in Canada.

https://arctichealth.org/en/permalink/ahliterature227503
Source
Health Rep. 1991;3(4):291-309
Publication Type
Article
Date
1991
Author
J F Gentleman
R. Wilkins
C. Nair
S. Beaulieu
Author Affiliation
Canadian Centre for Health Information, Statistics Canada.
Source
Health Rep. 1991;3(4):291-309
Date
1991
Language
English
French
Publication Type
Article
Keywords
Canada
Hospitalization - statistics & numerical data
Humans
Patient Discharge - statistics & numerical data
Poisson Distribution
Residence Characteristics - statistics & numerical data
Socioeconomic Factors
Surgical Procedures, Operative - statistics & numerical data - utilization
Abstract
This paper reports preliminary and selected results of an analysis of the frequencies of 36 common surgical procedures in hospitals across Canada during the period April 1985 to March 1987. Age-sex-specific and age-sex-standardized procedure rates were calculated for each procedure for each of 245 Census Divisions (CDs) across Canada, as well as for 338 smaller urban areas (FSAs) within the province of Ontario. Special attention was given to adjusting the rates for differing population sizes of the geographical regions. Procedure rates were computed based on the residence of the patient, not on the location of the hospital. Graphical techniques, analysis of variance, and other statistical techniques were used to identify unusually high or low procedure rates and to determine effects due to differences in age, sex, and geographical region. The relationship of procedure rate to the socio-economic level of a region (as measured by the proportion of low-income individuals in the region) was analyzed.
PubMed ID
1818730 View in PubMed
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The Canadian four-centre study of anaesthetic outcomes: III. Are anaesthetic complications predictable in day surgical practice?

https://arctichealth.org/en/permalink/ahliterature223844
Source
Can J Anaesth. 1992 May;39(5 Pt 1):440-8
Publication Type
Article
Date
May-1992
Author
P G Duncan
M M Cohen
W A Tweed
D. Biehl
W D Pope
R N Merchant
D. DeBoer
Author Affiliation
Department of Anesthesia, University of Saskatchewan, Canada.
Source
Can J Anaesth. 1992 May;39(5 Pt 1):440-8
Date
May-1992
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Ambulatory Surgical Procedures - adverse effects - statistics & numerical data
Anesthesia - adverse effects - statistics & numerical data
Anesthesia Recovery Period
Anesthesiology - education
Anesthetics - adverse effects
Canada - epidemiology
Diagnosis-Related Groups
Disease
Female
Humans
Male
Middle Aged
Monitoring, Intraoperative - statistics & numerical data
Multivariate Analysis
Outcome Assessment (Health Care)
Postoperative Care - statistics & numerical data
Preoperative Care
Probability
Safety
Surgical Procedures, Operative - statistics & numerical data
Abstract
To understand better the factors important to the safety of anaesthesia provided for day surgical procedures, we analyzed the intraoperative and immediate postoperative course of patients at four Canadian teaching hospitals' day treatment centres. After excluding those who received only monitored anaesthesia care, there were 6,914 adult (non-obstetrical) patients seen over a twelve-month period in 1988-89. The rate of adverse outcome consequent to their care was identified by a comprehensive surveillance system which included review of anaesthetic records (four hospitals) and follow-up telephone calls (two hospitals). The relationship between adverse events and preoperative factors was determined by using a multiple logistic regression analysis that included age, sex, duration of the procedure and the hospital care. There were no deaths during the study period and major morbid events were infrequent. Patient preoperative disease was predictive of some intraoperative events relating to the same organ system, but not to events in the PACU. Some unexpected relationships emerged including preoperative hypertension being related to a greater risk of difficult intubation, and neurological disease to perioperative cardiac abnormalities. Patients judged obese, or inadequately fasted, were found to experience a greater rate of recovery problems as well as discomfort. While the low response rate (36%) to the telephone interviews created a sampling bias, the high rate of patient dissatisfaction among those reached is disconcerting. We conclude that day surgical patients with preoperative medical conditions, even when optimally managed, are at higher risk for adverse events in the perioperative period.
Notes
Comment In: Can J Anaesth. 1993 Jan;40(1):79-818425250
PubMed ID
1596967 View in PubMed
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Changes in utilization of dental services of Alberta's universal dental plan for the elderly.

https://arctichealth.org/en/permalink/ahliterature218288
Source
J Can Dent Assoc. 1994 May;60(5):403-6
Publication Type
Article
Date
May-1994
Author
G W Thompson
D W Lewis
Author Affiliation
Division of Community Dentistry, Faculty of Dentistry, University of Alberta, Toronto, ON.
Source
J Can Dent Assoc. 1994 May;60(5):403-6
Date
May-1994
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Alberta
Dental Care for Aged - statistics & numerical data - utilization
Dental Health Services - statistics & numerical data - utilization
Dentistry, Operative - statistics & numerical data
Denturists - utilization
Fees, Dental - statistics & numerical data
Humans
Periodontics - statistics & numerical data
Preventive Dentistry - statistics & numerical data
Prosthodontics - statistics & numerical data
State Dentistry - statistics & numerical data - utilization
Surgical Procedures, Operative - statistics & numerical data
Abstract
Since 1973, Alberta's dental plan for the elderly has made government-sponsored, premium-free comprehensive care by dentists and denturists available to all residents of the province over age 64. Details on the numbers and types of different services provided were previously unavailable from the annual reports. However, an examination of the plan's six-million records, covering nearly 260,000 different patients from 1978 to 1992, has now made it possible, for the first time, to conduct a detailed analysis of these dental services. Many time-related changes have occurred in the types of services provided. The number of removable prosthodontic services declined from 14 per cent of all services offered by dentists in 1978-79 to five per cent of these services in 1991-1992, but the services provided by denturists increased by a factor of four. The relative number of surgical and restorative dentistry services offered by dentists also declined. Preventive services grew modestly, but periodontal services grew dramatically from three per cent of all services provided by dentists to 22 per cent. These shifts in services from prosthodontics, restorative dentistry and oral surgery to preventive and periodontic services have important implications for the planning and administration of dental plans for the elderly.
PubMed ID
8004517 View in PubMed
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Complications of peptic ulcer disease before and after the introduction of H2-receptor antagonists.

https://arctichealth.org/en/permalink/ahliterature224093
Source
Hepatogastroenterology. 1992 Apr;39(2):144-8
Publication Type
Article
Date
Apr-1992
Author
J. Mäkelä
S. Laitinen
M I Kairaluoma
Author Affiliation
Oulu University Central Hospital, Department of Surgery, Finland.
Source
Hepatogastroenterology. 1992 Apr;39(2):144-8
Date
Apr-1992
Language
English
Publication Type
Article
Keywords
Aged
Duodenal Ulcer - complications - drug therapy
Female
Finland - epidemiology
Histamine H2 Antagonists - therapeutic use
Humans
Incidence
Intestinal Obstruction - etiology - surgery
Male
Middle Aged
Peptic Ulcer Hemorrhage - etiology - surgery
Peptic Ulcer Perforation - etiology - surgery
Postoperative Complications - mortality
Stomach Ulcer - complications - drug therapy
Surgical Procedures, Operative - statistics & numerical data
Time Factors
Abstract
This study was undertaken in order to evaluate the incidence of operations for bleeding, perforated and obstructing peptic ulcers in a defined population before and after the introduction of H2-receptor antagonists. The annual incidence of surgery for all peptic ulcer complications increased slightly, from 6.9 per 10(5) individuals in 1977 to 14.2 per 10(5) in 1989 (n.s.), whereas the annual incidence of operations for ulcer bleeding and perforation remained relatively stable, varying from 2.8 to 8.9 per 10(5) inhabitants and from 2.3 to 7.5 per 10(5) inhabitants during the study period. Operations performed for gastric outlet obstruction did not increase, varying from 0.8 to 2.2 per 10(5) individuals over the study period. The annual proportion of emergency operations did not increase. Young men and old women were often operated on for bleeding (p less than 0.0001) and perforated ulcers (p less than 0.01). Duodenal ulcer bleeding and perforation were more frequent in the young patient groups. Overall mortality after operations performed for bleeding was 15%, and that after operations for perforation or obstruction, 17% and 8%, respectively. The mean age of the fatalities, 63 +/- 13 years, was significantly higher than that of those who survived after operation, 53 +/- 15 years (p 0.0001). Mortality was higher after operations for gastric ulcer complications (22%) than after operations for duodenal ulcer complications (10%) (p less than 0.01).
PubMed ID
1353048 View in PubMed
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[Correlation of the frequency of surgical procedures on the peripheral immunologic organs with the frequency of oncologic and other somatic diseases].

https://arctichealth.org/en/permalink/ahliterature167153
Source
Vopr Onkol. 2006;52(4):458-60
Publication Type
Article
Date
2006
Author
A V Dobzhanskii
V M Matrosov
M V Parusov
N I Pavlov
M V Travin
Source
Vopr Onkol. 2006;52(4):458-60
Date
2006
Language
Russian
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Epidemiology - statistics & numerical data
Female
Humans
Immune System - surgery
Incidence
Infant
Infant, Newborn
Lymphatic System - surgery
Male
Middle Aged
Neoplasms - epidemiology - immunology
Russia - epidemiology
Surgical Procedures, Operative - statistics & numerical data
Abstract
Regional Oncological Dispensary, Kostroma The study included 388 cancer patients (group 1) and 381 cases of other pathologies (group 2). Surgery on lymphoid organs was performed in 121 patients (31%) in group 1 and 150 in group 2. It was concluded that such intervention in the immune system was not an oncological hazard. That phenomenon might be accounted for by the specificity of immune response in patients suffering from such diseases.
PubMed ID
17024823 View in PubMed
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Delivery models of rural surgical services in British Columbia (1996-2005): are general practitioner-surgeons still part of the picture?

https://arctichealth.org/en/permalink/ahliterature155820
Source
Can J Surg. 2008 Jun;51(3):173-8
Publication Type
Article
Date
Jun-2008
Author
Nancy Humber
Temma Frecker
Author Affiliation
Department of Family Practice (Research Division), University of British Columbia, Vancouver, BC. Saffron2@telus.net
Source
Can J Surg. 2008 Jun;51(3):173-8
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Appendectomy - statistics & numerical data
British Columbia
Delivery of Health Care - manpower - organization & administration
Emergency Medical Services - statistics & numerical data
Family Practice - organization & administration
Foreign Medical Graduates
General Surgery - organization & administration
Humans
Maternal Health Services - statistics & numerical data
Outcome Assessment (Health Care)
Physician's Practice Patterns - statistics & numerical data
Physician's Role
Referral and Consultation - statistics & numerical data
Retrospective Studies
Rural Health Services - manpower - organization & administration
Surgical Procedures, Operative - statistics & numerical data
Abstract
To define the models of surgical service delivery in rural communities that rely solely on general practitioner (GP)-surgeons for emergency care, to examine how they have changed over the past decade and to identify some effects on communities that have lost their local surgical program.
We undertook a retrospective study using the Population Utilization Rates and Referrals For Easy Comparative Tables database (versions 6.0 and 9.0) and telephone interviews to hospitals that we identified. We included all hospitals in rural British Columbia with surgical programs that had no resident specialist surgeon and that relied on general practitioner-surgeons (GP-surgeons) for emergency surgical care. We examined surgical program characteristics, community size, distance from referral centre, role of itinerant surgery, where GPs were trained, their age and years of experience and referral rates for appendectomies and obstetrics.
Changes over the past decade include a decrease in the total number of GP-surgeons operating in these communities, more itinerant surgery and the loss of 3 of 12 programs. GP-surgeons are older, are usually foreign-trained and have more than 5 years of experience. Communities with no local program or that rely on solo practitioners refer more emergencies out of the community and do less maternity care than those with more than a single GP-surgeon.
GP-surgeons still play an integral role in the provision of emergency and elective surgical services in rural communities without the population base to sustain resident specialist surgeons. As GP-surgeons retire and surgical programs close, there is no accredited training program to replace them. More outcome comparisons between procedures performed by GP-surgeons and general surgeons are needed, as is the creation of a nationally accredited training program to replace these practitioners as they retire.
Notes
Cites: Can Med Assoc J. 1979 Apr 21;120(8):919436065
Cites: Am J Public Health. 1997 Jan;87(1):85-909065233
Cites: Can Fam Physician. 1998 Oct;44:2117-249805166
Cites: Can Fam Physician. 2005 Sep;51:1238-916926940
Cites: Can J Surg. 2008 Jun;51(3):179-8418682764
Cites: Am J Public Health. 1983 Apr;73(4):414-216829824
Cites: Can Med Assoc J. 1984 Mar 1;130(5):571-66697267
Cites: J Fam Pract. 1988 Oct;27(4):377-843171489
Cites: Am J Public Health. 1990 Jul;80(7):814-82356904
Cites: CMAJ. 1991 Jul 1;145(1):46-82049697
Cites: CMAJ. 1993 Nov 15;149(10):1541-58221438
Cites: CMAJ. 1995 Nov 15;153(10):1447-527585371
Cites: CMAJ. 1995 Nov 15;153(10):1453-47585372
Cites: Am J Public Health. 1996 Jul;86(7):1011-58669503
Cites: CMAJ. 1996 Aug 15;155(4):395-4018752064
Cites: Br J Gen Pract. 1997 Apr;47(417):205-109196961
PubMed ID
18682795 View in PubMed
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Effect of trauma center status on 30-day outcomes after emergency general surgery.

https://arctichealth.org/en/permalink/ahliterature136656
Source
J Am Coll Surg. 2011 Mar;212(3):277-86
Publication Type
Article
Date
Mar-2011
Author
Angela M Ingraham
Mark E Cohen
Mehul V Raval
Clifford Y Ko
Avery B Nathens
Author Affiliation
Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL, USA. aingraham@facs.org
Source
J Am Coll Surg. 2011 Mar;212(3):277-86
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Canada
Emergencies
Female
General Surgery - statistics & numerical data
Humans
Male
Middle Aged
Quality Improvement
Retrospective Studies
Surgical Procedures, Operative - statistics & numerical data
Trauma Centers - standards - statistics & numerical data
Treatment Outcome
United States
Abstract
Trauma surgeons increasingly care for emergency general surgery (EGS) patients. The extent to which trauma center (TC) performance improvement translates into improved quality for EGS is unknown. We hypothesized that EGS outcomes in TCs would be similar to outcomes in non-trauma centers (NTC); failure to support our hypothesis suggests that the effects of trauma performance improvement have extended beyond trauma patients.
We retrospectively studied EGS procedures at TCs versus NTCs among American College of Surgeons National Surgical Quality Improvement Program participants (2005-2008). Thirty-day outcomes were overall morbidity, serious morbidity, and mortality. TC versus NTC outcomes were compared using regression modeling, observed-to-expected (O/E) ratios (among hospitals submitting =20 EGS procedures), and outlier status (hospitals whose O/E confidence interval excludes 1.0).
Of 68,003 patients at 222 hospitals, 42,264 (62.2%) were treated at 121 TCs; 25,739 (37.8%) were treated at 101 NTCs. TCs had significantly higher overall morbidity (21.4% versus 17.2%; p 0.099).
Although overall morbidity tended to favor NTCs, mortality was no different. This suggests that the trauma performance improvement processes have not been applied to EGS patients, despite being cared for by similar providers. Despite having processes for trauma, there remains the opportunity for quality improvement for EGS care.
PubMed ID
21356485 View in PubMed
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[Experience in delivering specialized surgical care in a large hospital].

https://arctichealth.org/en/permalink/ahliterature212016
Source
Voen Med Zh. 1996 May;317(5):15-8, 80
Publication Type
Article
Date
May-1996
Author
G Iu Sharaevskii
A E Tkachev
V I Kovalev
V D Gurich
A L Levchuk
E Kh Umerov
Source
Voen Med Zh. 1996 May;317(5):15-8, 80
Date
May-1996
Language
Russian
Publication Type
Article
Keywords
Delivery of Health Care - statistics & numerical data
Hospitals, Military - statistics & numerical data
Humans
Multiple Trauma - surgery
Russia
Surgical Procedures, Operative - statistics & numerical data
War
Wounds, Gunshot - surgery
Abstract
Medical troops supply in local armed conflicts demonstrated advantages of fast evacuation of wounded personnel by aviation from the seat of combat actions to the stage of specialized surgical care. Wounded in head, breast, abdomen (particularly in case of multiple and combined character of wounds) are evacuated for treatment to central military hospitals equipped with modern diagnostic and medical equipment, completed with qualified specialists and having the opportunity of prolonged treatment. Surgical care in the zone of combat actions is confined to hemostasis, intensive therapy -to supporting of main vital functions. The article contains the data about terminations of wounded personnel treatment in central military-fleet clinical hospital.
PubMed ID
8754084 View in PubMed
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58 records – page 1 of 6.