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.
In high-income countries, non-communicable diseases drive the demand for surgical healthcare. Middle-income countries face a double disease burden, of both communicable and non-communicable disease. The aim of this study was to describe the role of surgery for the in-hospital care of infectious conditions in the high-income country Sweden and the middle-income country South Africa.
A retrospective cohort study was performed of 1.4 million infectious disease admissions. The study populations were the entire population of Sweden, and a cohort of 3.5 million South Africans with private healthcare insurance, during a 7-year interval. The outcome measures were frequency of surgical procedures across a spectrum of diseases, and sex and age during the medical care event.
Some 8.1 per cent of Swedish and 15.7 per cent of South African hospital admissions were because of infectious disease. The proportion of infectious disease admissions that were associated with surgery was constant over time: 8.0 (95 per cent c.i. 7.9 to 8.1) per cent in Sweden and 21.1 (21.0 to 21.2) per cent in South Africa. The frequency of surgery was 2.6 (2.6 to 2.7) times greater in South Africa, and 2.2 (2.2 to 2.3) times higher after standardization for age, sex and disease category.
The study suggests that surgical care is required to manage patients with communicable diseases, even in high-income settings with efficient prevention and functional primary care. These results further stress the importance of scaling up functional surgical health systems in low- and middle-income countries, where the disease burden is distinguished by infectious disease.
To study the association of increased serum group II phospholipase A2 concentrations to C-reactive protein concentrations in the sera of critically ill surgical patients.
Surgical intensive care unit (ICU) of a university hospital.
Sixty-seven consecutive patients admitted to the surgical ICU.
The catalytic activity of phospholipase A2 and the serum concentrations of group II phospholipase A2 and C-reactive protein were measured daily during each patient's stay in the ICU. A total of 205 blood samples were taken. In addition, the preoperative serum levels of group II phospholipase A2 were determined in patients admitted for cardiac surgery.
Serum group II phospholipase A2 values correlated statistically significantly with the catalytic activity of phospholipase A2 and serum C-reactive protein values. In particular, severe infections, diseases involving tissue destruction, and elective operations per se, caused considerable increases in serum group II phospholipase A2 concentrations.
Our results support the earlier presented idea that group II phospholipase A2 is an acute-phase reactant.
This paper identifies outliers (unusually high or low values) among rates of 39 surgical procedures in 255 Canadian census divisions. Surgery rates for the two-year period from April 1988 through March 1990 were standardized for age and sex, and then "normalized" to adjust for differences in census division population sizes. Among the 39 procedures, a total of 402 outlying census division rates were found, of which 48 were deemed to be very high, 254 high, 79 low, and 21 very low. The results are presented for individual procedures, by province, and for the 16 census divisions in which medical schools and their associated teaching hospitals are located.
BACKGROUND: IVF/ICSI twins are likely to have a higher risk of prematurity associated with higher morbidity. The aim of this study was to assess the use of hospital care resources in IVF/ICSI twins on data retrieved until 2-7 years of child age. METHODS: National controlled cohort study on hospital admissions and surgical interventions in 3393 IVF twins, 10,239 spontaneously conceived twins and 5130 IVF singletons born between 1995 and 2000 in Denmark. Cross-linkage of data from the Danish IVF Registry and the National Patient Registry enabled us to identify children who were admitted to hospital or underwent an operation. RESULTS: The frequency of hospitalized children was 69.8, 69.6 and 49.8%, and of children who underwent a surgical intervention 10.6, 11.2 and 8.5% in IVF/ICSI twins, control twins and IVF/ICSI singletons respectively. Odds ratios (OR) (95% confidence intervals) of hospitalization in IVF/ICSI twins versus control twins and IVF/ICSI singletons were 1.04 (0.96, 1.14) and 2.44 (2.22, 2.63) and OR adjusted for year of birth, maternal age and parity were 1.00 (0.91, 1.11) and 2.38 (2.17, 2.63) respectively. Also for term birth infants, IVF/ICSI twins were more likely to be hospitalized than IVF/ICSI singletons: adjusted OR 1.37 (1.22, 1.51). Similar risk of a surgical procedure was observed in IVF/ICSI versus control twins. However, IVF/ICSI twins more often underwent a surgical intervention than IVF/ICSI singletons: adjusted OR 1.26 (1.08, 1.47). This risk disappeared when restricted to term infants: adjusted OR 1.00 (0.81, 1.22). Different sex IVF/ICSI and control twins had equal risk of admissions and surgical interventions, and ICSI children had the same risk as children born after conventional IVF. CONCLUSIONS: Though the use of hospital care resources was similar in IVF/ICSI and control twins, the over-use in IVF/ICSI twins versus IVF/ICSI singletons adds to the arguments for implementing elective single embryo transfer as our standard procedure.
In addition to possibly prolonged suffering and anxiety, extended waits for children's surgery beyond critical developmental periods has potential for lifelong impact. The goal of this study was to determine the duration of waits for surgery for children and youth at Canadian paediatric academic health sciences centres using clinically-derived access targets (i.e., the maximum acceptable waiting periods for completion of specific types of surgery) as used in this Canadian Paediatric Surgical Wait Times project.
We prospectively applied standardized wait-time targets for surgery, created by nominal-group consensus expert panels, to pediatric patients at children's health sciences centres across Canada with decision-to-treat dates of Sept. 1, 2007 or later. From Jan. 1 to Dec. 30, 2009, patients' actual wait times were compared with their target wait times to determine the percentage of patients receiving surgery after the target waiting period.
Overall, 27% of pediatric patients from across Canada (17,411 of 64,012) received their surgery after their standardized target waiting period. Dentistry, ophthalmology, plastic surgery and cancer surgery showed the highest percentages of surgeries completed past target.
Many children wait too long for surgery in Canada. Specific attention is required, in particular, in dentistry, ophthalmology, plastic surgery and cancer care, to address children's wait times for surgery. Improved access may be realized with use of national wait-time targets.
Cites: J Am Dent Assoc. 2000 Jul;131(7):887-9910916327