global surgery

全球外科
  • 文章类型: Journal Article
    背景:机器人手术已经改变了微创手术,提供精度和效率。然而,机器人控制台的人体工程学方面及其对外科医生健康的影响仍未得到充分研究。这篇综述调查了中国机器人外科医生的人体工程学和肌肉疲劳的负担,将研究结果与一项跨国研究进行比较。
    方法:文献综述确定了与机器人手术中身体不适相关的主题。对中国机器人外科医生进行了问卷调查,产生40个响应。这项研究评估了人口统计学特征,外科医生的经验,符合人体工程学的做法,报告不适,和疼痛缓解机制。
    结果:研究表明,大多数外科医生都经历过肩颈疼痛,关于机器人手术是否是主要原因的意见不一。伸展运动通常用于缓解疼痛。外科医生认为,病例体积和手术时间会导致不适。与跨国研究的比较表明,潜在的人口统计学和经验相关差异。
    结论:虽然研究有局限性,包括小样本量和潜在的翻译问题,它强调了解决人体工程学问题并为机器人外科医生提供适当培训以确保他们在该领域的健康和长寿的重要性。有必要对更大的队列和特定平台的分析进行进一步的研究。
    BACKGROUND: Robotic surgery has transformed minimally invasive procedures, offering precision and efficiency. However, the ergonomic aspects of robotic consoles and their impact on surgeon health remain understudied. This review investigates the burden of ergonomics and muscle fatigue among robotic surgeons in China, comparing the findings to a multinational study.
    METHODS: A literature review identified themes related to physical discomfort in robotic surgery. A questionnaire was administered to Chinese robotic surgeons, yielding 40 responses. The study assessed demographic characteristics, surgeon experience, ergonomic practices, reported discomfort, and pain-relief mechanisms.
    RESULTS: The study revealed that most surgeons experienced shoulder and neck pain, with mixed opinions on whether robotic surgery was the primary cause. Stretching exercises were commonly used for pain relief. Surgeons believed that case volume and surgery duration contributed to discomfort. Comparisons with a multinational study suggested potential demographic and experience-related differences.
    CONCLUSIONS: While the study has limitations, including a small sample size and potential translation issues, it underscores the importance of addressing ergonomic concerns and providing proper training to robotic surgeons to ensure their well-being and longevity in the field. Further research with larger cohorts and platform-specific analyses is warranted.
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  • 文章类型: Journal Article
    手术是高功能医疗保健系统的基础方面。在柳叶刀全球手术委员会之后,以前的研究集中在定义儿科人群的手术负担,然而,这些研究往往没有包括强迫移民或难民。这项研究的目的是估计东非难民中小儿外科疾病的患病率。
    我们使用了先前经过验证的外科医生海外手术需求评估(SOSAS),该评估利用随机整群抽样的横断面设计来评估Nyarugusu难民营0至18岁参与者的手术疾病患病率。坦桑尼亚。我们使用了描述性和多变量分析,包括平均边际效应模型。
    共有1,658名参与者被纳入研究。我们样本的平均年龄为8.3±5.8岁。共有841名参与者(50.7%)为男性,817名参与者(49.3%)为女性。共有513人(n=30.9%)报告了可能是手术性质的问题的历史或存在。其中280人(54.6%)报告问题持续存在或未经治疗.总的来说,16.9%的人有持续的问题,可能适合手术。我们发现,在我们的多变量分析中,年龄的增加和最近的疾病与手术问题有关。
    据我们所知,这是对撒哈拉以南非洲地区难民儿童外科疾病患病率的首次也是最大规模的研究.我们发现,超过16%(六分之一)的难民儿童有可能接受手术的问题。我们的结果提供了一个基准,可以比较冲突或冲突后地区有难民或被迫移民人口的其他研究。
    Surgery is a foundational aspect to high functioning health care systems. In the wake of the Lancet Commission on Global Surgery, previous research has focused on defining the burden of surgical conditions among a pediatric population, however these studies often fail to include forced migrant or refugees. The goal of this study was to estimate the prevalence of pediatric surgical conditions among refugees in east Africa.
    We used the previously validated Surgeons OverSeas Assessment of Surgical Need (SOSAS) that utilizes cross-sectional design with random cluster sampling to assess prevalence of surgical disease among participants aged 0 to 18 years in Nyarugusu refugee camp, Tanzania. We used descriptive and multivariable analyses including an average marginal effects model.
    A total of 1,658 participants were included in the study. The mean age of our sample was 8.3 ± 5.8 years. A total of 841 participants (50.7%) were male and 817 participants (49.3%) were female. A total of 513 (n = 30.9%) reported a history or presence of a problem that may be surgical in nature, and 280 (54.6%) of them reported the problem was ongoing or untreated. Overall, 16.9% had an ongoing problem that may be amenable to surgery. We found that increasing age and recent illness were associated with having a surgical problem on both our multivariable analyses.
    To our knowledge, this is the first and largest study of prevalence of surgical conditions among refugee children in sub-Saharan Africa. We found that over 16% (one-in-six) of refugee children have a problem that may be amenable to surgery. Our results provide a benchmark upon which other studies in conflict or post-conflict zones with refugee or forced migrant populations may be compared.
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  • 文章类型: Journal Article
    背景:随着2019年冠状病毒病(COVID-19)的重复,预防和治疗将在一段时间内正常化。“病人数量大”和“转机快”的日间病房大大增加了政策制定和执行的难度。正常化也对患者/家庭成员产生了巨大的负面心理影响。本研究旨在介绍日间手术病房有效的疫情防控措施,明确COVID-19正常化过程中患者及家属焦虑和主观不适的影响因素。
    方法:为疫情正常化做准备,研究讨论了员工管理的改进,环境,过程。2021年12月至2022年3月,华西医院共收治148名患者及其亲属被要求有效填写问卷。使用焦虑自评量表,社会支持评定量表和主观痛苦量表分析焦虑及其危险因素。
    结果:在标准化控制措施下,没有工作人员被感染。体重指数(BMI)较低的人的主观不适评分较高。年轻和高社会支持评分是焦虑的危险因素(P<0.05)。社会支持与焦虑呈正相关。
    结论:疫情正常化是一个时期内的必然趋势。一个稳定安全的医疗环境需要充分消除政策缺陷,以适应人们并关注人们的心理健康。对于患者/家庭成员,谁更年轻,较低的BMI和较高的社会支持应得到更多关注。
    BACKGROUND: As the 2019 Coronavirus Disease (COVID-19) repeated, the prevention and treatment will be normalized in a period. \"Large number of patients\" and \" Turnover quickly\" of the day surgery ward greatly increased the difficulty of policy formulation and implementation. The normalization also had a huge negative psychological impact on patients/family members. This study aims to introduce effective epidemic prevention and control measures in day surgery wards, and to clarify the influencing factors of anxiety and subjective discomfort of patients and their families during the normalization of COVID-19.
    METHODS: To prepare for normalization of epidemic, research discuss improvements in the management of staff, environment, process. A total of 148 patients admitted to West China Hospital from December 2021 to March 2022 and their relatives were asked to complete a questionnaire effectively. Using the Self-rating Anxiety Scale, Social Support Rating Scale and Subjective Units of Distress scales to analyze anxiety and its risk factors.
    RESULTS: Under normalized control measures, no staff was infected. The subjective discomfort score was higher in people with lower body mass index (BMI). Young and high social support score were risk factors for anxiety (P < .05), and social support was positively correlated with anxiety.
    CONCLUSIONS: The normalization of epidemic is an inevitable trend in a period. A stable and safe medical environment needs to fully eliminate the policy defects, to fit the people and focus on mental health of the people. For patients/family members, who are younger,a lower BMI and higher social support should be attention more.
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  • 文章类型: Journal Article
    每年,全球估计有2260万新的神经外科咨询病例,其中1380万人需要手术。2016年,对全球神经外科劳动力进行了评估,并将其映射为开放获取的信息,以指导神经外科医生。附属公司,和政策制定者。我们提出了一项针对2018年全球神经外科劳动力的后续调查,以显示以前的数据收集方法的可复制性,并显示劳动力密度的任何变化。
    我们从全球神经外科劳动力映射项目数据库中提取了2016年每个低收入和中等收入国家(LMICs)神经外科医生绝对人数的数据。2018年每个LMIC的神经外科医生的估计人数来自合作者。计算了2016年和2018年的劳动力密度中位数。生成了神经外科劳动力密度热图。
    我们收到了119个国家的数据(回应率86.2%)和19个国家的数据(13.8%)。七十八(56.5%,N=138)国家的神经外科医生人数有所增加,9(6.5%)显示下降,而51名(37.0%)的神经外科医生在两年中的数量相同.合并中位数从0.17增加(四分位数间距,0.54)2016年至0.18(四分位数间距,0.59)2018年。
    总的来说,神经外科劳动力的密度从2016年到2018年有所增加。然而,以目前的速度,到2030年,80个LMIC(58.0%)将无法达到神经外科劳动力密度目标。
    Every year, there are an estimated 22.6 million new neurosurgical consultative cases worldwide, of which 13.8 million require surgery. In 2016, the global neurosurgical workforce was estimated and mapped as open-access information to guide neurosurgeons, affiliates, and policy makers. We present a subsequent investigation for mapping the global neurosurgical workforce for 2018 to show the replicability of previous data collection methods as well as to show any changes in workforce density.
    We extracted data on the absolute number of neurosurgeons per low and middle-income countries (LMICs) in 2016 from the database of the global neurosurgical workforce mapping project. The estimated number of neurosurgeons in each LMIC during 2018 was obtained from collaborators. The median workforce densities were calculated for 2016 and 2018. Neurosurgical workforce density heat maps were generated.
    We received data from 119 countries (response rate 86.2%) and imputed data for 19 countries (13.8%). Seventy-eight (56.5%, N = 138) countries had an increase in their number of neurosurgeons, 9 (6.5%) showed a decrease, whereas 51 (37.0%) had the same number of neurosurgeons in both years. The pooled median increased from 0.17 (interquartile range, 0.54) in 2016 to 0.18 (interquartile range, 0.59) in 2018.
    Overall, the density of the neurosurgical workforce has increased from 2016 to 2018. However, at the current rate, 80 LMICs (58.0%) will not meet the neurosurgical workforce density target by 2030.
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  • 文章类型: Journal Article
    目的:心胸的各种方法,心血管,心脏外科训练遍布全球,以安全生产为共同目标,独立的外科医生。尚未对国际培训模式进行比较分析,我们这样做的目标是提供有关如何最好地准备未来学员并确保我们专业健康的见解。
    方法:我们对现有出版物进行了比较分析,提供了各种心胸,心血管,和心脏外科训练范例。还直接联系了以前出版物的相应作者和其他国际合作者,以进行进一步的数据采集。
    结果:我们报告了各种常见挑战的方法:(1)选择受训者和未来外科劳动力的计划;(2)独立实践前的受训者评估和能力认证;(3)与不断变化的实践环境有关的挑战。
    结论:心胸外科仍然是一个充满活力和有益的专业。当前和未来的学员面临着一些超越国界的挑战。为了促进合作和采用最佳实践,我们强调了各国在劳动力选择方面的国际优势和劣势,见习手术经验和评估,董事会认证,并为心胸外科未来的变化做准备。
    OBJECTIVE: Various methods for cardiothoracic, cardiovascular, and cardiac surgical training exist across the globe, with the common goal of producing safe, independent surgeons. A comparative analysis of international training paradigms has not been undertaken, and our goal in doing so was to offer insights into how to best prepare future trainees and ensure the health of our specialty.
    METHODS: We performed a comparative analysis of available publications offering detailed descriptions of various cardiothoracic, cardiovascular, and cardiac surgical training paradigms. Corresponding authors from previous publications and other international collaborators were also reached directly for further data acquisition.
    RESULTS: We report various approaches to common challenges surrounding (1) selection of trainees and plans for the future surgical workforce; (2) trainee assessments and certification of competency before independent practice; and (3) challenges related to a changing practice landscape.
    CONCLUSIONS: Cardiothoracic surgery remains a dynamic and rewarding specialty. Current and future trainees face several challenges that transcend national borders. To foster collaboration and adoption of best practices, we highlight international strengths and weaknesses of various nations in terms of workforce selection, trainee operative experience and assessment, board certification, and preparation for future changes anticipated in cardiothoracic surgery.
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