Figure. International Cardiac Surgery: A Global Perspective. A Thomas Pezzella M. D. Seminars in Thoracic and CV Surgery 2. If I can stop one heart from breaking,I shall not live in vain; If I can ease one life the aching,Or cool one pain,Or help one fainting robin. Unto his nest again, I shall not live in vain.(1)Emily Dickinson. Lespwa fe viv- Hope makes us live. Haitian Proverb. Introduction. The big bang theory, as proposed by Stephen Hawkins, postulates that the. In fact, this time span was only a fraction of a second (2). Yet it. wasn’t until 1. AD that Nicolas Copernicus placed the sun and not the earth as. Solar System. Man appeared around 2. Thomas Henry. Huxley called the question of questions. The exponential growth in human. October 1. 2, 1. 99. By 2. 02. 0 the population will. This. comes about even with a declining birth rate from 2. The population growth is concentrated in. Residency and Fellowship Programs. 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Interestingly, the. The average global. Sub Saharan Africa to 7. Western Europe (5). The global mortality is over 5. PROVIDER REIMBURSEMENT REVIEW BOARD DECISION. Western Europe to 9. Sub Saharan Africa (4). The 1. 99. 9 World health Organization. WHO) global mortality statistics are summarized in (Figure 1). Interestingly. deaths from non- communicable diseases or chronic disease are greater than from. Anonymous or with information about the AA Fellowship.'. List of Approved Fellowships. Barry University School of Podiatric Medicine 11300 NE Second Avenue. Research Fellowship in Limb Preservation, Wound Care. Also, of note, is the fact that the rate of growth of. The Global Burden of Disease. Murray and Lopez in 1. DALYs). It was a joint study. WHO, the World Bank, and the Harvard School of Public. Health. Estimates of incidence, prevalence, mortality, and DALYs, in 1. The overall DALYs in. It is estimated that by 2. CVD) will claim. 2. This disability factor is of increased concern. This. is the burden of disease. It is measured in terms of disability- adjusted life. DALYs). Table 1. Global Mortality, 1. Population Total deaths Communicable diseases Noncomrnunicable disease Cardiovascular disease Rheumatic heart disease Ischernic heart disease Cerebrovascular disease Inflammatory cardiac disease 5,9. Adapted from: World Health Organization: The. World Health Report 2. Annex Table 3. Whether we like it or not globalization is a reality and here to stay. If viewed from just an economic and. The global. domestic product (GDP) is $3. More than $1. 5 trillion is traded. Clearly, global economics is dependent on this world. Natural and man- made disasters have created geographic and. The inescapable fact is we cannot ignore or run. Burden of Disease (1. Three Economic Regions of the World % of Deaths in region due. Region Population in Millions% Total World Population. Cardiovascular. Desease. Other Non- communicable. Deseasecommunicable. Desease. Injuries. Developed Est. ME7. 98 (1. 5. 2)4. Emg. ME3. 46 (6. 6)5. Developing Dev. E4. 12. 4(7. 8. 3)2. Totals. 52. 67. 28. Includes cancer, diabetes. Western. Europe. Japan, Australia, and New Zealand. India, other Asia. Suh- Saharan Africa. Middle Eastern Crescent, Latin. American, and the Caribbean. Adapted from Murray CLJ. Lopez AD: The Global of Burden of Disease. Current and Projected Burden of Chronic and. Infectious Diseases and Injuries in Selected Countries and Regions. County or Region 1. Life Years’)DALY’s. All developing countries Chronic diseases 3. Infectious diseases 4. Injuries 1. 52. 1Latin America Chronic diseases 4. Infectious diseases 3. Injuries 1. 61. 9China Chronic diseases 3. Infectious diseases 2. Injuries 1. 81. 6India Chronic diseases 2. Infectious diseases 5. Injuries 1. 51. 9Another way of looking at this objectively is the E- 9, which is a collection. Figure 4) (1. 1). Clearly there is economic. Pertinent to our discussion, representative health care cost and. Figure 5. Despite the high amount of expenditure in the. USA, quality of care in the USA remains 3. WHO. Table 4. Friedman (1. The second era from World War I. Russian Revolution, the Great depression, World War II, and through the Cold. War saw no great international movement aside from almost total global. The third era followed the breakdown of the Soviet System. Rapid. and massive transportation, along with technology now gives everyone a chance to. Simply put, globalization is the increasing interdependence that is emerging. No longer can we live in isolation. Eventually, the impact of war, terrorism, natural disasters. Once we appreciate the magnitude of the global problem we should focus on. Domestic health issues still concern all of. The changes in health care in the United States have been well outlined by. Jerome P. Needless to say market forces alone will not. USA rising to over 4. This has occurred in the face of an annual USA healthcare bill of 1. GDP and the greater than $4,0. Yet, Kassier in a further analysis of the. Four Current Challenges To Improve World. Health 1. Reduction of excess mortality and morbidity among the poor. Countering threats to health resulting from economic crises. Development of more effective health systems that can improve. Investing in research and development directed toward diseases of. Merson, M. E.. Mills, A. J. International Public Heaith, Aspen Publishers. Gaithersburg, Nfarylar~d, 2. We must be far more responsible for the use of resources than we have been in. We should pay attention to the cost of car even when it does not come. We should learn the techniques of disease management and. We should use less. We should take the time to discuss. Financial inducements are. We should not be fooled into thinking that we cannot be. We need more volunteers to join the. We need. individuals who are willing to put in the time, rise to the top, and make their. It is the only way to avoid the kinds of embarrassments, scandals. Unions are designed to deal with the economic and. Some of our national. We must speak out against. Given these facts, it is hard and. For those who are searching, join us and together let. There is work for everybody. There are no dollars and. This brief background is a sobering reminder of the. Figure 6 summarizes the. Herein lies the problem. Yet we must. remain cognizant of our role in prevention and the fact that curative medicine. The Ghana model. illustrates the mismatch of cost versus population served. Internationally, there. A longitudinal focused product line is very effective, i. Some Differences Between Public Health and Medicine’Public Health. Medicine. Primary focus on population. Primary locus on individual. Public service ethic, tempered by concerns awareness for. Personal Service ethic, conditioned by Social. Emphasis on health pronunciation and disease. Emphasis on diagnosis and treatment; care for the whole. Reliance on many sectors outside health care system. Reliance on health care systemworking together to eradicate or control a particular. As an example, approaching rheumatic fever and heart disease involves a. Examples include the emerging heart centers in. China, India, and Vietnam. Fu Wai Hospital in Beijing, China performs over 5,0. Escort Hospital in Delhi India averages 3,0. L’Institute du Coeur, in Ho Chi Minh. City, Vietnam performs over 1,0. These centers are. They are well. staffed, focused, and effective, both patient care wise, and economically. Global Trends in Cardiac Surgery. The modern era of cardiac surgery began with the successful closure of an. John Gibbon in May. Over the past 5. 0 years the growth in the quantity and. Estimated Global. Cardiac Surgery. Open Heart Centers > 4,0. Cardiothoracic Surgeons >. Open Heart Annual Caseload. No access to. Cardiac Surgery (outside North America, Europe, and Australia) CASES/Population. CENTERS/Population. North America 1. 22. Australia 7. 80/million I/I million. Europe 3. 69/million I/I million. South American 1. Russia 5. 7/million Asia 2. Africa 1. 8/million 1/3. Mean 1. 69/million Adapted from references IS. Cox (1. 9) estimated that 2- 2. He stressed the gross global mismatch in terms of. Figure 9). The global surgical. Figure 1. 0) (2. 0). Number of Surgeons per. Population Worldwide (2. United States. 51. Japan. 31. Sweden. Canada. 26. The Netherlands. Australia. 16. Germ any. New Zealand. 12. Poland. China. 10. Qatar. Ireland. 7Latin America (Colombia)7. United Kingdom. 6South Africa. Egypt. 6Bahrain. 5Kuwait. Philippines. 1. 4. Sudan. 6. Kenya. 6. West African states. Tanzania. 3 Information/ Communication. Recognizing the need for increased awareness of the global village Robert. Replogle, as president of the STS, traveled the world in 1. CT surgical societies to combine their efforts and share. These included a worldwide database, a shared. CT surgery training and education, as well as research efforts. The Internet became a. Along with doctors Thomas. Ferguson, Gerald Rainer, and Peter Greene, they pioneered and expanded the scope. CTS net. Today the CTS net is the most powerful force in. CT Surgery in terms of the transfer of thoughts, ideas, information, skills, and. Our European colleagues have also joined in this universal effort to. Paul Sergeant (2. CTS net as a tool for the customer or. Using the information from the CTS net creates a reengineering tool that. Bruce Keogh. (2. 4) introduced the spoke and wheel concept with local or regional. CTS net. Cho and Tamru (2. CT Surgeons of Asia, representing over half the world. Will the CTS net now replace journals, textbooks, and medical meetings? The. simple answer is no. The complex answer is to some degree. Journals and texts. PADs. They will now. Medical meetings will. Virtual meetings and video telemedicine. Baudt. (2. 6) emphasizes the importance of colleagues meeting and interacting, as. Many long lasting relationships have their foundation at these meetings. The. controversy remains regarding the number and content of many of these meetings. Corporate support or sponsorship for. Yet, as Baker (2. On an international level the dominant CT surgery. AATS, STS, EACTS, and ASCVS). These are extremely. The proliferation of major cardiothoracic textbooks, monographs dedicated to. English has become the dominant language of. On a global scale this creates more challenges. Articles from non- USA. USA journals. In a comparison of 5 USA general. In 1. 99. 8 6. 6.
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