Project for a network of excellence in surgical research: the Smit Map experience

La crescita delle innovazioni di dispositivi biomedicali è relativamente continua. Oggi le linee dei prodotti vengono aggiornate facendoli diventare più piccoli, più veloci, più economici, ecc - ma ci sono poche novità riguardanti il cambiamento della fondamentale tecnologia di base, le procedure cliniche, la fornitura di servizi sanitari, i requisiti normativi, e così via. È difficile per un unico centro o società di identificare e catturare le opportunità dirompenti che sorgono dall’interfacciarsi tra le procedure cliniche e di ricerca in medicina, biologia, ingegneria e fisica e, per lo più questo è spesso anche molto rischioso. L’obiettivo della piattaforma di eccellenza che stiamo presentando è quello di creare un processo dedicato, una organizzazione di rete che colleghi insieme ricercatori di tutte queste discipline con medici, fornitori dei servizi sanitari, compagnie e finanziatori/investitori di dispositivi medici perchè possano selezionare ed attuare velocemente delle opportunità di vantaggio reciproco. Nel 2006 il comitato direttivo della SMIT " Society for Medical Innovation and Technology" ha deciso di creare una rete di eccellenza, chiamata SMIT MAP. Il suo ruolo è quello di riunire le giuste collaborazioni e lo scambio di conoscenze accanto alle giuste possibilità per garantire un percorso graduale dal laboratorio alla clinica. Questa rete può diventare uno strumento per completare il trasferimento delle attività di sviluppo al partner aziendale durante la fase di pre-sperimentazione clinica del processo. La certificazione dei partner per lo sviluppo dei processi (ISO, GLP, ecc) faciliterà un efficiente trasferimento economico dei nuovi dispositivi tecnologici ai partner aziendali. I partner di questa rete possono condurre delle ricerche a livello mondiale di sviluppo in diversi settori, permettendo cosi progressi importanti per i pazienti, fornitori di cure sanitarie e compagnie operanti nel settore.Incremental innovation in biomedical devices is relatively straightforward. Today’s product line gets upgraded to become smaller, faster, cheaper, etc – but there’s little fundamental change to underlying technologies, clinical procedures, health service provision, regulatory requirements, and so on. It is hard for a single centre or company to identify and capture the disruptive opportunities that arise at the interfaces between clinical procedures and research into medicine, biology, engineering and physics and mostly it is even often very risky. The purpose of the excellence platform we are presenting is to create a dedicated process, organisation and network that binds together researchers from across these disciplines with clinicians, health service providers, biomedical device companies and funders/investors, to identify and rapidly implement mutually beneficial opportunities. In the year 2006 the Steering Committee of the "Society for Medical Innovation and Technology" decided to create a Network of Excellence, named SMIT MAP. Its role is to assemble the right collaborations and knowledge exchange around the right opportunities and ensure a smooth path from lab to clinic. The Network can become the tool to complete the transfer of development activities to the corporate partner(s) activities during the Pre-Clinical Trials Phase of the process. Certification of partners development processes (ISO, GLP, etc.) will facilitate the efficient, economic transfer of new device technologies to the corporate partners. The partners in this Network can conduct world-class research and development in several areas promising valuable advances for patients, healthcare providers and life science companies alike

Project for a network of excellence in surgical research: the Smit Map experience

La crescita delle innovazioni di dispositivi biomedicali è relativamente continua. Oggi le linee dei prodotti vengono aggiornate facendoli diventare più piccoli, più veloci, più economici, ecc - ma ci sono poche novità riguardanti il cambiamento della fondamentale tecnologia di base, le procedure cliniche, la fornitura di servizi sanitari, i requisiti normativi, e così via. È difficile per un unico centro o società di identificare e catturare le opportunità dirompenti che sorgono dall’interfacciarsi tra le procedure cliniche e di ricerca in medicina, biologia, ingegneria e fisica e, per lo più questo è spesso anche molto rischioso. L’obiettivo della piattaforma di eccellenza che stiamo presentando è quello di creare un processo dedicato, una organizzazione di rete che colleghi insieme ricercatori di tutte queste discipline con medici, fornitori dei servizi sanitari, compagnie e finanziatori/investitori di dispositivi medici perchè possano selezionare ed attuare velocemente delle opportunità di vantaggio reciproco. Nel 2006 il comitato direttivo della SMIT " Society for Medical Innovation and Technology" ha deciso di creare una rete di eccellenza, chiamata SMIT MAP. Il suo ruolo è quello di riunire le giuste collaborazioni e lo scambio di conoscenze accanto alle giuste possibilità per garantire un percorso graduale dal laboratorio alla clinica. Questa rete può diventare uno strumento per completare il trasferimento delle attività di sviluppo al partner aziendale durante la fase di pre-sperimentazione clinica del processo. La certificazione dei partner per lo sviluppo dei processi (ISO, GLP, ecc) faciliterà un efficiente trasferimento economico dei nuovi dispositivi tecnologici ai partner aziendali. I partner di questa rete possono condurre delle ricerche a livello mondiale di sviluppo in diversi settori, permettendo cosi progressi importanti per i pazienti, fornitori di cure sanitarie e compagnie operanti nel settore.Incremental innovation in biomedical devices is relatively straightforward. Today’s product line gets upgraded to become smaller, faster, cheaper, etc – but there’s little fundamental change to underlying technologies, clinical procedures, health service provision, regulatory requirements, and so on. It is hard for a single centre or company to identify and capture the disruptive opportunities that arise at the interfaces between clinical procedures and research into medicine, biology, engineering and physics and mostly it is even often very risky. The purpose of the excellence platform we are presenting is to create a dedicated process, organisation and network that binds together researchers from across these disciplines with clinicians, health service providers, biomedical device companies and funders/investors, to identify and rapidly implement mutually beneficial opportunities. In the year 2006 the Steering Committee of the "Society for Medical Innovation and Technology" decided to create a Network of Excellence, named SMIT MAP. Its role is to assemble the right collaborations and knowledge exchange around the right opportunities and ensure a smooth path from lab to clinic. The Network can become the tool to complete the transfer of development activities to the corporate partner(s) activities during the Pre-Clinical Trials Phase of the process. Certification of partners development processes (ISO, GLP, etc.) will facilitate the efficient, economic transfer of new device technologies to the corporate partners. The partners in this Network can conduct world-class research and development in several areas promising valuable advances for patients, healthcare providers and life science companies alike

Cecal volvulus during pregnancy. Case report

Introduction. Acute intestinal obstruction in pregnancy is a rare, but life-threatening complication associated with high fetal and maternal mortality. Case report. A 20-year old gravida presented with a 24 hour history of several episodes of vomiting, complete constipation and severe crampy abdominal pain. The patient was admitted with the diagnosis of acute abdomen associated with septic shock. On examination echography showed distended intestinal loops and presence of free peritoneal fluid. Abdominal X-ray with shielding of the fetus revealed colonic air-fluid levels. The obstetrician consult diagnosed dead fetus in utero and was decided to operate immediately. On laparotomy was found complete cecal volvulus with gangrene of cecum, part of ascending colon and terminal ileum. A right hemicolectomy was performed with side to side ileotransverse anastomosis. Afterwards a lower segment cesarean section was made and a stillborn fetus was delivered. The patient made an uneventful recovery and was discharged on 9th postoperative day. Conclusion. Cecal volvulus during pregnancy is a rare, but serious surgical problem. Correct diagnosis may be difficult until exploratory laparotomy is performed. Undue delay in diagnosis and surgical treatment can increase the maternal and fetal mortality

Rectal cancer surgery. A ten years experience

Il cancro del retto è una delle più comuni malattie maligne nella popolazione occidentale. Il trattamento del cancro del retto è cambiato radicalmente negli ultimi anni seguendo i repentini progressi delle tecniche chirurgiche, della diagnostica per immagini e della terapia adiuvante. Lo studio prende in esame 152 pazienti operati per cancro del retto nella 1ª Clinica di Chirurgia Generale del Centro Ospedaliero Universitario “Madre Teresa” di Tirana, Albania in un periodo di dieci anni. Nella documentazione medica sono stati analizzati dati demografici, diagnostici, clinici, operatori, patologici e post operatori. La ratio M:F era di 1,5:1. L’età media dei pazienti era di 59,8 ± 12,2 (29 – 79) anni. 48% dei pazienti erano di età compresa tra 61 a 70 anni. L’intervallo di diagnosi era di 6± 4,6 mesi. La distanza media del tumore dal margine anale era di 8,3 ± 4,2 (3,7 – 16) cm. Il 30% dei pazienti risultava allo stadio D della malattia secondo la classificazione di Aster–Coller. L’indice globale di operabilità è stato del 97,5%. Il 30% dei pazienti è stato sottoposto a trattamenti chirurgici palliativi. Il 67,5% dei pazienti è stato trattato con intento curativo. L’intervento curativo più comune è stata la resezione anteriore del retto con escissione del mesoretto, effettuata su 76 pazienti (51%). La degenza media ospedaliera post operatoria è stata di 12 ± 9,7 (3 – 45) giorni. La morbilità e la mortalità globale sono state del 30% e del 2,6% rispettivamente. Il trattamento chirurgico del cancro del retto in Albania negli ultimi anni è cambiato radicalmente. La resezione anteriore bassa e l’utilizzo della chemioterapia adiuvante hanno portato a risultati positivi sulla qualità della vita e sulla sopravivenza dei pazienti

Surgical treatment of the adenocarcinoma of the cardia

Adenocarcinomas of the esophagogastric junction should be classified into adenocarcinoma of the distal esophagus (Type I), true carcinoma of the cardia (Type II), and subcardial carcinoma (Type III) in a pathogenic and therapeutic point of view. During a 15-year period (1995 - 2009), 117 surgical laparotomies for adenocarcinoma of the cardia were performed in elective surgery in the First Clinic of General Surgery UHC “Mother Theresa” in Tirana. The classification was performed by summarizing the information obtained from oral contrast radiography, endoscopy, and intra-operative findings. There were 54 (46%) patients of Type I, 40 (34%) of Type II and 23 (20%) of Type III . Surgical procedures included “subtotal esophagectomy and proximal gastrectomy”, “distal esophagectomy and proximal gastrectomy”, “total gastrectomy and distal esophagectomy”. All anastomoses performed in the above mentioned procedures were hand sewn. Thirty-seven patients (32%) resulted inoperable at the time of laparotomy and 80 (68%) patients were treated with curative intent, those resulting in an operability index of 68%. The overall morbidity and mortality rates of 29% and 4,3% respectively

Physicians' perceptions about the quality of primary health care services in transitional Albania

AIM: To date, the available information regarding the quality of primary health care services in Albania is scarce. The aim of our study was to assess the quality of primary health care services in Albania based on physicians’ perceptions towards the quality of the services provided to the general population. METHODS: A cross-sectional study was conducted in January-March 2013 including a representative sample of 132 physicians (59 men aged 41.3±6.9 years and 73 women aged 43.7±4.8 years; overall response rate: 132/150=88%) providing primary health care services in several polyclinics (health centers) of Tirana, the Albanian capital city. A structured self-administered and anonymous questionnaire was applied including physicians’ perceptions regarding different dimensions of the quality of primary health care. Binary logistic regression was used to assess the association of self-perceived quality of health care services with baseline characteristics of physicians. RESULTS: Self-perceived adequate quality of health care services was positively related to the age of physicians, their working experience, female gender, a lower population served, and specialization in family medicine. CONCLUSION: Our findings provide useful evidence on the self-perceived quality of health services from primary health care physicians’ perspective in transitional Albania. Health authorities in Albania should implement suitable instruments to measure the quality of health care services at all levels

Actual status of preoperative diagnosis of thyroid cancer in Albania

Introduction. Thyroid cancer is the most common endocrine malignancy and accounts for almost 1% of human cancer. It is well known that the majority of cases occur in women in the middle decades of life. Thyroid cancer is a relatively rare disease; on the other hand clinically apparent thyroid nodules are present in 4-7% of the adult population. Most thyroid nodules are not malignant, with reported malignancy rates from 3-12%. It is important for the surgeon to know beforehand the diagnosis of malignancy, in order to perform a more radical operation on the thyroid gland. Patients and Methods. In our study we have analyzed the preoperative clinical data of 84 patients operated in the First Clinic of General Surgery, UHC “Mother Theresa” in Tirana; all with a positive histopathologic diagnosis of thyroid cancer. The data comprised age, sex, age distribution, blood group, time-lapse from the first endocrinologic visit, clinical examination, signs and symptoms, imaging, functional tests, preoperative FNA, admission diagnosis, associated diseases and preoperative treatment. Results. From the study emerged that only 9,3% of these patients were diagnosed preoperatively as thyroid cancer. Another related problem is the low percentage of preoperative FNA – only 22%. Among the signs and symptoms related to thyroid cancer we found that 40 and 33% of these patient presented dyspnea and dysphagia, respectively. The physical examination revealed apparent nodular growth of the thyroid gland in 81% and nodular hard consistency in 79% of cases. The proper endocrinologist consultation lacked in 23% of cases. Conclusion. In our opinion, close collaboration between endocrinologists and surgeons in a multidisciplinary frame is the key to correct preoperative thyroid cancer diagnosis and optimal treatment

The 6th Albanian Congress of Trauma and Emergency Surgery

After a three-year quarantine from the deadliest global pandemic of the last century, ASTES is organizing to gather all health professionals in Tirana, The 6th Albanian Congress of Trauma and Emergency Surgery(ACTES 2022) on 11-12 November 2022, with the topic Trauma & Emergency Surgery and not only...with the aim of providing high quality, the best standards, and the best results, for our patients ...ACTES 2022 is the largest event that ASTES (Albanian Society for Trauma and Emergency Surgery) has organized so far with 230 presentations, and 67 foreign lecturers with enviable geography, making it the largest national and wider scientific event.The scientific program is as strong as ever, thanks to the inclusiveness, where all the participants with a mix of foreign and local lecturers, select the best of the moment in medical science, innovation, and observation.The scientific committee has selected all the presentations so that the participants of each medical discipline will have something to learn, discuss, debate, and agree with updated methods, techniques, and protocols.I hope you will join us on Friday morning, and continue the journey of our two-day event together