Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Case Report Laparoscopic Splenectomy for Splenic Hamartoma: A Case Report

Hamartoma is a rare splenic benign tumor usually accidentally detected as a radiologic finding. Preoperative diagnosis poses a challenge and thus surgery becomes necessary to confirm the clinical suspicion. Laparoscopic splenectomy has gained consensus as a standard surgical procedure particularly for autoimmune hematological diseases. This former experience has allowed this technique to be extended to other splenic pathologies. Here we report a case of total laparoscopic splenectomy for a bulky splenic hamartoma in a young male patient

Liver Damage among Environmental Disinfestation Workers

Liver Damage among Environmental Disinfestation Workers: Francesco Tomei, et al. Occupational Medicine Dept., "La Sapienza" University, Rome—It has been reported that exposure to high doses of insecticides can damage the liver. It is now becoming apparent that even exposure to low doses may affect the liver and blood. Studies on the effects on the health of disinfestation workers are scant. This study investigated 37 males doing environmental disinfestation work. They all employed the same types and amounts of pesticides. They were compared with 60 controls not exposed to hepatotoxic substances. In the presence of a physician, all subjects completed a clinical‐history questionnaire. They all underwent a general clinical examination and specific blood chemistry tests were done. In the exposed group we found liver test values to be higher than controls (p<0.001), including AST (pcO.025), alkaline phosphatase (p<0.001), and total bilirubin (p<0.001). We found no abnormal hematological changes. The findings indicate that the use of pesticides in environmental disinfestation alters liver function and that this screening protocol is valid for identifying subjects at risk for hepatotoxicity