Responsabilidad social universitaria en Maracaibo, Venezuela

This article aims to analyze university social responsibility in Maracaibo, Venezuela. The work is based on the postulates of Rodriguez (2010), De la Cuesta (2011) and the Ministry of Education in Spain (2011), among others. It is a descriptive, field study. The population consisted of authorities from five universities, one (1) public and four (4) private, located in Maracaibo, who were accessed through a questionnaire composed of thirty-two (32) closed items. The instrument was validated by experts in the university management field. To determine the questionnaire’s reliability, the test-retest method was applied, obtaining a 0.94 coefficient. To analyze data, the arithmetic mean or average was used. Results indicate that the universities under study exhibit a social responsibility model with an instrumental, entrepreneurial tendency, where knowledge is seen as the main asset available for society’s use. However, a greater integration of these higher education institutions with their stakeholders is required.  El presente artículo tiene como objetivo analizar la responsabilidad social universitaria en Maracaibo, Venezuela. El trabajo se sustenta en los postulados de Rodríguez (2010), De la Cuesta (2011), el Ministerio de Educación de España (2011), entre otros. El estudio fue descriptivo, de campo. La población estuvo conformada por autoridades de cinco (5) universidades, una (1) pública y cuatro (4) privadas ubicadas en Maracaibo, a las cuales se accedió mediante un cuestionario compuesto por treinta y dos (32) ítems cerrados. El instrumento fue validado por expertos en el ámbito de la gerencia universitaria. Para determinar la confiabilidad del cuestionario se aplicó el método test-retest, obteniéndose un coeficiente de 0,94. Para analizar los datos se utilizó el promedio aritmético o media. Los resultados indican que las universidades estudiadas exhiben un modelo de responsabilidad social de tendencia empresarial instrumental, donde el conocimiento se perfila como el principal activo disponible para su uso por la sociedad, pero se requiere una mayor integración de las instituciones de educación superior con sus stakeholders. &nbsp

Erratum to nodal management and upstaging of disease. Initial results from the Italian VATS Lobectomy Registry

[This corrects the article DOI: 10.21037/jtd.2017.06.12.]

SARS-CoV-2 vaccination modelling for safe surgery to save lives : data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.Peer reviewe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The new frontier of hepatitis C virus (HCV)-mismatched heart and lung transplantation

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An alternative technique for anterior chest wall reconstruction: The sternal allograft transplantation

OBJECTIVES: Sternal resection is indicated for a variety of pathological conditions, mainly neoplastic or related to sternotomy complications. Resection of the sternum generally leaves a large chest-wall defect, and reconstruction is thus the most difficult part of the operation. Correct stabilization of the anterior chest wall is very important to avoid secondary complications and respiratory failure. In the last few years, different technical solutions have been used to reconstruct the sternum. We describe our technique using a sternal allograft to reconstruct the anterior chest wall after partial or complete sternal resection. METHODS: Between June 2010 and February 2012, four patients underwent sternectomy followed by anterior chest wall reconstruction using sternal allograft. The sternal allograft was harvested from a multitissue donor following Italian legislation for tissue donation. Three patients had neoplastic involvement of the sternum, and one had a complete sternal defect as a complication of a cardiac operation. RESULTS: We had no operative mortality. Three patients underwent partial sternal transplantation, and one underwent total sternal replacement. We had no postoperative respiratory insufficiency, infections or mechanical failure of the reconstructions. The respiratory function was preserved in all patients. The follow-up period was free from complications related to the sternal allograft implantation. CONCLUSIONS: The technique of sternal allograft transplantation is simple, reproducible and provides excellent functional and cosmetic results. Further studies including a larger number of patients are needed to understand the biology of the allograft and the long-term results of this technique

A Massive Post-Sternotomy Sternal Defect Treated by Allograft Sternal Transplantation

We report a case of a patient with complete sternal destruction after cardiac surgery, who underwent total sternal replacement with sternal allograft, titanium bars, and screws

Unilateral pulmonary vein atresia without anomalous connection in adult patient with recurrent severe hemoptysis

Isolated unilateral pulmonary vein atresia (UPVA) is a rare congenital malformation and the management remains controversial. In adults, pneumonectomy is the treatment of choice when significant hemoptysis becomes life-threatening. We report a case of a 28-year-old male with isolated unilateral right atresia of the pulmonary vein who had life-threatening hemoptysis treated with bronchial arteries embolization followed by successful right pneumonectomy