Predictors of complications in gynaecological oncological surgery: a prospective multicentre study (UKGOSOC-UK gynaecological oncology surgical outcomes and complications)

Background: There are limited data on surgical outcomes in gynaecological oncology. We report on predictors of complications in a multicentre prospective study. / Methods: Data on surgical procedures and resulting complications were contemporaneously recorded on consented patients in 10 participating UK gynaecological cancer centres. Patients were sent follow-up letters to capture any further complications. Post-operative (Post-op) complications were graded (I–V) in increasing severity using the Clavien-Dindo system. Grade I complications were excluded from the analysis. Univariable and multivariable regression was used to identify predictors of complications using all surgery for intra-operative (Intra-op) and only those with both hospital and patient-reported data for Post-op complications. / Results: Prospective data were available on 2948 major operations undertaken between April 2010 and February 2012. Median age was 62 years, with 35% obese and 20.4% ASA grade ⩾3. Consultant gynaecological oncologists performed 74.3% of operations. Intra-op complications were reported in 139 of 2948 and Grade II–V Post-op complications in 379 of 1462 surgeries. The predictors of risk were different for Intra-op and Post-op complications. For Intra-op complications, previous abdominal surgery, metabolic/endocrine disorders (excluding diabetes), surgical complexity and final diagnosis were significant in univariable and multivariable regression (P<0.05), with diabetes only in multivariable regression (P=0.006). For Post-op complications, age, comorbidity status, diabetes, surgical approach, duration of surgery, and final diagnosis were significant in both univariable and multivariable regression (P<0.05). / Conclusions: This multicentre prospective audit benchmarks the considerable morbidity associated with gynaecological oncology surgery. There are significant patient and surgical factors that influence this risk

COMPLEXITY OF SCENARIOS OF FUTURE HEALTH: INTEGRATING POLICIES AND LAWS

International audienceIn Southeast Asia, regional institutions insist on the crucial role of innovative research to address sustainable development challenges. Among those challenges, the increasing human dominance of the global landscape, particularly in regard to forest cover loss is of major concern. Such dramatic habitat changes are accelerating the biodiversity loss. This reduction in biodiversity through altered landscapes due to urbanization and agricultural intensification appears linked to major epidemiological changes in human diseases with higher disease risks and the emergence of novel pathogens resulting from increased contacts between wildlife, domesticated animals and humans. It appears necessary to investigate the multiple impacts of the intensification of the circulation along the economic corridor Thailand-Laos (linking Myanmar to Vietnam) on the evolution of infectious diseases of public health interests. Integrating the various dimensions of complexity thanks to disciplines such as ecology and environmental sciences, health sciences, policies and law, we analyse retrospectively, and comparatively infectious diseases' dynamics associated to policies, land use and biodiversity changes. The need of prospective scenarios of health that are embedded in the socioecosystems is crucial: we will thus produce scenarios of future health embodied in the One Healt

Salting-out assisted liquid–liquid extraction for the determination of ciprofloxacin residues in water samples by high performance liquid chromatography–diode array detector

Abstract Background The occurrence of emerging pollutants like pharmaceuticals and related compounds in the aquatic and terrestrial environments is of increasing concern. Ciprofloxacin is one of the pharmaceuticals which is active against a wide range of bacteria. The main objective of this research is to develop a simple method for the extraction and determination of ciprofloxacin residues in environmental water samples. Results A salting-out assisted liquid–liquid extraction (SALLE) method for the determination of ciprofloxacin in water samples by high-performance liquid chromatography with diode array detector (HPLC–DAD) was developed. The calibration curve was linear over the range of 0.1–100 μg/L with coefficient of determination (r2) of 0.9976. The limits of detection (LOD) and quantification (LOQ) of the method were 0.075 and 0.25 µg/L, respectively. The reproducibility in terms of relative standard deviation (% RSD) was less than 10%. The applicability of the developed method was investigated by analyzing tap water, bottled mineral water and waste water and demonstrated satisfactory recoveries in the ranges of 86.4–120%. Conclusion The method offered a number of features including wide linear range, good recovery, short analysis time, simple operation process and environmental friendly. The developed method can be utilized as an attractive alternative for the determination of ciprofloxacin residues in environmental water matrices