Invasive cervical cancer following treatment of pre-invasive lesions: A potential theory based on a small case series

Peer reviewe

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Σχεδιασμός και υλοποίηση οπτικοποίησης δεδομένων της Ευρωπαϊκής Επιτροπής στον τομέα των μεταφορών

Την εποχή που διανύουμε έχουμε στη διάθεσή μας έναν τεράστιο όγκο πληροφοριών από τον οποίο καλούμαστε να πάρουμε αποφάσεις που επηρεάζουν εμάς και τους γύρω μας. Είναι σημαντικό λοιπόν να βρούμε τρόπους να διαχειριστούμε όλες αυτές τις πληροφορίες προκειμένου να πάρουμε τις καλύτερες δυνατές αποφάσεις. Ένα από τα εργαλεία που έχουμε στη διάθεσή μας και μας βοηθάει σε αυτό το εγχείρημα είναι η οπτικοποίηση δεδομένων. Η παρούσα πτυχιακή εργασία έχει ως αντικείμενο το σχεδιασμό και την υλοποίηση οπτικοποίησης δεδομένων της Ευρωπαϊκής Επιτροπής στον τομέα των μεταφορών. Βασικός σκοπός αυτής της εργασίας είναι η καλύτερη και ευκολότερη κατανόηση της κατάστασης του τομέα των μεταφορών στο πλαίσιο της Ευρωπαϊκής Ένωσης. Οι αποδέκτες αυτών των πληροφοριών κυμαίνονται από το ευρύ κοινό μέχρι και τα μέλη της Ευρωπαϊκής Επιτροπής και τους αρμόδιους υπουργούς. Τα δεδομένα προέρχονται από το έργο TRIMIS που αποτελεί μέρος του Κοινού Κέντρου Ερευνών της Ευρωπαϊκής Επιτροπής. Σε αυτή την εργασία αναλύονται οι τρόποι με τους οποίους επιλέχθηκε η κατάλληλη οπτικοποίηση δεδομένων καθώς και οι τρόποι και τα εργαλεία με τα οποία υλοποιήθηκε. Κατά το σχεδιασμό και την υλοποίηση της οπτικοποίησης δεδομένων ακολουθήθηκε η μεθοδολογία της επαναληπτικής διαδικασίας σχεδίασης. Για την υλοποίηση, τα κύρια εργαλεία που χρησιμοποιήθηκαν ήταν το Drupal 8 και η D3.js. Το τελικό αποτέλεσμα αυτής της εργασίας ήταν η δημιουργία ενός κεντρικού πίνακα ελέγχου που συνοψίζει όλες τις σημαντικές πληροφορίες και δίνει τη δυνατότητα στον χρήστη να τις εξερευνήσει και να τις συγκρίνει μεταξύ τους. Επιπλέον, σκοπός ήταν η δημιουργία αυτόνομων οπτικοποιήσεων που ενισχύουν το υλικό και τις πληροφορίες που βρίσκονται στον ιστοχώρο του έργου TRIMIS. Όλες οι οπτικοποιήσεις βρίσκονται στον νέο ιστοχώρο του έργου TRIMIS.Nowadays, an enormous amount of information is at our disposal, from which we are called upon to make decisions that affect us and those around us. It is therefore important to find ways to explore all of this information in order to make the best possible decisions. One of the available tools to assist us in this task is data visualization. This thesis concerns the design and implementation of data visualizations of the European Commission’s data in the field of transport. The main purpose of this work is to provide a better and easier understanding of the state of the transport sector within the European Union. The recipients of this information range from the general public to the members of the European Commission and other stakeholders responsible for policy and decision making. The data come from the TRIMIS project which is part of the European Commission's Joint Research Centre. This thesis presents the methodology used for appropriate data visualisations, as well as the ways and tools with which they were implemented. The design and implementation of the data visualisations followed an iterative design approach. The main tools used for implementation were Drupal 8 and D3.js. The end result of this work was the creation of a central dashboard that summarizes all the important information and enables the user to explore and compare the data with each other, as well as the creation of standalone visualizations that enhance the material and information found on the TRIMIS project website. All visualisations are available on the new TRIMIS project website

Ovarian Teratomas in Children and Adolescents: Our Own Experience and Review of Literature

Background: Ovarian teratomas are the most common type of ovarian mass during childhood and adolescence. There is no clear guidance for the management of the ovarian teratomas in children and adolescents. It is necessary, however, to understand the feature of these tumours and the indications for operating on them, and to put subjective criteria for the management in elective or emergency presentations. Methods: Medical records of patients between the age of 12 and 20 years old that underwent surgery for ovarian teratomas at the Department of Obstetrics and Gynaecology in University Hospital of Ioannina, between January 2000 and August 2022, were reviewed. A medical database was searched between January 2000 and August 2022 with the following keywords: ovarian teratoma, paediatrics and adolescents. Results: We present the results of forty patients, with a mean age of 11.8 years of age. All patients had surgery, where three out of four underwent oophorectomy and only one out of four underwent ovary-sparing operation; similar results were found in the literature. Conclusion: Ovary-sparing treatment is more common recently compared with the past, such as MIS compared with laparotomy. Better-organised and -planned prospective multi-centre studies are necessary to gain a deeper knowledge of the physiology and prognostic factors of teratomas in children

Changing the way we train surgeons in the 21th century: A narrative comparative review focused on box trainers and virtual reality simulators

The traditional method of acquiring surgical skills by observing and assisting in surgical procedures involving human beings has been challenged during the past several years. Lessons obtained from aviation suggested that the use of simulators is related to reduced costs, increased efficiency in performing certain tasks and above all safety. A shift in paradigm is also required in modern surgical training. The development of endoscopic surgery allowed for the incorporation of medical simulators into training programmes. A review of the literature was conducted using specific inclusion and exclusion criteria, for articles published up to July 31th, 2018. Relevant studies were identified using computerized bibliographic searches of MEDLINE database. The keywords that were used in various combinations were: “Medical Simulators”, “Surgical Training”, “Laparoscopy”, “Surgical Skills”, “Box trainers”, “Virtual reality simulators”, “Surgical Education”. Surgical training with box trainers and/or virtual reality simulators confers a significant benefit in terms of surgical skills development, increases patient safety and reduces costs. Nevertheless, the use of virtual reality simulators was significantly more expensive. Simulation training allows trainees to learn from their mistakes, to repeat surgical tasks multiple times so as to establish muscle memory, and enhance skill competency with the aid of informative feedback. Simulators are necessary for the development of the skills required to meet the specific needs of endoscopic surgery in the 21st century. Teaching hospitals should introduce simulation training programmes in order to increase efficiency, reduce costs and improve patient safety. As medical advancements continue to transform the way we perform surgery day by day, simulation training will play a pivotal role in every surgical specialty. © 201