Endometrial effects, bleeding control, and compliance with a new postmenopausal hormone therapy regimen based on transdermal estradiol gel and every-other-day vaginal progesterone in capsules: a 3-year pilot study

n/

Guidelines on the management of abdominal aortic aneurysms: updates from the Italian Society of Vascular and Endovascular Surgery (SICVE)

The objective of these Guidelines was to revise and update the previous 2016 Italian Guidelines on Abdominal Aortic Aneurysm Disease, in accordance with the National Guidelines System (SNLG), to guide every practitioner toward the most correct management pathway for this pathology. The methodology applied in this update was the GRADE-SIGN version methodology, following the instructions of the AGREE quality of reporting checklist as well. The first methodological step was the formulation of clinical questions structured according to the PICO (Population, Intervention, Comparison, Outcome) model according to which the Recommendations were issued. Then, systematic reviews of the Literature were carried out for each PICO question or for homogeneous groups of questions, followed by the selection of the articles and the assessment of the methodological quality for each of them using qualitative checklists. Finally, a Considered Judgment form was filled in for each clinical question, in which the features of the evidence as a whole are assessed to establish the transition from the level of evidence to the direction and strength of the recommendations. These guidelines outline the correct management of patients with abdominal aortic aneurysm in terms of screening and surveillance. Medical management and indication for surgery are discussed, as well as preoperative assessment regarding patients' background and surgical risk evaluation. Once the indication for surgery has been established, the options for traditional open and endovascular surgery are described and compared, focusing specifically on patients with ruptured abdominal aortic aneurysms as well. Finally, indications for early and late postoperative follow-up are explained. The most recent evidence in the Literature has been able to confirm and possibly modify the previous recommendations updating them, likewise to propose new recommendations on prospectively relevant topics

Civiltà della Campania. Anno III, n. 4 (gennaio-marzo 1976)

A. III, n. 4 (gennaio-marzo 1976): Ricordo di Alfonso, P. 3 ; A. Gatto, Un sodalizio d’arte sotto lo stesso cielo, P. 4 ; R. Causa, Itinerari nell’arte catalana, P. 12 ; B. Gatta, Un altro inglese che ama Garibaldi, P. 18 ; A. Garzya, Napoli e Bisanzio, P. 26 ; S. Ferraretti, Il grande Archivio Napoletano, P. 32 ; B.G., L’Abate Galiani tra Napoli e Parigi, P. 34 ; M. Stefanile, Campania a tavola, P. 36 ; D. Rea, Pulcinella: il mistero di una maschera, P. 44 ; L. Compagnone, Il piccolo teatro di Raffaele Petra, P. 56 ; V. Ricciuti, Quando il cinema si chiamava Napoli, P. 58 ; R. Cantarella, C’era una volta una piccola città, P. 62 ; E. Mallardo, La cattedrale di Avellino, P. 66 ; V. Gramignazzi-Serrone, S. Guglielmo al Goleto, P. 70 ; F. de Ciuceis, I fasti del San Carlo, P. 78 ; L. Orsini, Faito una selva nel cielo, P. 82 ; S. Ferraro, Archeologia a Sorrento, P. 86 ; G. Blasi, Un parco negli Alburni, P. 88 ; D. Lanzara, Il convento di Ischia, P. 92 ; Notiziario, P. 93

Civiltà della Campania. Anno I, n. 1 (dicembre 1974)

A.I, n. 1 (dicembre 1974): M. Parrilli, Editoriale, P. 3 ; R. Virtuoso, Civiltà della Campania, P. 3 ; G. Galasso, Fisionomìa storica della regione, P. 6 ; Natale in Campania, P. 11, R. Causa, Cinque secoli di Presepe di, P. 12 ; M. Stefanile, I presepi d’una volta di, P. 20 ; D. Rea, L’universo mangereccio del Presepe di, P. 28 ; M. Prisco, Il presepe in provincia di, P. 34 ; B. Gatta, Una storia che non fu, P. 42 ; A. Mozzillo, Stendhal a Napoli, P. 47 ; E. Perrin, Viaggio a Cava d’un abate francese, P. 52 ; A.P. Carbone, Ravello: Villa Rufolo un paradiso per tutti, 54 ; D. Fernandez, Lettera d’amore a Napoli, P. 60 ; A. Gatto, Un mazzetto di poesie con la mia mano, 54 ; M. Parrilli, Vocazione turistica e culturale del Salernitano, P. 60 ; E. Comito, Poesia di Casertantica, P. 64 ; A. Fratta, Majorca e le Sirene, P. 67 ; V. Ricciuti, De Sica addio, P. 72 ; M. Perrotta, Il motoscafo spazzino del mare di Capri, P. 76 ; F. Canessa, Ritorna l’« opera buffa », P. 78 ; P. Gargano, Archeologia in villa, P. 83 ; E. Corsi, Per un nuovo equilibrio alberghiero, P. 86 ; F. Garbaccio, Un termalismo per tutte le stagioni, P. 88; G. Blasi, Amalfi by night, P. 90 ; A. Scelzo, La maratona Paestum-Salerno, P. 91 ; Notiziario, P. 92 ; F. De Ciuceis, Segnalazioni bibliografiche, P. 95

Outcomes of elective liver surgery worldwide: a global, prospective, multicenter, cross-sectional study

Background: The outcomes of liver surgery worldwide remain unknown. The true population-based outcomes are likely different to those vastly reported that reflect the activity of highly specialized academic centers. The aim of this study was to measure the true worldwide practice of liver surgery and associated outcomes by recruiting from centers across the globe. The geographic distribution of liver surgery activity and complexity was also evaluated to further understand variations in outcomes. Methods: LiverGroup.org was an international, prospective, multicenter, cross-sectional study following the Global Surgery Collaborative Snapshot Research approach with a 3-month prospective, consecutive patient enrollment within January–December 2019. Each patient was followed up for 90 days postoperatively. All patients undergoing liver surgery at their respective centers were eligible for study inclusion. Basic demographics, patient and operation characteristics were collected. Morbidity was recorded according to the Clavien–Dindo Classification of Surgical Complications. Country-based and hospital-based data were collected, including the Human Development Index (HDI). (NCT03768141). Results: A total of 2159 patients were included from six continents. Surgery was performed for cancer in 1785 (83%) patients. Of all patients, 912 (42%) experienced a postoperative complication of any severity, while the major complication rate was 16% (341/2159). The overall 90-day mortality rate after liver surgery was 3.8% (82/2,159). The overall failure to rescue rate was 11% (82/ 722) ranging from 5 to 35% among the higher and lower HDI groups, respectively. Conclusions: This is the first to our knowledge global surgery study specifically designed and conducted for specialized liver surgery. The authors identified failure to rescue as a significant potentially modifiable factor for mortality after liver surgery, mostly related to lower Human Development Index countries. Members of the LiverGroup.org network could now work together to develop quality improvement collaboratives

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