0000000000114097
AUTHOR
M. Khan
Der Einsatz eines optischen Navigationssystem in der Nasennebenh�hlenchirurgie
Hintergrund. Fur die moderne Nasennebenhohlenchirurgie stehen heute verschiedene CAS-Systeme zur Verfugung.Das Vector-Vision-Compact®-System stellt erstmals ein speziell fur Nasennebenhohleneingriffe konzipiertes optisches Gerat dar.Seine Praktikabilitat und Zuverlassigkeit wurde in der Nasennebenhohlenchirurgie uberpruft. Patienten und Methode. Das System wurde bei 60 Patienten mit polyposer Pansinusitis verwendet.Die Bestimmung der Systemgenauigkeit erfolgte visuell und wurde mit etablierten Systemen verglichen.Fehlerquellen sowie systembedingte Komplikationen wurden uberpruft. Ergebnisse. Die Systemgenauigkeit betrug 1,9 mm und war anderen Navigationssystemen gleichwertig. In 83,3% aller…
Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019
Background Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian…
Fehlerquellen der Navigation in der lateralen Sch�delbasischirurgie
Die Identifikation moglicher Storfaktoren navigationsunterstutzter Eingriffe an der lateralen Schadelbasis ermoglichen dem Anwender die Vermeidung und Behebung dieser Fehler. Anhand unserer Erfahrungen von 85 navigationsunterstutzten Eingriffen im Bereich der lateralen Schadelbasis werden Fehler der Hard- und Software, der Bildgebung und des -transfers, der Patientenregistrierung, durch den Anwender und solche strategischer Art analysiert. Bei optischen CAS-Systemen fuhrt eine Blockade des Sichtfelds der Kameras zu Funktionsbeschrankungen, wahrend elektromagnetische Systeme durch ferromagnetisch aktive Materialien beeinflusst werden konnen. Die bisherigen Verfahren der Patientenregistrierun…
Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019
Background: Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-…
The impact of conversion on the risk of major complication following laparoscopic colonic surgery: an international, multicentre prospective audit.
BACKGROUND: Laparoscopy has now been implemented as a standard of care for elective colonic resection around the world. During the adoption period, studies showed that conversion may be detrimental to patients, with poorer outcomes than both laparoscopic completed or planned open surgery. The primary aim of this study was to determine whether laparoscopic conversion was associated with a higher major complication rate than planned open surgery in contemporary, international practice.METHODS: Combined analysis of the European Society of Coloproctology 2017 and 2015 audits. Patients were included if they underwent elective resection of a colonic segment from the caecum to the rectosigmoid jun…
SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study
Abstract 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 su…
Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: a report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry
Abstract Background Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients’ clinical phenotypes and analyse the differential clinical course. Methods We performed a hierarchical cluster analysis based on Ward’s Method and Squared Euclidean Distance using 22 clinical binary variables, identifying the optimal number of clusters. We investigated differences in clinical management, use of healthcare resources and outcomes in a cohort of European AF patients from a Europe-wide observational registry. Results A total of 9363 were available for this analysis. We identified three …
Evaluating the incidence of pathological complete response in current international rectal cancer practice: the barriers to widespread safe deferral of surgery
INTRODUCTION: The mainstay of management for locally advanced rectal cancer is chemoradiotherapy followed by surgical resection. Following chemoradiotherapy, a complete response may be detected clinically and radiologically (cCR) prior to surgery or pathologically after surgery (pCR). We aim to report the overall complete pathological response (pCR) rate and the reliability of detecting a cCR by conventional pre-operative imaging.METHODS: A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients treated by elective rectal resection were included. A pCR was defined as a ypT0 N0 EMVI negative primary tumour; a partial response represented any r…
An international multicentre prospective audit of elective rectal cancer surgery; operative approach versus outcome, including transanal total mesorectal excision (TaTME)
Introduction: Transanal total mesorectal excision (TaTME) has rapidly emerged as a novel approach for rectal cancer surgery. Safety profiles are still emerging and more comparative data is urgently needed. This study aimed to compare indications and short-term outcomes of TaTME, open, laparoscopic, and robotic TME internationally. Methods: A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients undergoing elective total mesorectal excision (TME) for malignancy between 1 January 2017 and 15 March 2017 by any operative approach were included. The primary outcome measure was anastomotic leak. Results: Of 2579 included patients, 76.2% (1966/257…
Intraoperative Navigation in der Chirurgie der Nasennebenhöhlen und der vorderen Schädelbasis
Hintergrund und Fragestellung. Beim Einsatz der computerassistierten Chirurgie im Bereich der Nasennebenhohlen und vorderen Schadelbasis sind einige Fehlerquellen zu beachten, die durch physikalische Gesetze, den technischen Entwicklungs- und individuellen Kenntnisstand des Anwenders bedingt sind. Patienten/Methodik. Anhand unserer Erfahrungen von 436 navigationsunterstutzten Eingriffen werden Hard- und Softwarefehler, Fehler der Bildgebung und des -transfers, Fehler der Patientenregistrierung, Anwenderfehler und strategische Fehler analysiert. Ergebnisse. Bei optischen CAS-Systemen fuhrt die Blockade des Sichtfeldes der Kamera zu Funktionseinschrankungen, wahrend elektromagnetische Systeme…
Five insights from the Global Burden of Disease Study 2019
The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD …
The overlapping burden of the three leading causes of disability and death in sub-Saharan African children
Publisher Copyright: © 2022, The Author(s). Despite substantial declines since 2000, lower respiratory infections (LRIs), diarrhoeal diseases, and malaria remain among the leading causes of nonfatal and fatal disease burden for children under 5 years of age (under 5), primarily in sub-Saharan Africa (SSA). The spatial burden of each of these diseases has been estimated subnationally across SSA, yet no prior analyses have examined the pattern of their combined burden. Here we synthesise subnational estimates of the burden of LRIs, diarrhoea, and malaria in children under-5 from 2000 to 2017 for 43 sub-Saharan countries. Some units faced a relatively equal burden from each of the three diseas…
Parry Romberg Syndrome with localized scleroderma: a case report
Parry Romberg syndrome(PRS) is a rare acquired poorly understood neurocutaneous syndrome of unknown etiology characterized by slow progressive atrophic changes commonly affecting one half of the face. The exact incidence and etiology towards the syndrome remains unclear. Apart from the multifactorial etiology proposed, the possible primary cause is mainly attributed to the cerebral disturbance of the fat metabolism. The syndrome overlaps with “en coup de sabre” morphea, with an ill defined relationship existing between the two. Parry Romberg Syndrome is an invalidating lesion that may be associated with different neurological, cutaneous, ocular, dental and autoimmune abnormalities. This rep…