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OBJECTIVE: To evaluate the role of clinical exchange programs in postgraduate obgyn training using the International Federation of Gynecology and Obstetrics (FIGO)-World Association of Trainees in Obstetrics and Gynecology (WATOG) One World Exchange (OWE), a clinical exchange program held in France in October 2023, as a case-study. METHODS: This was a cross-sectional study. A 31-item structured questionnaire designed with Google Forms was electronically distributed to the 51 obgyn postgraduate trainees (OWE fellows) who participated in the OWE, to collect information about the exchange. Collected data was analyzed using IBM Statistical Product and Service Solutions (SPSS) Statistics for Windows. RESULTS: The survey response rate was 68.6%. The mean age of the respondents was 33.0 ± 4.0 years. Majority of the them were females (26, 74.3%), married (19, 54.3%), at least in their third year of training (30, 85.7%) and from Africa (11, 31.4%). During the period of the exchange program, fellows observed various obstetric and gynecologic procedures, including open and minimal access procedures, with more than one-fifth (8, 22.9%) of them reporting that they were allowed to assist in some of these procedures. The fellows noted salient differences in practice between their exchange hospitals and their home countries. An overwhelming majority (30, 85.7%) of the fellows believed the OWE was beneficial and would positively impact their clinical practices back in their home countries. CONCLUSION: Clinical exchange programs like the OWE provide valuable benefits in improving the clinical knowledge and skills of postgraduate obgyn trainees.
- MeSH
- dospělí MeSH
- gynekologie * výchova MeSH
- lidé MeSH
- mezinárodní vzdělávací výměna * MeSH
- porodnictví * výchova MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- společnosti lékařské MeSH
- studium lékařství specializační postgraduální * metody MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Francie MeSH
OBJECTIVE: Resection of the vestibular schwannoma causes acute peripheral vestibular loss. The process of central compensation starts immediately afterward. The rehabilitation goal is to support this process and restore the quality of life. MATERIALS AND METHODS: In this prospective single-center study, 67 consecutive patients underwent vestibular schwannoma resection (40 females, mean age 52 ± 12 years). The patients were divided into three groups: the prehabilitation with intratympanic gentamicin group, the virtual reality group (optokinetic stimulation via virtual reality goggles in the first ten days after the surgery), and the control group. All patients were examined with objective methods and completed questionnaires before the prehabilitation, before the surgery, at the hospital discharge, and after three months. RESULTS: Intratympanic gentamicin prehabilitation leads ipsilaterally to a significant aVOR reduction in all semicircular canals (p < 0.050), the increase of the unilateral weakness in air calorics (p = 0.026), and loss of cVEMPs responses (p = 0.017). Prehabilitation and postoperative exposure to virtual reality scenes improved the patient's perception of vertigo problems according to Dizziness Handicap Inventory (p = 0.039 and p = 0.076, respectively). These findings conform with the optokinetic testing results, which showed higher slow phase velocities at higher speeds (40 deg/s) in both targeted groups compared to the control group. CONCLUSION: Preoperative intratympanic gentamicin positively affects peripheral vestibular function, influencing balance perception after VS resection. In long-term follow-up, prehabilitation and postoperative exposure to virtual reality improve patients' quality of life in the field of vertigo problems.
- MeSH
- antibakteriální látky aplikace a dávkování MeSH
- dospělí MeSH
- gentamiciny * aplikace a dávkování MeSH
- intratympanická injekce MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- pooperační péče metody MeSH
- předoperační péče metody MeSH
- prospektivní studie MeSH
- senioři MeSH
- terapie pomocí virtuální reality metody MeSH
- vestibulární funkční testy MeSH
- vestibulární schwannom * chirurgie MeSH
- virtuální realita MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
Cíl: Tato studie se zaměřila na posouzení spolehlivosti a vzdělávací hodnoty videí o hysterektomii pomocí transluminální endoskopické operace s přirozeným vaginálním vstupem (vNOTES – vaginal natural orifice transluminal endoscopic surgery) na YouTube a jejich vhodnosti pro školení chirurgů. Materiál a metody: Dne 12. června 2024 byl YouTube prohledáván pomocí klíčových slov „vNOTES hysterektomie“, „TVNOTES hysterektomie“, „transvaginální transluminální endoskopická hysterektomie s přirozeným otvorem“, „vNOTES“ a „vaginální hysterektomie“. Kritéria pro zařazení splnilo celkem 73 videí. Byly zaznamenány metriky zapojení diváků, jako je doba od nahrání, počet zhlédnutí, hodnocení Líbí se mi, Nelíbí se mi, komentáře a délka videa. Byly vypočteny poměry, jako je poměr zobrazení, podobný poměr a index výkonu videa (VPI – video power index). Videa byla kategorizována pomocí modifikované globální škály kvality (GQS – global quality scale) a hodnocena na základě bodovacího systému odvozeného ze standardizovaného 10krokového postupu hysterektomie vNOTES se skóre v rozmezí 0–15. Výsledky: Ze 73 videí bylo 40 (53,8 %) označeno jako nekvalitní, 13 (17,8 %) jako středně kvalitní a 20 (27,4 %) jako dobré. Mezi skupinami nebyly nalezeny žádné významné rozdíly, pokud jde o dobu od nahrání, počet zhlédnutí, hodnocení Nelíbí se mi, komentářů nebo poměru Líbí se mi. Videa ve skupině dobré kvality však měla výrazně vyšší počet lajků a skóre VPI. Kritické prvky, jako je příprava a polohování pacientky, nastavení operačního sálu, obřízka děložního čípku a uzávěr klenby, byly ve videích nižší kvality nedostatečně řešeny. Videa s didaktickým hlasem měla výrazně více zhlédnutí, lajků a komentářů než videa s hudbou nebo bez zvuku. Mezi délkou videa a metrikami zapojení nebyly nalezeny žádné významné korelace. Závěr: Většina videí o hysterektomii vNOTES (53,8 %) na YouTube postrádá komplexní vzdělávací obsah, přičemž pouze malá část je považována za vhodnou pro chirurgický výcvik. Hodnocení zájmu diváků nemusí souviset s mírou užitečnosti videí. Chirurgové a organizace by se měli zaměřit na produkci vysoce kvalitních instruktážních recenzovaných videí, aby zlepšili vzdělávací hodnotu YouTube jako zdroje informací.
Objective: This study aimed to assess the reliability and educational value of vaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy videos on YouTube and their suitability for training surgeons. Materials and methods: On June 12, 2024, YouTube was searched using the keywords “vNOTES hysterectomy,” “TVNOTES hysterectomy,” “transvaginal natural orifice transluminal endoscopic hysterectomy,” “vNOTES,” and “vaginal notes hysterectomy.” A total of 73 videos met the inclusion criteria. Viewer engagement metrics, such as time since upload, number of views, likes, dislikes, comments, and video duration were recorded. Ratios such as a view ratio, a like ratio, and Video Power Index (VPI) were calculated. The videos were categorized by the modified Global Quality Scale (GQS) and evaluated based on a scoring system derived from a standardized 10-step vNOTES hysterectomy procedure, with scores ranging from 0 to 15. Results: Out of 73 videos, 40 (53.8%) were categorized as poor quality, 13 (17.8%) as moderate, and 20 (27.4%) as good. No significant differences were found between groups in terms of time since upload, views, dislikes, comments, or a like ratio. However, videos in the good-quality group had a significantly higher number of likes and VPI scores. Critical elements such as patient preparation and positioning, setup of the operation room, circumcision of the cervix, and vault closure were inadequately addressed in lower-quality videos. Videos with a didactic voice had significantly more views, likes, and comments than those with music or no sound. No significant correlations were found between video length and engagement metrics. Conclusion: The majority of vNOTES hysterectomy videos (53.8%) on YouTube lack comprehensive educational content, with only a small fraction deemed appropriate for surgical training. The interest rates of the viewers may not be correlated with the usefulness rates of the videos. Surgeons and organizations should focus on producing high-quality, peer-reviewed instructional videos to improve the educational value of YouTube as a resource.
PURPOSE: Minimally invasive surgery (MIS) in neonates and infants presents technical challenges and is still unfamiliar to many paediatrics surgeons. This study aims to identify currently available simulators for neonatal/infant MIS training, to assess their validity, level of evidence, and related recommendations. METHODS: The review followed PRISMA guidelines and was registered in PROSPERO (CRD420250581050). Electronic search limited to English articles was performed through PubMed/MEDLINE, SCOPUS, Web of Science and Cochrane Database from January 2010 to June 2024. RESULTS: Out of 1084 identified records, 72 studies met the inclusion criteria and were analysed across general, gastrointestinal, thoracic, and urological MIS specialties. Recent efforts have led to the development of 3D-printed, animal-based, and hybrid models several of which showed high fidelity, skill differentiation, and educational value. Despite promising results, no universal MIS training model exists for neonate/infant patients, highlighting the need for structured, proficiency-based curricula. Overall, studies demonstrated moderate levels of evidence and recommendation, supporting integration of cost-effective simulation into paediatrics MIS training CONCLUSION: This systematic review highlights the need for validated, standardized simulation models and proficiency-based curricula to optimize neonate and infant MIS training and guide future research toward improving model fidelity, accessibility, and long-term educational outcomes.
With the incorporation of effective therapies for myelofibrosis (MF), accurately predicting outcomes after allogeneic hematopoietic cell transplantation (allo-HCT) is crucial for determining the optimal timing for this procedure. Using data from 5183 patients with MF who underwent first allo-HCT between 2005 and 2020 at European Society for Blood and Marrow Transplantation centers, we examined different machine learning (ML) models to predict overall survival after transplant. The cohort was divided into a training set (75%) and a test set (25%) for model validation. A random survival forests (RSF) model was developed based on 10 variables: patient age, comorbidity index, performance status, blood blasts, hemoglobin, leukocytes, platelets, donor type, conditioning intensity, and graft-versus-host disease prophylaxis. Its performance was compared with a 4-level Cox regression-based score and other ML-based models derived from the same data set, and with the Center for International Blood and Marrow Transplant Research score. The RSF outperformed all comparators, achieving better concordance indices across both primary and postessential thrombocythemia/polycythemia vera MF subgroups. The robustness and generalizability of the RSF model was confirmed by Akaike information criterion and time-dependent receiver operating characteristic area under the curve metrics in both sets. Although all models were prognostic for nonrelapse mortality, the RSF provided better curve separation, effectively identifying a high-risk group comprising 25% of patients. In conclusion, ML enhances risk stratification in patients with MF undergoing allo-HCT, paving the way for personalized medicine. A web application (https://gemfin.click/ebmt) based on the RSF model offers a practical tool to identify patients at high risk for poor transplantation outcomes, supporting informed treatment decisions and advancing individualized care.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- primární myelofibróza * terapie mortalita MeSH
- prognóza MeSH
- senioři MeSH
- strojové učení * MeSH
- transplantace hematopoetických kmenových buněk * mortalita MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Introduction: The central venous catheter (CVC) and its use represents a step forward in patient treatment, but involves numerous potential complications. Applying nursing standards to clinical practice achieves high-quality nursing care. Design: Cross-sectional quantitative study using a questionnaire. Methods: Quantitative research using questionnaire technique was conducted to examine nurses' knowledge of nursing care for central venous catheters and adherence to nursing standards. The research sample consisted of 256 nurses in selected regional hospitals in the Slovak Republic. The criterion for including nurses in the sample was the provision of CVC care in routine practice. The data were analysed using descriptive statistics and statistical testing methods. Results: The research found that nurses have certain shortcomings in nursing care for central venous catheters. Nurses know how to work correctly according to aseptic procedures (81%), but they are unsure what barrier devices are needed for dressing and treatment (25%). Conclusion: Based on the research results, it can be concluded that despite nurses' knowledge being adequate, it is necessary to provide regular training on the principles of CVC care to reduce infections associated with healthcare.
Úvod: Badmintonová zranění jsou i přes celosvětovou oblibu tohoto sportu relativně opomíjenou problematikou. Metodika vyhledávání studií: Tento přehledový článek se zaměřuje na literaturu a výzkum zranění v badmintonu a na možnosti konzervativní léčby společně s rehabilitací těchto zranění. Jedním z cílů bylo shrnout poznatky z dostupných vědeckých studií publikovaných do roku 2023. Vyhledávání relevantní literatury bylo realizováno v databázích PubMed a Web of Science pomocí anglických ekvivalentů klíčových slov: badminton, zranění, etiologie, prevence, fyzioterapie. Výsledky: Celkem bylo pro tvorbu článku nalezeno a využito 51 studií, které se zabývají rizikovými faktory badmintonových zranění, jejich konkrétním typem a incidencí (zejména incidencí a rizikovými faktory), fyziologickými nároky badmintonu a možnostmi léčby daných poranění s důrazem na sportovní fyzioterapii. Studie zabývající se specificky možnostmi rehabilitace a jiných konzervativních postupů pro hráče badmintonu nebyly nalezeny. Možnosti rehabilitace vycházejí z aktuálních poznatků vztahující se obecně zejména k akutním a chronickým zraněním ve sportu. Diskuze: Ze současné evidence se jako efektivní přístup ke zraněním z přetížení jeví progresivní zatížení prvky silového tréninku s cílem navození pozitivních adaptačních změn v postižené tkáni. Ve sportovní fyzioterapii bývá hojně užíváno např. prvků kryoterapie, která ovšem pro podporu hojení a regenerace úponových bolestí nemá dostatečnou evidenci. Zranění, která vznikají akutním nedostatkem kapacity tkáně snášet nadměrnou zátěž, by měla být léčena primárně pohybovou terapií s konkrétně nastavenými parametry. Konkrétní rehabilitační postupy pozdní fáze návratu do hry jsou podmíněny specifikami sportu, jeho biomechanikou a konkrétním typem zranění. Závěr: I když je k většině zranění v badmintonu přistoupeno konzervativní metodou léčby, neexistuje dostatečná evidence vztahující se k rehabilitaci zranění specificky u badmintonistů. Cílem léčby badmintonových zranění je snížení bolestivosti, zvýšení kapacity, zlepšení koordinace a balance. Z východisek práce vyplývají následně i možnosti prevence zranění a konzervativních léčebných postupů zranění s akcentem na sportovní fyzioterapii.
Introduction: Badminton injuries are a relatively neglected issue despite the worldwide popularity of the sport. Methodology of the study search: This review article focuses on the literature and research on badminton injuries and conservative treatment options along with rehabilitation of these injuries. One of the objectives was to summarize the findings from available scientific studies published up until 2023. The search for relevant literature was performed in PubMed and Web of Science databases using the English equivalents of the keywords: badminton, injury, etiology, prevention, and physiotherapy. Results: A total of 51 studies were identified and used for the development of the article, which dealt with the risk factors of badminton injuries, their specific type and incidence (especially incidence and risk factors), the physiological demands of badminton, and treatment options for the injuries in question, with an emphasis on sports physiotherapy. Studies specifically addressing rehabilitation options and other conservative treatments for badminton players were not found. Rehabilitation options are based on current knowledge related to acute and chronic injuries in the sport in general. Discussion: From current evidence, progressive loading with elements of strength training to induce positive adaptive changes in the affected tissue appears to be an effective approach to overuse injuries. For example, elements of cryotherapy are widely used in sports physiotherapy, but there is insufficient evidence to support healing and regeneration of tendon pain. Injuries that result from an acute lack of tissue capacity to tolerate excessive load should be treated primarily with movement therapy with specific parameters. Specific rehabilitation procedures of the late phase of return to play are conditioned by the specifics of the sport, its biomechanics, and the particular type of injury. Conclusion: Although most injuries in badminton are treated conservatively, there is insufficient evidence relating to injury rehabilitation specifically for badminton players. The goal of treatment for badminton injuries is to reduce soreness, increase capacity, and improve coordination and balance. The premise of this article subsequently suggests options for injury prevention and conservative injury treatments with an emphasis on sports physiotherapy.
- MeSH
- lidé MeSH
- raketové sporty MeSH
- sportovní úrazy * etiologie prevence a kontrola rehabilitace MeSH
- techniky fyzikální terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
... 7.2.1 General -- 7.2.2 Employment process -- 7.3 Awareness -- 7.3.1 Awareness of personnel -- 7.3.2 Training ... ... for personnel -- 7.3.3 Training for business associates -- 7.3.4 Awareness and training programmes - ... ... evaluation -- 9.2 Internal audit -- 9.2.1 General -- 9.2.2 Internal audit programme -- 9.2.3 Audit procedures ...
Second edition 2 svazky v 1 (ix, 56 stran a viii, 47 stran) ; 30 cm
- MeSH
- organizace a řízení normy MeSH
- podvod prevence a kontrola MeSH
- řízení společenských procesů normy MeSH
- Publikační typ
- směrnice MeSH
- Konspekt
- Metrologie. Standardizace
- NLK Obory
- sociologie
BACKGROUND: Respiratory muscle training may improve ventilatory efficiency (VE/VCO2 slope), a strong predictor of postoperative pulmonary complications. We hypothesised that multimodal prehabilitation, incorporating high-intensity respiratory muscle training, before lung resection would reduce postoperative complications and length of hospital stay. METHODS: We conducted a prospective multicentre, randomised controlled trial (NCT04826575) to examine the effect of prehabilitation in individuals undergoing lung resection. Participants were defined as high-risk for postoperative pulmonary complications if they achieved VE/VCO2 slope ≥33, as determined by cardiopulmonary exercise testing. Participants were then randomised to either usual care or multimodal prehabilitation, which consisted of a 14-day programme of high-intensity respiratory muscle training, smoking cessation, nutritional support, and psychological support. The primary outcome were postoperative pulmonary and cardiovascular complications (pneumonia, atelectasis, respiratory failure necessitating mechanical ventilation, adult respiratory distress syndrome, prolonged air leak). RESULTS: A total of 122 patients (46% female; age range: 64-75 yr) completed the study. Postoperative pulmonary complications occurred in 20/58 (34%) of patients randomised to multimodal prehabilitation, compared with 35/64 (55%) patients receiving usual care (odds ratio 2.29 [95% confidence interval 1.10-4.77]; P=0.029). Hospital length of stay was shorter after multimodal rehabilitation compared with patients randomised to receive usual care (from 9 [7-11] days to 7 [6-9] days; P=0.038). After prehabilitation, mean (sd) VE/VCO2 slope decreased from 39 (8) to 36 (9); P=0.01. Prehabilitation also improved patient-reported quality of life measures. CONCLUSIONS: In high-risk patients undergoing elective lung resection surgery, multimodal prehabilitation, including high-intensity respiratory muscle training to target VE/VCO2, reduced postoperative pulmonary complications and hospital length of stay.
- MeSH
- dechová cvičení * metody MeSH
- délka pobytu statistika a číselné údaje MeSH
- fyzioterapie v předoperační přípravě * MeSH
- kombinovaná terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- odvykání kouření MeSH
- plicní nemoci * prevence a kontrola MeSH
- pneumektomie * MeSH
- pooperační komplikace * prevence a kontrola MeSH
- předoperační péče * metody MeSH
- prospektivní studie MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
Considering the growing role of ultrasound-guided procedures in musculoskeletal medicine, training as regards these interventions is pivotal. While hands-on training on cadavers can be considered optimal, it has several drawbacks, e.g., high cost, poor availability, and technical challenges regarding preservation. Apart from cadavers, different approaches to practicing needle guidance are taught in ultrasound workshops whereby phantoms from meat (e.g., chicken breast), cheese or gelatin are used. Likewise, this article aims to provide a detailed description as to how different gelatin-based phantoms can be prepared. In line with the EURO-MUSCULUS/USPRM (European Musculoskeletal Ultrasound Study Group/Ultrasound Study Group of the International Society of Physical and Rehabilitation Medicine) protocols/background, the authors describe particular basic and advanced phantoms to be used for practicing different technical/manual skills pertaining to common ultrasound-guided procedures. The present manuscript can be considered a practical and ready-to-use "recipe book" for readers who are interested in the wide spectrum of interventional ultrasound.
- MeSH
- fantomy radiodiagnostické * MeSH
- intervenční ultrasonografie * MeSH
- klinické kompetence MeSH
- lidé MeSH
- muskuloskeletální nemoci diagnostické zobrazování rehabilitace MeSH
- rehabilitační lékařství * výchova MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH