Ultrasound-guided transvaginal ethanol sclerotherapy belongs to one of the minimally invasive methods for endometrioma management. Nevertheless, some reports suggested a possible link between the method and the presence of pelvic adhesions. Therefore, our study aimed to describe ultrasound-guided transvaginal sclerotherapy with high-percentage ethanol, which resulted in the preservation of normal anatomy of the minor pelvis and the normal appearance of affected ovaries in the laparoscopic images obtained during postsclerotherapy surgeries. We present four cases of patients who underwent laparoscopic surgeries several months after ethanol sclerotherapies for ovarian endometriomas. During sclerotherapies, cyst fluid was aspirated under ultrasound guidance, cyst cavities were flushed with saline, and then filled with 96% ethanol to 60% of their initial volume for 10 min. The reported cases demonstrate that ultrasound-guided transvaginal ethanol sclerotherapy did not cause excessive adhesion formation or affect ovarian morphology. Therefore, it seems that this treatment method does not adversely affect fertility.
Transthoracic echocardiography (TTE) is a frequently requested investigation in patients admitted to hospital with various cardiorespiratory symptoms. With increasing life expectancy, these symptoms might be related to other clinical conditions, necessitating early and prompt diagnosis and subsequent management. We thought to broaden the use of the standard TTE to unmask clinically significant extracardiac findings (ECF). We screened the epigastrium, right upper abdominal quadrant, both flanks, and dorsal lung fields in 6468 consecutive inpatients undergoing TTE looking for aortic dilatation, liver pathology, ascites, pleural effusion and suspicious masses. We detected ECFs in 507 (8%) patients. Pleural effusion was the most commonly detected ECF seen in 86% of patients. ECF findings necessitating shift in the management plan were detected in 23% of patients and included large effusions necessitating drainage, malignant tumors (predominately liver metastases) and empyema. We concluded that routine screening of the liver, pleura, peritoneum and abdominal aorta could add an important piece of clinical information, detect pleural effusion, possible malignancies (mainly liver metastases) and aortic dilatation necessitating further assessment and management of hospitalized patients with various cardiopulmonary symptoms.
Personalised Care Planning for Older People with Frailty (PROSPER) is a complex intervention comprising four work packages with multiple layers of public involvement. We explored the perceived value of public involvement within PROSPER and evaluated the current structure using the six core standards for public involvement developed by the UK National Institute for Health and Care Research (NIHR). Two lay members trained as peer researchers. They conducted semi-structured interviews with other lay members, the trial and programme managers and chief investigator. Interviews were not audio-recorded. Interview notes were written up and returned to participants for verification. Documentary analysis of minutes was also undertaken. Twelve interviews were conducted. Lay members felt involvement in the programme made them reflect on their own experience of older age and encouraged them to be more involved in future research. Lay member input resulted in tangible benefits, including securing funding. The use of the NIHR framework highlighted areas of strength and weakness in the public involvement structure and underpinned an action plan for improvements in the final work package. Public involvement in PROSPER had both perceived and tangible benefits for individuals, the programme, the NHS and wider society. The NIHR standards framework is a useful tool for evaluating public involvement structures in programmes of complex interventions.
The article discusses the main aspects of data segmentation using machine learning algorithms, in particular K-Means, in the context of RFM (Recency, Frequency, Monetary Value) automation. The importance of the students' involvement in the realized research and practical work is emphasized, in order to gain applied experience. As a result, a visualized RFM-analysis was obtained, which in the future will allow to optimize marketing strategies and increase the effectiveness of communications with customers
Der wachsende Anteil von Frauen im Medizinstudium und in der medizinischen Praxis steht im Kontrast zu ihrer unterrepräsentierten Rolle in Führungspositionen innerhalb medizinischer Fachgesellschaften in Deutschland. Vor diesem Hintergrund wurde der Frauenanteil in den Spitzenpositionen medizinischer Fachgesellschaften in Deutschland analysiert. Bei der Analyse der Zusammensetzung der Vorstände/Präsidien der 183 Fachgesellschaften wurden 1460 Personen gezählt. Der Anteil der Frauen in den Vorständen/Präsidien lag bei 32,6%. Die 183 Fachgesellschaften wurden in 47 (25,7%) Fällen durch eine Frau als Präsidentin geführt. Als Vizepräsident*in fungierten 72 (39,3%) Frauen. Nur 39 (21,3%) Fachgesellschaften verfügten über einen Frauenanteil in den Vorständen/Präsidien ≥50%. Es liegt ein deutliches Ungleichgewicht weiblich besetzter Führungspositionen in medizinischen Fachgesellschaften in Deutschland vor. Um diese Ungleichheit zu adressieren, ist eine Strategie mit multiplen Initiativen notwendig, die sowohl Karriere-Entwicklungsprogramme wie Mentoring einschließt als auch die Gestaltung von aktiven Kongress-Teilnahmen zur Gewährleistung einer ausgewogenen Repräsentation der Geschlechter fokussiert.
