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4 (6.29) years] achieved moderate to good EULAR response. At 24 weeks, 90.8% of patients achieved moderate to good EULAR response, 19.8% achieved low disease activity and 29.5% achieved remission, with a mean change in DAS28-ESR from baseline of 2.9 (1.3). RTX failure and relapse were seen in 5.4% and 3.6%, respectively. The response was maintained for 12.3 (7.2) months with a mean RTX dose 521.1 (100.8) mg. Adverse events were seen in 9.6%. When compared with the standard dosing regimen with the originator molecule, a cost reduction of 90% was achieved.

A low-dose RTX regimen achieved reasonably good clinical outcomes at the end of 6 months, with a significantly lower cost.

A low-dose RTX regimen achieved reasonably good clinical outcomes at the end of 6 months, with a significantly lower cost.

In the Czech Republic, an outbreak of the coronavirus disease (COVID‑19) has been decelerated by quickly adopting strict and strongly limiting government measures. In this study, the authors present the preliminary results (April 1-5, 2020) of a public risk perception study of COVID‑19.

The online questionnaire survey was announced in the national TV and radio stations with the nationwide coverage. Respondents were recruited through the website of the University of Ostrava during the first 5 days of the survey (N = 7966). The data covered risk perception with a focus on physical and psychological aspects, the current socio-economic situation and adaptation to the lockdown. The authors used Mann-Whitney and Kruskal-Wallis tests, as well as ordered logistic regression, with a significance level of 5% using STATA version 15.

From the total sample of the respondents aged 40 years on average (a range of 15-87 years), the present study shows that women (p < 0.001) and elderly people (p < 0.001) perceived the health risk related to COVID‑19 as significantly worse than others. Older people (>60 years) perceived their mental health as significantly better than younger participants (p < 0.001). Most of the respondents assessed the adopted measures as adequate (71%) and believed in their effectiveness (69.7%).

This study contributes to understanding the risk perception as a public response to the COVID‑19 pandemic. Int J Occup Med Environ Health. 2021;34(2)165-76.

This study contributes to understanding the risk perception as a public response to the COVID‑19 pandemic. Int J Occup Med Environ Health. 2021;34(2)165-76.

The debate on equity in health, with long history and wide understanding, is more relevant today when considering the transcendence of this area. In the context of our system, it is appropriate to know the approach adopted by the autonomous communities. By analysing regional health plans in Spain it was intended to detect the perspectives applied in the search for equity, as well as to know the main goals of the plans and those groups or circumstances they try to deal with.

Based on the procedure of constant comparative analysis and content analysis, whose statistical treatment was conducted with Nvivo software (v12) and the analysis of Jaccard and Pearson correlation indexes, along with the triangulation of methods, data and researchers, the most recent regional health plans in progress (fourth quarter of 2019) were screened.

Analized plans brought out that the search for equity is not given sufficient relevance. However, there are specific circumstances that standed out among the references to equity p. Other items or groups considered by the regional administrations in a more reduced way, but also in a different manner, are immigration, rural habitat and infrastructures and elderly people.

Heterotaxy syndrome is associated with a plethora of cardiovascular and other multi-system anomalies with a high childhood mortality. A dilated azygos vein as part of the polysplenia variant of heterotaxy syndrome may cause oesophageal stenosis owing to a prolonged compression. We describe our technique of extramediastinal oesophago-oesophagostomy in the prone position for this rare congenital syndromic malformation with an excellent outcome.

A 17-year-old boy with heterotaxy syndrome presented with intermittent dysphagia and postprandial emesis with failure to thrive. Despite the presence of diverse anatomic abnormalities, it was only his symptom of dysphagia due to oesophageal stricture that merited surgical intervention. He underwent an azygos-preserving extramediastinal oesophago-oesophagostomy in the prone position without segmental resection with the establishment of continuity using a modified Collard-type anastomosis.

The patient had an uneventful convalescence, with imaging after 1 year showingmally invasive surgery ensured excellent outcomes. The hitherto unreported technique may open up avenues for further research regarding the behaviour of the oesophageal muscular tube with transection and re-anastomosis for rare benign abnormalities.

This study aims at describing the feasibility and safety of video-assisted thoracic surgery (VATS) in benign diseases such as pulmonary sequestrations (PSs) and report the surgical outcomes.

This is a retrospective analysis of prospectively maintained data of 25 patients who were operated for PS over 7 years at a dedicated thoracic surgery centre in India. Pre-operative details, operative technique and details, post-operative details and complications were recorded and analysed.

There were 15 (60%) males and 10 (40%) females, with a median age of 22.28 years (range, 16-28 years). All patients had intra-lobar type of sequestration. The most commonly involved was left lower lobe (n = 15 patients, 60%) followed by the right lower lobe (n = 10 patients, 40%). The origin of blood supply was from the descending thoracic aorta in 18 patients (72%), the abdominal aorta in 5 (20%) and the coeliac trunk and the inferior phrenic artery in one patient (4%) each. All patients underwent complete lobar resection. One patient was converted because of dense hilar adhesion. The average duration of surgery was 179 min and the average blood loss was 204 ml. The median hospital stay and chest tube duration were 4 and 3 days, respectively. One patient was re-explored because of post-operative bleeding. Only one patient had an air leak for >7 days. The median follow-up was 42 months (range, 6-90 months) without any recurrence.

VATS is a safe, feasible and effective option for PS at experienced centres.

VATS is a safe, feasible and effective option for PS at experienced centres.

Indocyanine green (ICG) fluorescence with high-definition, three-dimensional imaging systems is emerging as the latest strategy to reduce trauma and improve surgical outcomes during oncosurgery.

This is a prospective study involving 100 patients with carcinoma endometrium who underwent robotic-assisted Type 1 pan-hysterectomy, with ICG-directed sentinel lymph node (SLN) biopsy from November 2017 to December 2019. The aim was to assess the feasibility and diagnostic accuracy of SLN algorithm and to evaluate the location and distribution of SLN in pelvic, para-aortic and unusual areas and the role of frozen section.

The overall SLN detection rate was 98%. Bilateral detection was possible in 92% of the cases. Right side was detected in 98% of the cases and left side was visualised in 92% of the cases. MLN2480 Complete node dissection was done where SLN mapping failed. The most common location for SLN in our series was obturator on the right hemipelvis and internal iliac on the left hemipelvis. SLN in the para-aortomise as a modern staging strategy for endometrial cancer. In our experience, cervical injection was an optimal method of mapping the pelvis. ICG showed a high overall detection rate, and bilateral mapping appears to be a feasible alternative to the more traditional methods of SLN mapping in patients with endometrial cancer. The ICG fluorescence imaging system is simple and safe and may become a standard in oncosurgery in view of its staging and anatomical imaging capabilities. This approach can reduce the morbidity, operative times and costs associated with complete lymphadenectomy while maintaining prognostic and predictive information.

In retro-gastric Pancreatic pseudocyst (PP) Laparoscopic cystogastrostomy (LCG) is an established procedure of drainage.

To compare surgical outcome between laparoscopic cysto-gastrostomy conventional method and plication of the edge of anterior gastrotomy in patients of pancreatic pseudocyst.

Twenty six patients were underwent LCG from 2010-2020 by a single surgeon. Both the conventional LCG group Group-1(Gr-1) and the plication group Group-2 (Gr-2) where plication of edge of anterior gastrostomy was performed, contained 13 patients each.

The numbers of male/female in Gr-1 was 9/4 and that in Gr-2 was 10/3 (P = 1). Mean ages of patients were 45.3 ± 10.4 years (range 23-60) in Gr-1 and 48.0 ± 12.3 years (range 27-65) in Gr-2. Etiological factors were alcohol (46.1% in Gr-1, 53.8% in Gr-2), gallstone disease (38.4% in Gr-1,15.3% in Gr-2), trauma (15.3% in each groups), idiopathic cause (15.3% in Gr-2). The cyst size was 9.0 ± 1.5 cm in Gr-1and 8.9 ± 2.1cm in Gr-2. The mean operative time in Gr-1 (107.6 ± 12.5 minutes) was longer than Gr-2 (97 ± 1 3.6 minutes) (P = 0.06). The size of cystogastric anastomosis in Gr-1 was 4.6 ± 0.7 cm and that in Gr-2 was 4 ± 0.8 cm (P = 0.04). The intra-operative blood loss in Gr-1 and Gr-2 were 101.9 ± 21.7ml and 78.4 ± 30.7 ml respectively. There was a significant change in intraoperative blood loss and stoma size in Gr-2. The postoperative complications were managed conservatively. No recurrence over a period of 18 months of follow-up.

Plication of edges of anterior gastrostomy result in reduction in operative time, smaller anastomosis without complication and less intra-operative blood loss.

Plication of edges of anterior gastrostomy result in reduction in operative time, smaller anastomosis without complication and less intra-operative blood loss.

The incidence of ultrasound seromas has significantly increased after large hernial sac surgery. Several methods are available for preventing ultrasound seromas, but the clinical results are poor. It has also been demonstrated that hernial sac stump fenestration during laparoscopic incisional hernia repair surgery can significantly decrease the incidence of ultrasound seromas.

Ninety patients aged 18-75 years who were treated in our hospital for primary Type III indirect inguinal hernia from March 2017 to March 2018 were randomised to a preventive fenestration group and a control group. All patients underwent transabdominal preperitoneal repair. The number of ultrasound seromas in the inguinal regions and ultrasound seroma volume on day 6 and months 1 and 3 after surgery in the two groups were compared. The secondary outcomes included length of surgery, urinary retention, acute pain, chronic pain, length of hospitalisation, recurrence rate and other complications.

There were no significant differences in demographic characteristics. Ultrasound seroma incidence and ultrasound seroma volume on day 6 and months 1 and 3 after surgery were significantly lower in the preventive fenestration group than that in the control group. There were no significant differences in the length of hospitalisation or incidence of acute pain or urinary retention between the two groups.

Hernial sac stump fenestration after hernial sac transection in inguinal hernia repair surgery is a simple method that can effectively reduce post-operative ultrasound seromas.

Hernial sac stump fenestration after hernial sac transection in inguinal hernia repair surgery is a simple method that can effectively reduce post-operative ultrasound seromas.