Complications after surgical management of proximal humeral fractures: a systematic review of event terms and definitions.

BACKGROUND: The most frequently used surgical procedures for treating a proximal humeral fracture (PHF) are plate osteosynthesis, nail osteosynthesis and arthroplasty. Evidence-based recommendations for an appropriate surgical procedure after PHF requires transparent and valid safety data. We performed a systematic review to examine reported terms and definitions of complications after surgically-treated PHFs. METHODS: A literature search was conducted on PubMed, Cochrane Library, EMBASE, Scopus and WorldCat to identify clinical articles and book chapters on complications of PHF published from 2010 to 2017. Complication terms and definitions were extracted from each selected article independently by two reviewers and grouped according to a predefined scheme. RESULTS: From 1376 initial references, we selected 470 articles, of which 103 were reviewed in reverse chronological order until no further information was gained. Twelve book chapters were reviewed. We found 667 local event terms associated with complications after surgical treatment of PHFs. The most frequently used event terms were infection (52 references), nonunion (n = 42), malunion (n = 35), avascular necrosis (n = 27) and pain (n = 25). Overall, 345, 177, 257 and 102 local event terms were related to plating, nailing, arthroplasty and other surgical techniques, respectively. Radiological assessment was the basis for the majority of event terms and complication definitions. Thirty-six event definitions were extracted, mostly defining the terms "secondary fracture displacement", "screw perforation/cutout", "malunion", "delayed healing" and "notching". CONCLUSION: Scientific literature on surgically-managed PHF uses different terms to describe complications and without approved definitions, which highlights a lack of agreement on adverse event terminology for PHFs. Defined event terms are mostly based on radiological observations. Consensus among shoulder surgeons on a core event set is indispensable to support the standardization of safety reporting for surgically-treated PHFs.

[Precarcinoma and early carcinomatous lesions in the uterine cervix and the use of oral contraceptives]. / Prekarcinomske i rane karcinomske lezije cerviksa uterusa i upotreba oralnih kontraceptiva.

Precancerous and early cancerous lesions of the cervix uteri (ASCUS, AGUS, LSIL and HSIL) are precursors of invasive cancer of the cervix uteri. By Papanicolaou test they are graded as Pap III and Pap IV. Different factors may increase a risk for those lesions as well as converting low stage lesion into higher one. Oral contraceptive use is one of the most potential risk factor for those lesions. The goal of this study was to examine a relationship between oral contraceptive use and precancerous and early cancerous lesion of the cervix lesion of the cervix uteri by using Papanicolaou test. After adjustment for other potential risk factors our results have shown: 1) there is high significant positive relationship between oral contraceptives use and precancerous and early cancerous lesions of the cervix uteri; 2) the users of oral contraceptives have shown Pap III and Pap IV smear grade five to ten years earlier than non-users; 3) long-term users have shown Pap III and Pap IV five years earlier than short-term users for middle age group (35-44 years); 4) the border between Pap III and Pap IV is shifted for five years toward earlier age.

[Medicine and industry learning from each other]. / Medicina i industrija uce jedna od druge.

This paper presents a comparative review of the quality control methods in the industry and health care system with emphasis placed on hospitals. These standards were applied for the first time in the medical sector in 1995 in German hospital, which then was given the quality certificate. According to experience the application of standards ISO 9000, 9001 and 9002 in the hospital requires certain modification because the quality control in the health care is targeted on the process of production and not only on the outcome of the provided service. Unfortunately in the countries of former Yugoslavia there is no greater interest yet.