In the last three years, the European Union (EU) is being confronted with the most significant influx of migrants and refugees since World War II. Although the dimensions of this influx—taking the global scale into account—might be regarded as modest, the institutional response to that phenomenon so far has been suboptimal, including the health sector. While inherent challenges of refugee and migrant (R&M) health are well established, it seems that the EU health response oversees, to a large extend, these aspects. A whole range of emergency-driven health measures have been implemented throughout Europe, yet they are failing to address adequately the changing health needs and specific vulnerabilities of the target population. With the gradual containment of the migratory and refugee waves, three years after the outbreak of the so-called ‘refugee crisis’, we are, more than ever, in need of a sustainable and comprehensive health approach that is aimed at the integration of all of migrants and refugees—that is, both the new and old population groups that are already residing in Europe—in the respective national health systems.

Introduction: Knee arthrodesis is a limb salvage intervention for persistent periprosthetic joint infection (PJI) when revision total knee arthroplasty fails. Conventional arthrodesis techniques are associated with the increased rate of complications, especially in patients with extensive bone loss and extensor tendon deficiency. Methods: Eight patients with a modular silver-coated arthrodesis implant after failed exchange arthroplasty for infection, were retrospectively reviewed. All patients had significant bone loss, while 5 displayed extensor tendon deficiency. Survivorship, complications, leg length discrepancy, median Visual Analogue Scale (VAS) and Oxford Knee score (OKS) were evaluated. Results: The median follow up was 32 months (range 24–59 months). The survivorship rate of the prosthesis was 86% during the minimum time of follow up of 24 months. In one patient recurrence of the infection was observed and above-knee amputation was performed. The median postoperative leg length discrepancy was 2.07 ± 0.67 cm. Patients were able to ambulate with mild or no pain. The median VAS and OKS was 2.14 ± 0.9 and 34.7 ± 9.3, respectively. Conclusions: The results of our study demonstrated that knee arthrodesis with a silver coated arthrodesis implant, performed for persistent PJI in patients with significant bone loss and extensor tendon deficit, provided a stable construct, allowed eradication of infection and was associated with good functional outcome.

Objective: Operation based exercises represent simulation activities, which are of great importance for emergency preparedness, as they simulate real experiences in a guided manner. Whereas their primary purpose is to address the organizational emergency preparedness, little is known about the personal benefits of involved participants and whether these positive changes endure over time.Methods: Immediate and medium term assessment of the effectiveness on individual preparedness and benefits of participants, based on self-perception, after participating in a set of 4 interdisciplinary field exercises organized as part of the MSc in Global Health-Disaster Medicine of the Medical School of the National and Kapodistrian University of Athens, Greece. The field exercises were carried out yearly, from 2016 to 2019. Data were collected via questionnaires pre- and post-exercise (1 week and 10 months after participation). The sample size was 228 trainees, with a response rate of 88%.Results: The majority (95%) stated that Mass Casualty Incident (MCI) exercises are appropriate for disaster management training in terms of comprehending theory, and for team-building training. In the case of a real MCI, 22% of the participants declared themselves to be ready to respond prior to MCI exercises. Upon completion, the overall perception of readiness among the participants increased to 77%. Trainee feedback indicated enhancement of both technical and non-technical skills (87%), which were persistent over time, and revealed a high level of satisfaction with the training.Conclusion: This study shows a positive immediate and medium-term impact of operation-based exercises on technical, non-technical skills, and self-perception of participants.

Background: The lateralization shoulder angle (LSA) and distalization shoulder angle (DSA) are critical factors in predicting postoperative complications in shoulder surgeries. This study investigates the impact of LSA and DSA variations on functional outcomes and complications in shoulder surgery. Methods: A systematic literature search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library up to December 2024. The primary outcomes evaluated included the impact of LSA and DSA on postoperative functional outcomes, complication rates, optimal angular parameters, and biomechanical implications. Results: We included 14 high-quality studies encompassing 8372 patients. The synthesis demonstrated that maintaining an LSA within the optimal range of 75° to 95° is consistently linked to improved functional scores and enhanced active external rotation. Similarly, a DSA range of 40° to 65° is associated with superior anterior active elevation and abduction. The interplay between LSA and DSA is crucial, as balanced adjustments of these angles optimize deltoid tension and shoulder biomechanics, reducing the risk of different complications. Discussion: Maintaining the LSA between 75° and 95° and the DSA between 40° and 65° significantly enhances functional outcomes and shoulder mobility following arthroplasty. Future research should aim to validate these optimal ranges.