Robotic-assisted adrenalectomy: what advantages compared to lateral transperitoneal laparoscopic adrenalectomy?

BACKGROUND: This study evaluates the perioperative outcomes of robotic-assisted adrenalectomy (RA) compared with lateral transperitoneal laparoscopic adrenalectomy (LA). METHODS: Prospective evaluation of 50 patients who underwent unilateral RA versus 59 patients who underwent unilateral LA. RESULTS: RA was associated with lower blood loss (49 mL) but longer operative times (104 minutes) (P < .001). However, the difference in operative time was not significant after the learning curve of 20 cases. In patients with body mass index (BMI) > or = 30 kg/m(2), mean operative time was longer in the LA group (90 vs 78 minutes, P = .03) but not in the RA group. In patients with large tumors (> or = 55 mm), mean operative time was longer in the LA group (100 vs 80 minutes, P = .009) but not in the RA group. Conversion rate, morbidity, and hospital stay were similar in both groups. CONCLUSIONS: After a learning curve of 20 cases, RA has similar perioperative outcomes compared to lateral transperitoneal LA. Several criteria (previous laparoscopic expertise, first assistant's skill and tumor side) remain determinative on RA operative time.     

Is news media related to civic engagement? The effects of interest in and discussions about the news media on current and future civic engagement of adolescents

This study explored whether discussions about the media, when positively linked to interest in the news media, were related to adolescents' current and future civic engagement. A sample of 2638 adolescents (age M = 17, SD = 1.2), who participated in a school-based study on positive socialization, completed self-report measures on interest in the news media and discussions about the media with parents and friends. Current civic engagement was measured by involvement in volunteering and civic commitments. Future civic engagement was measured by intentions to participate in civic activities in the future. The results showed that more interpersonal discussions about the media and higher interest in the news media both predicted higher civic engagement. Positive links between discussions about the media and current civic engagement were partly mediated by interest in the news media. In addition, interest in the news media together with current civic engagement fully mediated a positive link between discussions about the media and future civic engagement. Moderating effects of gender were observed, with discussions about the media a better predictor of boys' interest in the news media, and current civic engagement a better predictor of girls' future civic engagement.     

Regulatory T cells and pulmonary hypertension

Pulmonary hypertension (PH) is a disease of high lethality arising from numerous causes. For a significant subset of PH patients, autoimmune biomarkers or frank autoimmune disease are simultaneously present, but the extent to which lung inflammation contributes to PH is unknown. However, emerging experimental and clinical evidence suggests that immune dysregulation may lead to the propagation of vascular injury and PH. A recent preclinical study demonstrated that regulatory T cells are important mediators normally enlisted to control inflammation and that, if absent or dysfunctional, may predispose to the development of PH.     

Properties of the Hopkins Symptom Checklist-25 (HSCL-25) and the Self-Reporting Questionnaire (SRQ-20) as screening instruments used in primary care in Afghanistan

Background Recent epidemiological studies in Afghanistan using mental health questionnaires yielded high prevalence rates for anxiety and depression. Objectives To explore the validity in the Afghan cultural context of two mental health questionnaires, the Hopkins Symptom Checklist-25 (HSCL-25) and the Self-Reporting Questionnaire-20 (SRQ-20). Methods The two mental health questionnaires were compared against a ‘gold standard’ semi-structured psychiatric interview, the Psychiatric Assessment Schedule (PAS). All instruments were administered to a sample of 116 Pashto-speaking patients (53 men, 63 women) attending primary health care facilities in Eastern Afghanistan. Results Both HSCL-25 and SRQ-20 had modest properties to correctly identify mental disorders, with an AUC (area under the curve) of 0.73 and 0.72 respectively. The optimal cut-off points for this population are different from those often used in transcultural research. For women the optimal cut-off points are higher than usual (2.25 for the HSCL-25 and 17 for the SRQ-20). For men the cut-off point for the HSCL-25 is lower than usual (1.50) and for the SRQ-20 it was 10). Conclusions This study underlines the necessity of validating instruments along with cultural context and gender. Earlier studies in Afghanistan may have overestimated the prevalence of mental disorders among women and underestimated the prevalence in men.