Increased hand digit length ratio (2D:4D) is associated with increased severity of hypospadias in pre-pubertal boys

Pediatric Surgery International - Hypospadias is a common congenital male disorder, with much research focusing on prenatal androgen exposure as a causative factor. Whilst digit length ratios were...     

Shortfalls in published neurosurgical literature

Expenditure related to neurosurgery has increased unevenly since the early 1990s. In this study we explored the literature by which clinical evidence is obtained to better direct neurosurgical practice. We searched different types of neurosurgery literature and four major neurosurgical procedures (excision of brain lesion, cerebral aneurysm clipping/coiling, discectomy, spine fusion) written in English on PubMed from 1996, the year of its launch, using the keyword "cost". Only a small and static portion of the neurosurgical literature was indexed as level I clinical evidence (randomized controlled trials), with a lack of cost appraisal in the outcome analysis of neurosurgical interventions. By way of rectification, a major increase in funding of grade I studies with cost analysis, and the requirement by peer-reviewed journals of a cost-benefit analysis, would promote the quality of clinical research yielding unquestionable advantage on national healthcare practice.     

Physical activity and mental well-being during COVID-19 pandemic

The corona virus disease 2019 (COVID-19) pandemic has resulted in most nations deciding upon self-isolation and social distancing policies for their citizens to control the pandemic and reduce hospital admission. This review aimed at evaluating the effect of physical activity on mental well-being during the COVID-19 pandemic. It was concluded that the COVID-19 pandemic may lead to augmented levels of angiotensin-converting enzyme (ACE)-2 that led to cardiovascular and neurological disorders associated with highly inflammatory effects of viral infection affecting the brain tissues leading to damage of the nervous system and resulting in cognition dysfunction, insulin sensitivity reduction, and behavioral impairments. Anxiety and depression may lead to negative effects on various quality of life domains, such as being physically inactive. Regular physical activities may reduce inflammatory responses, improve ACE-2 responses, and improve mental well-being during self-isolation and social distancing policies related to the COVID-19 pandemic. Further studies should be conducted to assess the different intensities of physical activities on cardiovascular function, and mental well-being during the COVID-19 pandemic.     

Characteristics of laparoscopic inguinal hernia recurrences

Purpose  This is so far the largest series of recurrences after laparoscopic inguinal hernia repair. Methods   Video documents of 1,071 laparoscopic inguinal hernia repairs were retrospectively studied with respect to the affected side, anatomical appearance, gender, history and time interval between operation and recurrence. Only indirect, clinically manifest hernias were included. Results  Recurrences occurred in 32 children (3%), 26 boys and 6 girls, aged 62 days to 14 years (median 3). The right side was affected in 21 children, the left in 10 and a bilateral recurrence was noted in 1 child. A total of 25 recurrences occurred medially to the previous suture and 7 laterally. The knot became loose in three cases. An experienced surgeon had only half the recurrences of a less experienced surgeon. The median time interval between surgery and recurrence was 3.8 months. Children up to the age of 2 years had the highest risk of recurrence. The right/left incidence of recurrences roughly was in proportion to the statistical incidence of hernias. Conclusions  Boys had more recurrences than girls. Most recurrences occur medially. The more experienced the surgeon was, the fewer recurrences he had. The stitches at the medial aspect of the hernia, close to the vas, seem to be the most crucial ones.