In the absence of local invasion, the outcomes of laparoscopic adrenalectomy for patients with tumours >/=6 cm were comparable to those with tumours <6 cm. This has helped confirm a policy of initial laparoscopic resection for all noninvasive adrenal tumours can be applied safely.

BackgroundColonoscopy is currently the gold standard for detection of colorectal lesions, but may be limited in anatomically localising lesions. This audit aimed to determine the accuracy of colonoscopy lesion localisation, any subsequent changes in surgical management and any potentially influencing factors.MethodsPatients undergoing colonoscopy prior to elective curative surgery for colorectal lesion/s were included from 8 registered U.K. sites (2012–2014). Three sets of data were recorded: patient factors (age, sex, BMI, screener vs. symptomatic, previous abdominal surgery); colonoscopy factors (caecal intubation, scope guide used, colonoscopist accreditation) and imaging modality. Lesion localisation was standardised with intra-operative location taken as the gold standard. Changes to surgical management were recorded.Results364 cases were included; majority of lesions were colonic, solitary, malignant and in symptomatic referrals. 82% patients had their lesion/s correctly located at colonoscopy. Pre-operative CT visualised lesion/s in only 73% of cases with a reduction in screening patients (64 vs. 77%; p = 0.008). 5.2% incorrectly located cases at colonoscopy underwent altered surgical management, including conversion to open. Univariate analysis found colonoscopy accreditation, scope guide use, incomplete colonoscopy and previous abdominal surgery significantly influenced lesion localisation. On multi-variate analysis, caecal intubation and scope guide use remained significant (HR 0.35, 0.20–0.60 95% CI and 0.47; 0.25–0.88, respectively).ConclusionLesion localisation at colonoscopy is incorrect in 18% of cases leading to potentially significant surgical management alterations. As part of accreditation, colonoscopists need lesion localisation training and awareness of when inaccuracies can occur.

No abstract

These data suggest an association between activation of p60SRC and JAK1-like kinases and monocyte adherence in response to ET-1. ET-1-induced monocyte adherence is upregulated by ET B receptor antagonist, suggesting a negative feedback on cell adhesion through this receptor.

In this study, we compared the effects of a 72-h exercise abstinence period and normal exercise on the affect and body dissatisfaction of 58 healthy women (mean age 26.1 years, s = 8.2) who exercised at least four times per week, and explored the relationship between the changes in affect and body dissatisfaction. Participants completed the UWIST-MACL and Body Dissatisfaction Scale to assess affect and body image, and were randomized to an abstinence or control group. Affect and body image for both groups were re-assessed following the 72-h abstinence period. Compared with the control group, the abstinence group had a significant decrease in hedonic tone and energetic arousal, and a significant increase in tense arousal and body dissatisfaction from pre-intervention to post-intervention. There were no significant relationships between the changes in body dissatisfaction and the components of affect. A 72-h exercise abstinence period resulted in increased affect disturbance and body dissatisfaction in regularly active women.