The impact of diabetes on the pathogenesis of sepsis

Diabetes is associated with an increased susceptibility to infection and sepsis. Conflicting data exist on whether the mortality of patients with sepsis is influenced by the presence of diabetes, fuelling the ongoing debate on the benefit of tight glucose regulation in patients with sepsis. The main reason for which diabetes predisposes to infection appears to be abnormalities of the host response, particularly in neutrophil chemotaxis, adhesion and intracellular killing, defects that have been attributed to the effect of hyperglycaemia. There is also evidence for defects in humoral immunity, and this may play a larger role than previously recognised. We review the literature on the immune response in diabetes and its potential contribution to the pathogenesis of sepsis. In addition, the effect of diabetes treatment on the immune response is discussed, with specific reference to insulin, metformin, sulphonylureas and thiazolidinediones

Robotic urologic surgery: How to make an effective robotic program\u2014a European perspective

Over the last decade the introduction of novel technologies substantially changed our approach to patients with urologic pathologies. Worldwide the number of robotic procedures performed per year is rapidly increasing. In current literature the relevance of robotic surgical training is progressively increasing although it is not easy to define and validate standardized paths for surgeons that are approaching for the first time to robotic surgery. In this context, the European Association of Urology Robotic Urology Section (ERUS) made several efforts in order to develop and validate an educational program for surgeons starting their robotic career