Applicability and outcome of laparoscopic adrenalectomy for large tumours

Laparoscopic adrenalectomy has been shown to be as safe and effective as conventional open surgery for small and benign adrenal lesions. With increasing experience with laparoscopic adrenalectomy, this approach has become the procedure of choice for the majority of patients requiring adrenalectomy. In our department, from 2011 to 2016, a total of 28 patients with 31 adrenal tumours underwent laparoscopic adrenalectomy regardless of tumour size. Our policy in the department is to exclude adrenal tumours that are potentially malignant or metastatic adrenal tumours for laparoscopic resection. In this a retrospective study, we divided patients into two groups according to tumour size: < 5 or ≥ 5 cm, which was considered as the definition of large adrenal tumours. We compared demographic data and per- and postoperative outcomes. There was no statistical difference between the two groups for per-operative complications (16,6% vs 18,75% , P = 0.71), postoperative complications (16,6% vs 18,75% , P = 0.71), postoperative length of hospital stay (5 vs 8 days P = 0.40), mortality (0% vs 0%) or oncologic outcomes: recurrence and metastasis (8.3% vs 6.25% P = 0.70). The only statistical difference was the operating time, at a mean (SD) 194 (60) vs 237 (71) min (P = 0.039) and the conversion rate (0% vs 12.5% P < 0.01). Laparoscopic adrenalectomy can be done for all patients with adrenal tumours regardless of tumour size, even it needs more time for large tumour but appears to be safe and feasible when performed by experienced surgeons

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Maturation du systeme d'accumulation intracellulaire de l'AMP cyclique dans la thyroiede foetale de Rat en fin de gestation

CNRS T 57352 / INIST-CNRS - Institut de l'Information Scientifique et TechniqueSIGLEFRFranc

Scaling-Up of Solution-Processable Tungsten Trioxide (WO₃) Nanoparticles as a Hole Transport Layer in Inverted Organic Photovoltaics

We reported the comparative studies of the optimization of solution-processable tungsten trioxide (WO3) as a hole transporting layer (HTL) in inverted organic photovoltaics (OPVs) using spin coating, slot-die coating, and spray coating technologies for scaling-up applications. To facilitate the technology’s transition into commercial manufacturing, it is necessary to explore the role of scalable technologies for low-cost and efficient device fabrication. We investigated the role of diluting WO3 with isopropanol as an HTL in inverted OPVs to solve the issue of poor wettability of the hydrophobic surface of the PBDB-T: ITIC bulk heterojunction layer. The optimal dilution ratios of WO3 with isopropanol were 1:4, 1:4 and 1:8 with spin coating, slot-die coating and spray coating techniques, respectively. We evaluated the device performance by conducting a current density–voltage (J-V) analysis, incident photon-to-current conversion efficiency (IPCE) measurements, and ultraviolet–visible (UV-Vis) absorbance spectra for various WO3 concentrations. The J-V characteristics revealed that slot-die coating resulted in the highest performance, followed by the spray coating technology. We further investigated the impact of the annealing temperature on device performance for both slot-die- and spray-coated diluted WO3. The highest device performance was achieved at an annealing temperature of 120 °C for both coating technologies. This research offers valuable insights into the scalable fabrication of inverted OPV devices, paving the way for cost-effective and efficient large-scale production