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HCL Anticipates Increasing Demand For Locums As NHS Funding Is Squeezed, UK
HCL, the UK"s largest health and social care recruiter, said today that it anticipates increasing demand for its temporary and locum staff as the NHS seeks to increase efficiencies in healthcare provision.
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NHS Reflects On Delivery Of Key Priorities, UK
NHS Chief Executive David Nicholson thanked NHS staff for their hard work improving care for patients this year, including reducing healthcare associated infections and waiting times, and extending GP opening hours.
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Fathers Respond To Teens' Risky Sexual Behavior With Increased Supervision
Two-thirds of American teenagers have sex by the time they"re 18. A new longitudinal study finds that when adolescents engage in risky sexual activity, fathers respond by increasing their efforts to supervise and monitor their children.
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The Necessity Of Adrenalectomy At The Time Of Radical Nephrectomy: A Systematic Review

UroToday.com - To take the adrenal or not at the time of radical nephrectomy, that is the question. These researchers from New York University School of Medicine performed an extensive literature search to determine the role of adrenalectomy at radical nephrectomy and discovered that the incidence of solitary, synchronous, ipsilateral adrenal involvement, and therefore potentially curable tumor disease with ipsilateral adrenalectomy occurred extremely infrequently - in only 1% to 5% of cases. Cross sectional imaging is now accurate at demonstrating the absence of adrenal involvement but still carries a significant risk of false positives. Disease-specific and overall survival of those patients undergoing radial nephrectomy, with or without adrenalectomy, is very similar. However, several characteristics on preoperative evaluation are associated with a greater risk of adrenal tumor involvement and these include both upper pole location of the renal tumor and size > 7 cm, multi-focality of the disease, venous thrombosis particularly at the level of the adrenal vein, and CT or MRI adrenal abnormality such as non-visualization, irregular borders, nodule, enlargement or contiguous infiltration. Therefore it would appear that in the majority of patients, the apparent benefit of ipsilateral adrenalectomy does not support it as a standard practice in all patients who have otherwise normal imaging preoperatively. However in the 2% of patients who have isolated adrenal metastasis, the concomitant adrenalectomy may provide a survival advantage. O"Malley RL, Godoy G, Kanofsky JA, Taneja SS J Urol. 2009 May;181(5):2009-17. doi:10.1016/j.juro.2009.01.018 Written by UroToday.com Contributing Editor Elspeth M. McDougall, MD, FRCSC, MHPE UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice. To access the latest urology news releases from UroToday, go to: www.urotoday.com Copyright © 2009 - UroToday


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