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1.
Arch Sex Behav ; 53(3): 1129-1140, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38151570

ABSTRACT

The aim of this study was to examine the associations between sexting profiles and five factor model (FFM) personality traits among Greek university students. A sample of 2913 participants predominantly aged between 18 and 25 years (M = 22; SD = 3.54; 69.6% females) completed a self-report online questionnaire that measured sexting behaviors and FFM traits. Latent profile analysis identified five distinct profiles which were labeled uninvolved, consensual sexters, non-consensual sexters, unwanted sexters, and highly involved sexters. The different sexting profiles were associated with distinct patterns of FFM trait scores. Specifically, the uninvolved scored higher on agreeableness, conscientiousness, and openness than those highly involved in sexting, consensual, non-consensual, and unwanted sexters. Furthermore, those who sent unwanted sexts were more likely to be emotionally unstable than the consensual sexters and those not involved. These findings indicate that sexting behaviors may be related to certain personality traits and emphasize the importance of considering individual differences when studying sexting behaviors. The practical implications of the findings are discussed.


Subject(s)
Sexual Behavior , Text Messaging , Female , Humans , Adolescent , Young Adult , Adult , Male , Sexual Behavior/psychology , Universities , Personality , Students/psychology
2.
J Genet Psychol ; : 1-14, 2023 Dec 26.
Article in English | MEDLINE | ID: mdl-38146689

ABSTRACT

Understanding the correlates of academic dishonesty is crucial for designing effective preventive interventions, as is the investigation of moderating factors that could affect these interactions. Despite increased interest in the Dark Triad personality traits and their potential link with unethical behavior, there is limited evidence regarding the moderating role of moral disengagement in the relationship. This study aimed to investigate academic dishonesty among Greek university students, its relationship with the Dark Triad, and the moderating role of moral disengagement, using gender as a covariate. Overall, 587 students attending Greek public Universities voluntarily completed an anonymous self-report questionnaire assessing the constructs under investigation. Results showed that male students had higher scores in unauthorized collaboration, plagiarism, Dark Triad, and moral disengagement. Moderation analysis indicated that moral disengagement had an effect in the relationship of psychopathy with unauthorized collaboration, especially among men. Overall, the findings of this study highlight the importance of psychopathy and moral disengagement in the prediction of academic dishonesty and have the potential to make a significant contribution to its prevention, particularly in Greek universities where relative initiatives are lacking.

3.
J Psychol ; 157(8): 473-495, 2023.
Article in English | MEDLINE | ID: mdl-37625138

ABSTRACT

This study investigated the associations among humor styles, general mental health (GMH), and subjective well-being (SWB) in a non-clinical sample of 662 university students (Mage = 21.35, SD = 4.14; 66.3% females) attending Greek public universities, via an online survey. In addition, it investigated possible moderating effects of humor styles in the association between GMH and SWB as well as gender differences. Positive correlations emerged between GMH and SWB, as well as among GMH, SWB, and benign humor styles. Malignant humor styles had a negative correlation with both GMH and SWB. The use of aggressive and self-defeating humor moderated the association between GMH and SWB in that at low levels of these humor styles the link between GMH and SWB was stronger. Finally, males scored higher on self-enhancing and aggressive humor than females. The findings expand previous research and are discussed in terms of their implications.


Subject(s)
Aggression , Mental Health , Male , Female , Humans , Young Adult , Adult , Universities , Surveys and Questionnaires , Aggression/psychology , Students/psychology
4.
Microsurgery ; 43(8): 847-854, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37415380

ABSTRACT

The thumb is acknowledged to contribute significantly to hand function, accounting for up to 40% of its overall capability. Consequently, injuries affecting the thumb can have a profound impact on the quality of life experienced by patients. When it comes to the surgical reconstruction of thumb injuries, the primary objective is to promptly provide coverage of the affected area with glabrous skin, thus preserving both the length and functionality of the thumb. Managing injuries specifically involving the thumb pulp can be particularly challenging due to the digit's size and vital role. Acquiring an adequate amount of glabrous soft tissue poses a difficulty in such cases. Various reconstructive approaches, encompassing a range of options on the reconstructive ladder, have been documented for thumb pulp injuries. The most popular options include pedicled flaps and free flaps obtained from both the hands and feet. However, a consensus regarding the optimal method for reconstructing the thumb pulp has yet to be reached. We present a case of total thumb pulp reconstruction for a 40 × 30 mm defect using the free thenar flap in a 65-year-old carpenter who sustained a work-related injury. This flap was designed and raised on the superficial branch of the radial artery with a single subcutaneous vein and a branch of the palmar cutaneous nerve, the flap measured 43 × 32 mm. It was inset transversely with an end-to-end arterial anastomosis to the ulnar digital artery, venous anastomosis to the dorsal digital vein and nerve coaptation to the ulnar digital nerve. The postoperative course was uneventful, and the patient was discharged the following day without any complications. Eight months after surgery, the patient was extremely satisfied with the results of the procedure in terms of both function and appearance. The patient had experienced an improvement in function, sensation, and aesthetics. The patient had a QuickDASH disability/symptom score of 15.91 and a QuickDASH work module score of 18.75; the range of motion in the treated thumb was almost the same as the opposite thumb. The patient successfully resumed work three weeks following the procedure, initially with modified duties, and fully regained their work capacity within six weeks. As the patient's primary concern was their ability to return to work, the utilization of a free thenar flap offered several distinct advantages. These included minimal post-operative complications, facilitated by a single operative site, allowing for reconstruction under regional anesthesia. Moreover, the procedure was conducted in a single stage, enabling the patient to be discharged on the same day without the need for further procedures. Furthermore, similar to several other reconstructive options for the thumb, the utilization of a free thenar flap offered the advantage of providing high-quality, like-for-like glabrous tissue.


Subject(s)
Finger Injuries , Free Tissue Flaps , Hand Injuries , Plastic Surgery Procedures , Humans , Aged , Thumb/surgery , Thumb/injuries , Free Tissue Flaps/surgery , Quality of Life , Hand Injuries/surgery , Radial Artery/injuries , Radial Artery/surgery , Finger Injuries/surgery , Skin Transplantation/methods , Treatment Outcome
5.
Plast Reconstr Surg Glob Open ; 10(9): e4511, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36148030

ABSTRACT

Arterialized venous flaps can be an excellent option for reconstruction of digital defects. Previously, they remained unpopular owing to the high rate of venous congestion. Different techniques of restriction of the arteriovenous shunting have been described to mitigate this problem. In this article, the authors discuss a unique case whereby a reverse flow shunt restricted venous flap was used in an Urbaniak type III ring avulsion.

6.
J Plast Reconstr Aesthet Surg ; 75(9): 3384-3389, 2022 09.
Article in English | MEDLINE | ID: mdl-35794062

ABSTRACT

BACKGROUND: The first-line treatment for basal cell carcinoma (BCC) involved either surgical excision (SE) or Mohs micrographic surgery (MMS). The current waiting time for MMS and whether this is associated with worsening of outcome is unknown. We aim to look at the waiting time for MMS upon review at the Outpatient Specialist Dermatology Clinic and the increase in lesion size during this time period. METHODS: A retrospective analysis of all patients who underwent MMS for biopsy-proven BCC over a duration of 5 years was performed. Variables analysed included patient age, sex, location, histologic subtype, lesion size at initial presentation, lesion size during MMS, defect size following MMS, waiting time for MMS, and projected defect size if lesions were treated with SE at earlier time point. RESULTS: A total of 233 patients were included in the final analysis. The mean wait time between referral to MMS was 215.8±125.7 days. The mean maximum diameter of lesions was 9.34±5.23 mm at referral for MMS and 11.91±6.60 mm at presentation for MMS, hence an increase of 3.01±3.03 mm (p=0.001, paired t-test), which equates to 1.41±0.42 times increase. The mean maximum diameter of the actual defect size post-MMS was 18.03±9.45mm, while the projected diameter of defect post SE was 15.29±5.71 mm, hence, smaller by 3.27±5.51 mm (p=0.001, paired t-test) compared with actual defect size post-MMS. CONCLUSION: This study highlights that the lesion grows significantly during the long wait for MMS. Hence, an increase in capacity for MMS is essential to reduce the waiting time for surgery which could lead to a defect which is easier to reconstruct with better outcome for patients.


Subject(s)
Carcinoma, Basal Cell , Skin Neoplasms , Carcinoma, Basal Cell/pathology , Carcinoma, Basal Cell/surgery , Humans , Mohs Surgery , Neoplasm Recurrence, Local/surgery , Retrospective Studies , Skin Neoplasms/pathology , Skin Neoplasms/surgery , Waiting Lists
7.
J Psychol ; 156(7): 459-477, 2022.
Article in English | MEDLINE | ID: mdl-35881415

ABSTRACT

The study examines sexting among 3,171 Greek university students in the context of different relationship types (i.e. romantic partners, friends, strangers). Participants completed an anonymous online survey, assessing sexting during the last year along with demographic and relationship status information. Sexting was a common practice among participants, with the use of mobile phones and the Messenger application to exchange sexts. Sexting was more common among males and non-heterosexuals. Participants aged 25 and above were more likely to exchange sexts with strangers than those aged between 18 and 24. Romantic partners reported exchanging sexts more often than strangers. Hierarchical regression analyses indicated that non-heterosexual males in a long-distance romantic relationship were more likely to participate in sexting, and that non-heterosexual older males who have been single for the last year were more likely to exchange sexual or provocative messages with strangers. Findings are discussed in terms of their implications.


Subject(s)
Adolescent Behavior , Text Messaging , Adolescent , Adult , Humans , Male , Prevalence , Sexual Behavior , Students , Universities , Young Adult
8.
J Sch Psychol ; 92: 19-32, 2022 06.
Article in English | MEDLINE | ID: mdl-35618370

ABSTRACT

The current study explored the temporal stability in relational aggressor's profiles over a 6-month period. Data were gathered at two time points from a sample of 2207 Greek junior high school students (52.8% females) aged between 13 and 16 (M = 14.04, SD = 0.81) years. This study also considered the role of callous-unemotional traits and hostile attribution bias in predicting profile membership. Results of latent profile and latent transition analyses revealed three distinct relational aggression profiles (i.e., low relational aggression, moderate relational aggression/high reactive indirect relational aggression, and high relational aggression). The examination of the short-term longitudinal stability of these profiles over a period of 6 months showed that their basic structure remained stable at both the within-sample and within-person level across measurement points. In addition, this study showed that callous-unemotional traits and hostile attribution bias affect adolescents' possibility of membership in all three profiles. Adolescents scoring high on callous-unemotional traits and hostile attribution bias were more likely to be associated with the more aggressive profiles, namely with the high relational aggression, and to a lesser extent, with the moderate relational aggression profile. Overall, this study demonstrated that the basic structure of relational aggression profiles remained stable across a short-term time period and provides numerous crucial practical implications including social-cognitive reframing interventions, as well as enhancement of social skills and empathic reactions.


Subject(s)
Aggression , Conduct Disorder , Adolescent , Aggression/psychology , Conduct Disorder/psychology , Empathy , Female , Hostility , Humans , Male , Social Perception
9.
Dyslexia ; 28(2): 149-165, 2022 May.
Article in English | MEDLINE | ID: mdl-35138002

ABSTRACT

Language skills are important in the formation and maintenance of friendships. Children with specific learning disorder (SLD) or attention-deficit/hyperactivity disorder (ADHD) experience difficulties with their relationships and have language-related problems. This study aims to examine how expressive and receptive vocabulary may relate to friendships of children with and without SLD or ADHD. Participants were 64 children with SLD, 64 children with ADHD, and 64 typically developing (TD) children, aged 8-12 years (Mage  = 9.77 years, SD = 1.22), attending Grades 3 to 6 in inclusive primary schools of Attica, Greece. The Greek versions of the Peabody Picture Vocabulary Test and the expressive vocabulary subscale of the WISC-III were administered along with the sociometric nominations of friends and the self-reports of best friendship duration. Results showed that children with SLD and ADHD reported best friendships of shorter duration and had significantly poorer receptive and expressive vocabulary. Children with ADHD had significantly fewer close and best friends than children with SLD, who in turn had significantly fewer close and best friends than the TD children. Children's vocabulary in all three groups was positively correlated with the duration of their best friendships and was found to moderately predict children's close friendships.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Dyslexia , Specific Learning Disorder , Attention Deficit Disorder with Hyperactivity/complications , Child , Friends , Humans , Vocabulary
11.
J Affect Disord ; 300: 289-295, 2022 Mar 01.
Article in English | MEDLINE | ID: mdl-34979179

ABSTRACT

BACKGROUND: The purpose of this study was to provide an operating mechanism for understanding the effects of COVID-19's on satisfaction with life, subject to students' general mental health METHODS: A sample of 1653 Greek speaking university students (72.4% females, 65.3% undergraduate, M age=26.1) completed an online survey including measures for perceived psychological, academic, and financial impact of the COVID-19 pandemic, general mental health and satisfaction with life. RESULTS: A mediation model was tested to illuminate these relationships by considering students' general mental health as a mediator. Findings demonstrated that there were significant direct effects of perceived COVID-19 impact on participants' financial status on satisfaction with life and indirect effects of perceived COVID-19 impact on participants' financial status and academic performance respectively on satisfaction with life through general mental health. LIMITATIONS: The study's cross-sectional design, self-report data and snowball sampling. CONCLUSIONS: The findings add to our understanding of the relationship between perceived COVID-19 impact and life satisfaction among university students, and they shed light on the critical role of general mental health in mediating the relationship. Targeting the factors that influence general mental health can help to mitigate potential problems while also finding ways to improve mental health and well-being.


Subject(s)
COVID-19 , Adult , Cross-Sectional Studies , Female , Humans , Male , Mental Health , Pandemics , Personal Satisfaction , SARS-CoV-2 , Students , Universities
12.
Child Abuse Negl ; 109: 104717, 2020 11.
Article in English | MEDLINE | ID: mdl-32971349

ABSTRACT

BACKGROUND: Limited research has confirmed the effects of adolescents' interactions with parents on adolescents' engagement in relational aggression. Youth reporting insecure attachment with parents are more likely to be involved in Relational aggression, while the positive association of Relational aggression with emotions such as friendship jealousy and anxiety are well-documented. However, little is known about the longitudinal association between parental attachment and Relational aggression. OBJECTIVE: The current study expands upon previous research by investigating the short-term longitudinal associations between father and mother attachment (i.e., dependency, availability) and relational aggression, with friendship jealousy and anxiety as potential mediators of this association based on the theoretical framework of General Aggression Model. PARTICIPANTS: The sample consisted of 2207 Greek adolescents (52.8 % girls) attending the three junior high school grades. METHODS: Participants completed a self-report questionnaire at two different time points with a six-month interval during the school year. RESULTS: Results showed that that higher T1 father dependency (ß = 0.14) and availability (ß = 0.11), and lower mother dependency (ß = -0.12) and availability (ß = -0.11) were associated with higher relational aggression at T2. Further, the effects of T1 father availability (ß = - 0.02), mother availability (ß = -0.04), mother dependency (ß = -0.03) to T2 relational aggression through friendship jealousy were significant. Finally, the effects of T1 father availability (ß = -0.03), father dependency (ß = -0.02), mother availability (ß = -0.03), mother dependency (ß = -0.02) to T2 relational aggression via anxiety were also significant. CONCLUSIONS: These findings provide an understanding of the relational aggression during adolescence by emphasizing the role of both social parameters and affective characteristics of the perpetrators.


Subject(s)
Adolescent Behavior/psychology , Aggression/psychology , Anxiety/psychology , Parent-Child Relations , Parents/psychology , Adolescent , Codependency, Psychological , Fathers/psychology , Female , Friends/psychology , Greece , Humans , Jealousy , Longitudinal Studies , Male , Mothers/psychology , Self Report , Surveys and Questionnaires
13.
Psicol. educ. (Madr.) ; 22(1): 27-38, jun. 2016. tab
Article in English | IBECS | ID: ibc-152146

ABSTRACT

The present study investigates possible individual characteristics associated with traditional and cyber-bullying/victimization among 146 Greek junior high school students and their contribution in the prediction of the phenomena. Participants completed a self-report questionnaire, measuring online disinhibition, personality traits, social skills, and relations, as well as Internet use. Results indicated that although some students participated with the same role in traditional and cyber-bullying/victimization and shared common characteristics, most of them participated in either one or both phenomena with opposite roles. In terms of predictive factors, cyber-bullying was predicted by being a male, online disinhibition, online activity and psychopathic traits, while traditional bullying was predicted by being a male, online disinhibition and sensation seeking. Cyber-victimization was predicted by online disinhibition, assertion, and few peer relations, while traditional victimization by Internet skills and impulsive-irresponsible traits. Findings are discussed in terms of common and differentiated prevention and intervention practices


Este estudio investiga las posibles características individuales asociadas a la victimización tradicional y por ciberacoso en 146 estudiantes de secundaria griegos y su contribución a la predicción del fenómeno. Los participantes cumplimentaron un cuestionario de autoinforme que medía la desinhibición en la red, rasgos de personalidad, habilidades y relaciones sociales y la utilización de internet. Los resultados indican que a pesar de que algunos estudiantes participaron con el mismo rol en la victimización tradicional y en la de ciberacoso y compartían características, la mayoría participaron en uno de los fenómenos o en ambos con roles opuestos. En relación a los factores predictores, el ciberacoso se predijo por el género masculino, la desinhibición online, la actividad online y rasgos psicopáticos, mientras que el acoso tradicional por el género masculino, la desinhibición online y la búsqueda de sensaciones. La victimización cibernética la predecía la desinhibición online, asertividad y escasas relaciones con compañeros, mientras que la victimización tradicional la predecían las aptitudes cibernéticas y los rasgos de impulsividad y falta de responsabilidad. Se comentan los resultados en cuanto a la prevención común y diferenciada y a la praxis en intervención


Subject(s)
Humans , Male , Female , Child , Adolescent , Bullying/physiology , Cybernetics/education , Cybernetics/trends , Crime Victims/psychology , Prevalence , Adaptation, Psychological/physiology , Criminal Behavior/physiology , Social Skills , Emotions/physiology , Adolescent/physiology , Students/psychology , Privacy/psychology , Educational Technology/education , Educational Technology/instrumentation , Educational Technology/trends , Conduct Disorder/prevention & control , Conduct Disorder/psychology , Conduct Disorder/therapy , Antisocial Personality Disorder/prevention & control , Antisocial Personality Disorder/psychology , Antisocial Personality Disorder/therapy
14.
J Psychol ; 148(5): 549-67, 2014.
Article in English | MEDLINE | ID: mdl-25087318

ABSTRACT

The present study examines the association between coping and personality, by testing the hypothesis that dispositional coping mediates the relationship between personality and psychological distress. Canonical correlations evaluated the degree of the association among personality and coping dimensions in a community sample (N = 489) from Cyprus. Results partially support the hypothesized mediation model with Agreeableness predicting distress through the full mediation of avoidant coping, expression of negative feelings and active-positive coping. Partial mediation was found for Neuroticism and Openness. Canonical correlations deciphered how coping relates to the Big Five dimensions. Neuroticism was mostly associated with maladaptive coping, whereas Conscientiousness and Extraversion with adaptive coping.


Subject(s)
Adaptation, Psychological/physiology , Personality/physiology , Stress, Psychological/psychology , Adolescent , Adult , Association , Cyprus , Female , Humans , Male , Middle Aged , Personality Inventory , Regression Analysis , Sex Factors , Young Adult
15.
J Plast Reconstr Aesthet Surg ; 67(1): 23-6, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24100204

ABSTRACT

BACKGROUND: The preferred method of treatment of Dermatofibrosarcoma Protuberance (DFSP) is surgery. Clear margins are achieved by wide local excision (WLE) or by Mohs micrographic surgery. Mohs surgery and reconstruction always requires two or more procedures. This study aims to assess the ability of WLE to accomplish clear histopathological margins and low recurrence rate with a single procedure. We present our results from ten years experience of wide local excision. METHODS: This is a retrospective analysis of data of all cases of DFSP treated with WLE by a single operator in our department between 2002 and 2012. RESULTS: Twenty patients were identified. The surgical excision and reconstruction were performed on the same day in all cases. The mean histological peripheral margin was 17 mm and the deep 9 mm. There was no incomplete excision and no recurrence recorded. There were no postoperative complications or tumour recurrences reported for an average period of 5.6 years follow-up. CONCLUSION: Mohs surgery offers clear histological margins but requires multiple patient visits to achieve complete excision and later reconstruction. We show that WLE can achieve these in one procedure, the excision margins making little difference when planning the eventual reconstruction.


Subject(s)
Dermatofibrosarcoma/surgery , Mohs Surgery , Neoplasm Recurrence, Local/prevention & control , Skin Neoplasms/surgery , Adult , Aged , Female , Humans , Male , Middle Aged , Neoplasm, Residual , Plastic Surgery Procedures , Retrospective Studies , Skin Transplantation , Surgical Flaps , Young Adult
16.
J Adolesc ; 34(2): 349-60, 2011 Apr.
Article in English | MEDLINE | ID: mdl-20471074

ABSTRACT

The present study examined the role of adolescents' self-esteem and perceptions of family and classroom contexts on their domain specific self-perceptions. 345 Greek junior high school adolescents aged 14-16 completed measures of domain specific self-perceptions, self-esteem, parenting styles and classroom climate. Hierarchical regression analyses revealed that both family and classroom contexts predicted students' self-perceptions, after students' demographics, academic achievement and self-esteem were controlled for. However, different patterns emerged in the relationship between family, classroom climate and self-esteem depending on domain specific self-perceptions. Academic self-perceptions (scholastic, mathematics and language competences) were predicted by classroom climate dimensions (order and organization, student involvement, rule clarity), whereas self-perceptions regarding relations with parents, close friends and behaviour conduct, were predicted by parenting styles. Given the fact that adolescence is a period of fluctuation in self-understanding which renders self-perceptions particularly malleable, the results support the critical role of the social environments where adolescents operate.


Subject(s)
Self Concept , Achievement , Adolescent , Adolescent Behavior , Analysis of Variance , Family Relations , Female , Greece , Humans , Male , Parenting , Peer Group , Regression Analysis , Schools , Social Environment
17.
J Health Psychol ; 15(2): 215-29, 2010 Mar.
Article in English | MEDLINE | ID: mdl-20207665

ABSTRACT

The construct of coping has received increasing attention over the past years in relation to psychological and physical health, yet its dimensional and conceptual understanding is not consistent across theoretical models. The present study investigates the dimensionality of coping in a sample of 1127 Greek-speaking adults using the Brief-COPE. Both exploratory and confirmatory factor analyses revealed a structure comprised of eight factors, four of which were broader, and included active/positive, avoidant, support seeking and negative emotional approaches. Results indicated adequate psychometric characteristics for the Greek translation of the Brief-COPE for this population. Associations between coping strategies with gender, education, and psychological symptomatology are also discussed.


Subject(s)
Adaptation, Psychological , Cross-Cultural Comparison , Language , Personality Inventory/statistics & numerical data , Adolescent , Adult , Affective Symptoms/psychology , Aged , Alcohol Drinking/psychology , Burnout, Professional/psychology , Child , Child Behavior Disorders/psychology , Cyprus , Depressive Disorder/psychology , Education, Special , Female , Greece , Humans , Learning Disabilities/psychology , Male , Middle Aged , Parenting/psychology , Phobic Disorders/psychology , Psychometrics/statistics & numerical data , Reproducibility of Results , Translating , Young Adult
18.
J Learn Disabil ; 42(6): 483-93, 2009.
Article in English | MEDLINE | ID: mdl-19458208

ABSTRACT

The purpose of the study was to examine whether the Greek translation of the Learning Disability Evaluation Scale (LDES) can be used in the identification of learning disabilities. The LDES was completed by 165 teachers for one of their students, aged 5 to 14 years. The LDES was significantly correlated to students' grades in Math and Greek Language and to the Reading Ability Test. Scores on LDES from the above randomly selected sample were significantly different from scores on LDES for another sample of 47 students, who were manifesting learning disabilities, indicating that the LDES can distinguish between the two samples. The exploratory factor analysis revealed that the LDES maintains the original factor structure and the reliability values supported its internal consistency. Results and limitations are discussed.


Subject(s)
Aptitude Tests/statistics & numerical data , Cross-Cultural Comparison , Education, Special , Language , Learning Disabilities/diagnosis , Adolescent , Child , Child, Preschool , Female , Greece , Humans , Male , Mathematics , Observer Variation , Psychometrics , Reading , Reproducibility of Results , Translating
19.
Ann Surg ; 247(1): 58-70, 2008 Jan.
Article in English | MEDLINE | ID: mdl-18156924

ABSTRACT

OBJECTIVE: The aim of this study was to compare laparoscopic versus open live donor nephrectomy using meta-analytical techniques. SUMMARY BACKGROUND DATA: Laparoscopic live donor nephrectomy has gained widespread acceptance and is increasingly performed. The body of evidence assessing the safety and efficacy of laparoscopic compared with established open techniques is growing; however, very few randomized control trials exist and individual studies often have small patient numbers with varying results. We combined the available raw data to strengthen the current literature in comparing these techniques. METHODS: A literature search was performed and comparative studies published between 1997 and 2006 of open versus laparoscopic donor nephrectomy were included. Outcomes evaluated were operative and warm ischemia times, blood loss, donor complications, length of hospital stay, time to return to work, and delayed graft function. RESULTS: Seventy-three studies matched the selection criteria and included 6594 patients, 3751 (57%) had undergone laparoscopic surgery and 2843 (43%) open nephrectomy. The open nephrectomy group had shorter operative and warm ischemia times by 52 minutes (P < 0.001) and 102 seconds (P < 0.001), respectively. This did not translate into higher delayed graft function or graft loss rates between the 2 groups. Patients in the laparoscopic group had a shorter hospital stay and a faster return to work by 1.58 days (P < 0.001) and 2.38 weeks (P < 0.001), respectively. There was a significantly higher rate of overall donor complications in the open group (P = 0.007), a finding not reproduced in any subsequent sensitivity analyses. When only randomized control trials were considered, there were shorter operative times (P = 0.002) for the open group but nonsignificantly different warm ischemia times. In contrast to the main analysis there were no differences in the overall complication rate, postoperative analgesia, hospital stay, or time taken to return to work. CONCLUSIONS: Laparoscopic nephrectomy in live donor transplantation is a safe alternative to the open technique. Although open nephrectomy may be associated with shorter operative and warm ischemia times, patients undergoing laparoscopic nephrectomy may benefit from a shorter hospital stay and faster return to work without compromising graft function.


Subject(s)
Kidney Transplantation , Laparoscopy/methods , Living Donors , Nephrectomy/methods , Data Interpretation, Statistical , Humans
20.
Transplantation ; 83(9): 1193-9, 2007 May 15.
Article in English | MEDLINE | ID: mdl-17496535

ABSTRACT

BACKGROUND: This study aimed to assess outcomes of kidney transplants from nonheart-beating (NHB) compared with heart-beating (HB) cadaveric donors with meta-analytical techniques. METHODS: A literature search was performed for studies comparing kidney transplants from NHB vs. HB cadaveric donors between 1992 and 2005. The following outcomes were evaluated: warm and cold ischemia times, primary nonfunction, delayed graft function, length of hospital stay, acute graft rejection, patient and graft survival, and post-transplant serum creatinine. RESULTS: Eighteen comparative studies of 114,081 patients matched the selection criteria; 1,858 received kidney from NHB and 112,223 from HB donor. Warm ischemia time was significantly longer for the NHB group by 24 min (P<0.001). Cold ischemia time was similar for the two groups (P=0.97). The incidence of primary nonfunction and delayed graft function was 2.4 times (P<0.001) and 3.6 times (P<0.001) greater, respectively, in the NHB group. Length of hospital stay was longer for the NHB group by 4.6 days (P<0.001). The 6-month, 2-year, and 5-year patient survival were similar between the two groups. The incidence of acute rejection was similar between the two groups whereas the initial graft survival advantage in favor of the HB group diminished gradually over the course of time. There was no statistically significant difference between the two groups for the recipient serum creatinine levels at 3 and 12 months after transplantation. CONCLUSION: NHB donors carry the potential of expanding the cadaveric kidney pool. Although, transplants from NHB donors are associated with a greater incidence of early adverse events, long-term outcomes appear comparable with those of transplants from HB donors.


Subject(s)
Heart Arrest , Heart/physiopathology , Kidney Transplantation , Tissue Donors , Acute Disease , Cadaver , Cold Ischemia/statistics & numerical data , Delayed Graft Function/epidemiology , Graft Rejection/epidemiology , Graft Survival , Humans , Incidence , Kidney Transplantation/adverse effects , Kidney Transplantation/statistics & numerical data , Length of Stay/statistics & numerical data , Publication Bias , Survival Analysis , Treatment Outcome , Warm Ischemia/statistics & numerical data
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