Robotic systems have become popular in modern surgical procedures.The option of telesurgery has effectively addressed geographic limitations.These systems are offered by numerous companies worldwide.In this review article,we discuss four models of robotic systems to determine their advantages:the Sina flex system from Iran and the da Vinci Xi,SP,and 5 systems from the USA.We compared aspects such as architecture,instruments,visualizations,clinical use,and costs.Our findings suggest that the da Vinci robot,which was introduced earlier than the Sina system,utilizes proprietary and limited-use EndoWrist instruments with diameters ranging from 8 to 12 mm and features advanced imaging capabilities,including three-dimensional optical,tomographic,and fluorescence imaging.It is well established and widely utilized in various surgical procedures.Conversely,the Sina flex system employs single-use 5 mm instruments and is equipped with two-dimensional optical imaging as a standard,with optional three-dimensional and fluorescence imaging upgrades available.Despite its affordability,the Sina flex system is relatively new and has not yet been clinically tested.Additionally,the Sina flex system is more user-friendly.
Introduction: Renal lithiasis is a very common condition worldwide, linked to the presence of calculi in the urinary tract. It is multifactorial, recurrent and serious. It is the 3rd leading cause of chronic kidney disease (CKD) in Morocco. The aim of our study is to describe the clinical, paraclinical and management aspects of renal lithiasis in our patients, to determine the factors of recurrence of renal lithiasis and to identify the factors of progression of renal failure. Materials and Methods: This is a retrospective, descriptive and analytical study conducted in the nephrology department of CHU IBN Sina in Rabat, over a 3-year period from 2020 to 2023. We included 160 patients with renal lithiasis having a follow-up in our training. We analyzed their epidemiological, clinical, paraclinical and therapeutic profile. Results: The mean age of our patients was 56 +/− 16.6 years, with a M/F sex ratio of 1.02. Lithiasis was expressed by renal colic in 71% of cases, and by stone emission in 31% of cases, although discovery was incidental in 16% of cases. At the time of the first consultation, 59% of patients had renal failure (RF), 15% of whom were at the stage of chronic end-stage renal disease. Crystalluria and calculus spectrophotometry were performed in only 30% and 22% of patients respectively. All patients benefited from hygienic and dietary measures according to the nature of the stone, as well as additional urological management. Recurrence of renal lithiasis was reported in 36% of cases. In univariate analysis, advanced age, male gender, diabetes, hypertension and the presence of recurrent urinary tract infection were factors in the progression to CKD (OR = 0.979, p = 0.035;OR = 0.527, p = 0.48;OR = 4.127, p = 0.015;OR = 1.926;p = 0.015, OR = 2.5 p = 0.019, respectively). In multivariate analysis, only diabetes and high baseline creatinine were factors in the progression to CKD. Recurrence of renal lithiasis was reported in 36.5% of cases. Only the presence of a history of familial lithiasis and of rena
To the editor:Non-suicidal self-injury(NSSI)is defined as direct,repetitive self-injury to bodily tissues without suicidal intent. The estimated prevalence of NsSI among adolescents is 17.2%worldwide with a comparable rate observed in China. As a behavioural addiction, NSSI poses a significant suicide risk,and is emerging as a major mental health problem among adolescents.To unravel this puzzle,the four-function model(FFM)distinguishes between interpersonal and intrapersonal functions,as well as positive and negative reinforcement functions,proving relatively comprehensive among various theoretical models.