[Urological surgery : what's new in 2023]. / Chirurgie urologique : ce qui a changé en 2023.

Urology continues its development in minimally invasive surgery, and the year 2023 is marked by important innovations in the different approaches such as endoscopy, laparoscopy, and open surgery. The following innovations are instruments or medical devices which are still being evaluated. What they have in common is a questioning of our current practices, on the technical side but also for some of them on the ecological vision of our profession with the eternal debate of single use or reusable. Even if the evaluation of new devices is primarily medical and medico-economic, it is actually no longer possible to ignore the ecological aspect and the impact on the environment of the various new products. New technologies also make it possible to think about smart connected prostheses and precision intraoperative imaging that can ultimately guide the surgeon's hand.

L'urologie est une spécialité en constante évolution. L'année 2023 a été marquée par le développement de nouveautés en chirurgie minimalement invasive, tant en endoscopie qu'en laparoscopie ou chirurgie ouverte, principalement dans les domaines de la robotique, des technologies connectées, ainsi que dans les instruments médicaux réutilisables. Dans le domaine de l'imagerie, le TEP/CT peropératoire pourrait dans l'avenir guider le geste chirurgical afin d'améliorer les résultats oncologiques. Ces nouvelles technologies permettent le développement de nouveaux instruments ou dispositifs médicaux, dont l'évaluation doit se faire aujourd'hui tant sur le plan médical que socio-économique ou écologique.

Vaccinating humanitarian workers against COVID-19.

Objective: To describe the United Nations' (UN's) coronavirus disease 2019 (COVID-19) vaccination programme and its efforts to vaccinate frontline humanitarian personnel stationed in locations where access to COVID-19 vaccine was limited or absent. Methods: The vaccination programme was structured as a two-level operation: a global vaccine deployment support team and local vaccine deployment teams in each participating country, territory or administrative area. The central group, led by a global vaccine coordinator, oversaw medical, legal, financial, logistical, data, technological and communication aspects. Local vaccine deployment teams were led by coordinators who managed registration, logistics, communication and vaccine administration. The programme used World Health Organization-approved COVID-19 vaccines and developed prioritization criteria for distributing vaccine supplies. The programme ensured that vaccines for the UN personnel were not diverted from the populations they were intended to serve. Findings: The programme successfully formed 120 deployment teams across 152 eligible countries, territories and administrative areas, targeting approximately 673 000 individuals. By April 2023, 72 countries, territories and administrative areas had received over 470 000 doses, of which 337 072 doses were administered. Almost half of the doses administered (167 616) were to individuals in five UN hardship countries. Ninety-five severe adverse events were reported, but none led to any reported medical evacuation, permanent disability or death. Conclusion: The programme demonstrated effective global coordination and local implementation, adapting to diverse contexts and operational challenges. The model can serve as a guide for global actors for future health emergencies, or for deploying health aid at a regional or global scale.

The relationship between maternal psychopathology and parental perceptions of their children's reactions in survivors of the 1998 US Embassy bombing in Nairobi, Kenya.

BACKGROUND: The increase in terrorism worldwide has stimulated research on directly and indirectly exposed survivors, but there have been few investigations of the children of highly exposed survivors. This study examined the relationship between parental psychopathology and outcomes in their children who were exposed indirectly to a terrorist incident through their parents' exposures. METHODS: Eight to 10 months after the 1998 US Embassy bombing in Nairobi, Kenya, 280 survivors were interviewed about themselves and their 611 children using the Diagnostic Interview Schedule for DSM-IV to perform a full diagnostic assessment of survivors' pre- and post-disaster psychiatric disorders. The Disaster Supplement was used to obtain information about the survivors' demographics and disaster experiences and their children's disaster-related experiences. RESULTS: Survivors who experienced high rates of post-disaster psychiatric disorders reported that their children had low levels of disasterrelated posttraumatic stress symptoms, post-disaster behavior problems, and changes in school functioning. Only maternal psychopathology predicted adverse outcomes in survivors' children. CONCLUSIONS: The relationship between maternal psychopathology and youth outcomes has important clinical implications. Clinicians working with disaster survivors should ask individuals about their children routinely, refer family members-including children-for assessment and services as indicated, and offer child-oriented and/or family-focused interventions when appropriate.

Trauma, grief and depression in Nairobi children after the 1998 bombing of the American Embassy.

Despite the increasingly dangerous world where trauma and loss are common, relatively few studies have explored traumatic grief in children. The 1998 American Embassy bombing in Nairobi, Kenya, provided an unfortunate opportunity to examine this topic. This report describes findings in 156 children who knew someone killed in the incident, assessed 8 to 14 months after the explosion. Bomb-related posttraumatic stress was associated with physical exposure, acute response, posttraumatic stress related to other negative life events, type of bomb-related loss, and subsequent loss. Grief was associated with bomb-related posttraumatic stress, posttraumatic stress related to other negative life events, and type of bomb-related loss. The study supports the developing literature on traumatic grief and the need for studies exploring the potentially unique aspects of this construct.

Comparison of post-disaster psychiatric disorders after terrorist bombings in Nairobi and Oklahoma City.

BACKGROUND: African disaster-affected populations are poorly represented in disaster mental health literature. AIMS: To compare systematically assessed mental health in populations directly exposed to terrorist bombing attacks on two continents, North America and Africa. METHOD: Structured diagnostic interviews compared citizens exposed to bombings of the US Embassy in Nairobi, Kenya (n=227) and the Oklahoma City Federal Building (n=182). RESULTS: Prevalence rates of post-traumatic stress disorder (PTSD) and major depression were similar after the bombings. No incident (new since the bombing) alcohol use disorders were observed in either site. Symptom group C was strongly associated with PTSD in both sites. The Nairobi group relied more on religious support and the Oklahoma City group used more medical treatment, drugs and alcohol. CONCLUSIONS: Post-disaster psychopathology had many similarities in the two cultures; however, coping responses and treatment were quite different. The findings suggest potential for international generalisability of post-disaster psychopathology, but confirmatory studies are needed.