Perioperative Outcomes of Single vs Multi-Port Robotic Assisted Radical Prostatectomy: A Single Institutional Experience.

PURPOSE: Surgical approach to radical prostatectomy has evolved due to advances in minimally invasive surgery, with most contemporary approaches involving the Si or Xi multi-port robotic systems. U.S. Food and Drug Administration approval of the single-port da Vinci® SP robotic platform has led to a few case series suggesting its safety and feasibility for robotic assisted radical prostatectomy in patients with prostate cancer. However, there are no established data on perioperative outcomes comparing single-port to multi-port robotic approaches to robot-assisted radical prostatectomy. MATERIALS AND METHODS: All patients who underwent robot-assisted radical prostatectomy by 2 urological surgeons at our institution between October 2018 and June 2019 were retrospectively reviewed. The available preoperative clinical and demographic data, operative parameters and postoperative outcomes were collected and analyzed using the t-test, chi-square and Fisher exact statistical measures. RESULTS: Overall 95 patients who underwent robot-assisted radical prostatectomy at our institution were included in our study, with 47 single-port and 48 multi-port. Preoperative clinical parameters including age, body mass index, prior abdominal surgery and biopsy grade group were similar across the 2 groups. No differences in estimated blood loss (169.2±114.2 vs 157.7±125.4 ml, p=0.64), operative time (255.9±44.1 vs 274.7±50.4 minutes, p=0.06), length of hospitalization (1.1±0.5 vs 1.4±1.1 days, p=0.17), rate of perioperative inpatient Clavien-Dindo complications 2 or greater (4.3% vs 6.3% p=0.66) and rate of positive pathological margin (21.3% vs 27.1%, p=0.51) were noted comparing the single-port and multi-port approaches, respectively. CONCLUSIONS: The single-port robotic system allows a feasible approach to robot-assisted radical prostatectomy and has operative and perioperative outcomes comparable to those of the well accepted multi-port robotic approach.

Mini-Mental State Examination and Montreal Cognitive Assessment as Tools for Following Cognitive Changes in Alzheimer's Disease Neuroimaging Initiative Participants.

BACKGROUND: Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) are two commonly used cognitive screening and diagnostic tools. OBJECTIVE: Our goal was to assess their efficacy for monitoring cognitive changes, as well as the correlation between the two tests. METHODS: At baseline, participants in the Alzheimer's Disease Neuroimaging Initiative (ADNI) were divided into four groups based on their cognitive diagnoses: healthy control (HC), early mild cognitive impairment (EMCI), late mild cognitive impairment (LMCI), and Alzheimer's disease (AD). MMSE or MoCA scores were compared among the four groups using an analysis of variance (ANOVA) model with repeated measures with post-hoc Bonferroni correction. For those participants who had both MMSE and MoCA assessments done, a Pearson correlation analysis was performed between the two assessments for each visit. RESULTS: The MMSE scores were significantly different among the four groups at baseline, which was true for each of the three annual follow-up visits. By contrast, the MoCA scores were not significantly different between HC and EMCI groups at either baseline or any of the follow-up visits. For participants with a diagnosis of LMCI, the cognitive performance deteriorated in a linear manner 12 months after the baseline, which was independent of MMSE or MoCA. At last, the MMSE scores were moderately related to MoCA scores, which got stronger along with the time of follow-up. CONCLUSION: MMSE and MoCA are comparable as cognitive assessment tools to monitor cognitive changes. In addition, the measurements of MMSE and MoCA are moderately correlated for the follow-up visits.

Examining the Correlation Between Altmetric Score and Citations in the Urology Literature.

OBJECTIVE: To determine if article Altmetric scores correlate with journal impact factor and citation count in the urologic literature. METHODS: We identified the top 10 most-cited articles for the 15 urology journals with the highest impact factor in 2013 and 2016. Citation count and Altmetric scores were recorded for each of the articles. The journal impact factor and date of Twitter account development were recorded for each of the journals. The variables were analyzed in Microsoft excel using Pearson's correlation testing. RESULTS: A total of 300 articles were analyzed. In 2013, Altmetric scores and citation number showed a significant positive correlation (r = 0.164, P = .045), although Altmetric scores did not correlate with journal impact factor (r = 0.005, P = .957). In 2016, there was significant positive correlation between Altmetric scores and citation number (r = 0.268, P = .0009), as well as between Altmetric scores and journal impact factor (r = 0.201, P = .014). The total citation count decreased from 15,235 in 2013 to 8622 in 2016 while the total Altmetric score increased from 1135 in 2013 to 2563 in 2016. Older Twitter accounts were not associated with increasing correlations between Altmetric score and bibliometrics in either 2013 (r = 0.221, P = .54) or 2016 (r = 0.083, P = .819). CONCLUSION: At this point in time, Altmetric score is only weakly correlated with citation counts in the urology literature. Altmetrics and traditional bibliometrics should be viewed as complements to one another rather than surrogates when determining research dissemination and impact.