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Vinícius Suartz C, Araújo Simões PA, Doratioto Serrano Faria Braz N, da Silva FR, Uwagoya R, Masiero F, Dener Cordeiro M, Santos Costa MS, de Arruda Pessoa F, Mota JM, Nahas WC, Alves Ribeiro-Filho L. Surviving the Storm: Challenges of Bladder Cancer Care During the COVID-19 Pandemic. Clin Genitourin Cancer 2024; 22:102129. [PMID: 38945023 DOI: 10.1016/j.clgc.2024.102129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 05/25/2024] [Indexed: 07/02/2024]
Abstract
PURPOSE To evaluate the impact of the COVID-19 pandemic on the care of patients with bladder cancer in a tertiary oncology center. MATERIALS AND METHOD We performed a retrospective analysis of patients admitted to a tertiary cancer center for the treatment of bladder cancer between 2019 and 2022. Surgical volumes, patient demographics, clinical characteristics, and postoperative outcomes were compared across these years. RESULTS A total of 463 patients with bladder cancer were admitted in the period, and 78 patients underwent radical cystectomy . The distribution of TMN stages between admitted patients remained consistent across the years, with no statistically significant differences. Patients who underwent RC in 2020 presented more advanced disease at surgery (pT3/pT4 stage) (P = .045; 95% CI, 0.18-0.55) and had a longer hospital stay compared to other years (P = .024; 95% CI, 10.26-41.27). CONCLUSIONS The COVID-19 pandemic posed significant challenges for the treatment of patients with bladder cancer. These results highlight the need to adapt health systems to unforeseen challenges, emphasizing the clinical impact on patients with advanced stages of the disease and the repercussions on their overall survival.
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Affiliation(s)
- Caio Vinícius Suartz
- Division of Urology, Institute of Cancer of São Paulo, University of São paulo, Brazil.
| | | | | | - Flávio Rossi da Silva
- Division of Urology, Institute of Cancer of São Paulo, University of São paulo, Brazil
| | - Robson Uwagoya
- Division of Urology, Institute of Cancer of São Paulo, University of São paulo, Brazil
| | - Fernanda Masiero
- Division of Urology, Institute of Cancer of São Paulo, University of São paulo, Brazil
| | | | | | | | - José Maurício Mota
- Department of Urology, Genitourinary Medical Oncology Service, Instituto do Cancer do Estado de São Paulo, University of São Paulo, Brazil
| | - William Carlos Nahas
- Division of Urology, Institute of Cancer of São Paulo, University of São paulo, Brazil
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Pinto LOAD, Silva RC, Bentes LGDB, Bacelar HPHD, Kietzer KS. Low-fidelity simulation models in urology resident's microsurgery training. Acta Cir Bras 2023; 38:e386523. [PMID: 38055400 DOI: 10.1590/acb386523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/15/2023] [Indexed: 12/08/2023] Open
Abstract
PURPOSE To evaluate the gain of microsurgical skills and competencies by urology residents, using low-fidelity experimental models. METHODS The study involved the use of training boards, together with a low-fidelity microsurgery simulator, developed using a 3D printer. The model consists in two silicone tubes, coated with a resin, measuring 10 cm in length and with internal and external diameters of 0.5 and 1.5 mm. The support for the ducts is composed by a small box, developed with polylactic acid. The evaluation of the gain of skills and competencies in microsurgery occurred throughout a training course consisting of five training sessions. The first sessions (S1-S4) took place at weekly intervals and the last session (S5) was performed three months after S4. During sessions, were analyzed: the speed of performing microsurgical sutures in the pre and post-training and the performance of each resident through the Objective Structure Assessment of Technical Skill (OSATS) and Student Satisfaction Self-Confidence tools in Learning (SSSCL). RESULTS There was a decrease in the time needed to perform the anastomosis (p=0.0019), as well as a progressive increase in the score in the OSATS over during sessions S1 to S4. At S5, there was a slightly decrease in performance (p<0.0001), however, remaining within the expected plateau for the gain of skills and competences. The SSSCL satisfaction scale showed an overall approval rating of 96.9%, with a Cronback alpha coefficient of 83%. CONCLUSIONS The low-fidelity simulation was able to guarantee urology residents a solid gain in skills and competencies in microsurgery.
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Affiliation(s)
| | - Renata Cunha Silva
- Universidade Estadual do Pará - Department of Morphophysiology Applied to Health - Belém (PA), Brazil
| | | | | | - Kátia Simone Kietzer
- Universidade Estadual do Pará - Department of Morphophysiology Applied to Health - Belém (PA), Brazil
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3
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Militaru A, Bulai CA, Ene C, Popescu RI, Cozma C, Mares C, Balacescu S, Moldoveanu C, Georgescu DA, Geavlete PA, Geavlete BF. Double J Stents and Reno-Ureteral Lithiasis: Dynamic Changes in Management during the COVID-19 Pandemic. Life (Basel) 2023; 13:2113. [PMID: 38004253 PMCID: PMC10672095 DOI: 10.3390/life13112113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/08/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
PURPOSE To provide an evidence-based review of the use of ureteral stents in managing reno-ureteral lithiasis during the COVID-19 pandemic. MATERIALS AND METHODS A literature search was conducted between 2020 and 2023 using the PubMed and SCOPUS databases. As a part of the search query, we entered "ureteral stents" OR "double J stent" AND "renal colic" OR "ureteral obstruction" OR "reno-ureteral lithiasis" AND "COVID-19 Pandemic" OR "SARS-CoV-2 infection". RESULTS Patients with lithiasis should be categorized into low priority, intermediate priority, high priority, and emergency under the COVID-19 pandemic scenario to manage their delay and save resources, including healthcare professionals, beds, and ventilators. However, immediate interventions are necessary for individuals at risk of life-threatening septic complications. During the COVID-19 pandemic, the feasibility of conducting or resuming elective activity depended on local circumstances, the accessibility of beds and ventilators, and the execution of screening protocols. If lithiasis surgery is delayed, consequences and increased effort will be inevitable. It is possible that teleconsultation could help guide these patients and cut down on unnecessary visits and exposure. CONCLUSIONS COVID-19 has shifted treatment options for urinary stones, with ureteral stents being a safe, efficient, and cost-effective option for managing urolithiasis. Decompression is essential in emergency situations, while ureteral stents reduce the risk of infection and hospital visits.
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Affiliation(s)
- Adrian Militaru
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari, 050474 Bucharest, Romania
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti, 042122 Bucharest, Romania
| | - Catalin Andrei Bulai
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari, 050474 Bucharest, Romania
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti, 042122 Bucharest, Romania
| | - Cosmin Ene
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari, 050474 Bucharest, Romania
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti, 042122 Bucharest, Romania
| | - Razvan Ionut Popescu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari, 050474 Bucharest, Romania
- Department of Urology, “Prof. Dr. Th. Burghele” Clinical Hospital, 20 Panduri, 050659 Bucharest, Romania
| | - Cosmin Cozma
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari, 050474 Bucharest, Romania
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti, 042122 Bucharest, Romania
| | - Cristian Mares
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari, 050474 Bucharest, Romania
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti, 042122 Bucharest, Romania
| | - Stefan Balacescu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari, 050474 Bucharest, Romania
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti, 042122 Bucharest, Romania
| | - Cristian Moldoveanu
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti, 042122 Bucharest, Romania
| | - Dragos Adrian Georgescu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari, 050474 Bucharest, Romania
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti, 042122 Bucharest, Romania
| | - Petrisor Aurelian Geavlete
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari, 050474 Bucharest, Romania
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti, 042122 Bucharest, Romania
| | - Bogdan Florin Geavlete
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari, 050474 Bucharest, Romania
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti, 042122 Bucharest, Romania
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Gupta A, Patil A, Patel D, Singh AG, Ganpule AP, Sabnis RB, Desai MR. Stage Migration in Renal Malignancies in COVID Era: A Single-Center Analysis. Indian J Surg Oncol 2023:1-6. [PMID: 37363712 PMCID: PMC10187501 DOI: 10.1007/s13193-023-01771-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 05/10/2023] [Indexed: 06/28/2023] Open
Abstract
The COVID-19 disease, caused by SARS-CoV-2 virus, attained the status of a pandemic by March 2020. There was apprehension among patients suffering from renal malignancies about balancing cancer treatment and preventing COVID-19 infection transmission. We analyzed 184 patients with renal malignancies retrospectively, who presented to our institute over 2 years: 91 patients of renal malignancies in pre-COVID era (March 2019-Feb 2020) and 93 patients in COVID era (March 2020-Feb 2021). The parameters analyzed were age, tumor size, clinical presentation, clinical stage, pathological stage, nuclear grade, and presence of metastasis. Level of significance was kept at 95%, and p value <0.05 was considered significant. The age of patients was comparable in both groups (p: 0.381). Clinical presentation was also similar in both groups whereas there were more cases diagnosed during routine evaluation in pre-COVID era (p: 0.022). Tumor size was 5.84 ± 3.03cm vs. 7.10±3.83cm (p: 0.017) in pre-COVID vs. COVID era, respectively. Patients in COVID era had significantly higher clinical stage (p = 0.041), pathological stage (p =0.027), nuclear grade (p = 0.007), and presence of metastasis (p = 0.005) as compared to pre-COVID era. Patients, who underwent Nephron-sparing surgery, also had higher pathological stage in COVID era. COVID overshadowed the management of renal malignancies. There was a clear shift and stage migration in patients of renal malignancies in COVID era as compared to pre-COVID era, probably because of less routine health check-ups and patients deferring hospital visits due to fear of contracting COVID infection.
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KELEŞ A, KARAKECİ A, OZAN T, YUVANÇ E. Comparative assessment of patients' admission to urology departments during and before the COVID-19 pandemic: a retrospective cohort study. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2023. [DOI: 10.32322/jhsm.1220104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
Aim: To determine the diseases that presented to the urology department during the COVID-19 pandemic and for hospital-based comparison with the diseases that presented in the same period of the previous year.
Material and Method: In this retrospective follow-up study, patients who were admitted to the tertiary university hospital and secondary state hospital urology departments between April-July 2019 and April-July 2020 were included in the study. We searched the health administrative data using the International Classification of Diseases-10 codes. The number and variety of patients who were admitted to the urology departments in the same months of 2019 and 2020 were compared.
Results: In both hospitals, the total number of admissions decreased during the pandemic in 2020 compared to the pre-pandemic year. Also, elective admissions decreased in 2020 compared to the pre-pandemic year (p
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Affiliation(s)
- Ahmet KELEŞ
- ISTANBUL MEDENIYET UNIVERSITY, SCHOOL OF MEDICINE
| | | | - Tunç OZAN
- FIRAT UNIVERSITY, SCHOOL OF MEDICINE
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Nocera L, Stolzenbach LF, Collà Ruvolo C, Wenzel M, Wurnschimmel C, Tian Z, Gandaglia G, Fossati N, Mirone V, Chun FKH, Shariat SF, Graefen M, Saad F, Montorsi F, Briganti A, Karakiewicz PI. Predicting the probability of pT3 or higher pathological stage at radical prostatectomy: COVID19-specific considerations. Front Oncol 2022; 12:990851. [PMID: 36561531 PMCID: PMC9763886 DOI: 10.3389/fonc.2022.990851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Background We tested whether a model identifying prostate cancer (PCa) patients at risk of pT3-4/pN1 can be developed for use during COVID19 pandemic, in order to guarantee appropriate treatment to patients harboring advanced disease patients without compromising sustainability of care delivery. Methods Within the Surveillance, Epidemiology and End Results database 2010-2016, we identified 27,529 patients with localized PCa and treated with radical prostatectomy. A multivariable logistic regression model predicting presence of pT3-4/pN1 disease was fitted within a development cohort (n=13,977, 50.8%). Subsequently, external validation (n=13,552, 49.2%) and head-to-head comparison with NCCN risk group stratification was performed. Results In model development, age, PSA, biopsy Gleason Grade Group (GGG) and percentage of positive biopsy cores were independent predictors of pT3-4/pN1 stage. In external validation, prediction of pT3-4/pN1 with novel nomogram was 74% accurate versus 68% for NCCN risk group stratification. Nomogram achieved better calibration and showed net-benefit over NCCN risk group stratification in decision curve analyses. The use of nomogram cut-off of 49% resulted in pT3-4/pN1 rate of 65%, instead of the average 35%. Conclusion The newly developed, externally validated nomogram predicts presence of pT3-4/pN1 better than NCCN risk group stratification and allows to focus radical prostatectomy treatment on individuals at highest risk of pT3-4/pN1.
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Affiliation(s)
- Luigi Nocera
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada,Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy,*Correspondence: Luigi Nocera,
| | - Lara F. Stolzenbach
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada,Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Collà Ruvolo
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada,Department of Urology, University of Naples Federico II, Naples, Italy
| | - Mike Wenzel
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada,Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Christoph Wurnschimmel
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada,Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Zhe Tian
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada
| | - Giorgio Gandaglia
- Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Nicola Fossati
- Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Vincenzo Mirone
- Department of Urology, University of Naples Federico II, Naples, Italy
| | - Felix K. H. Chun
- Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Shahrokh F. Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria,Departments of Urology, Weill Cornell Medical College, New York, NY, United States,Department of Urology, University of Texas Southwestern, Dallas, TX, United States,Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czechia,Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia,Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Markus Graefen
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Fred Saad
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Briganti
- Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Pierre I. Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada
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Mariani MP, Facio FN, Spessoto LCF. Impact of the COVID-19 Pandemic on Surgical Treatment of Patients With Urological Diseases at a University Hospital. Cureus 2022; 14:e29572. [PMID: 36312668 PMCID: PMC9595263 DOI: 10.7759/cureus.29572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2022] [Indexed: 11/05/2022] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) appeared in China and spread quickly to other regions of the country and around the world, changing the way of life of individuals and the routine of healthcare systems. Objective: The aim of the present study was to investigate the impact of the pandemic on the surgical treatment of patients with urological diseases at a university hospital. Materials and methods: A retrospective analysis of the charts of patients with urological diseases submitted to surgical treatment between January 2019 and December 2020 was conducted. The variables of interest were age, sex, and most performed surgical procedures (double-J stent placement, cystoscopy, vasectomy, removal of double-J stent, ureterolithotripsy, endoscopic bladder procedure, kidney transplant, and endoscopic prostate procedure). Results: Around 59.03% of patients with urological diseases who had surgery in 2019 were male; placement of the double-J stent accounted for 35.85% of all surgeries; 3556 surgical procedures were performed. In 2020, 57.22% of the patients were male, placement of the double-J stent accounted for 38.34% of all surgeries, and 3093 surgical procedures took place. Analyzing the types of surgery conducted in 2019 and 2020, a significant reduction occurred in the number of procedures in 2020 (p = 0.000). Conclusion: The pandemic exerted an impact on the surgical treatment of patients with urological diseases at a university hospital. No significant changes occurred with regard to the sex and age of the patients, but a significant difference was found in the number of surgical procedures performed.
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Tristão LS, Bresler R, Modesto VA, Fernandes RDC, Bernardo WM. Urological complications of COVID-19: a systematic review. Int Braz J Urol 2022; 49:24-40. [PMID: 36512453 PMCID: PMC9881803 DOI: 10.1590/s1677-5538.ibju.2022.0281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/29/2022] [Indexed: 12/15/2022] Open
Abstract
PURPOSE COVID-19 continues to be an urgent World issue. Receptors of angiotensin converting enzyme 2 (ACE2), gateway of SARS-CoV-2, are present in the lungs, bladder, prostate, and testicles. Therefore, these organs face high risk of damage caused by the virus and this mechanism may explain non-respiratory symptoms of the disease. MATERIALS AND METHODS This systematic review, guided by the PRIMSA statement, was proposed to elucidate possible urological complications of COVID-19. Searches were carried out in Medline (PubMed), Cochrane (CENTRAL), Embase, MedRxiv and LILACS. Bias analysis was made using the specific Newcastle-Ottawa Scale for each study design. RESULTS Search was carried out until April 2022, and 8,477 articles were identified. Forty-nine of them were included in this systematic review. There is evidence that lower urinary tract symptoms and acute scrotum may be signs of COVID-19 in men, although in a small proportion. Also, the disease may have a transitory impact on male fertility, evidenced by several alterations in sperm counts. However, it must be clarified whether this impact is transitory, or may last for longer periods. Several patients showed reduction of total value of testosterone. Two authors linked low levels of testosterone with worse outcomes of COVID-19, suggesting that the hormone may be used as an early biomarker of the severity of the disease. Moreover, it is extremely unlikely that SARS-CoV-2 is transmitted by semen. CONCLUSION This systematic review identified possible repercussions of COVID-19 in the urinary as well as in the male reproductive system.
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Affiliation(s)
- Luca Schiliró Tristão
- Faculdade de Ciências Médicas de SantosDepartamento de Medicina Baseada em EvidênciasSantosSPBrasilDepartamento de Medicina Baseada em Evidências, Faculdade de Ciências Médicas de Santos (FCMS-UNILUS), Santos, SP, Brasil,Correspondence address: Luca Schiliró Tristão, MD, Departamento de Medicina Baseada em Evidências, Faculdade de Ciências Médicas de Santos – UNILUS, R. Oswaldo Cruz, 179 – Boqueirão Santos, SP, 11045-101, Brasil. Telephone: +5511 9 6915-6070 E-mail:
| | - Rafael Bresler
- Faculdade de Ciências Médicas de SantosDepartamento de Medicina Baseada em EvidênciasSantosSPBrasilDepartamento de Medicina Baseada em Evidências, Faculdade de Ciências Médicas de Santos (FCMS-UNILUS), Santos, SP, Brasil
| | - Victoria Andrade Modesto
- Faculdade de Ciências Médicas de SantosDepartamento de Medicina Baseada em EvidênciasSantosSPBrasilDepartamento de Medicina Baseada em Evidências, Faculdade de Ciências Médicas de Santos (FCMS-UNILUS), Santos, SP, Brasil
| | - Roni de Carvalho Fernandes
- Divisão de UrologiaSanta Casa de São PauloSão PauloSPBrasilDivisão de Urologia, Santa Casa de São Paulo, São Paulo, SP, Brasil
| | - Wanderley Marques Bernardo
- Faculdade de Ciências Médicas de SantosDepartamento de Medicina Baseada em EvidênciasSantosSPBrasilDepartamento de Medicina Baseada em Evidências, Faculdade de Ciências Médicas de Santos (FCMS-UNILUS), Santos, SP, Brasil,Faculdade de Medicina da Universidade de São PauloDepartamento de Medicina Baseada em EvidênciasSão PauloSPBrasilDepartamento de Medicina Baseada em Evidências, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
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Urakawa R, Shibata T, Sogou M, Takamori K, Inoue T, Konishi K, Sakai T. The Bactericidal Effect of MA-T for Factitiously Contaminated and Used Masks. Biol Pharm Bull 2022; 45:757-762. [PMID: 35650103 DOI: 10.1248/bpb.b22-00046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Matching transformation system (MA-T), an on-demand aqueous chlorine dioxide solution, is an excellent safety disinfectant, because chlorine dioxide is not detected during storage or before use. The production of chlorine dioxide in MA-T is induced by a catalytic reaction in the presence of target microorganisms. In this study, we investigated MA-T disinfection of masks as a reuse method to eliminate mask shortages. After spraying Escherichia coli on sterilized surgical mask, samples (factitiously contaminated masks) were treated with MA-T spraying or immersion, and the bactericidal efficacy was assessed by culturing. Used surgical masks were also sprayed with MA-T or were immersed in MA-T, and then were cultured to verify the bactericidal effect. The performance of N95 masks was assessed before and after application of MA-T. After spraying with MA-T, the numbers of bacteria of factitiously contaminated masks and used masks were drastically reduced compared with control samples (not applicable and p = 0.002, respectively). After MA-T immersion, the bacterial counts of both masks (factitiously contaminated masks and used masks) were significantly reduced (both p = 0.002). Taken together, the disinfection test on factitiously contaminated with E. coli and used surgical masks showed that masks can be disinfected by MA-T spray and sterilized by immersion, respectively. The N95 mask performance test after 30 min of immersion in MA-T showed that MA-T disinfected the mask without degrading the performance of the mask. In conclusion, MA-T is useful for the reuse of masks because of its decontamination effect and safety while maintaining the function of the mask.
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Affiliation(s)
- Ryuta Urakawa
- Department of Pharmacy, Osaka University Dental Hospital.,Department of Clinical Pharmacy Research and Education, Graduate School of Pharmaceutical Sciences, Osaka University
| | - Takekatsu Shibata
- Acenet Inc.,Institute for Open and Transdisciplinary Research Initiatives, Osaka University.,Division of Advance Pharmaco-Science, Graduate School of Pharmaceutical Sciences, Osaka University
| | - Motofumi Sogou
- Office of Strategic Innovative Dentistry Professor, Graduate School of Dentistry, Osaka University
| | | | - Tsuyoshi Inoue
- Institute for Open and Transdisciplinary Research Initiatives, Osaka University.,Division of Advance Pharmaco-Science, Graduate School of Pharmaceutical Sciences, Osaka University
| | - Kiyoshi Konishi
- Institute for Open and Transdisciplinary Research Initiatives, Osaka University.,Division of Advance Pharmaco-Science, Graduate School of Pharmaceutical Sciences, Osaka University
| | - Takayoshi Sakai
- Department of Oral-Facial Disorders, Graduate School of Dentistry, Osaka University
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Pérez CA, Michelutti LBC, Palharini MV, Teixeira LP, Silva VR, Teixeira LEPDP, da Silva SLA, Botelho S. Interaction between the impact of the Coronavirus disease 2019 pandemic and demographic characteristics on sexual/erectile dysfunction in Latin America: cross-sectional study. Int Braz J Urol 2022; 48:512-547. [PMID: 35373948 PMCID: PMC9060173 DOI: 10.1590/s1677-5538.ibju.2021.0764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/07/2022] [Indexed: 12/29/2022] Open
Abstract
Aim: Our objective was to investigate whether there is an interaction between the COVID-19 pandemic, demographic characteristics and erectile/sexual (E/S) function in individuals from Latin America. Materials and Methods: Cross-sectional study which included Latin American individuals over 18 years old, recruited through social media and interviewed between July and August 2020 by online surveys (Google Forms) in Portuguese and Spanish languages. The E/S function was evaluated through the following questionnaires: Simplified International Index of Erectile Function (IIEF-5) and Female Sexual Function Index (FSFI); while post-traumatic stress disorder (PTSD) triggered by the COVID-19 pandemic was assessed through the Impact of Event Scale Revised (IES-R). The data was analyzed by T Student, bivariate and multivariate logistic regression, with significance determined by the Wald test (p<0.05), using the R software v4.0. Results: Out of the 2016 individuals that responded to the survey, 1986 were included and 743 of them presented E/S dysfunction. PTSD occurrence was greater among people with E/S dysfunction when compared to those without E/S dysfunction, in the total score (males: IES-R=26.54[±19.17] and females: IES-R=35.92[±19.25]) and also in the three domains. It was found that those who do not live with a partner were 74% more likely to have E/S dysfunction, but living with a partner during the pandemic had a greater impact on E/S function. Conclusion: A negative interaction between the impact of the COVID-19 pandemic and erectile/sexual function of the Latin American population was observed, with greater implications among the individuals who live with their partners.
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Affiliation(s)
- Constanza Alvear Pérez
- Programa de Pós-Graduação em Ciências da Reabilitação, Instituto de Ciências Motoras da Universidade Federal de Alfenas - UNIFAL-MG, Alfenas, MG, Brasil
| | - Luciana Barros Cavalcanti Michelutti
- Programa de Pós-Graduação em Ciências da Reabilitação, Instituto de Ciências Motoras da Universidade Federal de Alfenas - UNIFAL-MG, Alfenas, MG, Brasil.,Faculdade de Medicina da Universidade Federal de Alfenas - UNIFAL-MG, Alfenas, MG, Brasil
| | - Maria Volpato Palharini
- Programa de Pós-Graduação em Ciências da Reabilitação, Instituto de Ciências Motoras da Universidade Federal de Alfenas - UNIFAL-MG, Alfenas, MG, Brasil
| | - Luisa Pasqualotto Teixeira
- Programa de Pós-Graduação em Ciências da Reabilitação, Instituto de Ciências Motoras da Universidade Federal de Alfenas - UNIFAL-MG, Alfenas, MG, Brasil.,Programa de Pós-Graduação em Ciências Cirúrgicas, Faculdade de Ciências Médicas da Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brasil
| | - Valeria Regina Silva
- Programa de Pós-Graduação em Ciências Cirúrgicas, Faculdade de Ciências Médicas da Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brasil.,Universidade José do Rosário Vellano - UNIFENAS, - Alfenas, MGm Brasil
| | - Lucas Emmanuel Pedro de Paiva Teixeira
- Programa de Pós-Graduação em Ciências da Reabilitação, Instituto de Ciências Motoras da Universidade Federal de Alfenas - UNIFAL-MG, Alfenas, MG, Brasil
| | - Silvia Lanziotti Azevedo da Silva
- Programa de Pós-Graduação em Ciências da Reabilitação, Instituto de Ciências Motoras da Universidade Federal de Alfenas - UNIFAL-MG, Alfenas, MG, Brasil.,Departamento de Saúde Coletiva, Faculdade de Medicina, Universidade Federal de Juiz de Fora - UFJF, Juiz de Fora, MG, Brasil
| | - Simone Botelho
- Programa de Pós-Graduação em Ciências da Reabilitação, Instituto de Ciências Motoras da Universidade Federal de Alfenas - UNIFAL-MG, Alfenas, MG, Brasil.,Programa de Pós-Graduação em Ciências Cirúrgicas, Faculdade de Ciências Médicas da Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brasil
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11
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Porcacchia AS, Pires GN, Ortiz V, Andersen ML, Tufik S. Prostate cancer mortality and costs of prostate surgical procedures in the Brazilian public health system. Int Braz J Urol 2022; 48:583-590. [PMID: 35168315 PMCID: PMC9060162 DOI: 10.1590/s1677-5538.ibju.2021.0781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 11/24/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- Allan Saj Porcacchia
- Departamento de Psicobiologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brasil
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brasil
| | - Valdemar Ortiz
- Departamento de Cirurgia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brasil
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brasil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brasil
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12
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Hout M, Marcovich R, Shah H. Changes in practice patterns of nephrolithiasis in the era of the coronavirus disease 2019 pandemic: a review. Curr Opin Urol 2022; 32:158-164. [PMID: 34954706 PMCID: PMC8815651 DOI: 10.1097/mou.0000000000000970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW The coronavirus disease 2019 (COVID-19) pandemic led to a drastic change in healthcare priorities, availability of resources and accommodation of different needs and scenarios. We sought to review the effect of the pandemic on different aspects of nephrolithiasis. RECENT FINDINGS The pandemic resulted in a significant impact on management of patients with nephrolithiasis around the world. A significant decrease in patient presentation and differences in strategies of management to truncate exposure and surgery time and expedite patient discharge deferring definitive management has been noted. Moreover, new safety measures such as COVID-19 PCR testing prior to surgery and limiting any intervention for COVID-19 positive patients to only life-saving scenarios has been implemented. Different emergency triaging proposals are being used, mainly including high risk patients with septic shock or complete obstruction/renal injury. Moreover, the emergence of telehealth has changed outpatient practice dramatically with a significant adoption to minimize exposure. Lastly, the effect of COVID-19 on renal physiology has been described with significant potential to cause morbidity from immediate or delayed acute kidney. No physiological effect on stone formation has yet been described, and transmission through urine is rare. SUMMARY The COVID-19 pandemic has markedly shifted the treatment of nephrolithiasis in many ways, including emergency triage, outpatient care, and definitive management. Although various approaches and algorithms proposed are meant to optimize management in the time of the pandemic, further studies are required for validation.
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Affiliation(s)
- Mohammad Hout
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA
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13
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Ginting JT, Sigumonrong Y. Abol-Enein pouch modification after radical cystectomy in bladder rhabdomyosarcoma in 5 years old child during COVID-19 pandemic: A case report. Int J Surg Case Rep 2022; 90:106701. [PMID: 34956826 PMCID: PMC8686445 DOI: 10.1016/j.ijscr.2021.106701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To discuss the consideration of performing radical cystectomy for rhabdomyosarcoma in children during the COVID-19 pandemic in the urology department of Adam Malik Hospital, Medan. INTRODUCTION Rhabdomyosarcoma is a rare malignancy that develops from primitive mesenchymal stem cells. The gold standard for the treatment of rhabdomyosarcoma is radical cystectomy. However, during the COVID-19 pandemic, radical cystectomy becomes a concern due to the risk of virus transmission. This article reported a patient who underwent radical cystectomy during the COVID-19 pandemic. CASE PRESENTATION A five-year-old female child was admitted to the hospital with chief complaints of bloody urine 1 month before admission. A month before hospital admission, the patient had pain during urination and was treated with radical cystectomy with Abol-Enein pouch modification. RESULT After the surgery, the patient was able to urinate without any disturbance. Hematuria was not found. There was no complaint related to stricture of the ureter after the surgery. CONCLUSION In our center, radical cystectomy could be performed in child with bladder rhabdomyosarcoma during COVID-19 pandemic. The procedure is considered a high priority therapy in most regions during COVID-19 pandemic. Abol-Enein technique after radical cystectomy resulted in improvement of symptom with no reported complication in our case.
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Affiliation(s)
- Jeremy Thompson Ginting
- Urology Resident of Urology Department, Faculty of Medicine, Universitas Indonesia - H. Adam Malik Hospital, Medan, Indonesia.
| | - Yacobda Sigumonrong
- Urology Consultant of Urology Department, Faculty of Medicine, Universitas Indonesia - H. Adam Malik Hospital, Medan, Indonesia
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14
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Teixeira TOA, Carvalho LG, Camargo GG, De Domenico EBL. Cancer care in the COVID-19 era and psychosocial impacts on oncology nursing in Brazil. Ecancermedicalscience 2021; 15:1331. [PMID: 35211200 PMCID: PMC8816500 DOI: 10.3332/ecancer.2021.1331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Globally, Brazil has the third highest number of confirmed COVID-19 cases and the second highest number of deaths related to COVID-19 at the time of writing. Maintaining cancer care has been a challenge for patient safety and for the physical and mental health of oncology nurses. OBJECTIVES To describe which effects of the COVID-19 pandemic on cancer care could already be evaluated and to identify the psychosocial impact on cancer nurses in Brazil. METHOD Reflective, analytical, qualitative study. RESULTS Although the Brazilian cancer care policy has reached important achievements in overcoming access barriers to cancer diagnosis and treatment over the past decade, the COVID-19 pandemic has caused losses of timely access to health services for patients with cancer, which has compromised screening, early diagnosis and treatment, and patient follow-up. Oncology nurses have actively participated in the management and assistance strategies during the pandemic. This path has generated an increase in oncology nurses' workload, leading to physical and mental stress and anxiety related to the fear of contagion for themselves and their family. CONCLUSION The pandemic has affected the care of cancer patients, with the potential to suffer greater losses because of reductions in screening, early diagnosis and treatment, and patient follow-up. In addition to the worsening of the cancer setting, the COVID-19 pandemic has overwhelmed Brazilian oncology nurses, physically and mentally.
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Affiliation(s)
- Tamara Otsuru Augustinho Teixeira
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, 754, Napoleão de Barros Street, Vila Clementino, São Paulo, SP 04023-062, Brazil,https://orcid.org/0000-0002-3588-653X
| | - Leticia Gomes Carvalho
- Universidade Federal de São Paulo, 754, Napoleão de Barros Street, Vila Clementino, São Paulo, SP 04023-062, Brazil,https://orcid.org/0000-0003-1719-6014
| | - Guilherme Gasparini Camargo
- Universidade Federal de São Carlos, Washington Luiz, s/n – São Carlos, SP 13565-905, Brazil,https://orcid.org/0000-0003-4310-892X
| | - Edvane Birelo Lopes De Domenico
- Department of Clinical and Surgical Nursing, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, 754, Napoleão de Barros Street, Vila Clementino, São Paulo, SP 04023-062, Brazil,https://orcid.org/0000-0001-7455-1727
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15
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Abou-Chedid W, Nason GJ, Evans AT, Yamada K, Moschonas D, Patil K, Langely SE, Perry MJ. The impact of COVID-19 on surgical volume and surgical training at a high-volume pelvic oncology centre. Urologia 2021; 89:495-499. [PMID: 34877900 DOI: 10.1177/03915603211062827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The coronavirus (COVID-19) pandemic has overwhelmed most health services. As a result, many surgeries have been deferred and diagnoses delayed. The aim of this study was to assess the effect of the COVID-19 pandemic at a high-volume pelvic oncology centre. METHODS A retrospective review was performed of clinical activity from 2017 to 2020. We compared caseload for index procedures 2017-2019 (period 1) versus 2020 (period 2) to see the effect of the COVID pandemic. We then compared the activity during the first lockdown (March 23rd) to the rest of the year when we increased our theatre access by utilising a 'clean' site. RESULTS The average annual number of robotic assisted radical cystectomy (RARC) and robotic assisted radical prostatectomy (RARP) performed during period 1 was 82 and 352 respectively. This reduced to 68 (17.1% reduction) and 262 (25.6% reduction) during period 2. The number of patients who underwent prostate brachytherapy decreased from 308 to 243 (21% reduction). The number of prostate biopsies decreased from 420 to 234 (44.3% reduction). The number of radical orchidectomies decreased from 18 to 11 (39% reduction). The mean number of RARC and RARP per month during period 2 was 5.5 and 22. This decreased to 4 and 9 per month during the first national lockdown but was maintained thereafter despite two further lockdowns. CONCLUSION There has been a substantial decrease in urological oncology caseload during the COVID pandemic. The use of alternate pathways such as 'clean' sites can ensure continuity of care for cancer surgery and training needs.
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Affiliation(s)
| | - Gregory J Nason
- Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK
| | - Andrew T Evans
- Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK
| | - Kohei Yamada
- Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK
| | | | - Krishna Patil
- Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK
| | - Stephen E Langely
- Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK
| | - Matthew Ja Perry
- Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK
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16
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Korkes F, Smaidi K, Salles MP, Lopes AC, Heilberg IP, Glina S. COVID-19: The impact on urolithiasis treatment in Brazil. Int Braz J Urol 2021; 48:101-109. [PMID: 34735086 PMCID: PMC8691230 DOI: 10.1590/s1677-5538.ibju.2021.0405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 08/20/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction: It has been more than a year since the first case of Covid-19 was diagnosed in Brazil, and its most problematic feature is the oversaturation of the healthcare system capacity. Urolithiasis is a disease that requires timely and appropriate management. The present study aimed to evaluate the impact of the pandemic in hospital admissions for urolithiasis in the Brazilian public healthcare system. Materials and Methods: In this cross-sectional study, hospital admissions were obtained from the Brazilian Public Health Information system. All hospital admissions associated with urolithiasis diagnosis (ICD-10 N20) between March 2017 and February 2021 were analyzed. Results: During the COVID-19 outbreak, there was a significant decrease in hospital admissions (p<0.0001). More than 20.000 patients probably did not have the opportunity to undergo their surgeries. The impact of the COVID-19 outbreak on women's admissions was significantly more intense than for men, reducing from 48.91% to 48.36% of the total (p=0.0281). The extremes of age seemed to be more affected, with patients younger than 20 years and older than 60 years having a significant reduction in access to hospital services (p=0.033). Conclusions: In conclusion, we have noticed a considerable reduction in overall admissions for the treatment of urolithiasis in the Brazilian public healthcare system during the first year of the Covid-19 pandemic. Women and individuals older than 60 years were especially affected. In contrast, we noted a rise in urgent procedures, comparing with the average of the corresponding period of the three previous years. Recovery plans will be needed while returning to activities to handle the impounded surgical volume.
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Affiliation(s)
- Fernando Korkes
- Disciplina de Urologia, Faculdade de Medicina do ABC - FMABC, Santo André, SP, Brasil
| | - Khalil Smaidi
- Disciplina de Urologia, Faculdade de Medicina do ABC - FMABC, Santo André, SP, Brasil
| | | | - Antonio Correa Lopes
- Disciplina de Urologia, Faculdade de Medicina do ABC - FMABC, Santo André, SP, Brasil
| | - Ita Pfeferman Heilberg
- Departamento de Nefrologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brasil
| | - Sidney Glina
- Disciplina de Urologia, Faculdade de Medicina do ABC - FMABC, Santo André, SP, Brasil
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Anesi GL, Kerlin MP. The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage. Curr Opin Crit Care 2021; 27:513-519. [PMID: 34267075 PMCID: PMC8416747 DOI: 10.1097/mcc.0000000000000859] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Resource limitation, or capacity strain, has been associated with changes in care delivery, and in some cases, poorer outcomes among critically ill patients. This may result from normal variation in strain on available resources, chronic strain in persistently under-resourced settings, and less commonly because of acute surges in demand, as seen during the coronavirus disease 2019 (COVID-19) pandemic. RECENT FINDINGS Recent studies confirmed existing evidence that high ICU strain is associated with ICU triage decisions, and that ICU strain may be associated with ICU patient mortality. Studies also demonstrated earlier discharge of ICU patients during high strain, suggesting that strain may promote patient flow efficiency. Several studies of strain resulting from the COVID-19 pandemic provided support for the concept of adaptability - that the surge not only caused detrimental strain but also provided experience with a novel disease entity such that outcomes improved over time. Chronically resource-limited settings faced even more challenging circumstances because of acute-on-chronic strain during the pandemic. SUMMARY The interaction between resource limitation and care delivery and outcomes is complex and incompletely understood. The COVID-19 pandemic provides a learning opportunity for strain response during both pandemic and nonpandemic times.
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Affiliation(s)
- George L. Anesi
- Division of Pulmonary, Allergy, and Critical Care
- Palliative and Advanced Illness Research (PAIR) Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Meeta Prasad Kerlin
- Division of Pulmonary, Allergy, and Critical Care
- Palliative and Advanced Illness Research (PAIR) Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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18
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Chhibber A, Kharat A, Kneale D, Welch V, Bangpan M, Chaiyakunapruk N. Assessment of health equity consideration in masking/PPE policies to contain COVID-19 using PROGRESS-plus framework: a systematic review. BMC Public Health 2021; 21:1682. [PMID: 34525995 PMCID: PMC8443429 DOI: 10.1186/s12889-021-11688-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/29/2021] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION There is increasing evidence that COVID-19 has unmasked the true magnitude of health inequity worldwide. Policies and guidance for containing the infection and reducing the COVID-19 related deaths have proven to be effective, however the extent to which health inequity factors were considered in these policies is rather unknown. The aim of this study is to measure the extent to which COVID-19 related policies reflect equity considerations by focusing on the global policy landscape around wearing masks and personal protection equipment (PPE). METHODS A systematic search for published documents on COVID-19 and masks/PPE was conducted across six databases: PubMed, EMBASE, CINAHL, ERIC, ASSIA and Psycinfo. Reviews, policy documents, briefs related to COVID-19 and masks/PPE were included in the review. To assess the extent of incorporation of equity in the policy documents, a guidance framework known as 'PROGRESS-Plus': Place of residence, Race/ethnicity, Occupation, Gender/sex, Religion, Education, Socioeconomic status, Social capital, Plus (age, disability etc.) was utilized. RESULTS This review included 212 policy documents. Out of 212 policy documents, 190 policy documents (89.62%) included at least one PROGRESS-plus component. Most of the policy documents (n = 163, 85.79%) focused on "occupation" component of the PROGRESS-plus followed by personal characteristics associated with discrimination (n = 4;2.11%), place of residence (n = 2;1.05%) and education (n = 1;0.53%). Subgroup analysis revealed that most of the policy documents (n = 176, 83.01%) were focused on "workers" such as healthcare workers, mortuary workers, school workers, transportation workers, essential workers etc. Of the remaining policy documents, most were targeted towards whole population (n = 30; 14.15%). Contrary to "worker focused" policy documents, most of the 'whole population focused' policy documents didn't have a PROGRESS-plus equity component rendering them equity limiting for the society. CONCLUSION Our review highlights even if policies considered health inequity during the design/implementation, this consideration was often one dimensional in nature. In addition, population wide policies should be carefully designed and implemented after identifying relevant equity related barriers in order to produce better outcomes for the whole society.
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Affiliation(s)
| | - Aditi Kharat
- School of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - Dylan Kneale
- The Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), UCL Social Research Institute, University College London, London, UK
| | - Vivian Welch
- Bruyere Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Mukdarut Bangpan
- The Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), UCL Social Research Institute, University College London, London, UK
| | - Nathorn Chaiyakunapruk
- School of Pharmacy, University of Utah, Salt Lake City, UT, USA.
- School of Pharmacy, Monash University, Subang Jaya, Malaysia.
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19
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Figueiredo RT, Costa MRA, Carrerette FB, Lara CMC, Damião R. Safety of performing urologic elective surgeries during the covid-19 pandemic in a referential hospital. Int Braz J Urol 2021; 47:1050-1056. [PMID: 33861541 PMCID: PMC8321446 DOI: 10.1590/s1677-5538.ibju.2020.0860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 11/09/2020] [Indexed: 11/22/2022] Open
Affiliation(s)
- Rui T Figueiredo
- Serviço de Urologia do Hospital Universitário Pedro Ernesto - HUPE/UERJ, Rio de Janeiro, RJ, Brasil
| | - Marina R A Costa
- Serviço de Urologia do Hospital Universitário Pedro Ernesto - HUPE/UERJ, Rio de Janeiro, RJ, Brasil
| | - Fabricio B Carrerette
- Serviço de Urologia do Hospital Universitário Pedro Ernesto - HUPE/UERJ, Rio de Janeiro, RJ, Brasil
| | - Celso M C Lara
- Serviço de Urologia do Hospital Universitário Pedro Ernesto - HUPE/UERJ, Rio de Janeiro, RJ, Brasil
| | - Ronaldo Damião
- Serviço de Urologia do Hospital Universitário Pedro Ernesto - HUPE/UERJ, Rio de Janeiro, RJ, Brasil
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20
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da Silva AGT, Diaz JO, Görgen ARH, Schwengber VH, de Oliveira RT, Tavares PM, Rosito TE. Brazilian Urologist's mental health aspects auring the Covid-19 pandemic. Int Braz J Urol 2021; 47:882-886. [PMID: 33566473 PMCID: PMC8321475 DOI: 10.1590/s1677-5538.ibju.2020.0869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/01/2020] [Indexed: 11/22/2022] Open
Affiliation(s)
- Aline Gularte Teixeira da Silva
- Hospital de Clínicas de Porto AlegreServiço de UrologiaPorto AlegreRSBrasilServiço de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.
| | - Johanna Ovalle Diaz
- Hospital de Clínicas de Porto AlegreServiço de UrologiaPorto AlegreRSBrasilServiço de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.
| | - Antônio Rebello Horta Görgen
- Hospital de Clínicas de Porto AlegreServiço de UrologiaPorto AlegreRSBrasilServiço de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.
| | - Victor Hugo Schwengber
- Hospital de Clínicas de Porto AlegreServiço de UrologiaPorto AlegreRSBrasilServiço de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.
| | - Renan Timoteo de Oliveira
- Hospital de Clínicas de Porto AlegreServiço de UrologiaPorto AlegreRSBrasilServiço de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.
| | - Patric Machado Tavares
- Hospital de Clínicas de Porto AlegreServiço de UrologiaPorto AlegreRSBrasilServiço de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.
| | - Tiago Elias Rosito
- Hospital de Clínicas de Porto AlegreServiço de UrologiaPorto AlegreRSBrasilServiço de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.
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21
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Prezotti JA, Henriques JVT, Favorito LA, Canalini AF, Machado MG, Brandão TBV, Barbosa AMV, Moromizato JKM, Anzolch KMJ, Fernandes RDC, Rodrigues FRA, Bellucci CHS, Silva CS, Pompeo ACL, de Bessa J, Gomes CM. Impact of COVID-19 on education, health and lifestyle behaviour of Brazilian urology residents. Int Braz J Urol 2021; 47:753-776. [PMID: 33848067 PMCID: PMC8321480 DOI: 10.1590/s1677-5538.ibju.2021.99.09] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 01/09/2021] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES To evaluate the impact of COVID-19 on clinical and surgical practice, educational activities, health and lifestyle behavior of Brazilian urology residents. MATERIALS AND METHODS A web-based survey was sent to 468 Brazilian urology residents from postgraduate years (PGY) 3 to 5 to collect data on clinical practice and training after 4 months of COVID-19. We also assessed health-related and behavior changes, rate of infection by SARS-CoV-2, deployment to the front line of COVID-19, residents' concerns, and access to personal protective equipment (PPE). RESULTS Massive reductions in elective and emergency patient consultations, diagnostic procedures and surgeries were reported across the country, affecting PGY 3 to 5 alike. Most in-person educational activities were abolished. The median damage to the urological training expected for 2020 was 6.0 [3.4 -7.7], on a scale from 0 to 10, with senior residents estimating a greater damage (P < 0.001). Educational interventions developed included online case-based discussions, subspeciality conferences and lectures, and grand rounds. Most senior residents favored extending residency to compensate for training loss and most younger residents favored no additional training (p< 0.001). Modifications in health and lifestyle included weight gain (43.8%), reduced physical activity (68.6%), increased alcoholic intake (44.9%) and cigarette consumption (53.6%), worsening of sexual life (25.2%) and feelings of sadness or depression (48,2%). Almost half were summoned to work on the COVID-19 front-line and 24.4% had COVID-19. Most residents had inadequate training to deal with COVID-19 patients and most reported a shortage of PPE. Residents' concerns included the risk of contaminating family members, being away from residency program, developing severe COVID-19 and overloading colleagues. CONCLUSIONS COVID-19 had a massive impact in Brazilian urology residents´ training, health and lifestyle behavior, which may reflect what happened in other medical specialties. Studies should confirm these findings to help developing strategies to mitigate residents' losses.
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Affiliation(s)
- José Antonio Prezotti
- Universidade de São PauloFaculdade de MedicinaDivisão de UrologiaSão PauloSPBrasilDivisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - João Victor T. Henriques
- Universidade de São PauloFaculdade de MedicinaDivisão de UrologiaSão PauloSPBrasilDivisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Luciano A. Favorito
- Universidade do Estado do Rio de Janeiro - UERJUnidade de Pesquisa UrogenitalRio de JaneiroRJBrasilUnidade de Pesquisa Urogenital, Universidade do Estado do Rio de Janeiro - UERJ, Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Alfredo F. Canalini
- Universidade do Estado do Rio de Janeiro - UERJDisciplina de UrologiaRio de JaneiroRJBrasilDisciplina de Urologia, Universidade do Estado do Rio de Janeiro - UERJ, Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Marcos G. Machado
- Universidade de São PauloFaculdade de MedicinaDivisão de UrologiaSão PauloSPBrasilDivisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Thulio B. V. Brandão
- Universidade de São PauloFaculdade de MedicinaDivisão de UrologiaSão PauloSPBrasilDivisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Akemi M. V. Barbosa
- Universidade de São PauloFaculdade de MedicinaDivisão de UrologiaSão PauloSPBrasilDivisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Julyana K. M. Moromizato
- Universidade de São PauloFaculdade de MedicinaDivisão de UrologiaSão PauloSPBrasilDivisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Karin M. J. Anzolch
- Hospital Moinhos de VentoServiço de UrologiaPorto AlegreRSBrasilServiço de Urologia, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil
| | - Roni de C. Fernandes
- Santa Casa de São PauloFaculdade de Ciências MédicasSão PauloSPBrasilFaculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil
| | - Fransber R. A. Rodrigues
- Universidade de Brasília - UNBDivisão de UrologiaBrasíliaDFBrasilDivisão de Urologia, Universidade de Brasília - UNB, Brasília, DF, Brasil
| | - Carlos H. S. Bellucci
- Universidade de São PauloFaculdade de MedicinaDivisão de UrologiaSão PauloSPBrasilDivisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Caroline S. Silva
- Universidade Estadual de Feira de SantanaDepartamento de CirurgiaFeira de SantanaBABrasilDepartamento de Cirurgia, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brasil
| | - Antonio Carlos L. Pompeo
- Universidade Federal do ABC - UFABCDisciplina de UrologiaSanto AndréSPBrasilDisciplina de Urologia, Universidade Federal do ABC - UFABC, Santo André, SP, Brasil
| | - Jose de Bessa
- Universidade Estadual de Feira de SantanaDepartamento de CirurgiaFeira de SantanaBABrasilDepartamento de Cirurgia, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brasil
| | - Cristiano M. Gomes
- Universidade de São PauloFaculdade de MedicinaDivisão de UrologiaSão PauloSPBrasilDivisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
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22
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Chen Z, Chen L, Chen H. The impact of COVID-19 on the clinical trial. PLoS One 2021; 16:e0251410. [PMID: 33974651 PMCID: PMC8112689 DOI: 10.1371/journal.pone.0251410] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 04/26/2021] [Indexed: 01/10/2023] Open
Abstract
The objective of this study was to explore the impact of the coronavirus disease 2019 epidemic on ongoing and upcoming drug clinical trials. Qualitative semi-structured interviews were conducted with clinical trial staff and clinical trial subjects were surveyed by questionnaire in this study. The results of interviews and questionnaire showed that coronavirus disease 2019 pandemic has led to many changes in the implementation of drug clinical trials, including: a variety of meetings being held online webinars using various platforms, telemedicine and follow-up by video, A large number of deviations from protocol and losses of follow-up, delivery of clinical trial drugs by express, additional workload caused by screening for coronavirus, and anxiety of subjects. These results suggest that the coronavirus disease 2019 outbreak has hindered the progress and damaged the quality of clinical trials. The online meeting, remote follow-up, express delivery of drugs and remote monitoring in the epidemic environment can ensure the progress of clinical trials to a certain extent, but they cannot fully guarantee the quality as before.
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Affiliation(s)
- Zhimin Chen
- Ningbo Hospital of Traditional Chinese Medicine, Zhejiang, China
- * E-mail:
| | - Liran Chen
- Tang Wealth Investment Management Co. Ltd, Shanghai, China
| | - Huafang Chen
- Office of Drug Clinical Trial Institution, First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
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23
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Ferenczi BA, Cheng RR, Daily A, Kuhr C, Kobashi K, Corman JM. Pre-operative COVID-19 screening: a model to provide non-discretionary care for urologic patients. Int Braz J Urol 2021; 47:631-636. [PMID: 33621013 PMCID: PMC7993963 DOI: 10.1590/s1677-5538.ibju.2020.0516] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/25/2020] [Indexed: 01/19/2023] Open
Affiliation(s)
- Basil A. Ferenczi
- Virginia Mason Medical CenterSection of UrologySeattleWashingtonUSAVirginia Mason Medical Center, Section of Urology, Seattle Washington, USA
| | - Ron Ron Cheng
- Virginia Mason Medical CenterSection of UrologySeattleWashingtonUSAVirginia Mason Medical Center, Section of Urology, Seattle Washington, USA
| | - Adam Daily
- Virginia Mason Medical CenterSection of UrologySeattleWashingtonUSAVirginia Mason Medical Center, Section of Urology, Seattle Washington, USA
| | - Christian Kuhr
- Virginia Mason Medical CenterSection of UrologySeattleWashingtonUSAVirginia Mason Medical Center, Section of Urology, Seattle Washington, USA
| | - Kathleen Kobashi
- Virginia Mason Medical CenterSection of UrologySeattleWashingtonUSAVirginia Mason Medical Center, Section of Urology, Seattle Washington, USA
| | - John M. Corman
- Virginia Mason Medical CenterSection of UrologySeattleWashingtonUSAVirginia Mason Medical Center, Section of Urology, Seattle Washington, USA
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24
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Fallara G, Sandin F, Styrke J, Carlsson S, Lissbrant IF, Ahlgren J, Bratt O, Lambe M, Stattin P. Prostate cancer diagnosis, staging, and treatment in Sweden during the first phase of the COVID-19 pandemic. Scand J Urol 2021; 55:184-191. [PMID: 33913376 DOI: 10.1080/21681805.2021.1910341] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The first case of COVID-19 in Sweden was diagnosed in late January 2020, the first recommendations against the spread of the virus were released in mid-March, and the peak of the first wave of the pandemic was reached in March-June. The aim of this cross-sectional study was to assess the short-term effects of the first wave of the COVID-19 pandemic on prostate cancer (PCa) diagnosis, staging, and treatment. MATERIALS AND METHODS Data in the National Prostate Cancer Register (NPCR) of Sweden on newly diagnosed PCa cases and on the number of diagnostic and therapeutic procedures performed between 18 March 2020 and 2 June 2020 were compared with those in the corresponding time periods in 2017-2019, as reported until January 31 of the year after each study period. RESULTS During the study period in 2020, 36% fewer PCa cases were registered in NPCR compared with the corresponding time period in previous years: 1458 cases in 2020 vs a mean of 2285 cases in 2017-2019. The decrease in new PCa registrations was more pronounced in men above age 75 years, down 51%, than in men aged 70-75, down 37%, and in men below age 70, down 28%. There was no decrease in the number of radical prostatectomies and number of radical radiotherapy courses increased by 32%. CONCLUSIONS During the peak of the first phase of the COVID-19 pandemic, the number of men diagnosed with PCa in Sweden decreased by one third compared with previous years, whereas there was no decrease in the number of curative treatments.
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Affiliation(s)
- Giuseppe Fallara
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy.,Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Fredrik Sandin
- Regional Cancer Centre, Uppsala/Örebro, Uppsala University Hospital, Uppsala, Sweden
| | - Johan Styrke
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - Stefan Carlsson
- Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institutet, Stockholm, Sweden
| | - Ingela Franck Lissbrant
- Department of Oncology Institute of Clinical Sciences, the Sahlgrenska Academy, University of Göteborg, Göteborg, Sweden
| | - Johan Ahlgren
- Regional Cancer Centre, Uppsala/Örebro, Uppsala University Hospital, Uppsala, Sweden
| | - Ola Bratt
- Department of Urology, Institute of Clinical Science, the Sahlgrenska Academy, Gothenburg University, Sweden.,Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mats Lambe
- Regional Cancer Centre, Uppsala/Örebro, Uppsala University Hospital, Uppsala, Sweden
| | - Pär Stattin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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25
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Danilovic A. Editorial Comment: Objective Assessment and Standard Setting for Basic Flexible Ureterorenoscopy Skills Among Urology Trainees Using Simulation-Based Methods. Int Braz J Urol 2021; 47:462-463. [PMID: 33284554 PMCID: PMC7857756 DOI: 10.1590/s1677-5538.ibju.2021.02.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Alexandre Danilovic
- Serviço de Urologia, Hospital das Clínicas da Faculdade de Medicina da USP - HCFMUSP, São Paulo, SP, Brasil
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26
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Gorgen ARH, Diaz JO, da Silva AGT, Paludo A, de Oliveira RT, Tavares PM, Rosito TE. The impact of COVID-19 pandemic in urology practice, assistance and residency training in a tertiary referral center in Brazil. Int Braz J Urol 2021; 47:1042-1049. [PMID: 33861540 PMCID: PMC8321449 DOI: 10.1590/s1677-5538.ibju.2020.0761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
- Antonio Rebello Horta Gorgen
- Serviço de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.,Grupo de Urologia Reconstrutiva e Infantil, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
| | - Johanna Ovalle Diaz
- Serviço de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.,Grupo de Urologia Reconstrutiva e Infantil, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.,Departamento de Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Aline Gularte Teixeira da Silva
- Serviço de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.,Grupo de Urologia Reconstrutiva e Infantil, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.,Departamento de Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Artur Paludo
- Serviço de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.,Grupo de Urologia Reconstrutiva e Infantil, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
| | - Renan Timoteo de Oliveira
- Serviço de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.,Grupo de Urologia Reconstrutiva e Infantil, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
| | - Patric Machado Tavares
- Serviço de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.,Grupo de Urologia Reconstrutiva e Infantil, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
| | - Tiago Elias Rosito
- Serviço de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.,Departamento de Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.,Departamento de Cirurgia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
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27
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Benign Prostatic Hyperplasia and Kidney Stone Disease Thermobalancing Therapy with Dr Allen’s Device: Key to Successful Ageing Without Medications, Surgery, and Risky Exposure to Coronavirus Infection. Nephrourol Mon 2021. [DOI: 10.5812/numonthly.110771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The choice of treatment for benign prostatic hyperplasia (BPH) and kidney stone disease (KSD) impacts the attainment of successful ageing and the level of patient care required in the long-term. Medications and surgeries typically used for these conditions have serious side effects and can interfere with healthy aging. Objectives: This study assesses the impact of Dr Allen’s Therapeutic devices (DATD) and thermobalancing therapy® (TT) on the ageing process of people with BPH and KSD. Methods: This study evaluated the outcomes of a clinical trial investigating the dynamics of symptoms and parameters in 124 male patients with BPH who used DATD as a monotherapy for six months at home and compared the results with a control group comprising 124 BPH patients who did not receive treatment with DATD. Furthermore, five case studies were randomly selected for assessment from 10-year empirical observations of patients with KSD treated with DATD. Results: DATD with TT reduced prostate volume (PV) from 45 mL to 31 mL (P < 0.001) and reduced urinary symptoms score from 14.2 to 4.9 (P < 0.001). It also improved quality of life (QoL) as measured by the reduction in the International Prostate Symptom score (I-PSS) from 3.9 to 1.3 (P < 0.001), while the control group showed no positive changes. DATD with TT dissolved kidney stones without renal colic in all patients. No side effects were observed. Conclusions: Using DATD and TT to treat BPH and KSD demonstrated high efficacy, safety, and easy disease management at home. In contrast, medications and surgeries for BPH and KSD often lead to sexual dysfunction, depression, hypertension, chronic kidney failure, and other morbidities, requiring an increased care level in the long-term. Thus, DATD and TT generate high treatment efficacy with lower exposure to coronavirus, reduce long-term care needs, and are vital to attaining successful ageing and longevity.
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28
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Moussa M, Chakra MA, Papatsoris AG, Dellis A. The Impact of COVID-19 Disease on Urology Practice. Surg J (N Y) 2021; 7:e83-e91. [PMID: 34104720 PMCID: PMC8175122 DOI: 10.1055/s-0041-1725155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 01/12/2021] [Indexed: 11/24/2022] Open
Abstract
The diagnosis and timely treatment of cancer patients should not be compromised during an infectious disease pandemic. The pandemic of coronavirus disease 2019 (COVID-19) has serious implications on urology practice and raises particular questions for urologists about the management of different conditions. It was recommended to cancel most of the elective urological surgeries. Urological cancers surgeries that should be prioritized are radical cystectomy for selective tumors, orchiectomy for suspected testicular tumors, nephrectomy for c T3 + , nephroureterectomy for high-grade disease, and radical adrenalectomy for tumors >6 cm or adrenal carcinoma. Most prostatectomies can be delayed without compromising the survival rate of patients. Urological emergencies should be treated adequately even during this pandemic. There is a potential risk of coronavirus diffusion during minimally invasive procedures performed. It is crucial to use specific precautions when urologists performed those type of surgeries. It was also recommended to suspend the kidney transplantation program during the COVID-19 pandemic except for specific cases. In this review, we discussed the triage of urological surgeries, the risk of minimally invasive urological procedure, the kidney transplantation challenges, the systemic therapies, intravesical instillation of Bacillus Calmette-Guérin (BCG), endourology, teleconferencing, and telemedicine application in urology during the COVID-19 pandemic.
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Affiliation(s)
- Mohamad Moussa
- Department of Urology, Al Zahraa Hospital & Lebanese University, Beirut, Lebanon
| | | | - Athanasios G. Papatsoris
- 2nd Department of Urology, School of Medicine, National and Kapodistrian University of Athens, Sismanoglio Hospital, Athens, Greece
| | - Athanasios Dellis
- Department of Urology/General Surgery, Areteion Hospital, Athens, Greece
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29
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Mazzucchi E, Torricelli FCM, Vicentini FC, Marchini GS, Danilovic A, Batagello CA, Srougi M, Nahas WC. The impact of COVID-19 in medical practice. A review focused on Urology. Int Braz J Urol 2021; 47:251-262. [PMID: 32840335 PMCID: PMC7857770 DOI: 10.1590/s1677-5538.ibju.2020.99.08] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 12/22/2022] Open
Abstract
COVID-19 pandemic is a rapidly spreading virus that is changing the World and the way doctors are practicing medicine. The huge number of patients searching for medical care and needing intensive care beds led the health care system to a burnout status especially in places where the care system was already overloaded. In this setting, and also due to the absence of a specific treatment for the disease, health authorities had to opt for recommending or imposing social distancing to relieve the health system and reduce deaths. All other medical specialties non-directly related to the treatment of COVID-19 had to interrupt or strongly reduce their activities in order to give room to seriously ill patients, since no one knows so far the real extent of the virus damage on human body and the consequences of doing non deferrable procedures in this pandemic era. Despite not been a urological disease, the urologist needs to be updated on how to deal with these patients and how to take care of himself and of the medical team he works with. The aim of this article is to review briefly some practical aspects of COVID-19 and its implications in the urological practice in our country.
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Affiliation(s)
- Eduardo Mazzucchi
- Universidade de São PauloFaculdade de MedicinaHospital das ClínicasSão PauloSPBrasilSetor de Endourologia, Divisão de Urologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brasil.
| | - Fabio C. M. Torricelli
- Universidade de São PauloFaculdade de MedicinaHospital das ClínicasSão PauloSPBrasilSetor de Endourologia, Divisão de Urologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brasil.
| | - Fabio C. Vicentini
- Universidade de São PauloFaculdade de MedicinaHospital das ClínicasSão PauloSPBrasilSetor de Endourologia, Divisão de Urologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brasil.
| | - Giovanni S. Marchini
- Universidade de São PauloFaculdade de MedicinaHospital das ClínicasSão PauloSPBrasilSetor de Endourologia, Divisão de Urologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brasil.
| | - Alexandre Danilovic
- Universidade de São PauloFaculdade de MedicinaHospital das ClínicasSão PauloSPBrasilSetor de Endourologia, Divisão de Urologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brasil.
| | - Carlos A. Batagello
- Universidade de São PauloFaculdade de MedicinaHospital das ClínicasSão PauloSPBrasilSetor de Endourologia, Divisão de Urologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brasil.
| | - Miguel Srougi
- Universidade de São PauloFaculdade de MedicinaHospital das ClínicasSão PauloSPBrasilSetor de Endourologia, Divisão de Urologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brasil.
| | - William C. Nahas
- Universidade de São PauloFaculdade de MedicinaHospital das ClínicasSão PauloSPBrasilSetor de Endourologia, Divisão de Urologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brasil.
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30
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Travassos TC, De Oliveira JMI, Selegatto IB, Reis LO. COVID-19 impact on bladder cancer-orientations for diagnosing, decision making, and treatment. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL UROLOGY 2021; 9:132-139. [PMID: 33816701 PMCID: PMC8012830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 02/04/2021] [Indexed: 06/12/2023]
Abstract
The world is going through an unprecedented time in history, and Urologists are, like many other healthcare professionals, facing and combating on two fronts: against the pandemic itself and cancer. When looking at the fatality rates, bladder cancer overcomes Coronavirus disease 2019 (COVID-19) by far and can be as high as 52%, so Urologists must not postpone investigation. Cystoscopy remains the gold standard for the investigation of bladder cancer and computed tomography (CT) urography for obtaining images of the upper tract in cases of macroscopic hematuria. Whenever transurethral resection of bladder tumor (TURB) is necessary, extra care must be taken to assure muscle sample, avoiding another surgical intervention and hospitalization, but when necessary it should not be postponed due to the elevated progression rate of the disease. Follow-up cystoscopies can be postponed for 6 months for low risk, 3 months for intermediate, 6 weeks for high risk, and not beyond 24 hours in case of emergencies as life-threatening hematuria, anemia, and urinary retention. Regarding chemotherapy, more than ever the key point is to evaluate each case individually. Bacille Calmette Guerin (BCG) must be considered only as an inducing course, in selected intermediate and most high-risk cancers. Whenever possible patients should be tested before surgery. Based on the current literature on optimal bladder cancer patients approach we comprehensively synthetize the major societies guidelines on the issue so far, adding a critical view to the topic. This article aims to guide Urologists on decision making against bladder cancer in the COVID-19 era.
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Affiliation(s)
- Thiago C Travassos
- UroScience, University of Campinas and Pontifical Catholic University of Campinas Campinas, SP, Brazil
| | | | - Ivan B Selegatto
- UroScience, University of Campinas and Pontifical Catholic University of Campinas Campinas, SP, Brazil
| | - Leonardo O Reis
- UroScience, University of Campinas and Pontifical Catholic University of Campinas Campinas, SP, Brazil
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31
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Assad A, Nguyen DD, Sadri I, Bhojani N. The impact of delaying acute kidney stone surgery on outcomes. Can Urol Assoc J 2021; 15:E418-E422. [PMID: 33410739 DOI: 10.5489/cuaj.6877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Anis Assad
- Department of Urology, University of Montreal, Montreal, QC, Canada
| | | | - Iman Sadri
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Naeem Bhojani
- Department of Urology, University of Montreal, Montreal, QC, Canada
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32
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Folkard SS, Sturch P, Mahesan T, Garnett S. Effect of coronavirus disease 2019 on urological surgery services and training up to the peak of the pandemic in South East England. JOURNAL OF CLINICAL UROLOGY 2021. [DOI: 10.1177/2051415820970396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: The coronavirus disease 2019 (COVID-19) pandemic is having significant effects on health services globally, including on urological surgery for which the British Association of Urological Surgeons (BAUS) has provided national guidance. Kent, Surrey and Sussex (KSS) is one of the regions most affected by COVID-19 in the UK to date. Methods: An anonymous online survey of all KSS urology trainees was conducted. The primary outcome was to assess the effects on urology services, both malignant and benign, across the region in the acceleration phase and at the peak of the pandemic compared to standard care. The second was to quantify the effects on urology training, especially regarding operative exposure. Results: There were significant decreases in urological services provided at the peak of the pandemic across KSS compared to standard care ( p<0.0001). Only 22% of urology units were able to continue operating for low-risk cancer and to continue cystoscopy for two-week wait non-visible haematuria referrals in line with BAUS escalation guidelines. A third (33%) did not complete any prostate biopsies at the peak. The majority of urology units continued clinics by telephone. Urology trainees reported completing substantially fewer operating procedures and workplace-based assessments. A third (33%) had moved to consultant-only operating by the peak. Conclusions: The COVID-19 pandemic has caused significant changes to urological surgery services and training in KSS, with heterogeneity across the region. We suggest further work to quantify the effects nationally. Level of evidence: 4.
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Affiliation(s)
| | - Paul Sturch
- Department of Urology, St Peter’s Hospital, UK
| | | | - Stephen Garnett
- KSS Training Programme Director and Consultant Urologist, Eastbourne District General Hospital, UK
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Thapa BB, Shrestha D, Bista S, Thapa S, Niranjan V. Urology during COVID-19 Pandemic Crisis: A Systematic Review. Surg J (N Y) 2021; 7:e3-e10. [PMID: 33469564 PMCID: PMC7810570 DOI: 10.1055/s-0040-1722341] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/14/2020] [Indexed: 12/05/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) has evolved as a pandemic of unimaginable magnitude. The health care system is facing a tremendous challenge to provide ethical and quality care. The transformation of the patient-based care to population-based care during the COVID-19 pandemic has raised ethical dilemma among urologists. Our objective is to explore the consensus in modified standard urology care, that can be adopted and applied during COVID-19 and similar pandemic. Methods We adopted an exploratory study design using secondary data. The data were extracted from a web-based medical library using keywords "COVID-19," "severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)," and "urology." We identify and extrapolate (screening, eligibility, and inclusion) the data using PRISMA protocol, and summarize pandemic standard urology care under four main themes: (1) general urology care, (2) choice of surgical modality, (3) triage, and (4) urology training. Result We identified 63 academic papers related to our research question. The majority are expert opinions and perspectives on urology care. The common consensus is triage-based urology care and surgeries. Life or organ threatening conditions need immediate attention. Universal protective measures (personal protective equipment, safe operative environment) and protocol-based patient care are necessary to prevent and control SARS-CoV-2 infection. Conservation of the resources and its rational distribution provide an ethical basis for population-based health care during a pandemic. Informed decision making serves best to patients, families, and society during the public health crisis. Conclusion COVID-19 pandemic tends to transform standard urology practice into crisis standard population-based care. The consensus in crisis is drawn from evolving pieces of medical evidence and public health ethics. The provision of urology care during a pandemic is based on the availability of resources; severity of the disease, consequences of deferment of service, and dynamics of the pandemic.
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Affiliation(s)
- Bikash Bikram Thapa
- Department of Surgery, College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Dhan Shrestha
- Department of Emergency Medicine, Mangalbare Hospital, Morang, Nepal
| | - Sanjeeb Bista
- Department of Surgery, College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Suresh Thapa
- Department of Surgery, College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Vikram Niranjan
- Health Research Institute/Graduate Entry Medical School, University of Limerick, Limerick, Ireland
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Zhang J, Lu X, Jin Y, Zheng ZJ. Hospitals' responsibility in response to the threat of infectious disease outbreak in the context of the coronavirus disease 2019 (COVID-19) pandemic: Implications for low- and middle-income countries. ACTA ACUST UNITED AC 2020; 4:113-117. [PMID: 33294250 PMCID: PMC7713538 DOI: 10.1016/j.glohj.2020.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/07/2020] [Accepted: 11/27/2020] [Indexed: 12/16/2022]
Abstract
The WHO declared the coronavirus disease 2019 (COVID-19) outbreak as a public health emergency of international concern on January 30, 2020, and then a pandemic on March 11, 2020. COVID-19 affected over 200 countries and territories worldwide, with 25,541,380 confirmed cases and 852,000 deaths associated with COVID-19 globally, as of September 1, 2020.1 While facing such a public health emergency, hospitals were on the front line to deliver health care and psychological services. The early detection, diagnosis, reporting, isolation, and clinical management of patients during a public health emergency required the extensive involvement of hospitals in all aspects. The response capacity of hospitals directly determined the outcomes of the prevention and control of an outbreak. The COVID-19 pandemic has affected almost all nations and territories regardless of their development level or geographic location, although suitable risk mitigation measures differ between developing and developed countries. In low- and middle-income countries (LMICs), the consequences of the pandemic could be more complicated because incidence and mortality might be associated more with a fragile health care system and shortage of related resources.2, 3 As evidenced by the situation in Bangladesh, India, Kenya, South Africa, and other LMICs, socioeconomic status (SES) disparity was a major factor in the spread of disease, potentially leading to alarmingly insufficient preparedness and responses in dealing with the COVID-19 pandemic.4 Conversely, the pandemic might also bring more unpredictable socioeconomic and long-term impacts in LMICs, and those with lower SES fare worse in these situations. This review aimed to summarize the responsibilities of and measures taken by hospitals in combatting the COVID-19 outbreak. Our findings are hoped to provide experiences, as well as lessons and potential implications for LMICs.
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Affiliation(s)
- Ji Zhang
- Department of Global Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China.,Institute for Global Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Xinpu Lu
- Graduate School of Education, Peking University, 5 Yiheyuan Road, Haidian District, Beijing 100871, China.,Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing 100142, China
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China.,Institute for Global Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China.,Institute for Global Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China
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Abdel Raheem A, Alowidah I, Soliman M, Haresy M, Almozeni A, Althagafi S, Almousa M, Alturki M. Urolithiasis treatment options during COVID-19 pandemic: review of current recommendations and triage systems. AFRICAN JOURNAL OF UROLOGY 2020; 26:75. [PMID: 33250632 PMCID: PMC7685777 DOI: 10.1186/s12301-020-00085-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND COVID-19 pandemic has overwhelmed healthcare systems and limited access to surgical care. Urolithiasis can lead to emergencies and affect renal function during long-term follow-up. Therefore, timely and appropriate treatment is essential. MAIN TEXT This is a non-systematic review of the recently published recommendations regarding urolithiasis treatment options during COVID-19. Fourteen publications were the basis of our review. Regarding anesthesia methods, the optimal methods are still unknown. During COVID-19, most of the endo-urologists changed their routine clinical practice and elective surgical treatment approaches. Despite decreasing number of emergency visits and admissions for stone disease, patients tend to have leukocytosis, higher creatinine levels, increased grade 3 and 4 hydronephrosis, and higher incidence of complications compared to non-COVID-19 time. Several alarming indications if present, intervention should be performed within 24 h to prevent irreversible kidney damage, disease progression, or even death. Some endo-urologists prefer definitive stone treatment over temporarily drainage to reduce the number of emergency room visits and hospital admissions, except if infection is present or staged treatment is planned. Several clinical scenarios of non-emergency and non-urgent urinary stones are present; thus, endo-urologists should appropriately weigh patient's risk and surgery benefit to decide to the proper intervention time. If risks outweighed benefits to the patient, postpone the surgery. Renal colic should be managed with medical expulsive therapy and proper pain control with close follow-up just in case it becomes an emergency. Indwelling JJ stent removal or exchange is a matter of debate; some endo-urologists recommend removing, while others recommend postponing. CONCLUSION Treatment options for urinary stones have markedly changed during COVID-19 pandemic. The optimal anesthesia methods are still unknown. Emergency intervention is a must if any alarming indications exist. Emergency cases tend to have higher incidence of complications compared to non-COVID-19 time. For non-emergency and non-urgent urolithiasis, endo-urologists should make judicious treatment decision to prioritize urolithiasis treatment, and they should weigh benefits and risks before surgery.
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Affiliation(s)
- Ali Abdel Raheem
- Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
- Department of Urology, King Saud Medical City, Riyadh, Saudi Arabia
| | - Ibrahim Alowidah
- Department of Urology, King Saud Medical City, Riyadh, Saudi Arabia
| | - Mohamed Soliman
- Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mefarrih Haresy
- Department of Urology, King Saud Medical City, Riyadh, Saudi Arabia
| | - Ali Almozeni
- Department of Urology, King Saud Medical City, Riyadh, Saudi Arabia
| | - Sultan Althagafi
- Department of Urology, King Saud Medical City, Riyadh, Saudi Arabia
| | - Mohamed Almousa
- Department of Urology, King Saud Medical City, Riyadh, Saudi Arabia
| | - Mohamed Alturki
- Department of Urology, King Saud Medical City, Riyadh, Saudi Arabia
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Wroclawski M, Heldwein FL. Editorial Comment: Digital Physician Burnout in the "New Normal" Workplace. J Endourol 2020; 35:885-887. [PMID: 32781833 DOI: 10.1089/end.2020.0631] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
- Marcelo Wroclawski
- Hospital Israelita Albert Einstein, São Paulo - SP, Brazil.,BP, a Beneficência Portuguesa de São Paulo, São Paulo - SP, Brazil
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Silva GCDA, Abe DK, Pedrenho R, Vilares RN, Cordeiro MD, Coelho RF, Nahas WC. Evaluation of uro-oncological surgical treatment during the Sars-CoV-2 pandemic in a Brazilian tertiary oncology institution, the new world epicenter. Int Braz J Urol 2020; 47:378-385. [PMID: 33146983 PMCID: PMC7857743 DOI: 10.1590/s1677-5538.ibju.2020.0479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/20/2020] [Indexed: 01/08/2023] Open
Abstract
Introduction: The rapid spread of coronavirus disease 2019 (COVID-19) has dramatic effects on individuals and health care systems. In our institute, a tertiary oncologic public hospital with high surgical volume, we prioritize maintaining cancer treatment as well as possible. The aim of this study is to evaluate if uro-oncological surgeries at pandemic are safe. Materials and Methods: We evaluated patients who underwent uro-oncological procedures. Epidemiological data, information on COVID-19 infection related to surgery and clinical characteristics of non-survival operative patients with COVID-19 infections were analyzed. Results: From 213 patients analyzed, Covid-19 symptoms were noticed in 8 patients at preoperative process or at hospital admission postponing operation; 161 patients were submitted to elective surgery and 44 to emergency surgery. From patients submitted to elective surgeries, we had 1 patient with laboratory confirmation of COVID-19 (0,6%), with mild symptoms and quick discharge. From the urgencies group, we had 6(13%) patients tested positive; 5 were taken to ICU with 4 deaths. Conclusion: Elective uro-oncological procedures at the COVID-19 epidemic period in a COVID-19-free Institute are safe, and patients who need urgent procedures, with a long period of hospitalization, need special care to avoid COVID-19 infection and its outcomes.
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Affiliation(s)
- Gabriel Carvalho Dos Anjos Silva
- Instituto do Câncer de São Paulo - ICESP, São Paulo, SP, Brasil.,Divisão de Urologia, Faculdade de Medicina, Universidade de São Paulo, SP, Brasil
| | - Daniel Kanda Abe
- Instituto do Câncer de São Paulo - ICESP, São Paulo, SP, Brasil.,Divisão de Urologia, Faculdade de Medicina, Universidade de São Paulo, SP, Brasil
| | - Rubens Pedrenho
- Instituto do Câncer de São Paulo - ICESP, São Paulo, SP, Brasil.,Divisão de Urologia, Faculdade de Medicina, Universidade de São Paulo, SP, Brasil
| | - Rafael Nascimento Vilares
- Instituto do Câncer de São Paulo - ICESP, São Paulo, SP, Brasil.,Divisão de Urologia, Faculdade de Medicina, Universidade de São Paulo, SP, Brasil
| | - Mauricio Dener Cordeiro
- Instituto do Câncer de São Paulo - ICESP, São Paulo, SP, Brasil.,Divisão de Urologia, Faculdade de Medicina, Universidade de São Paulo, SP, Brasil
| | - Rafael Ferreira Coelho
- Instituto do Câncer de São Paulo - ICESP, São Paulo, SP, Brasil.,Divisão de Urologia, Faculdade de Medicina, Universidade de São Paulo, SP, Brasil
| | - William Carlos Nahas
- Instituto do Câncer de São Paulo - ICESP, São Paulo, SP, Brasil.,Divisão de Urologia, Faculdade de Medicina, Universidade de São Paulo, SP, Brasil
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Gomes CM, Favorito LA, Henriques JVT, Canalini AF, Anzolch KMJ, de Carvalho Fernandes R, Bellucci CHS, Silva CS, Wroclawski ML, Pompeo ACL, de Bessa J. Impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists. Int Braz J Urol 2020; 46:1042-1071. [PMID: 32539253 PMCID: PMC7527096 DOI: 10.1590/s1677-5538.ibju.2020.99.15] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 05/10/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To evaluate the impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists during the month of April 2020. MATERIALS AND METHODS A 39-question, web-based survey was sent to all urologist members of the Brazilian Society of Urology. We assessed socio-demographic, professional, health and behavior parameters. The primary goal was to evaluate changes in urologists' clinical practice and income after two months of COVID-19. We also looked at geographical differences based on the incidence rates of COVID-19 in different states. RESULTS Among 766 urologists who completed the survey, a reduction ≥ 50% of patient visits, elective and emergency surgeries was reported by 83.2%, 89.6% and 54.8%, respectively. An income reduction of ≥ 50% was reported by 54.3%. Measures to reduce costs were implemented by most. Video consultations were performed by 38.7%. Modifications in health and lifestyle included weight gain (32.9%), reduced physical activity (60.0%), increased alcoholic intake (39.9%) and reduced sexual activity (34.9%). Finally, 13.5% of Brazilian urologists were infected with SARS-CoV-2 and about one third required hospitalization. Urologists from the highest COVID-19 incidence states were at a higher risk to have a reduction of patient visits and non-essential surgeries (OR=2.95, 95% CI 1.86 - 4.75; p< 0.0001) and of being infected with SARS-CoV-2 (OR=4.36 95%CI 1.74-10.54, p=0.012). CONCLUSIONS COVID-19 produced massive disturbances in Brazilian urologists' practice, with major reductions in patient visits and surgical procedures. Distressing consequences were also observed on physicians' income, health and personal lives. These findings are probably applicable to other medical specialties.
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Affiliation(s)
- Cristiano M Gomes
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Luciano A Favorito
- Unidade de Pesquisa Urogenital, Universidade Estadual do Rio de Janeiro - Uerj, Rio de Janeiro, RJ, Brasil
| | - João Victor T Henriques
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Alfredo F Canalini
- Divisão de Urologia, Universidade Estadual do Rio de Janeiro - Uerj, Rio de Janeiro, RJ, Brasil
| | - Karin M J Anzolch
- Departamento de Urologia, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil
| | | | - Carlos H S Bellucci
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Caroline S Silva
- Departamento de Saúde Pública e Epidemiologia, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brasil
| | - Marcelo L Wroclawski
- Departamento de Urologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
- Departamento de Urologia, Beneficência Portuguesa de São Paulo, São Paulo, SP, Brasil
| | | | - José de Bessa
- Departamento de Saúde Pública e Epidemiologia, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brasil
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Figueiredo AA, Fernandes A, Fornari A, Campos AF, Martins MHT, Haruta CM, Almeida SHM, de Toledo LGM, Moser DC, Tomé ALF, Averbeck MA, Gomes CM. Interim Guidance for Urodynamic Practice during COVID-19 Pandemic. Int Braz J Urol 2020; 47:178-184. [PMID: 33047923 PMCID: PMC7712711 DOI: 10.1590/s1677-5538.ibju.2020.0671] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 07/30/2020] [Indexed: 12/17/2022] Open
Affiliation(s)
| | - Ailton Fernandes
- Departamento de Urologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Alexandre Fornari
- Serviço de Urologia, Santa Casa de Porto Alegre, Porto Alegre, RS, Brasil
| | - Aleia Faustina Campos
- Divisão de Doenças Infecciosas do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | | | | | | | | | | | | | | | - Cristiano Mendes Gomes
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP Brasil
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40
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Kawahara LT, Costa IBSDS, Barros CCS, Almeida GCD, Bittar CS, Rizk SI, Testa L, Moniz CMV, Pereira J, Oliveira GMMD, Diz MDPE, Guimarães PO, Pinto IM, Kalil R, Hajjar LA, Hoff PM. Câncer e Doenças Cardiovasculares na Pandemia de COVID-19. Arq Bras Cardiol 2020; 115:547-557. [PMID: 33027380 PMCID: PMC9363105 DOI: 10.36660/abc.20200405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/24/2020] [Indexed: 01/08/2023] Open
Abstract
O desafio imposto ao sistema de saúde pela pandemia da COVID-19 faz com que haja uma necessidade de readequações de rotinas e serviços de saúde, com os objetivos de controlar a disseminação do vírus e preservar a saúde. Torna-se ainda mais importante o manejo seguro e correto dos pacientes dos grupos de risco, como os pacientes idosos, os portadores de doenças cardiovasculares e os pacientes com câncer. Dessa forma, a cardio-oncologia ganha novo dimensionamento, no intuito de se adequar às necessidades dos pacientes diante de uma pandemia, reestruturando o sistema de atendimento de forma a oferecer qualidade e segurança na assistência à saúde.
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Heldwein FL, Loeb S, Wroclawski ML, Sridhar AN, Carneiro A, Lima FS, Teoh JYC. A Systematic Review on Guidelines and Recommendations for Urology Standard of Care During the COVID-19 Pandemic. Eur Urol Focus 2020; 6:1070-1085. [PMID: 32532703 PMCID: PMC7274599 DOI: 10.1016/j.euf.2020.05.020] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/29/2020] [Indexed: 01/01/2023]
Abstract
CONTEXT The first case of the new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), was identified in Wuhan, China, in late 2019. Since then, the coronavirus disease 2019 (COVID-19) outbreak was reclassified as a pandemic, and health systems around the world have faced an unprecedented challenge. OBJECTIVE To summarize guidelines and recommendations on the urology standard of care during the COVID-19 pandemic. EVIDENCE ACQUISITION Guidelines and recommendations published between November 2019 and April 17, 2020 were retrieved using MEDLINE, EMBASE, and CINAHL. This was supplemented by searching the web pages of international urology societies. Our inclusion criteria were guidelines, recommendations, or best practice statements by international urology organizations and reference centers about urological care in different phases of the COVID-19 pandemic. Our systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Of 366 titles identified, 15 guidelines met our criteria. EVIDENCE SYNTHESIS Of the 15 guidelines, 14 addressed emergency situations and 12 reported on assessment of elective uro-oncology procedures. There was consensus on postponing radical prostatectomy except for high-risk prostate cancer, and delaying treatment for low-grade bladder cancer, small renal masses up to T2, and stage I seminoma. According to nine guidelines that addressed endourology, obstructed or infected kidneys should be decompressed, whereas nonobstructing stones and stent removal should be rescheduled. Five guidelines/recommendations discussed laparoscopic and robotic surgery, while the remaining recommendations focused on outpatient procedures and consultations. All recommendations represented expert opinions, with three specifically endorsed by professional societies. Only the European Association of Urology guidelines provided evidence-based levels of evidence (mostly level 3 evidence). CONCLUSIONS To make informed decisions during the COVID-19 pandemic, there are multiple national and international guidelines and recommendations for urologists to prioritize the provision of care. Differences among the guidelines were minimal. PATIENT SUMMARY We performed a systematic review of published recommendations on urological practice during the coronavirus disease 2019 (COVID-19) pandemic, which provide guidance on prioritizing the timing for different types of urological care.
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Affiliation(s)
- Flavio Lobo Heldwein
- Federal University of Santa Catarina and Baiasul Medical Hospital, Florianopolis, Brazil; Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
| | - Stacy Loeb
- New York University and Manhattan Veterans Affairs Medical Center, New York, NY, USA
| | - Marcelo Langer Wroclawski
- Hospital Israelita Albert Einstein, Sao Paulo, Brazil; Hospital Beneficiencia Portuguesa, Sao Paulo, Brazil
| | | | - Arie Carneiro
- Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | | | - Jeremy Yuen-Chun Teoh
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
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Jessop ZM, Dobbs TD, Ali SR, Combellack E, Clancy R, Ibrahim N, Jovic TH, Kaur AJ, Nijran A, O'Neill TB, Whitaker IS. Personal protective equipment for surgeons during COVID-19 pandemic: systematic review of availability, usage and rationing. Br J Surg 2020; 107:1262-1280. [PMID: 32395837 PMCID: PMC7273092 DOI: 10.1002/bjs.11750] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/08/2020] [Accepted: 05/11/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Surgeons need guidance regarding appropriate personal protective equipment (PPE) during the COVID-19 pandemic based on scientific evidence rather than availability. The aim of this article is to inform surgeons of appropriate PPE requirements, and to discuss usage, availability, rationing and future solutions. METHODS A systematic review was undertaken in accordance with PRISMA guidelines using MEDLINE, Embase and WHO COVID-19 databases. Newspaper and internet article sources were identified using Nexis. The search was complemented by bibliographic secondary linkage. The findings were analysed alongside guidelines from the WHO, Public Health England, the Royal College of Surgeons and specialty associations. RESULTS Of a total 1329 articles identified, 95 studies met the inclusion criteria. Recommendations made by the WHO regarding the use of PPE in the COVID-19 pandemic have evolved alongside emerging evidence. Medical resources including PPE have been rapidly overwhelmed. There has been a global effort to overcome this by combining the most effective use of existing PPE with innovative strategies to produce more. Practical advice on all aspects of PPE is detailed in this systematic review. CONCLUSION Although there is a need to balance limited supplies with staff and patient safety, this should not leave surgeons treating patients with inadequate PPE.
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Affiliation(s)
- Z M Jessop
- Reconstructive Surgery and Regenerative Medicine Research Group, Swansea University Medical School, Institute of Life Science, University of Swansea, Swansea, UK
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | - T D Dobbs
- Reconstructive Surgery and Regenerative Medicine Research Group, Swansea University Medical School, Institute of Life Science, University of Swansea, Swansea, UK
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | - S R Ali
- Reconstructive Surgery and Regenerative Medicine Research Group, Swansea University Medical School, Institute of Life Science, University of Swansea, Swansea, UK
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | - E Combellack
- Reconstructive Surgery and Regenerative Medicine Research Group, Swansea University Medical School, Institute of Life Science, University of Swansea, Swansea, UK
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | - R Clancy
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | - N Ibrahim
- Reconstructive Surgery and Regenerative Medicine Research Group, Swansea University Medical School, Institute of Life Science, University of Swansea, Swansea, UK
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | - T H Jovic
- Reconstructive Surgery and Regenerative Medicine Research Group, Swansea University Medical School, Institute of Life Science, University of Swansea, Swansea, UK
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | - A J Kaur
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | - A Nijran
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | - T B O'Neill
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | - I S Whitaker
- Reconstructive Surgery and Regenerative Medicine Research Group, Swansea University Medical School, Institute of Life Science, University of Swansea, Swansea, UK
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
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Zaniboni A, Ghidini M, Grossi F, Indini A, Trevisan F, Iaculli A, Dottorini L, Moleri G, Russo A, Vavassori I, Brevi A, Rausa E, Boni L, Dondossola D, Valeri N, Ghidini A, Tomasello G, Petrelli F. A Review of Clinical Practice Guidelines and Treatment Recommendations for Cancer Care in the COVID-19 Pandemic. Cancers (Basel) 2020; 12:E2452. [PMID: 32872421 PMCID: PMC7565383 DOI: 10.3390/cancers12092452] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 02/07/2023] Open
Abstract
The COVID-19 pandemic has inevitably caused those involved in cancer care to change clinical practice in order to minimize the risk of infection while maintaining cancer treatment as a priority. General advice during the pandemic suggests that most patients continue with ongoing therapies or planned surgeries, while follow-up visits may instead be delayed until the resolution of the outbreak. We conducted a literature search using PubMed to identify articles published in English language that reported on care recommendations for cancer patients during the COVID-19 pandemic from its inception up to 1st June 2020, using the terms "(cancer or tumor) AND (COVID 19)". Articles were selected for relevance and split into five categories: (1) personal recommendations of single or multiple authors, (2) recommendations of single authoritative centers, (3) recommendations of panels of experts or of multiple regional comprehensive centers, (4) recommendations of multicenter cooperative groups, (5) official guidelines or recommendations of health authorities. Of the 97 included studies, 10 were personal recommendations of single or multiple independent authors, 16 were practice recommendations of single authoritative cancer centers, 35 were recommendations provided by panel of experts or of multiple regional comprehensive centers, 19 were cooperative group position papers, and finally, 17 were official guidelines statements. The COVID-19 pandemic is a global emergency, and has rapidly modified our clinical practice. Delaying unnecessary treatment, minimizing toxicity, and identifying care priorities for surgery, radiotherapy, and systemic therapies must be viewed as basic priorities in the COVID-19 era.
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Affiliation(s)
| | - Michele Ghidini
- Oncology Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy; (M.G.); (F.G.); (A.I.); (G.T.)
| | - Francesco Grossi
- Oncology Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy; (M.G.); (F.G.); (A.I.); (G.T.)
| | - Alice Indini
- Oncology Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy; (M.G.); (F.G.); (A.I.); (G.T.)
| | | | - Alessandro Iaculli
- Oncology Unit, ASST Bergamo Est, 24068 Seriate (BG), Italy; (A.I.); (L.D.)
| | - Lorenzo Dottorini
- Oncology Unit, ASST Bergamo Est, 24068 Seriate (BG), Italy; (A.I.); (L.D.)
| | - Giovanna Moleri
- Centro Servizi, Direzione Socio-Sanitaria, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy;
| | - Alessandro Russo
- Surgical Oncology Unit, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy;
| | - Ivano Vavassori
- Urology Unit, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy;
| | - Alessandra Brevi
- Otorhinolaryngology-Head and Neck Surgery Unit, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy;
| | - Emanuele Rausa
- General Surgery 1 Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy;
| | - Luigi Boni
- Department of Surgery, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy;
| | - Daniele Dondossola
- General and Liver Transplant Surgery Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy;
- Department of Pathophysiology and Transplantation, Università degli Studi of Milan, 20122 Milan, Italy
| | - Nicola Valeri
- Division of Molecular Pathology and Centre for Evolution and Cancer, The Institute of Cancer Research, London SW7 3RP, UK;
- Department of Medicine, The Royal Marsden Hospital, London SW3 6JJ, UK
| | | | - Gianluca Tomasello
- Oncology Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy; (M.G.); (F.G.); (A.I.); (G.T.)
| | - Fausto Petrelli
- Oncology Unit, Medical Sciences Department, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy
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Fakhr Yasseri A, Aghamir SMK. Urinary stone management during the COVID-19 pandemic: a suggested approach and review of literature. Ther Adv Urol 2020; 12:1756287220939513. [PMID: 32849913 PMCID: PMC7425260 DOI: 10.1177/1756287220939513] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/08/2020] [Indexed: 01/09/2023] Open
Abstract
COVID-19 is now the major health concern of the century in many countries. Prolonged homestay has various undesirable consequences for people, such as physical inactivity and weight gain, which potentially could put people at risk of urinary stone formation. With regard to the prevention and treatment strategy for urinary stones during this COVID-19 pandemic period, patients can be divided into two groups. The first group comprises those for whom urological intervention is not indicated and where general dietary and lifestyle recommendations are helpful. The second group comprises those patients where urological intervention is indicated. This group can be divided into emergent and nonemergent subgroups. Patients with urinary stones and concomitant uremia, sepsis, anuria, or refractory pain and vomiting make up the emergent group, where intervention is necessary. The preferred option during the novel coronavirus crisis for these patients is percutaneous nephrostomy tube insertion under local anesthesia. The second subgroup is made up of those patients with asymptomatic and noncomplicated renal and ureteral stones where urologic intervention is indicated in the usual time scale. However, we suggest conservative treatment for 3 months during the COVID-19 outbreak after which re-evaluation of the patient should be carried out. Thus the operation could be chosen carefully based on the patient’s and urologist’s preference and the rate of infection in that center.
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Zequi SDC, Abreu D. Consideration in the management of renal cell carcinoma during the COVID-19 Pandemic. Int Braz J Urol 2020; 46:69-78. [PMID: 32549075 PMCID: PMC7720004 DOI: 10.1590/s1677-5538.ibju.2020.s108] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/10/2020] [Indexed: 12/15/2022] Open
Abstract
Introduction: Recently the COVID-19 pandemic became the main global priority; main efforts and health infrastructures have been prioritized in favor of COVID-19 battle and the treatment of benign diseases has been postponed. Renal cell cancer (RCC) patients configure a heterogenous populations: some of them present indolent cases which can safely have postponed their treatments, others present aggressive tumors, deserving immediate care. These scenarios must be properly identified before a tailored therapeutic choice. Objectives We propose a risk- based approach for patients with RCC, to be used during this unprecedented viral infection time. Materials and Methods: After a literature review focused in COVID-19 and current RCC treatments, we suggest therapeutic strategies of RCC in two sections: surgical approach and systemic therapy, in all stages of this malignance. Results: Patients with cT1a tumors (and complex cysts, Bosniak III/IV), must be put under active surveillance and delayed intervention. cT1b-T2a/b cases must be managed by partial or radical nephrectomy, some selected T1b-T2a (≤7cm) cases can have the surgery postponed by 60-90 days). Locally advanced tumors (≥cT3 and or N+) must be promptly resected. As possible, minimally invasive surgery and early hospital discharge are encouraged. Upfront cytoreduction, is not recommendable for low risk oligometastatic patients, which must start systemic treatment or even could be put under surveillance and delayed therapy. Intermediate and poor risk metastatic patients must start target therapy and/or immunotherapy (few good responders intermediate cases can have postponed cytoreduction). The recommendation about hereditary RCC syndromes are lacking, thus we recommend its usual care. Local or loco regional recurrence must have individualized approaches. For all cases, we suggest the application of a specific informed consent and a shared therapeutic choice. Conclusion: In the pandemic COVID -19 times, a tailored risk-based approach must be used for a safe management of RCC, aiming to not compromise the oncological outcomes of the patients.
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Affiliation(s)
- Stênio de Cássio Zequi
- Divisão de Urologia, A.C. Camargo Cancer Center, Fundação A. Prudente, São Paulo, Brasil.,Instituto Nacional de Ciência e Tecnologia em Oncogenômica e Inovação Terapêutica - INCIT - INOTE, A. C. Camargo Cancer Center, Fundação A. Prudente, São Paulo, Brasil.,Latin American Renal Cancer Group - LARCG, São Paulo, SP, Brasil
| | - Diego Abreu
- Latin American Renal Cancer Group - LARCG, São Paulo, SP, Brasil.,Department of Urology, Pasteur Hospital, Montevideo, Uruguay
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Iscaife A, Marchini GS, Srougi V, Torricelli FCM, Danilovic A, Vicentini FC, Machado M, Hisano M, Tiseo BC, Bissoli JC, Cocuzza M, Hallak J, Srougi M, Nahas WC. The urologist's role in the fight of COVID-19 pandemic: mandatory mindset shift on the frontline. Int Braz J Urol 2020; 46:879-882. [PMID: 32459458 PMCID: PMC7822373 DOI: 10.1590/s1677-5538.ibju.2020.0316] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 04/20/2020] [Indexed: 11/22/2022] Open
Affiliation(s)
- Alexandre Iscaife
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Giovanni S Marchini
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Victor Srougi
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Fabio C M Torricelli
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Alexandre Danilovic
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Fabio C Vicentini
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Marcos Machado
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Marcelo Hisano
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Bruno C Tiseo
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Júlio C Bissoli
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Marcello Cocuzza
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Jorge Hallak
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - Miguel Srougi
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | - William C Nahas
- Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
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Abstract
INTRODUCTION There is little information on how to prioritize testis cancer (TC) patients' care during COVID-19 pandemic in order to relieve its pressure on the health care systems. OBJECTIVE To describe the recommendations for diagnosis, treatment and follow-up of patients with TC amidst COVID- 19 pandemic. MATERIAL AND METHODS Pubmed search and review of the main urological association guidelines on TC. RESULTS The biology of TC requires immediate care of patients during diagnosis, initial surgical therapy and management of recurrent disease. Active surveillance is the first choice of management and should be offered to all compliant clinical stage I TC patients provided they understand the need to self-isolate. Active surveillance may also help decrease the demand for intensive care unit beds, ventilators, personal protective equipment, and other critical hospital and human resources by minimizing surgeries without compromising patient outcomes. Complications of therapy and symptomatic patients represent medical emergencies and should be treated immediately. Telemedicine may be useful during follow-up periods. CONCLUSIONS Most stages of testis cancer require urgent care; however, all recommendations must be adapted to local health care priorities considering that most of these patients are at low risk of severe COVID-19 infection.
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Affiliation(s)
- Fernando P. Secin
- University of Buenos Aires School of MedicineDiscipline of UrologyBuenos AiresArgentinaDiscipline of Urology, University of Buenos Aires School of Medicine, Buenos Aires, Argentina
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Socarrás MER, Esperto F, Bapstistussi MD, Barufaldi F, Vital MS, Papalia R, Salerno A, Cataldo R, Autrán-Gómez AM, Scarpa RM. Endourology (Lithiasis). Management, surgical considerations and follow-up of patients in the COVID-19 era. Int Braz J Urol 2020; 46:39-49. [PMID: 32568495 PMCID: PMC7719981 DOI: 10.1590/s1677-5538.ibju.2020.s105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 05/10/2020] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To provide recommendations on the endourological management of lithiasis in the scenario of the COVID-19 pandemic. MATERIALS AND METHODS A non-systematic review in PubMed and the grey literature, as well as recommendations by a panel of stakeholders was made, regarding management, surgical considerations and follow-up of patients affected by lithiasis in the COVID-19 era. RESULTS Under the current outbreak and COVID-19 pandemic scenario, patients affected by lithiasis should be prioritized into low, intermediate and high risk categories, to decide their delay and save resources, healthcare personnel, beds and ventilators. However, patients with potentially serious septic complications need emergency interventions. The possibility of performing or restarting elective activity depends on local conditions, the availability of beds and ventilators, and the implementation of screening protocols in the context of the COVID-19 pandemic. Delaying lithiasis surgery and increasing waiting lists will have consequences and will require considerable additional effort. Teleconsultation may be useful in guiding these patients, reducing visits and unnecessary exposure. CONCLUSIONS categorization and prioritization of patients affected by lithiasis is crucial for management, surgical selection and follow-up. Protocols, measures and additional efforts should be carried out in the current situation of the COVID-19 pandemic.
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Affiliation(s)
| | - Francesco Esperto
- University of RomeCampus BiomedicoDepartment of UrologyRomeItalyDepartment of Urology, Campus Biomedico, University of Rome, Rome, Italy
- European Society of Residents in UrologyArnhemThe NetherlandsEuropean Society of Residents in Urology (ESRU), Arnhem, The Netherlands
| | - Marcelo Denilson Bapstistussi
- Beneficência Portuguesa HospitalDepartment of UrologySão PauloSPBrasilDepartment of Urology, Beneficência Portuguesa Hospital, São Paulo, SP, Brasil
- American Confederation of UrologyDepartment of LithiasisBuenos AiresArgentinaDepartment of Lithiasis of American Confederation of Urology (CAU), Buenos Aires, Argentina
| | - Felipe Barufaldi
- Beneficência Portuguesa HospitalDepartment of UrologySão PauloSPBrasilDepartment of Urology, Beneficência Portuguesa Hospital, São Paulo, SP, Brasil
| | - Matheus Soares Vital
- Beneficência Portuguesa HospitalDepartment of UrologySão PauloSPBrasilDepartment of Urology, Beneficência Portuguesa Hospital, São Paulo, SP, Brasil
| | - Rocco Papalia
- University of RomeCampus BiomedicoDepartment of UrologyRomeItalyDepartment of Urology, Campus Biomedico, University of Rome, Rome, Italy
| | - Annamaria Salerno
- University of RomeCampus BiomedicoDepartment of UrologyRomeItalyDepartment of Urology, Campus Biomedico, University of Rome, Rome, Italy
| | - Rita Cataldo
- University of RomeUnit of Anesthesia, Intensive care and pain managementDepartment of MedicineRomeItalyDepartment of Medicine, Unit of Anesthesia, Intensive care and pain management, Campus Biomédico, University of Rome, Rome, Italy
| | - Ana María Autrán-Gómez
- University Hospital Fundación Jiménez DíazDepartment of UrologyMadridSpainDepartment of Urology, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Roberto Mario Scarpa
- University of RomeCampus BiomedicoDepartment of UrologyRomeItalyDepartment of Urology, Campus Biomedico, University of Rome, Rome, Italy
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Fiesco-Sepúlveda KY, Serrano-Bermúdez LM. Contributions of Latin American researchers in the understanding of the novel coronavirus outbreak: a literature review. PeerJ 2020; 8:e9332. [PMID: 32547890 PMCID: PMC7276147 DOI: 10.7717/peerj.9332] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/19/2020] [Indexed: 12/13/2022] Open
Abstract
This article aimed to give the visibility of Latin American researchers' contributions to the comprehension of COVID-19; our method was a literature review. Currently, the world is facing a health and socioeconomic crisis caused by the novel coronavirus, SARS-CoV-2, and its disease COVID-19. Therefore, in less than 4 months, researchers have published a significant number of articles related to this novel virus. For instance, a search focused on the Scopus database on 10 April 2020, showed 1,224 documents published by authors with 1,797 affiliations from 80 countries. A total of 25.4%, 24.0% and 12.6% of these national affiliations were from China, Europe and the USA, respectively, making these regions leaders in COVID-19 research. In the case of Latin America, on 10 April 2020, we searched different databases, such as Scopus, PubMed and Web of Science, finding that the contribution of this region was 2.7 ± 0.6% of the total publications found. In other words, we found 153 publications related to COVID-19 with at least one Latin American researcher. We summarized and processed the information from these 153 publications, finding active participation in topics like medical, social and environmental considerations, bioinformatics and epidemiology.
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Favorito LA. In these difficult times of COVID-19, urologic research cannot stop: COVID-19 pandemic and reconstructive urology highlighted in International Brazilian Journal of Urology. Int Braz J Urol 2020; 46:496-498. [PMID: 32374121 PMCID: PMC7239294 DOI: 10.1590/s1677-5538.ibju.2020.04.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Luciano A Favorito
- Unidade de Pesquisa Urogenital - Universidade Estadual do Rio de Janeiro - Uerj, Rio de Janeiro, RJ, Brasil.,Serviço de Urologia, Hospital Federal da Lagoa, Rio de Janeiro, RJ, Brasil
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