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Polo R, Canós-Nebot À, Caballero-Romeu JP, Caballero P, Galán-Llopis JA, Soria F, de la Cruz-Conty JE, Tuells J. Post-Ureteroscopic Lesion Scale to determine ureteral wall damage, not so easy to employ. Actas Urol Esp 2024; 48:162-169. [PMID: 37832847 DOI: 10.1016/j.acuroe.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 10/15/2023]
Abstract
OBJECTIVE To analyze the level of agreement of the Post-Ureteroscopy Lesion Scale (PULS) and the consequences on its application in clinical practice with more reliable statistical data than the one used in the original work. METHODS 14 URS and 14 micro-URS were performed in 14 female porcine model. All the procedures were video recorded and an anatomopathological analysis was performed in each ureter. Sixteen urologists (9 endourologists and 7 general urologists) and 4 residents evaluated the ureteral lesions according to the PULS, with degrees 0, 1 and ≥2. The agreement was calculated with percentages, Kendall's W coefficient and the indicators Fleiss' Kappa and Krippendorff's Alpha, while the inter-rater agreement was calculated with Spearman's correlation and Cohen's Kappa. RESULTS The percent of agreement was 11.1%. The coefficients were likewise classified as low or very low, with the greatest agreement found among the inexperienced. Also, 50% of the raters did not agree with the rest. CONCLUSIONS The low inter-rater agreement, the specificity of the PULS and the clinical-pathological correlation suggests that this scale is not simple, and probably has a long learning curve.
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Affiliation(s)
- R Polo
- Servicio de Urología, Hospital Marina Baixa, Denia, Valencia, Spain
| | - À Canós-Nebot
- Servicio de Urología, Hospital General de la Universidad de Alicante, Instituto de Investigación Sanitaria y Biomédica (ISABIAL - Fundación FISABIO), Alicante, Spain
| | - J P Caballero-Romeu
- Servicio de Urología, Hospital General de la Universidad de Alicante, Instituto de Investigación Sanitaria y Biomédica (ISABIAL - Fundación FISABIO), Alicante, Spain
| | - P Caballero
- Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Universidad de Alicante, Alicante, Spain.
| | - J A Galán-Llopis
- Servicio de Urología, Hospital General de la Universidad de Alicante, Instituto de Investigación Sanitaria y Biomédica (ISABIAL - Fundación FISABIO), Alicante, Spain
| | - F Soria
- Unidad de Cirugía Experimental, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - J E de la Cruz-Conty
- Departamento de Fisiología-Laboratorio del Dr. Adebiyi, Centro de Ciencias de la Salud de la Universidad de Tennessee (UTHSC), Memphis, TN, USA
| | - J Tuells
- Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Universidad de Alicante, Alicante, Spain
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Estevan-Ortega M, de la Encarnación Castellano C, Mendiola-López A, Parker LA, Caballero-Romeu JP, Lumbreras B. Urologists' and general practitioners' knowledge, beliefs and practice relevant for opportunistic prostate cancer screening: a PRISMA-compliant systematic review. Front Med (Lausanne) 2024; 11:1283654. [PMID: 38435387 PMCID: PMC10905619 DOI: 10.3389/fmed.2024.1283654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/06/2024] [Indexed: 03/05/2024] Open
Abstract
Background Recent guidelines on opportunistic prostate cancer screening conclude that the decision to screen with prostate-specific antigen should be made by each patient individually together with the clinician. However, there is evidence of a lack of clinicians' awareness of prostate cancer screening. This study sought to assess the recent evidence of clinicians' knowledge, beliefs, and practice regarding opportunistic prostate cancer screening comparing urologists and generals practitioners. Methods A systematic search was conducted in 3 online databases: MEDLINE, Web of Science and EMBASE (from January 1, 2015, to January 9th, 2023). Studies that explored clinicians' knowledge, beliefs, and practices regarding opportunistic prostate cancer screening were included. Studies were assessed for quality reporting according to the Strengthening the Reporting of Observational studies in Epidemiology guidelines. Results A total of 14 studies met the inclusion criteria: ten studies included primary care health professionals, three studies included urologists, and one study included both. Studies involving general practitioners showed a generally low level of awareness of the recommended uses of the test, and urologists showed a greater knowledge of clinical practice guidelines. General practitioners' opinion of prostate-specific antigen was generally unfavourable in contrast to urologists' who were more likely to be proactive in ordering the test. Less than half of the included studies evaluated shared-decision making in practice and 50% of clinicians surveyed implemented it. Conclusion General practitioners had less knowledge of prostate cancer risk factors and clinical practice guidelines in the use of PSA than urologists, which makes them less likely to follow available recommendations. A need to carry out education interventions with trusted resources based on the available evidence and the current guidelines was identified.
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Affiliation(s)
| | | | | | - Lucy A. Parker
- Department of Public Health, University Miguel Hernández de Elche, Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Juan Pablo Caballero-Romeu
- Department of Urology, University General Hospital of Alicante, Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Blanca Lumbreras
- Department of Public Health, University Miguel Hernández de Elche, Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Estevan-Vilar M, Parker LA, Caballero-Romeu JP, Ronda E, Hernández-Aguado I, Lumbreras B. Barriers and facilitators of shared decision-making in prostate cancer screening in primary care: A systematic review. Prev Med Rep 2024; 37:102539. [PMID: 38179441 PMCID: PMC10764268 DOI: 10.1016/j.pmedr.2023.102539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/28/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024] Open
Abstract
Objective To identify barriers and facilitators of the implementation of shared decision-making (SDM) on PSA testing in primary care. Design Systematic review of articles. Data sources PubMed, Scopus, Embase and Web of Science. Eligibility criteria Original studies published in English or Spanish that assessed the barriers to and facilitators of SDM before PSA testing in primary care were included. No time restrictions were applied. Data extraction and synthesis Two review authors screened the titles, abstracts and full texts for inclusion, and assessed the quality of the included studies. A thematic synthesis of the results were performed and developed a framework. Quality assessment of the studies was based on three checklists: STROBE for quantitative cross-sectional studies, GUIDED for intervention studies and SRQR for qualitative studies. Results The search returned 431 articles, of which we included 13: five cross-sectional studies, two intervention studies, five qualitative studies and one mixed methods study. The identified barriers included lack of time (healthcare professionals), lack of knowledge (healthcare professionals and patients), and preestablished beliefs (patients). The identified facilitators included decision-making training for professionals, education for patients and healthcare professionals, and dissemination of information. Conclusions SDM implementation in primary care seems to be a recent field. Many of the barriers identified are modifiable, and the facilitators can be leveraged to strengthen the implementation of SDM.
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Affiliation(s)
- María Estevan-Vilar
- Pharmacy Faculty, Miguel Hernandez University, 03550 San Juan de Alicante, Spain
| | - Lucy Anne Parker
- Department of Public Health, History of Science and Gynecology, Miguel Hernandez University, 03550 San Juan de Alicante, Spain
- CIBER of Epidemiology and Public Health, CIBERESP, 28029 Madrid, Spain
| | - Juan Pablo Caballero-Romeu
- Department of Urology, Hospital General Universitario de Alicante, 03010 Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
| | - Elena Ronda
- CIBER of Epidemiology and Public Health, CIBERESP, 28029 Madrid, Spain
- Public Health Research Group, Alicante University, 03690 San Vicente del Raspeig, Spain
| | - Ildefonso Hernández-Aguado
- Department of Public Health, History of Science and Gynecology, Miguel Hernandez University, 03550 San Juan de Alicante, Spain
- CIBER of Epidemiology and Public Health, CIBERESP, 28029 Madrid, Spain
| | - Blanca Lumbreras
- Department of Public Health, History of Science and Gynecology, Miguel Hernandez University, 03550 San Juan de Alicante, Spain
- CIBER of Epidemiology and Public Health, CIBERESP, 28029 Madrid, Spain
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Lumbreras B, Parker LA, Caballero-Romeu JP, Gómez-Pérez L, Puig-García M, López-Garrigós M, García N, Hernández-Aguado I. Reply to Jue, J.S.; Alameddine, M. Role of PSA Density and MRI in PSA Interpretation. Comment on "Lumbreras et al. Variables Associated with False-Positive PSA Results: A Cohort Study with Real-World Data. Cancers 2023, 15, 261". Cancers (Basel) 2023; 15:2685. [PMID: 37345022 DOI: 10.3390/cancers15102685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/04/2023] [Indexed: 06/23/2023] Open
Abstract
We thank you and your co-authors for the comment [...].
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Affiliation(s)
- Blanca Lumbreras
- Department of Public Health, University Miguel Hernández de Elche, 03550 Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Lucy Anne Parker
- Department of Public Health, University Miguel Hernández de Elche, 03550 Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Juan Pablo Caballero-Romeu
- Department of Urology, University General Hospital of Alicante, 03010 Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
| | - Luis Gómez-Pérez
- Urology Department, General University Hospital of Elche, 03203 Elche, Spain
- Pathology and Surgery Department, Miguel Hernández University of Elche, 03550 Alicante, Spain
| | - Marta Puig-García
- Department of Public Health, University Miguel Hernández de Elche, 03550 Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Maite López-Garrigós
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Clinical Laboratory Department, University Hospital of San Juan de Alicante, Sant Joan d'Alacant, 03550 Alicante, Spain
| | - Nuria García
- Department of Urology, University General Hospital of Alicante, 03010 Alicante, Spain
| | - Ildefonso Hernández-Aguado
- Department of Public Health, University Miguel Hernández de Elche, 03550 Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
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Soria F, de La Cruz JE, Caballero-Romeu JP, Pamplona M, Pérez-Fentes D, Resel-Folskerma L, Sanchez-Margallo FM. Comparative assessment of biodegradable-antireflux heparine coated ureteral stent: animal model study. BMC Urol 2021; 21:32. [PMID: 33639905 PMCID: PMC7916282 DOI: 10.1186/s12894-021-00802-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/18/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Double J ureteral stents are widely used on urological patients to provide drainage of the upper urinary tract. Unfourtunately, ureteral stents are not free from complications, as bacterial colonization and require a second procedure for removal. The purpose of the current comparative experimental study is to evaluate a new heparin-coated biodegradable antireflux ureteral stent (BraidStent®-H) to prevent urinary bacterial colonization. METHODS A total of 24 female pigs were underwent determination of bacteriuria and nephrosonographic, endoscopic and contrast fluoroscopy assessment of the urinary tract. Afterward, were randomly assigned animals to Group-I, in which a 5Fr double-pigtail ureteral stent was placed for 6 weeks, or Group-II, in which a BraidStent®-H was placed. Follow-up assessments were performed at 1, 3, 6, 8, 12 weeks. The final follow-up includes the above methods and an exhaustive pathological study of the urinary tract was accomplished after 20 weeks. RESULTS Bacteriuria findings in the first 48 h were significant between groups at 6 h and 12 h. Asymptomatic bacteriuria does not reach 100% of the animals in Group-II until 48 h versus Group-I where it appears at 6 h. The weekly bacteriuria mean rate was 27.7% and 44.4% in Group I and II respectively, without statistical significance. In Group II there were no animals with vesicoureteral reflux, with statistical significance at 3 and 6 weeks with Group-I. The 91.2% of stents in Group-II were degraded between 3 and 6 weeks, without obstructive fragments. Distal ureteral peristalsis was maintained in 66.6-75% in Group-II at 1-6 weeks. CONCLUSIONS The heparin coating of BraidStent® allows an early decrease of bacterial colonization, but its effectiveness is low at the long term. Heparin coating did not affect scheduled degradation rate or size of stents fragments. BraidStent®-H avoids the side effects associated with current ureteral stents, thus should cause less discomfort to patients.
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Affiliation(s)
- Federico Soria
- Endoscopy-Endourology Department, Jesús Usón Minimally Invasive Surgery Centre Foundation, Carretera N-521, Km. 41.8, C.P.10071, Cáceres, Spain.
| | - Julia E de La Cruz
- Endoscopy-Endourology Department, Jesús Usón Minimally Invasive Surgery Centre Foundation, Cáceres, Spain
| | - Juan Pablo Caballero-Romeu
- Urology Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL Foundation), Alicante, Spain
| | - Manuel Pamplona
- Urology Department, 12 de Octubre University Hospital, Madrid, Spain
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Caballero-Romeu JP, Galán-Llopis JA. [MicroURS. Is it a technique to stay?]. ARCH ESP UROL 2017; 70:134-140. [PMID: 28221148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Micro-ureteroscopy is a novel technique derived from the need to reduce the morbidity associated with conventional ureteroscopy. Reducing morbidity, we will be able to improve quality of life of patients, for example, by shortening the times to elimination of the stones. In this article the authors intend to expose the different applications of micro ureteroscopy as well as the incipient scientific evidence on the topic.
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