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Aftab OM, Davis M, Obeidallah A, Rogers A, Hou L, Abdollah F, Ahmed M, Billah MS. Short-Term Reported Urologic Adverse Events Following COVID-19 Immunization: A Vaccine Adverse Event Reporting System Analysis. Urol Pract 2024; 11:312-323. [PMID: 38377155 DOI: 10.1097/upj.0000000000000497] [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: 09/18/2023] [Accepted: 11/03/2023] [Indexed: 02/22/2024]
Abstract
INTRODUCTION Medical misinformation regarding COVID-19 immunization remains rampant and a public concern, and as such, there is a need for national studies evaluating the immunization's safety profile. We sought to quantify and analyze urologic adverse events and symptoms after COVID-19 immunization, compare these events reported between COVID-19 vaccine types, and compare these events reported following COVID-19 immunization relative to those reported following other immunizations. METHODS We conducted a retrospective case-control disproportionality analysis by querying the Food and Drug Administration Vaccine Adverse Event Reporting System for all reported symptoms following COVID-19 immunization through December 23, 2022, as well as for all non-COVID immunizations. RESULTS Using a total of 704,231 event reports containing 2,982,187 symptoms related to COVID vaccination and a total of 770,975 event reports containing 2,198,993 symptoms related to all vaccinations other than COVID-19 for disproportionality analysis, no urologic symptom produced a positive signal when grouping all vaccinations. When stratifying by manufacturer, some symptoms related to Janssen vaccination were positive, but this may be in part due to overreporting secondary to media attention rather than a strong association between Janssen vaccination and urologic adverse events. CONCLUSIONS Although there have been anecdotal reports of adverse events associated with the COVID-19 vaccine, our review of the Vaccine Adverse Event Reporting System database did not produce positive signals across all 4 measures for any potential adverse event. Our findings do not suggest increased scrutiny is required regarding these adverse events potentially related to the COVID-19 immunization. Further evaluation and analysis of the COVID-19 immunization is ongoing.
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Affiliation(s)
- Owais M Aftab
- Division of Urology, Rutgers-New Jersey Medical School, Newark, New Jersey
| | - Matthew Davis
- Vattikuti Urology Institute-Center for Outcomes Research, Analysis, and Evaluation, Detroit, Michigan
| | - Aisha Obeidallah
- Division of Urology, Rutgers-New Jersey Medical School, Newark, New Jersey
| | - Alexandra Rogers
- Vattikuti Urology Institute-Center for Outcomes Research, Analysis, and Evaluation, Detroit, Michigan
| | - Laurence Hou
- Hackensack University Medical Center, Hackensack Meridian School of Medicine at Seton Hall University, Hackensack, New Jersey
| | - Firas Abdollah
- Vattikuti Urology Institute-Center for Outcomes Research, Analysis, and Evaluation, Detroit, Michigan
| | - Mutahar Ahmed
- Hackensack University Medical Center, Hackensack Meridian School of Medicine at Seton Hall University, Hackensack, New Jersey
| | - Mubashir Shabil Billah
- Hackensack University Medical Center, Hackensack Meridian School of Medicine at Seton Hall University, Hackensack, New Jersey
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Bødker C, Riisbøl MF, Khan BYA, Hansen RM, Severinsen KE. Urologic surveillance of persons with spinal cord injuries - a scoping review. Spinal Cord 2024; 62:91-98. [PMID: 38182679 DOI: 10.1038/s41393-023-00955-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 01/07/2024]
Abstract
STUDY DESIGN Scoping review - standardized according to the Equator-network and the Prisma-Statement guidelines with PRISMA-ScR. OBJECTIVES Review the literature concerning surveillance of the urinary- and renal systems in persons with spinal cord injuries (SCI). Specifically, to assess: #1 the usability of non-invasive and non-ultrasound methods, #2 the usage of systematic ultrasound surveillance #3 patient characteristics which predispose to urinary tract abnormalities (UTA) or renal function deterioration. METHODS The literature assessed was collected from PubMed by creating a search string comprised of three main phrases: #1 persons with SCI, #2 kidney function and #3 surveillance program. The final search resulted in 685 studies. Eligibility criteria were defined prior to the search to assess the studies systematically. RESULTS Four studies found serum cystatin C (s-cysC) to be accurate in estimating the glomerular filtration rate in persons with SCI. One study found no difference in UTA between surveillance adherent and surveillance non-adherent persons up to 30 years post injury. UTA and especially renal function deterioration seems rare the first 15 years post-injury. Non-traumatic SCI, time since injury, high detrusor pressure, upper urinary tract dilation, vesicourethral reflux, trabeculated bladder, history of calculi removal are significant risk factors for developing UTA or renal function deterioration. CONCLUSION Measurements of S-cysC should be considered to replace serum creatinine in most cases. Surveillance non-adherent persons are not at higher risk of developing UTA. A selective surveillance based on a baseline risk profile may be beneficial for patients and caretakers.
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Affiliation(s)
| | - Maja F Riisbøl
- Spinal Cord Injury Center of Western Denmark, Viborg, Denmark
| | | | - Rikke M Hansen
- Spinal Cord Injury Center of Western Denmark, Viborg, Denmark
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Suarez Arbelaez MC, Nackeeran S, Shah K, Blachman-Braun R, Bronson I, Towe M, Bhat A, Marcovich R, Ramasamy R, Shah HN. Association between body mass index, metabolic syndrome and common urologic conditions: a cross-sectional study using a large multi-institutional database from the United States. Ann Med 2023; 55:2197293. [PMID: 37036830 PMCID: PMC10088970 DOI: 10.1080/07853890.2023.2197293] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 03/25/2023] [Indexed: 04/11/2023] Open
Abstract
INTRODUCTION The study aims to determine whether body mass index (BMI), metabolic syndrome (MS) or its individual components (primary hypertension, type 2 diabetes mellitus and dyslipidemias) are risk factors for common urological diseases. MATERIALS AND METHODS Cross-sectional study with data collected on February 28, 2022 from the TriNetX Research Network. Patients were divided in cohorts according to their BMI, presence of MS (BMI > 30 kg/m2, type 2 diabetes mellitus, primary hypertension and disorders of lipoprotein metabolism) and its individual components and its association with common urological conditions was determined. For each analysis, odds ratio (OR) with 95% confidence intervals were calculated. Statistical significance was assessed at p < .05. RESULTS BMI > 30 kg/m2 was associated with increased risk of lithiasis, kidney cancer, overactive bladder, male hypogonadism, benign prostatic hyperplasia, and erectile dysfunction (p < .05). On the contrary, BMI was inversely associated with ureteral, bladder and prostate cancer (p < .05). In all urological diseases, MS was the strongest risk factor, with prostate cancer (OR = 2.53) showing the weakest and male hypogonadism the strongest (OR = 13.00) associations. CONCLUSIONS MS and its individual components were significant risk factors for common urological conditions. Hence holistic approaches with lifestyle modification might prevent common urological disease.Key messagesOverall, metabolic syndrome is the strongest risk factor for all the analysed urological diseases.Abnormally high body mass index can be a risk or protective factor depending on the threshold and urological disease that are being evaluated.Metabolic syndrome and increased BMI should be considered important factors associated to the prevalence of common urological diseases.
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Affiliation(s)
| | - Sirpi Nackeeran
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Khushi Shah
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ruben Blachman-Braun
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Isaac Bronson
- UMass Chann Medical School, University of Massachusetts, Amherst, MA, USA
| | - Maxwell Towe
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Abhishek Bhat
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Robert Marcovich
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hemendra N. Shah
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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Sturgess G, Beckley I, Shepherd R, Downey A. Ketamine uropathy: Clinical experience in a high prevalence center. Neurourol Urodyn 2023; 42:1555-1562. [PMID: 37401364 DOI: 10.1002/nau.25240] [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: 02/23/2023] [Revised: 05/06/2023] [Accepted: 06/22/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVES Ketamine uropathy causes inflammatory changes to the urothelium, manifesting as significant lower urinary tract symptoms, small bladder capacity, and pelvic pain. Upper tract involvement and hydronephrosis can occur. Data from UK centers are limited, and no formal treatment guidelines exist. PATIENTS AND METHODS All patients with ketamine uropathy presenting to our unit over an 11-year period were identified through operative and clinic lists, emergency presentations, and a prospectively collected local database. Demographic data, biochemical findings, imaging techniques, and both medical and surgical management were recorded. RESULTS A total of 81 patients with ketamine uropathy were identified from 2011 to 2022; however, a large proportion presented from 2018 onwards. The average age at presentation was 26 years (interquartile range [IQR]: 27-34), 72.8% were male, and average follow-up time was 34 months (IQR: 8-46). Therapeutic interventions included anticholinergic medication, cystodistension, and intravesical sodium hyaluronate. Hydronephrosis was present in 20 (24.7%) patients and nephrostomy insertion was required in six. One patient underwent bladder augmentation surgery. Serum gamma-glutamyl transferase and length of follow-up were significantly higher in patients with hydronephrosis. Adherence to follow-up was poor. CONCLUSIONS We present a large cohort of patients with ketamine uropathy from a small town in the UK which is unusual. The incidence appears to be rising, in-keeping with increasing recreational ketamine use and should be of concern to urologists. Abstinence is a key aspect of management, and a multi-disciplinary approach works best particularly as many patients are lost to follow-up. The development of formal guidance would be helpful.
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Affiliation(s)
- George Sturgess
- Department of Urology, Pinderfields Hospital, Wakefield, UK
- Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
| | - Ian Beckley
- Department of Urology, Pinderfields Hospital, Wakefield, UK
- Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
| | - Robin Shepherd
- Department of Urology, Pinderfields Hospital, Wakefield, UK
- Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
| | - Alison Downey
- Department of Urology, Pinderfields Hospital, Wakefield, UK
- Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
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Wu W, Zou J, Luo S, Lin H. Epidemiology Trend of Urogenital System Disorders of Hospitalized Patients in an Eastern Chinese City from 2017 to 2019. ARCH ESP UROL 2023; 76:389-396. [PMID: 37681329 DOI: 10.56434/j.arch.esp.urol.20237606.47] [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] [Indexed: 09/09/2023]
Abstract
OBJECTIVE To evaluate trends in the prevalence and clinical characteristics of urogenital diseases in hospitalized patients of secondary and tertiary hospitals in Ningbo, an east coast city in China, from 2017 to 2019. METHODS We collected the data on hospitalized patients in Ningbo secondary and tertiary hospitals from January 1, 2017 to December 31, 2019. The data included age, sex, and diagnosis identified using the International Classification of Diseases (ICD) codes, which were obtained from Ningbo National Health Information Platform. We quantified the epidemiology (age/sex-specific) trend of urogenital system disorders. RESULTS From January 2017 to December 2019, there were 256750 hospitalized patients with urogenital system disorders. These hospitalized patients comprised more women than men (1.45:1.00). The number of hospitalized patients with these diseases significantly increased over the 3 years (77505, 89167, and 90078, respectively; Z = 20.03, p < 0.001). The highest prevalence of these diseases was in the 40- to 64-year-old age group (47.37%), followed by the 18- to 39-year-old age group (23.94%). Over the 3 years, the five most common diseases in hospitalized male patients were male reproductive organ disorders, urolithiasis, tubulointerstitial disease, renal failure, and glomerular disease; Whereas the five most common diseases in hospitalized female patients were non-inflammatory disorders of the female genital tract, benign or dynamic undetermined tumors of the female reproductive organs, disorders of breast (according to ICD-10, disorders of breast (N60-N64) were involved in urogenital system diseases (N00-N99)), inflammatory diseases of female pelvic organs, and renal tubulointerstitial disease. In addition, the number of inpatients with renal tubulointerstitial disease significantly increased from 5952 to 9616 over the 3 years (rank increased from 6 to 3). CONCLUSIONS Patients with urogenital system disorders significantly increased over the 3 years, occurring more often in women and most commonly in young and middle-aged people, which warrants more attention in clinical practice.
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Affiliation(s)
- Wenxiao Wu
- Department of Respiratory/General Medicine, Hangzhou Bay Hospital, Ningbo NO. 2 Hospital, 315300 Ningbo, Zhejiang, China
| | - Jing Zou
- Department of Respirology, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, 200127 Shanghai, China
| | - Shenglan Luo
- Department of Medical Record Statistics, Li Huili Hosptal, Ningho Medical Center, 315000 Ningbo, Zhejiang, China
| | - Haixue Lin
- Department of Nephrology, Ningbo NO. 2 Hospital, 315000 Ningbo, Zhejiang, China
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Laukhtina E. Gender aspects in urological disease. World J Urol 2023; 41:1719-1720. [PMID: 37439930 DOI: 10.1007/s00345-023-04504-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Affiliation(s)
- Ekaterina Laukhtina
- Department of Urology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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Li Q, Tian D, Cen J, Duan L, Xia W. Novel AVPR2 mutations and clinical characteristics in 28 Chinese families with congenital nephrogenic diabetes insipidus. J Endocrinol Invest 2021; 44:2777-2783. [PMID: 34101133 DOI: 10.1007/s40618-021-01607-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/02/2021] [Indexed: 01/01/2023]
Abstract
AIMS To investigate genotype and phenotype of congenital nephrogenic diabetes insipidus caused by AVPR2 mutations, which is rare and limitedly studied in Chinese population. METHODS 88 subjects from 28 families with NDI in a department (Beijing, PUMCH) were screened for AVPR2 mutations. Medical records were retrospectively reviewed and characterized. Genotype and phenotype analysis was performed. RESULTS 23 AVPR2 mutations were identified, including six novel mutations (p.Y117D, p.W208R, p.L313R, p.S127del, p.V162Sfs*30 and p.G251Pfs*96). The onset-age ranged from 1 week to 3 years. Common presentations were polydipsia and polyuria (100%) and intermittent fever (57%). 21% and 14% of patients had short stature and mental impairment. Urine SG and osmolality were decreased, while serum osmolality and sodium were high. Urological ultrasonography results showed hydronephrosis of the kidney (52%), dilation of the ureter (48%), and thickened bladder wall or increased residual urine (32%), led to intermittent urethral catheterization (7%), cystostomy (11%) and binary nephrostomy (4%). Urological defects were developed in older patients. Genotype and phenotype analysis revealed patients with non-missense mutations had higher levels of serum sodium than missense mutations. CONCLUSION In the first and largest case series of NDI caused by AVPR2 mutations in Chinese population, we established genetic profile and characterized clinical data, reporting six novel mutations. Further, we found genotype was associated with phenotype. This knowledge broadens genotype and phenotype spectrum of rare congenital NDI caused by AVPR2 mutations, and provides basis for studying molecular biology of AVPR2.
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Affiliation(s)
- Q Li
- Department of Endocrinology, Key Laboratory of Endocrinology, NHC, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Dongcheng District, Beijing, 100730, China
| | - D Tian
- Department of Nuclear Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, People's Republic of China
| | - J Cen
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - L Duan
- Department of Endocrinology, Key Laboratory of Endocrinology, NHC, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Dongcheng District, Beijing, 100730, China.
| | - W Xia
- Department of Endocrinology, Key Laboratory of Endocrinology, NHC, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Dongcheng District, Beijing, 100730, China.
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ÇAKICI MÇ, TEMİZ MZ, İPLİKÇİ A, ÖZGÖR F, AKSOY AK, ÖZER M, ERDEM S, ULUS İ, KÜÇÜK EV, ÖTÜNÇTEMUR A, DEĞİRMENCİ E, AYDIN R, ATIŞ G, MÜSLÜMANOĞLU AY, SARILAR Ö, ÖZCAN F, YILDIRIM A. The clinical impact of the COVID-19 pandemic on daily urological practice: first 3-month multicenter results from İstanbul. Turk J Med Sci 2021; 51:962-971. [PMID: 33433971 PMCID: PMC8283505 DOI: 10.3906/sag-2009-184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/12/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND/AIM The aim of this paper was to determine the general tendencies of urology patients and effect of COVID-19 pandemic on daily urological practice at tertiary centers located in the most affected area in Turkey. MATERIALS AND METHODS We retrospectively analyzed the data of 39,677 patients (group 1) that applied to 6 different large-volume tertiary centers in İstanbul for outpatient consultation, surgery, or other procedures in the 3-month period between March 16 and June 14, 2020. The distribution of the number of patients who applied to subspecialty sections of urology outpatient clinics and inpatient services were recorded by weeks. That data was compared to data obtained from 145,247 patients that applied to the same centers in the same period of the previous year (group 2). The reflection of worldwide and Turkish COVID-19 case distribution on the daily urological practice was analyzed. RESULTS There was a decrease in the number of patients in all subspecialty sections the in group 1 compared to group 2; however, there was a significant proportional increase in urooncology and general urology admissions. A decrease of approximately 75% was observed in the total number of surgeries (p < 0.001). We detected a negative correlation between the numbers of admission to all outpatient clinics and COVID-19 cases or deaths in Turkey (p < 0.05). The same negative correlation was present for all surgical procedures and consultations (p < 0.05). The multivariate linear regression analysis revealed that the number of cases in Turkey, and the number of deaths worldwide affect the number of outpatient clinic admissions (R2 = 0.38, p = 0.028) and urological surgery (R2 = 0.33, p = 0.020) in Turkey negatively. CONCLUSION This novel pandemic has implications even for urology practice. Urological surgical procedures were more affected by COVID-19-related deaths in Turkey and worldwide. Outpatient admissions and urological surgeries decreased significantly by increasing COVID-19 case numbers in Turkey and worldwide deaths.
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Affiliation(s)
- Mehmet Çağlar ÇAKICI
- Department of Urology, Istanbul Medeniyet University Goztepe Training and Research Hospital, İstanbulTurkey
- * To whom correspondence should be addressed. E-mail:
| | - Mustafa Zafer TEMİZ
- Department of Urology, Health Science University, Bağcılar Training and Research Hospital, İstanbulTurkey
| | - Ayberk İPLİKÇİ
- Department of Urology, Istanbul Medeniyet University Goztepe Training and Research Hospital, İstanbulTurkey
| | - Faruk ÖZGÖR
- Department of Urology, Health Science University, Sultangazi Haseki Training and Research Hospital, İstanbulTurkey
| | - Alper Kerem AKSOY
- Department of Urology, Health Science University, Ümraniye Training and Research Hospital, İstanbulTurkey
| | - Murat ÖZER
- Department of Urology, Health Science University, Okmeydanı Training and Research Hospital, İstanbulTurkey
| | - Selçuk ERDEM
- Department of Urology, Istanbul Faculty of Medicine, İstanbul University, İstanbulTurkey
| | - İsmail ULUS
- Department of Urology, Health Science University, Bağcılar Training and Research Hospital, İstanbulTurkey
| | - Eyüp Veli KÜÇÜK
- Department of Urology, Health Science University, Ümraniye Training and Research Hospital, İstanbulTurkey
| | - Alper ÖTÜNÇTEMUR
- Department of Urology, Health Science University, Okmeydanı Training and Research Hospital, İstanbulTurkey
| | - Enes DEĞİRMENCİ
- Department of Urology, Istanbul Faculty of Medicine, İstanbul University, İstanbulTurkey
| | - Reşat AYDIN
- Department of Urology, Istanbul Faculty of Medicine, İstanbul University, İstanbulTurkey
| | - Gökhan ATIŞ
- Department of Urology, Istanbul Medeniyet University Goztepe Training and Research Hospital, İstanbulTurkey
| | - Ahmet Yaser MÜSLÜMANOĞLU
- Department of Urology, Health Science University, Bağcılar Training and Research Hospital, İstanbulTurkey
| | - Ömer SARILAR
- Department of Urology, Health Science University, Sultangazi Haseki Training and Research Hospital, İstanbulTurkey
| | - Faruk ÖZCAN
- Department of Urology, Istanbul Faculty of Medicine, İstanbul University, İstanbulTurkey
| | - Asıf YILDIRIM
- Department of Urology, Istanbul Medeniyet University Goztepe Training and Research Hospital, İstanbulTurkey
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Davidson JR, Uus A, Matthew J, Egloff AM, Deprez M, Yardley I, De Coppi P, David A, Carmichael J, Rutherford MA. Fetal body MRI and its application to fetal and neonatal treatment: an illustrative review. Lancet Child Adolesc Health 2021; 5:447-458. [PMID: 33721554 PMCID: PMC7614154 DOI: 10.1016/s2352-4642(20)30313-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/28/2020] [Accepted: 09/08/2020] [Indexed: 12/14/2022]
Abstract
This Review depicts the evolving role of MRI in the diagnosis and prognostication of anomalies of the fetal body, here including head and neck, thorax, abdomen and spine. A review of the current literature on the latest developments in antenatal imaging for diagnosis and prognostication of congenital anomalies is coupled with illustrative cases in true radiological planes with viewable three-dimensional video models that show the potential of post-acquisition reconstruction protocols. We discuss the benefits and limitations of fetal MRI, from anomaly detection, to classification and prognostication, and defines the role of imaging in the decision to proceed to fetal intervention, across the breadth of included conditions. We also consider the current capabilities of ultrasound and explore how MRI and ultrasound can complement each other in the future of fetal imaging.
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Affiliation(s)
- Joseph R Davidson
- Prenatal Cell and Gene Therapy, Elizabeth Garrett Anderson Institute of Women's Health, University College London, London, UK; UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
| | - Alena Uus
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Jacqueline Matthew
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Alexia M Egloff
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Maria Deprez
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Iain Yardley
- Paediatric Surgery, Evelina London Children's Hospital, London, UK
| | - Paolo De Coppi
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK; Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children, London, UK; Katholieke Universiteit Leuven, Leuven, Belgium
| | - Anna David
- Prenatal Cell and Gene Therapy, Elizabeth Garrett Anderson Institute of Women's Health, University College London, London, UK; Fetal Medicine Unit, University College London, London, UK
| | - Jim Carmichael
- Paediatric Radiology, Evelina London Children's Hospital, London, UK
| | - Mary A Rutherford
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
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Gan ZS, Williams C, Familusi OO, El-Fahmawi A, Kabaha R, Lee DJ, Lee DI. Urologic emergencies before and after COVID-19: a retrospective chart review. Can J Urol 2021; 28:10614-10619. [PMID: 33872560] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
UNLABELLED INTRODUCTION During the coronavirus disease 2019 (COVID-19) pandemic, decreased presentations for various emergent conditions have been observed. Our objective was to compare the volume of patients with urologic emergencies presenting to emergency departments (EDs) within a single health system before and after the onset of the COVID-19 pandemic. MATERIALS AND METHODS A retrospective chart review was performed for 3 EDs within a single health system in the United States to identify all ED consults to urology from January 1, 2019 to May 31, 2020. For emergent consults, covariates were extracted, including demographic information, insurance status, Charlson Comorbidity Index (CCI) score, travel distance from home to the ED, and whether the patient had seen a provider in the hospital system before. Data were compared between COVID-19 months (March-May 2020) and corresponding months in 2019. RESULTS The study period encompassed 1,179 consults and 373 urologic emergencies. We observed not only a 22% decrease in urologic presentations to the ED compared to corresponding months in 2019, but also a 54% decrease in the proportion of urologic presentations that were truly emergent. For patients with emergent diagnoses, April 2020 saw an increase in Medicare/Medicaid coverage and a decrease in private insurance, May 2020 saw a decreased travel distance from home to the ED, and March and May 2020 saw an increase in patients who had previously seen a health system provider outside of the ED. No changes were seen in demographic characteristics or CCI. CONCLUSIONS During the early COVID-19 pandemic, urologic emergencies within a single health system decreased by 54% compared to the corresponding months pre-pandemic. Those who do present for care may be influenced by both locality and provider familiarity.
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Affiliation(s)
- Zoe S Gan
- Division of Urology, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Winkelman AJ, Beller HL, Morgan KE, Corbett ST, Leroy SV, Noona SW, Berry KL, Kern NG. Benefits and barriers to pediatric tele-urology during the COVID-19 pandemic. J Pediatr Urol 2020; 16:840.e1-840.e6. [PMID: 33077389 PMCID: PMC7543732 DOI: 10.1016/j.jpurol.2020.09.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/27/2020] [Accepted: 09/28/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Telemedicine video visits are an under-utilized form of delivering health care. However due to the COVID-19 pandemic, practices are rapidly adapting telemedicine for patient care. We describe our experience in rapidly introducing video visits in a tertiary academic pediatric urology practice, serving primarily rural patients during the COVID-19 pandemic. OBJECTIVE The primary aim of this study was to assess visit success rate and identify barriers to completing video visits. The secondary aim identified types of pathologies feasible for video visits and travel time saved. We hypothesize socioeconomic status is a predictor of a successful visit. MATERIALS AND METHODS Data was prospectively collected and analyzed on video visits focusing on visit success, defined by satisfactory completion of the visit as assessed by the provider. Other variables collected included duration, video platform and technical problems. Retrospective data was collected via chart review and analyzed including demographics, insurance, and distance to care. Socioeconomic status was estimated using the Distressed Communities Index generated for patient zip code. RESULTS/DISCUSSION Out of 116 attempted visits, 81% were successful. The top two reasons for failure were "no-show" (64%) and inability to connect (14%). Success versus failure of visit was similar for patient age (p = 0.23), sex (p = 0.42), type of visit (initial vs. established) (p = 0.51), and socioeconomic status (p = 0.39). After adjusting for race, socioeconomic status, and type of provider, having public insurance remained a significant predictor of failure (p = 0.017). Successful visits were conducted on multiple common pediatric urologic problems (excluding visits requiring palpation on exam), and video was sufficient for physical exams in most cases (Summary Table). A median of 2.25 h of travel time was saved. CONCLUSIONS While socioeconomic status, estimated using the Distressed Communities Index, did not predict success of video visits, patients with public insurance were more likely to have a failed video visit. There is compelling evidence that effective video visits for certain pathologies can be rapidly achieved in a pediatric urology practice with minimal preparation time.
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Affiliation(s)
| | - Haerin L Beller
- Department of Urology, University of Virginia, Charlottesville, VA, USA.
| | - Kathryn E Morgan
- Department of Urology, University of Virginia, Charlottesville, VA, USA.
| | - Sean T Corbett
- Department of Urology, University of Virginia, Charlottesville, VA, USA.
| | - Susan V Leroy
- Department of Urology, University of Virginia, Charlottesville, VA, USA.
| | - Sean W Noona
- School of Medicine, University of Virginia, Charlottesville, VA, USA.
| | - Kaitlin L Berry
- School of Medicine, University of Virginia, Charlottesville, VA, USA.
| | - Nora G Kern
- Department of Urology, University of Virginia, Charlottesville, VA, USA.
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12
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Bernardino R, Gil M, Andrade V, Severo L, Alves M, Papoila AL, Campos Pinheiro L. What has changed during the state of emergency due to COVID-19 on an Academic Urology Department of a Tertiary Hospital in Portugal. Actas Urol Esp 2020; 44:604-610. [PMID: 32843150 PMCID: PMC7381920 DOI: 10.1016/j.acuro.2020.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 06/30/2020] [Indexed: 12/13/2022]
Abstract
Objetivo Comparar la actividad del Servicio de Urología de un Hospital Universitario Portugués durante el estado de alarma y el periodo equivalente del año anterior. Comparamos el número de consultas electivas y pruebas diagnósticas urológicas, el número y el tipo de cirugías electivas, así como las características demográficas de los pacientes y las principales causas de ingreso al Servicio de Urgencias (SU) de Urología durante los dos periodos mencionados. Materiales y métodos Los datos de 691 pacientes que acudieron a urgencias desde el 18 de marzo de 2020 hasta el 2 de mayo de 2020 -y del mismo periodo del año anterior- se recogieron del software medico institucional. Los datos recopilados fueron edad, sexo, fecha de visita al servicio de urgencias, derivación desde otros hospitales, color del triaje, causa del ingreso, diagnóstico al alta y la necesidad de cirugía de urgencia u hospitalización. Con la intención de identificar las asociaciones entre las variables demográficas y clínicas con el hecho de haber sido sometido a una cirugía de urgencia (variable), se aplicaron modelos de regresión logística. Resultados El análisis multivariante mostró asociación entre el sexo del paciente con el hecho de ser sometido a una cirugía, con una disminución del 65,6% en las probabilidades para el género masculino. El periodo (COVID versus sin-COVID) no mostró una asociación significativa con la cirugía. Conclusión Nuestro departamento experimentó una reducción importante en la actividad. También observamos una reducción de las causas urgentes para acudir a los servicios de urgencias considerados menos graves. El porcentaje de casos que requirieron cirugía de urgencia y hospitalización fue mayor durante el periodo COVID.
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Affiliation(s)
- R Bernardino
- Urology Department, Central Lisbon Hospital Center, Lisbon, Portugal.
| | - M Gil
- Urology Department, Central Lisbon Hospital Center, Lisbon, Portugal
| | - V Andrade
- Urology Department, Central Lisbon Hospital Center, Lisbon, Portugal
| | - L Severo
- Urology Department, Central Lisbon Hospital Center, Lisbon, Portugal
| | - M Alves
- Epidemiology and Statistics Unit, Research Center, Central Lisbon Hospital Center, Lisbon, Portugal
| | - A L Papoila
- Epidemiology and Statistics Unit, Research Center, Central Lisbon Hospital Center, Lisbon, Portugal
| | - L Campos Pinheiro
- Urology Department, Central Lisbon Hospital Center, Lisbon, Portugal
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13
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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14
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Ojetti V, Covino M, Brigida M, Petruzziello C, Saviano A, Migneco A, Candelli M, Franceschi F. Non-COVID Diseases during the Pandemic: Where Have All Other Emergencies Gone? Medicina (Kaunas) 2020; 56:medicina56100512. [PMID: 33019514 PMCID: PMC7599851 DOI: 10.3390/medicina56100512] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 02/05/2023]
Abstract
Background and objectives: the emergency department (ED) is frequently identified by patients as a possible solution for all healthcare problems, leading to a high rate of misuse of the ED, possibly causing overcrowding. The coronavirus disease 2019 (COVID-19) pandemic started in China; it then spread throughout Italy, with the first cases confirmed in Lombardy, Italy, in February 2020. This has totally changed the type of patients referred to EDs. The aim of this study was to analyze the reduction of ED admissions at a Second level urban teaching (Fondazione Policlinico Universitario Agostino Gemelli IRCCS) during the COVID-19 pandemic. Materials and Methods: in this retrospective observational cross-sectional study, we reviewed and compared clinical records of all the patients consecutively admitted to our ED over a 40-day period (21 February -31 March) in the last three years (2018-2019-2020). Mean age, sex, triage urgency level, day/night admission, main presentation symptom, and final diagnosis, according to different medical specialties, hospitalization, and discharge rate, were analyzed. Results: we analyzed 16,281 patient clinical records. The overall reduction in ED admissions in 2020 was 37.6% compared to 2019. In 2020, we observed an increase in triage urgency levels for ED admissions (the main presentation symptom was a fever). We noticed a significant drop in admissions for cardio-thoracic, gastroenterological, urological, otolaryngologic/ophthalmologic, and traumatological diseases. Acute neurological conditions registered only a slight, but significant, reduction. Oncology admissions were stable. Admissions for infectious diseases were 30% in 2020, compared to 5% and 6% in 2018 and 2019, respectively. In 2020, the hospitalization rate increased to 42.9% compared to 27.7%, and 26.4% in previous years. Conclusions: the drastic reduction of ED admissions during the pandemic may be associated with fear of the virus, suggesting that patients with serious illnesses did not go to the emergency room. Moreover, there was possible misuse of the ED in the previous year. In particular, worrisome data emerged regarding a drop in cardiology and neurology admissions. Those patients postponed medical attention, possibly with fatal consequences, just for fear of exposure to COVID-19, leading to unnecessary morbidity and mortality.
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Affiliation(s)
- Veronica Ojetti
- Emergency Department—Fondazione Policlinico Universitario A. Gemelli, IRCCS—Largo A. Gemelli, 00168 1 Rome, Italy; (M.C.); (A.M.); (M.C.); (F.F.)
- Università Cattolica del Sacro Cuore—Largo F. Vito, 00168 1 Rome, Italy; (M.B.); (A.S.)
- Correspondence: ; Tel.: +39-06-30153188
| | - Marcello Covino
- Emergency Department—Fondazione Policlinico Universitario A. Gemelli, IRCCS—Largo A. Gemelli, 00168 1 Rome, Italy; (M.C.); (A.M.); (M.C.); (F.F.)
| | - Mattia Brigida
- Università Cattolica del Sacro Cuore—Largo F. Vito, 00168 1 Rome, Italy; (M.B.); (A.S.)
| | - Carmine Petruzziello
- Ospedale Cristo Re, Emergency Department—Via delle Calasanziane, 00168 25 Rome, Italy;
| | - Angela Saviano
- Università Cattolica del Sacro Cuore—Largo F. Vito, 00168 1 Rome, Italy; (M.B.); (A.S.)
| | - Alessio Migneco
- Emergency Department—Fondazione Policlinico Universitario A. Gemelli, IRCCS—Largo A. Gemelli, 00168 1 Rome, Italy; (M.C.); (A.M.); (M.C.); (F.F.)
| | - Marcello Candelli
- Emergency Department—Fondazione Policlinico Universitario A. Gemelli, IRCCS—Largo A. Gemelli, 00168 1 Rome, Italy; (M.C.); (A.M.); (M.C.); (F.F.)
| | - Francesco Franceschi
- Emergency Department—Fondazione Policlinico Universitario A. Gemelli, IRCCS—Largo A. Gemelli, 00168 1 Rome, Italy; (M.C.); (A.M.); (M.C.); (F.F.)
- Università Cattolica del Sacro Cuore—Largo F. Vito, 00168 1 Rome, Italy; (M.B.); (A.S.)
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15
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Affiliation(s)
- L Harper
- Department of Pediatric Urology and Pediatric Surgery, Hopital Pellegrin-Enfants, CHU Bordeaux, France.
| | - N Kalfa
- Service de chirurgie et urologie pédiatrique, hôpital Lapeyronie, CHU de Montpellier et Université de Montpellier, France.
| | - G M A Beckers
- Department of Urology, Section of Pediatric Urology, AmsterdamUMC, Location VUmc, Amsterdam, the Netherlands.
| | - M Kaefer
- Indiana University, 702 Barnhill Drive, Suite 4230, Indianapolis, IN, USA.
| | - A J Nieuwhof-Leppink
- Department of Medical Psychology and Social Work, Urology, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO box 85090, 3508 AB, Utrecht, the Netherlands.
| | - Magdalena Fossum
- Department of Pediatric Surgery, Copenhagen University Hospital Rigshospitalet, DK-2100, Denmark; Department of Women's and Children's Health, Bioclinicum, Floor 10, Karolinska Institutet, SE-171 76, Stockholm, Sweden.
| | - K W Herbst
- Division of Urology, Department of Research, Connecticut Children's Medical Center, Hartford, CT, USA.
| | - D Bagli
- Hospital for Sick Chidlren, Univeristy of Toronto, Canada.
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16
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Lu Y, Liu X. Urologists and the Novel Coronavirus Disease 2019 (COVID-19): a Urologist's Perspective from China. Urol J 2020; 17:557. [PMID: 32920814 DOI: 10.22037/uj.v16i7.6086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/13/2020] [Indexed: 06/11/2023]
Abstract
No need for letter to the editor.
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Affiliation(s)
- Yi Lu
- epartment of Urology, Tianjin Medical University General Hospital, Tianjin, 300052, China.
| | - Xiaoqiang Liu
- epartment of Urology, Tianjin Medical University General Hospital, Tianjin, 300052, China.
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17
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Jain A, Croghan SM, Kelly C, Scanlon L, Daniels AE, Fitzgibbon L, O'Connor K, Shields WP, Nama G, Cullen IM, Daly PJ. The Early Impact of COVID-19 on Urological Service Provision. Ir Med J 2020; 113:157. [PMID: 33730472] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Aim COVID-19 has posed an unprecedented challenge to healthcare systems. We aimed to observe the impact on urological care delivery in an Irish university hospital. Methods Data on urological activity was prospectively collected for 3 months from March 2020. A retrospective review of the same period in 2019 was performed for control data. Results Over the 2020 study period, 356 urological admissions were recorded; a 23.1% decrease from the 2019 corresponding period(n=463). A 21.7% decrease in flexible cystoscopies was seen (162 versus 207). 125 theatre cases (36 off-site) were performed in the 2020 period, versus 151 in 2019. Emergency case load remained stable, with 69 cases in the 2020 period. The percentage of trainee-performed cases was preserved. COVID-era outpatient activity increased, to involve 559 clinic consultations compared to 439 the preceding year; a reflection of annual growth in service demand and facilitated by virtual clinic application (n=403). There were 490 instances of patients cancelling/failing to attend outpatient appointments, compared to 335 in 2019. Conclusion The Irish COVID-19 outbreak has created obstacles for urological care. Nonetheless, urgent/emergent urological cases persist. Our unit has managed this to-date with flexible adaptation of service delivery. The global challenge posed by COVID-19 will demand ongoing resourcefulness to minimise impact on patients with time-sensitive urological conditions.
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Affiliation(s)
- A Jain
- University Hospital Waterford, Waterford, Ireland
| | - S M Croghan
- University Hospital Waterford, Waterford, Ireland
| | - C Kelly
- University Hospital Waterford, Waterford, Ireland
| | - L Scanlon
- University Hospital Waterford, Waterford, Ireland
| | - A E Daniels
- University Hospital Waterford, Waterford, Ireland
| | - L Fitzgibbon
- University Hospital Waterford, Waterford, Ireland
| | - K O'Connor
- University Hospital Waterford, Waterford, Ireland
| | - W P Shields
- University Hospital Waterford, Waterford, Ireland
| | - G Nama
- University Hospital Waterford, Waterford, Ireland
| | - I M Cullen
- University Hospital Waterford, Waterford, Ireland
| | - P J Daly
- University Hospital Waterford, Waterford, Ireland
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18
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Papaefstathiou E, Apostolopoulou A, Papaefstathiou E, Moysidis K, Hatzimouratidis K, Sarafis P. Urology during a Crisis: A Management Algorithm. Urol J 2020; 17:536-539. [PMID: 32869251 DOI: 10.22037/uj.v16i7.6278] [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] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/09/2020] [Indexed: 06/11/2023]
Abstract
COVID-19 pandemic has affected more than a million people worldwide causing a public health crisis. Under these unique circumstances, urologists continue to provide essential healthcare services and support healthcare systems, by participating in the treatment of COVID-19(+) patients and sparing vital equipment and hospital beds. However, delivering medical care during the pandemic requires strategic planning for all surgical and outpatient activities. Proposed measures include rescheduling elective non-oncological surgeries and using a prioritization protocol for oncological surgeries according to hospital capacity. Following that, outpatient clinics could be partly replaced by telemedicine. Additionally, urologists should be trained in screening and treating patients with COVID-19 during their daily routine. In order to efficiently provide their services, a management protocol for suspected or known COVID-19 urological patients should be implemented. Furthermore, preventive measures for the nosocomial dispersion of the virus and training on self-protective equipment is mandatory for all physicians. Finally, organizational planning for the best utilization of the staff is of utmost importance. Implementation and adaptation of the protocols according to local requirements and guidelines will ameliorate the quality of services and population's health status. Finally, enhancement of current practices will prepare health systems for future crisis.
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Affiliation(s)
- Efstathios Papaefstathiou
- 2nd Urology Department of Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Aikaterini Apostolopoulou
- GP- Emergency Department, General Hospital AHEPA, reference center for COVID-19, Thessaloniki, Greece.
| | | | - Kyriakos Moysidis
- 2nd Urology Department of Medical School, Aristotle University of Thessaloniki.
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19
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Soytas M, Boz MY, Guzelburc V, Calik G, Kactan MC, Horuz R, Akbulut Z, Albayrak S. Analysis of patients undergoing urological intervention amid the COVID-19: experience from the pandemic hospital. Int Urol Nephrol 2020; 52:2059-2064. [PMID: 32583371 PMCID: PMC7312099 DOI: 10.1007/s11255-020-02553-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/20/2020] [Indexed: 01/22/2023]
Abstract
Purpose It is reported that surgical procedures performed during the COVID-19 pandemic are accompanied by high complications and risks. In this study, the urological interventions applied with appropriate infrastructure and protocols during the pandemic in the pandemic hospital that is carrying out the COVID-19 struggle are analyzed. Methods Urological interventions were reviewed in the 5-week period between March 11 and April 16. The distribution of outpatient and interventional procedures was determined by weeks concurrently along with the COVID-19 patient workload, and data in the country, subgroups were further analyzed. Patients intervened were divided into four groups as Emergency, High, Intermediate, and Low Priority cases according to the EAU recommendations. The COVID-19-related findings were recorded; staff and patient effects were reported. Results Of the 160 interventions, 65 were minimally invasive or open surgical intervention, 95 were non-surgical outpatient intervention, and the outpatient admission was 777. According to the priority level, 33 cases had emergency and high priority, 32 intermediate and low priority. COVID-19 quarantine and follow-up were performed at least 1 week in 22 (33.8%) operated patients at the last week, 43 (66.2%) patients who were operated in the previous 4 weeks followed up at least 2 weeks. No postoperative complications were encountered in any patient due to COVID-19 during the postoperative period. Conclusion In the COVID-19 pandemic, precautions, isolation, and algorithms are required to avoid disruption in the intervention and follow-up of urology patients; priority urological interventions should not be disrupted in the presence of necessary experience and infrastructure.
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Affiliation(s)
- Mustafa Soytas
- Department of Urology, Faculty of Medicine, Istanbul Medipol University, 34200 Istanbul, Turkey
| | - Mustafa Yucel Boz
- Department of Urology, Faculty of Medicine, Istanbul Medipol University, 34200 Istanbul, Turkey
| | - Vahit Guzelburc
- Department of Urology, Faculty of Medicine, Istanbul Medipol University, 34200 Istanbul, Turkey
| | - Gokhan Calik
- Department of Urology, Faculty of Medicine, Istanbul Medipol University, 34200 Istanbul, Turkey
| | - Mehmet Cagri Kactan
- Department of Urology, Faculty of Medicine, Istanbul Medipol University, 34200 Istanbul, Turkey
| | - Rahim Horuz
- Department of Urology, Faculty of Medicine, Istanbul Medipol University, 34200 Istanbul, Turkey
| | - Ziya Akbulut
- Department of Urology, Faculty of Medicine, Istanbul Medipol University, 34200 Istanbul, Turkey
| | - Selami Albayrak
- Department of Urology, Faculty of Medicine, Istanbul Medipol University, 34200 Istanbul, Turkey
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20
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Wang C, Zhu G, Zhang L, Chen K. Particulate matter pollution and hospital outpatient visits for endocrine, digestive, urological, and dermatological diseases in Nanjing, China. Environ Pollut 2020; 261:114205. [PMID: 32113107 DOI: 10.1016/j.envpol.2020.114205] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/16/2020] [Accepted: 02/16/2020] [Indexed: 06/10/2023]
Abstract
Clinical or pathological evidence demonstrated that air pollution could undermine other organ systems of human body besides respiratory and circulation systems. Investigations that directly relate hospital outpatient visits for endocrine (ENDO), digestive (DIGE), urological (UROL), and dermatological (DERM) diseases categories with ambient particulate matter (PM) are still lacking, particularly in heavily polluted cities. Here, we conducted a time-series analysis using 812,624, 1,111,342, 539,803, and 741,662 hospital visits for ENDO, DIGE, UROL, and DERM, respectively, in Nanjing, China from 2013 to 2019. A generalized additive model was applied to estimate the exposure-response associations. Results showed that a 10 μg/m3 increase in PM2.5 concentration on lag 0 day was significantly associated with 0.59% (95% CI: 0.30%, 0.88%), 0.43% (0.15%, 0.70%), 0.36% (0.06%, 0.66%), and 0.65% (0.42%, 0.87%) increase for ENDO, DIGE, UROL, and DERM hospital visits, respectively. The estimated effects of PM10 were slightly smaller but still statistically significant. The magnitude and significance of the associations between PM and four health outcomes were sensitive to additional adjustment for co-pollutants. Exposure-response relationships were linear for PM concentrations lower than 100 μg/m3 but the curves became nonlinear across the full range of exposures due to a flatten slope at higher concentrations. We also explored the effect modifications by season (cold or warm), age (5-18, 18-64, 65-74, or 75+ years), and sex (male or female). Results showed that the DERM-related population aged 65 years or older was more vulnerable to PM exposure, compared with the 5 to 17-year age group; the DERM-related population aged 75 years or older and 65 years or older was more vulnerable to PM2.5 and PM10 exposure, respectively, compared with the 18 to 64-year age group. Our study provided suggestive evidence that ambient PM pollution was associated with ENDO, DIGE, UROL, and DERM outpatient hospital visits in Nanjing, China.
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Affiliation(s)
- Ce Wang
- School of Energy and Environment, Southeast University, Nanjing, 210096, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Southeast University, Nanjing, 210096, PR China.
| | - Guangcan Zhu
- School of Energy and Environment, Southeast University, Nanjing, 210096, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Southeast University, Nanjing, 210096, PR China.
| | - Lei Zhang
- Outpatient Department, Zhongda Hospital of Southeast University, Nanjing, 210096, PR China.
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, 06520-8034, USA.
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Porreca A, Colicchia M, D'Agostino D, Amenta M, Corsaro A, Zaramella S, Zegna L, Gallo F, Schenone M, Bozzini G, Calori A, Pastore AL, Al Salhi Y, Sciorio C, Spirito L, Varca V, Marenghi C, Greco F, Altieri VM, Verze P, Barba C, Antonelli A, Cerruto MA, Falabella R, Di Bello S, Leonardo C, Tufano A, Volpe A, Umari P, Parma P, Nidini M, Pini G, Borghesi M, Terrone C, Cacciamani GE, Sighinolfi MC, Busetto GM, Wennberg AM, Finocchiaro M, Falsaperla M, Oderda M, Ceruti C, Rocco B, Schiavina R, Bianchi L, Mari A, Di Maida F, Dalpiaz O, Celia A, Pirozzi M, Bove P, Iacovelli V, Cafarelli A, Cindolo L, Ferrari G, Gatti L, Pirola G, Annino F, Pucci L, Romagnoli D, Artibani W, Minervini A. Urology in the Time of Coronavirus: Reduced Access to Urgent and Emergent Urological Care during the Coronavirus Disease 2019 Outbreak in Italy. Urol Int 2020; 104:631-636. [PMID: 32434207 PMCID: PMC7360500 DOI: 10.1159/000508512] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/07/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) pandemic has put a substantial burden on the Italian healthcare system, resulting in the restructuring of hospitals to care for COVID-19 patients. However, this has likely impacted access to care for patients experiencing other conditions. We aimed to quantify the impact of COVID-19 on access to care for patients with urgent/emergent urological conditions throughout Italy. MATERIALS AND METHODS A questionnaire was sent to 33 urological units in the AGILE consortium, asking clinicians to report on the number of urgent/emergent urological patients seen and/or undergoing surgery over a 3-week period during the peak of the COVID-19 outbreak and a reference week prior to the outbreak. ANOVA and linear regression models were used to quantify these changes. RESULTS Data from 27 urological centres in Italy showed a decrease from 956 patients/week seen just prior to the outbreak to 291 patients/week seen by the end of the study period. There was a difference in the number of patients with urgent/emergent urological disease seen within/during the different weeks (all p values < 0.05). A significant decrease in the number of patients presenting with haematuria, urinary retention, urinary tract infection, scrotal pain, renal colic, or trauma and urgent/emergent cases that required surgery was reported (all p values < 0.05). CONCLUSION In Italy, during the COVID-19 outbreak there has been a decrease in patients seeking help for urgent/emergent urological conditions. Restructuring of hospitals and clinics is mandatory to cope with the COVID-19 pandemic; however, the healthcare system should continue to provide adequate levels of care also to patients with other conditions.
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Affiliation(s)
- Angelo Porreca
- Department of Urology, Policlinico Abano Terme, Abano Terme, Italy
| | | | | | - Michele Amenta
- Department of Urology, Ospedale Civile di Portogruaro, Portogruaro, Italy
| | - Alfio Corsaro
- Department of Urology, Ospedale Civile di Portogruaro, Portogruaro, Italy
| | | | - Luisa Zegna
- Department of Urology, Biella Hospital, Ponderano, Italy
| | - Fabrizio Gallo
- Department of Surgery, Division of Urology, San Paolo Hospital, Savona, Italy
| | - Maurizio Schenone
- Department of Surgery, Division of Urology, San Paolo Hospital, Savona, Italy
| | - Giorgio Bozzini
- Department of Urology, ASST Valle Olona, Busto Arsizio, Italy
| | - Alberto Calori
- Department of Urology, ASST Valle Olona, Busto Arsizio, Italy
| | - Antonio L Pastore
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Urology Unit, ICOT Hospital Latina, Rome, Italy
| | - Yazan Al Salhi
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Urology Unit, ICOT Hospital Latina, Rome, Italy
| | | | | | - Virginia Varca
- Hospital G. Salvini, ASST Rhodense Garbagnate Milanese, Milan, Italy
| | - Carlo Marenghi
- Hospital G. Salvini, ASST Rhodense Garbagnate Milanese, Milan, Italy
| | | | | | - Paolo Verze
- Department of Urology, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Ciro Barba
- Department of Urology, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Alessandro Antonelli
- Department of Urology, Azienda Ospedaliera Universitaria Integrata of Verona, University of Verona, Verona, Italy
| | - Maria A Cerruto
- Department of Urology, Azienda Ospedaliera Universitaria Integrata of Verona, University of Verona, Verona, Italy
| | - Roberto Falabella
- Department of Urology, Azienda Ospedaliera Regionale di Potenza, Potenza, Italy
| | - Silvana Di Bello
- UO Pronto Soccorso, Accettazione, Medicina Urgenza, Azienda Ospedaliera Regionale di Potenza, Potenza, Italy
| | | | - Antonio Tufano
- Department of Urology, La Sapienza University of Rome, Rome, Italy
| | - Alessandro Volpe
- Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Paolo Umari
- Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Paolo Parma
- Urology Department, ASST Mantova, Mantova, Italy
| | | | | | - Marco Borghesi
- Department of Urology, S. Martino Hospital, Department of Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy
| | - Carlo Terrone
- Department of Urology, S. Martino Hospital, Department of Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy
| | - Giovanni E Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Maria C Sighinolfi
- Urology Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Gian Maria Busetto
- Department of Urology, Sapienza Rome University Policlinico Umberto I, Rome, Italy
| | - Alexandra M Wennberg
- Department of Neurosciences (Padova Neuroscience Centre), Università degli Studi di Padova, Padova, Italy
| | | | | | - Marco Oderda
- Università di Torino, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Carlo Ceruti
- Università di Torino, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Bernardo Rocco
- Urology Department, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Lorenzo Bianchi
- Department of Urology, University of Bologna, Bologna, Italy
| | - Andrea Mari
- Department of Urology, University of Florence, Florence, Italy
| | | | - Orietta Dalpiaz
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Antonio Celia
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Italy
| | - Marco Pirozzi
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Italy
| | - Pierluigi Bove
- Urology Unit, San Carlo Di Nancy Hospital, GVM Care and Research, Rome, Italy
| | - Valerio Iacovelli
- Urology Unit, San Carlo Di Nancy Hospital, GVM Care and Research, Rome, Italy
| | | | - Luca Cindolo
- Department of Urology, Villa Stuart Casa di Cura, Rome, Italy
| | | | - Lorenzo Gatti
- Department of Urology, Hesperia Hospital, Modena, Italy
| | - Giacomo Pirola
- Department of Urology, San Donato Hospital, USL Toscana Sudest, Arezzo, Italy
| | - Filippo Annino
- Department of Urology, San Donato Hospital, USL Toscana Sudest, Arezzo, Italy
| | - Luigi Pucci
- Department of Urology, AORN A. Cardarelli, Naples, Italy
| | | | - Walter Artibani
- Department of Urology, Policlinico Abano Terme, Abano Terme, Italy
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Martí D, Carballeira D, Morales MJ, Concepción R, Del Castillo H, Marschall A, Delgado-Calva FA, Dejuán-Bitriá C, Pérez-Guzmán J, López-Soberón E, Palazuelos J, Álvarez-Antón S. Impact of Anemia on the Risk of Bleeding Following Percutaneous Coronary Interventions in Patients ≥75 Years of Age. Am J Cardiol 2020; 125:1142-1147. [PMID: 32087994 DOI: 10.1016/j.amjcard.2020.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 01/18/2020] [Accepted: 01/21/2020] [Indexed: 12/19/2022]
Abstract
Bleeding risk stratification is an unresolved issue in older adults. Anemia may reflect subclinical blood losses that can be exacerbated after percutaneous coronary intervention . We sought to prospectively determine the contribution of anemia to the risk of bleeding in 448 consecutive patients aged 75 or more years, treated by percutaneous coronary interventions without concomitant indication for oral anticoagulation. We evaluated the effect of WHO-defined anemia on the incidence of 1-year nonaccess site-related major bleeding. The prevalence of anemia was 39%, and 13.1% of anemic and 5.2% of nonanemic patients suffered a bleeding event (hazard ratio 2.75, 95% confidence interval 1.37 to 5.54, p = 0.004). Neither PRECISE-DAPT nor CRUSADE scores were superior to hemoglobin for the prediction of bleeding. In conclusion, anemia is a powerful predictor of bleeding with potential utility for simplifying tailoring therapies.
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Affiliation(s)
- David Martí
- Cardiology Department, Central Defense Hospital, Alcalá University, Madrid, Spain.
| | - Damaris Carballeira
- Cardiology Department, Central Defense Hospital, Alcalá University, Madrid, Spain
| | - María José Morales
- Cardiology Department, Central Defense Hospital, Alcalá University, Madrid, Spain
| | - Ricardo Concepción
- Cardiology Department, Central Defense Hospital, Alcalá University, Madrid, Spain
| | - Hugo Del Castillo
- Cardiology Department, Central Defense Hospital, Alcalá University, Madrid, Spain
| | - Alexander Marschall
- Cardiology Department, Central Defense Hospital, Alcalá University, Madrid, Spain
| | | | - Carmen Dejuán-Bitriá
- Cardiology Department, Central Defense Hospital, Alcalá University, Madrid, Spain
| | - Joaquín Pérez-Guzmán
- Cardiology Department, Central Defense Hospital, Alcalá University, Madrid, Spain
| | - Edurne López-Soberón
- Cardiology Department, Central Defense Hospital, Alcalá University, Madrid, Spain
| | - Jorge Palazuelos
- Cardiology Department, Central Defense Hospital, Alcalá University, Madrid, Spain
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Gungabissoon U, Perera G, Galwey NW, Stewart R. The association between dementia severity and hospitalisation profile in a newly assessed clinical cohort: the South London and Maudsley case register. BMJ Open 2020; 10:e035779. [PMID: 32284392 PMCID: PMC7200045 DOI: 10.1136/bmjopen-2019-035779] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/07/2020] [Accepted: 03/20/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To evaluate the risk and common causes of hospitalisation in patients with newly diagnosed dementia and variation by severity of cognitive impairment. SETTING We used data from a large London mental healthcare case register linked to a national hospitalisation database. PARTICIPANTS Individuals aged ≥65 years with newly diagnosed dementia with recorded cognitive function and the catchment population within the same geography. OUTCOME MEASURES We evaluated the risk and duration of hospitalisation in the year following a dementia diagnosis. In addition we identified the most common causes of hospitalisation and calculated age-standardised and gender-standardised admission ratios by dementia severity (mild/moderate/severe) relative to the catchment population. RESULTS Of the 5218 patients with dementia, 2596 (49.8%) were hospitalised in the year following diagnosis. The proportion of individuals with mild, moderate and severe dementia who had a hospital admission was 47.9%, 50.8% and 51.7%, respectively (p= 0.097). Duration of hospital stay increased with dementia severity (median 2 days in mild to 4 days in severe dementia, p 0.0001). After excluding readmissions for the same cause, the most common primary hospitalisation discharge diagnoses among patients with dementia were urinary system disorders, pneumonia and fracture of femur, accounting for 15%, 10% and 6% of admissions, respectively. Overall, patients with dementia were hospitalised 30% more than the catchment population, and this trend was observed for most of the discharge diagnoses evaluated. Standardised admission ratios for urinary and respiratory disorders were higher in those with more severe dementia at diagnosis. CONCLUSIONS Individuals with a dementia diagnosis were more likely to be hospitalised than individuals in the catchment population. The length of hospital stay increased with dementia severity. Most of the common causes of hospitalisation were more common than expected relative to the catchment population, but standardised admission ratios only varied by dementia stage for certain groups of conditions.
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Affiliation(s)
- Usha Gungabissoon
- Epidemiology (Value Evidence and Outcomes), GSK, Brentford, London, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Gayan Perera
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Robert Stewart
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
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24
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Capogrosso P, Candela L, Rossi P, Guarasci C, Muttin F, Roscigno M, Chianese R, Santoleri L, Tassara M, Carcano G, Naspro R, Da Pozzo L, Montorsi F, Salonia A, Dehò F. Increased Use of Blood Transfusions to Manage Urological Conditions during the COVID-19 Pandemic. Urol Int 2020; 104:849-852. [PMID: 33017835 PMCID: PMC7573906 DOI: 10.1159/000511651] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 09/08/2020] [Indexed: 12/02/2022]
Abstract
Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to an extensive reorganization of the healthcare system in Italy, with significant deferment of the treatment of urology patients. We aimed to assess the impact of deferred treatment during the SARS-CoV-2 pandemic on the need for blood transfusions in 3 Italian urology departments. Methods We reviewed hospital chart data on blood transfusions at the urology units of 3 academic centers in the north of Italy from March to April 2020. Data were compared with values from the same time frame in 2019 (March to April 2019). Results We observed significant reductions of the number of patients admitted to the urology units from March to April 2020 (373 vs. 119) and the number of performed surgeries (242 vs. 938) compared to 2019. Though, the number of transfused blood units was comparable between the 2 years (182 vs. 252), we found a greater mean number of blood units transfused per admission in 2020 (0.49 vs. 0.22; p < 0.0001). As a whole, the transfusion rate for hematuria was higher in 2020 than in 2019 (36 vs. 7.9%; p < 0.0001). Discussion/Conclusion The observed increased number of blood transfusions needed throughout the SARS-CoV-2 era could have had a negative impact on both patients and the healthcare system. It is possible to speculate that this is the consequence of a delayed diagnosis and deferred treatment of acute conditions.
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Affiliation(s)
- Paolo Capogrosso
- Department of Urology, Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi, Varese, Italy,
| | - Luigi Candela
- Unit of Urology, Division of Experimental Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Piercarlo Rossi
- Department of Urology, Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi, Varese, Italy
| | - Cristian Guarasci
- Department of Urology, Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi, Varese, Italy
| | - Fabio Muttin
- Vita-Salute San Raffaele University, Milan, Italy
- Department of Urology, Papa Giovanni XIII Hospital, Bergamo, Italy
| | - Marco Roscigno
- Department of Urology, Papa Giovanni XIII Hospital, Bergamo, Italy
| | - Rosa Chianese
- Department of Urology, Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi, Varese, Italy
- University of Insubria, Varese, Italy
| | - Luca Santoleri
- Unit of Urology, Division of Experimental Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Michela Tassara
- Unit of Urology, Division of Experimental Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Giulio Carcano
- Department of Urology, Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi, Varese, Italy
- University of Insubria, Varese, Italy
| | - Richard Naspro
- Department of Urology, Papa Giovanni XIII Hospital, Bergamo, Italy
| | - Luigi Da Pozzo
- Department of Urology, Papa Giovanni XIII Hospital, Bergamo, Italy
- University of Bicocca, Milan, Italy
| | - Francesco Montorsi
- Unit of Urology, Division of Experimental Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Salonia
- Unit of Urology, Division of Experimental Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Federico Dehò
- Department of Urology, Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi, Varese, Italy
- University of Insubria, Varese, Italy
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25
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Khan DM, Asghar N, Ali I, Khan WA. The frequency of various diseases among patients attending Tehsil Headquarter Hospital Khwazakela, Swat. J PAK MED ASSOC 2019; 69:1369-1371. [PMID: 31511727] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This hospital-based study was conducted in THQ (Tehsil Headquarter) Hospital Khwazakhela, district Swat in April 2018, to determine the incidence of various diseases among patients in general and the cases attended in the OPD (out patients department) in particular. One year of data was taken from April 2017 to March 2018, of all the patients who attended the THQ Hospital to check the frequency of individual diseases, month wise, gender wise, age wise as well as, case wise. Information on patients attending OPD with respiratory, gastro intestinal, urinary tract diseases and other communicable diseases were compiled. A total of 219,056 patients attended Civil Hospital Khwazakhela during that period, with an average of 18,254.66 patients per month. This comprised 104,349(47.63%) males and 114,707 (52.36%) females. Most patients were in the age group of 15 to 59 years which comprised a total of 109,217 (49.85%) patients. In this age group 42,713 (39.10%) were males and 66,504 (60.89%) were females. A total of 77,286 patients attended OPD having respiratory, gastro intestinal, urinary tract diseases and communicable diseases. Among these patients, about 28,115 (36.37%) had respiratory diseases, 23,045 (29.81%) had gastro intestinal diseases, 18,060 (23.36%) had urinary tract diseases and 8,066 (10.43%) had other communicable diseases. Respiratory diseases were the most common in our study. The ratio of female cases was higher than males. Most of the patients were in the age group of 15-59 years. The emerging challenges for health practitioners are to prevent respiratory diseases that pose a major healthcare burden in the region.
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Loughlin KR. Global warming: the implications for urologic disease. Can J Urol 2019; 26:9806-9808. [PMID: 31469634] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Global warming is receiving more attention in both the lay and scientific press. However, many individuals still view global warming as an abstract, distant concern that has little, if any, impact on their daily lives. As urologists, it is important to realize that global warming may influence some of the diseases that we treat. Much of the scientific basis for the link between climate and urologic disease is still in its nascent stages. However, a review of the emerging literature suggests that climatic changes may well alter the frequency of some urologic conditions.
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Affiliation(s)
- Kevin R Loughlin
- Division of Urology, Brigham and Women's Hospital, Harvard Medical Center, Boston, Massachusetts, USA
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27
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Wang Y, Yao C, Xu C, Zeng X, Zhou M, Lin Y, Zhang P, Yin P. Carbon monoxide and risk of outpatient visits due to cause-specific diseases: a time-series study in Yichang, China. Environ Health 2019; 18:36. [PMID: 31014335 PMCID: PMC6477706 DOI: 10.1186/s12940-019-0477-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 12/20/2018] [Accepted: 04/05/2019] [Indexed: 05/08/2023]
Abstract
BACKGROUND Previous studies showed inconsistent results on risk of increased outpatient visits for cause-specific diseases associated with ambient carbon monoxide (CO). METHODS Daily data for CO exposure and outpatient visits for all-causes and five specific diseases in Yichang, China from 1st January 2016 to 31st December 2017 were collected. Generalised additive models with different lag structures were used to examine the short-term effects of ambient CO on outpatient visits. Potential effect modifications by age, sex and season were examined. RESULTS A total of 5,408,021 outpatient visits were recorded. We found positive and statistically significant associations between CO and outpatient visits for multiple outcomes and all the estimated risks increased with longer moving average lags. An increase of 1 mg/m3 of CO at lag06 (a moving average of lag0 to lag6), was associated with 24.67% (95%CI: 14.48, 34.85%), 21.79% (95%CI: 12.24, 31.35%), 39.30% (95%CI: 25.67, 52.92%), 25.83% (95%CI: 13.91, 37.74%) and 19.04% (95%CI: 8.39, 29.68%) increase in daily outpatient visits for all-cause, respiratory, cardiovascular, genitourinary and gastrointestinal diseases respectively. The associations for all disease categories except for genitourinary diseases were statistically significant and stronger in warm seasons than cool seasons. CONCLUSION Our analyses provide evidences that the CO increased the total and cause-specific outpatient visits and strengthen the rationale for further reduction of CO pollution levels in Yichang. Ambient CO exerted adverse effect on respiratory, cardiovascular, genitourinary, gastrointestinal and neuropsychiatric diseases especially in the warm seasons.
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Affiliation(s)
- Yu Wang
- Department of Anesthesiology, Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Chengye Yao
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Chengzhong Xu
- Yichang Center for Disease Control and Prevention, 3 Dalian Road, Yichang, 443005 China
| | - Xinying Zeng
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 China
| | - Yun Lin
- Department of Anesthesiology, Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Pei Zhang
- Yichang Center for Disease Control and Prevention, 3 Dalian Road, Yichang, 443005 China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 China
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28
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Vasconcelos MA, Simões E Silva AC, Dias CS, Gomes IR, Carvalho RA, Figueiredo SV, Dumont TR, Oliveira MCL, Pinheiro SV, Mak RH, Oliveira EA. Posterior urethral valves: comparison of clinical outcomes between postnatal and antenatal cohorts. J Pediatr Urol 2019; 15:167.e1-167.e8. [PMID: 30554921 DOI: 10.1016/j.jpurol.2018.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/09/2018] [Accepted: 11/14/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Posterior urethral valves (PUVs) constitute the most common infravesical urinary obstruction in boys and are often accompanied by severe consequences to the lower and upper urinary tract. Currently, about two-thirds of diagnosis of PUVs has been suspected by prenatal ultrasonography findings. The aim of this study was to compare long-term clinical outcomes in two groups of patients with PUVs, with antenatal vs. postnatal diagnosis. STUDY DESIGN This was a retrospective cohort study of 173 patients with PUVs systematically followed up in a tertiary center. Median follow-up time was 66.5 months (interquartile range [IQ], 11.4-147.9 months) for those patients who survived neonatal period. Seventy-nine (45.6%) patients were followed up for more than 5 years and 55 (32%) for more than 10 years. For analysis, the cohort was stratified into two groups according to the clinical presentation (prenatal vs. postnatal). The events of interest were urinary tract infection (UTI), surgical interventions, proteinuria, hypertension, chronic kidney disease (CKD), and death. Survival analyses were performed to evaluate time until occurrence of the events. RESULTS Sixty-two patients (35.8%) were diagnosed by fetal sonography. Patients of postnatal group presented a higher incidence rate of UTI episodes (6.5, 95% confidence interval [CI], 4.9-8.3) than antenatal group (1.2, 95% CI, 0.4-2.7) (P < 0.001). Thirty-six patients (21%) presented hypertension, and 77 (44.5%) had persistent mild proteinuria. There was no significant difference in the estimated incidence of hypertension (P = 0.28) and proteinuria (P = 0.78) between antenatal and postnatal groups. The cumulative incidence of CKD stage ≥3 was estimated to be about 37% at 10 years of age, and 56% at 18 years of age. By survival analysis, there was no significant difference in the estimated incidence of CKD stage ≥3 (log-rank = 0.32, P = 0.57) and CKD stage 5 (log-rank = 1.08, P = 0.28, Figure) between antenatal and postnatal groups. Of 173 patients included in the analysis, 13 (7.5%) died during follow-up with a median age of 2.6 months (IQ, 15 days-62 months). Survival analyses have not shown any significant difference in the estimated incidence of death between antenatal and postnatal groups (log-rank = 1.38, P = 0.24). CONCLUSION The study findings did not corroborate the initial hypothesis that the rates of renal function declining in patients with PUVs would be attenuated by an early diagnosis and intervention after antenatal diagnosis.
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Affiliation(s)
- M A Vasconcelos
- Pediatric Nephrourology Division, Department of Pediatrics, National Institute of Science and Technology (INCT) of Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais(UFMG), Brazil
| | - A C Simões E Silva
- Pediatric Nephrourology Division, Department of Pediatrics, National Institute of Science and Technology (INCT) of Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais(UFMG), Brazil
| | - C S Dias
- Pediatric Nephrourology Division, Department of Pediatrics, National Institute of Science and Technology (INCT) of Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais(UFMG), Brazil
| | - I R Gomes
- Pediatric Nephrourology Division, Department of Pediatrics, National Institute of Science and Technology (INCT) of Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais(UFMG), Brazil
| | - R A Carvalho
- Pediatric Nephrourology Division, Department of Pediatrics, National Institute of Science and Technology (INCT) of Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais(UFMG), Brazil
| | - S V Figueiredo
- Pediatric Nephrourology Division, Department of Pediatrics, National Institute of Science and Technology (INCT) of Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais(UFMG), Brazil
| | - T R Dumont
- Pediatric Nephrourology Division, Department of Pediatrics, National Institute of Science and Technology (INCT) of Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais(UFMG), Brazil
| | - M C L Oliveira
- Pediatric Nephrourology Division, Department of Pediatrics, National Institute of Science and Technology (INCT) of Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais(UFMG), Brazil
| | - S V Pinheiro
- Pediatric Nephrourology Division, Department of Pediatrics, National Institute of Science and Technology (INCT) of Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais(UFMG), Brazil
| | - R H Mak
- Division of Pediatric Nephrology, Rady Children's Hospital San Diego, University of California, San Diego, La Jolla, CA, USA
| | - E A Oliveira
- Pediatric Nephrourology Division, Department of Pediatrics, National Institute of Science and Technology (INCT) of Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais(UFMG), Brazil; Visiting Scholar, Division of Pediatric Nephrology, Rady Children's Hospital San Diego, University of California, San Diego, La Jolla, CA, USA.
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Borg M, Nitschke M, Williams S, McDonald S, Nairn J, Bi P. Using the excess heat factor to indicate heatwave-related urinary disease: a case study in Adelaide, South Australia. Int J Biometeorol 2019; 63:435-447. [PMID: 30687904 DOI: 10.1007/s00484-019-01674-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 01/12/2019] [Accepted: 01/15/2019] [Indexed: 06/09/2023]
Abstract
The excess heat factor (EHF) is being adopted nationally for heatwave forecasting in Australia, but there is limited research utilizing it as a predictor for heat-related morbidity from diseases of the urinary system (urinary diseases). In this study, the incidence of eight temperature-prone specific urinary disease categories was analyzed in relation to the EHF. Daily data for maximum and minimum temperature and data for metropolitan hospital emergency department presentations and inpatient admissions for urinary disease were acquired in Adelaide, South Australia, from 1 July 2003 to 31 March 2014. An increased incidence for urolithiasis, acute kidney injury (AKI), chronic kidney disease, and lower urinary tract infections was associated with the EHF. Using the Australian national heatwave definition with the EHF, emergency department presentations increased on heatwave days compared to non-heatwave days for total urinary disease (IRR 1.046, 95% CI 1.016-1.076), urolithiasis (IRR 1.106, 95% 1.046-1.169), and acute kidney injury (AKI) (IRR 1.416, 95% CI 1.258-1.594). Likewise, inpatient admissions increased for total urinary disease (IRR 1.090, 95% CI 1.048-1.133) and AKI (IRR 1.335, 95% CI 1.204-1.480). The EHF is a reliable metric for predicting heat-induced morbidity from urinary disease. Climate change-related elevations in temperature can increase morbidity from urinary disease, especially AKI and urolithiasis. Diseases of the urinary system should be highlighted when providing public health guidance during heatwaves indicated by the EHF.
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Affiliation(s)
- Matthew Borg
- School of Public Health, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Monika Nitschke
- SA Health, Government of South Australia, Adelaide, South Australia, Australia
| | - Susan Williams
- School of Public Health, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Stephen McDonald
- The Central Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - John Nairn
- South Australian State Office, Bureau of Meteorology, Adelaide, South Australia, Australia
| | - Peng Bi
- School of Public Health, University of Adelaide, Adelaide, SA, 5005, Australia.
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Bikbov B, Perico N, Remuzzi G. A comparison of metrics and performance characteristics of different search strategies for article retrieval for a systematic review of the global epidemiology of kidney and urinary diseases. BMC Med Res Methodol 2018; 18:110. [PMID: 30340535 PMCID: PMC6194627 DOI: 10.1186/s12874-018-0569-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 10/04/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Conducting a systematic review requires a comprehensive bibliographic search. Comparing different search strategies is essential for choosing those that cover all useful data sources. Our aim was to develop search strategies for article retrieval for a systematic review of the global epidemiology of kidney and urinary diseases, and evaluate their metrics and performance characteristics that could be useful for other systematic epidemiologic reviews. METHODS We described the methodological framework and analysed approaches applied in the previously conducted systematic review intended to obtain published data for global estimates of the kidney and urinary disease burden. We used several search strategies in PubMed and EMBASE, and compared several metrics: number needed to retrieve (NNR), number of extracted data rows, number of covered countries, and when appropriate, sensitivity, specificity, precision, and accuracy. RESULTS The initial search obtained 29,460 records from PubMed, and 4247 from EMBASE. After the revision, the full text of 381 and 14 articles respectively was obtained for data extraction (the percentage of useful records is 1.3% for PubMed, 0.3% for EMBASE). For PubMed we developed two search strategies and compared them with a 'gold standard' formed by merging their results: free word search strategy (FreeWoSS) was based on the search for keywords in all fields, and subject headings based search strategy (SuHeSS) used only MeSH-mapped conditions and countries names. SuHeSS excluded almost 15% of useful articles and data rows extracted from them, but had a lower NNR of 40 and higher specificity. FreeWoSS had better sensitivity and was able to cover the vast majority of articles and extracted data rows, but had a higher NNR of 65. CONCLUSIONS The sensitive FreeWoSS strategy provides more data for modelling, while the more specific SuHeSS strategy could be used when resources are limited. EMBASE has limited value for our systematic review.
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Affiliation(s)
- Boris Bikbov
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via G.-B. Camozzi 3 –, 24020 Bergamo, Ranica Italy
| | - Norberto Perico
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via G.-B. Camozzi 3 –, 24020 Bergamo, Ranica Italy
| | - Giuseppe Remuzzi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via G.-B. Camozzi 3 –, 24020 Bergamo, Ranica Italy
- Unit of Nephrology, Dialysis and Transplantation, Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
- L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
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Fernández Córdoba MS, Parrondo Muiños C, Argumosa Salazar YM, Marijuán Sahuquillo V, Ramírez Piqueras M, Moratalla Jareño T, Rojas Ticona J, Vidal Company A. [Video-urodynamic evaluation with cystosonography for the study of lower urinary tract dysfunction and other uropathies in children]. Cir Pediatr 2018; 31:146-152. [PMID: 30260108] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To assess the utility of a new modality of video-urodynamic for study of lower urinary tract dysfunction and other uropathies in kids, replacing voiding cystourethrography by echo-enhanced cystosonography, without ionizing radiations. MATERIAL AND METHODS Prospective study with simultaneous performance of filling cystometry and cystosonography in 43 kids during the last two years. The sonographic contrast was infused trough the urodynamic catheter. RESULTS 18 girls and 25 boys, with an average age of 6.18 years (between 2 months and 14 years). The most frequent indication was micturition disfunction in boys and vesicoureteral reflux follow-up in girls. 60,5% presented urodynamic alterations, predominating low bladder accommodations (N = 9), mixed detrusor overactivity (N = 5) and bladder sphincter dyssynergia (N = 4). 15 children had vesicoureteral reflux: 8 passive, 5 active (associated with contractile activity of the detrusor or in the voiding phase) and two mixed. Urethral pathology was seen in two males (urethral valves and stenosis) and two girls (spinning top urethra). A statistically significant relationship was found between the presence of vesicoureteral reflux and other variables: bladder capacity (t = 4.98; p <0.005), detrusor activity (t = 3; p = 0.005), sex (t = 2.543; p = 0.015) and high post-void residual volume (t = 3.75; p <0.005), so that it was more frequent in girls with big bladders, with detrusor activity and high post-void residue. CONCLUSIONS Cystosonography can replace conventional cystourethrography as an imaging test associated with urodynamics. With this type of exploration we have been able to indicate the treatment to our patients, subjecting them to a single catheterization and without exposing them to ionizing radiation.
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Affiliation(s)
| | - C Parrondo Muiños
- Servicio de Radiología. Complejo Hospitalario Universitario de Albacete
| | | | | | - M Ramírez Piqueras
- Servicio de Cirugía Pediátrica. Complejo Hospitalario Universitario de Albacete
| | - T Moratalla Jareño
- Servicio de Cirugía Pediátrica. Complejo Hospitalario Universitario de Albacete
| | - J Rojas Ticona
- Servicio de Cirugía Pediátrica. Complejo Hospitalario Universitario de Albacete
| | - A Vidal Company
- Servicio de Pediatría. Complejo Hospitalario Universitario de Albacete
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Kasabwala K, Wise GJ. Varicella-zoster virus and urologic practice: a case-based review. Can J Urol 2018; 25:9301-9306. [PMID: 29900816] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Each year, varicella-zoster virus (VZV) affects nearly one million people in the United States, often in the form of herpes zoster, or shingles. The urologic system is a rare but often debilitating target. This paper reviews the epidemiology, symptomatology, diagnosis, and management of VZV as it relates to urologic practice. MATERIALS AND METHODS We performed a PubMed search using the query "herpes zoster" and "varicella-zoster virus" combined with multiple urological terms. RESULTS Infection caused by VZV, specifically the resurgent clinical infection herpes zoster (HZ), is prevalent and increasing. It often affects older men and women and those in immunocompromised states and usually manifests as a painful cutaneous rash. However, urological conditions such as voiding dysfunction, erectile issues, and flank pain have also been noted in conjunction with an HZ infection. Additionally, urological procedures and treatments may incite an HZ outbreak. Awareness and prompt treatment can ameliorate the intensity and duration of this infection. CONCLUSIONS An understanding of the atypical manifestations of HZ and disseminated VZV infection may aid urologic practitioners in avoiding misdiagnosis and delay of treatment.
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Affiliation(s)
- Khushabu Kasabwala
- Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York, USA
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Li F, Guo H, Qiu H, Liu S, Wang K, Yang C, Tang C, Zheng Q, Hou Y. Urological complications after radical hysterectomy with postoperative radiotherapy and radiotherapy alone for cervical cancer. Medicine (Baltimore) 2018; 97:e0173. [PMID: 29595646 PMCID: PMC5895433 DOI: 10.1097/md.0000000000010173] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 01/09/2018] [Accepted: 02/22/2018] [Indexed: 11/03/2022] Open
Abstract
Radiotherapy is a reliable method to cure cervical cancer patients, but it could cause serious urological complications after the treatment due to the anatomical location of the cervix. The main purpose of this retrospective analysis is to study the incidence, latency, and therapeutic efficacy of urological complications caused by radical hysterectomy with postoperative radiotherapy or radiotherapy alone in patients with cervical cancer.A retrospective analysis was conducted on patients with cervical cancer who received radical hysterectomy with postoperative radiotherapy or radiotherapy alone at the First Hospital of Jilin University between January 2010 and May 2016. The urological complications were confirmed by clinical manifestation, ultrasound, computed tomography (CT), nuclear scintigraphy, and assessment of renal function. All the patients with urological complications received conventional treatment, including conservative, electrosurgery, ureteral stents, nephrectomy, and neoplasty. The onset time of radiation injury symptoms was confirmed according to the medical history and follow-up. The surveillance for the therapeutic effects for these complications was accomplished by cystoscopy, imaging, and laboratory assessment.The overall rate of urological complications after treatment was 3.26%, comprising 2.12% ureteral obstruction, 0.98% radiocystitis, and 0.16% vesicovaginal fistula. The incidence of ureteral obstruction in patients treated with radical hysterectomy with postoperative radiotherapy and radiotherapy alone was not statistically significant (2.18% vs 1.59%, P > .05). The median onset time of radiocystitis and ureteral obstruction was 10 months (0-75 months) and 12 months (2-66.3 months), respectively. The onset time of vesicovaginal fistula was 3.5 months. After the appropriate treatment, the majority of the complications were under control.The incidence of urological complications is acceptable. There was no statistical difference in the risk between patients treated with radical hysterectomy with postoperative radiotherapy and radiotherapy alone. The latency period between radiotherapy and the manifestation of urological complications may be relatively long. So it is crucial to underline long-term follow-up after radiotherapy. The majority of urological complications were alleviated after symptomatic treatment and the patients with cervical cancer achieved long-term remissions or cures.
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Shoskes DA, Vij SC, Shoskes A, Nyame Y, Gao T. Development of a Clinically Relevant Men's Health Phenotype and Correlation of Systemic and Urologic Conditions. Urology 2018; 114:77-82. [PMID: 29360485 DOI: 10.1016/j.urology.2017.12.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/07/2017] [Accepted: 12/28/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To develop a clinically relevant men's health phenotype and investigate the correlation between severity of urologic symptoms and systemic health conditions METHODS: Retrospective chart review was performed for men seeking care for benign prostatic hypertrophy, erectile dysfunction or chronic prostatitis or chronic pelvic pain syndrome. Urologic symptoms were assessed with the International Prostate Symptom Score, Sexual Health Inventory for Men, and National Institute of Health Chronic Prostatitis Symptom Score. Each was graded as absent or mild (0), moderate (1), or severe (2) and totaled for a urologic score (US). Seven comorbidities with known impact on urologic symptoms were similarly graded (0-2 for each) and totaled for a systemic score (SS). These domains were anxiety, cardiovascular, testosterone deficiency, insulin (diabetes), obesity, neurologic, and sleep apnea. RESULTS The study included 415 men with median age of 53.8 (range 19-92). Mean total US was 2.1 (range 0-6) and mean SS was 4.1 (0-12). There was a strong correlation between US and SS (Spearman Rho = 0.37, P < .00001) which was consistent regardless of age. The hierarchy of systemic condition impact on US was cardiovascular> neurologic> diabetes> anxiety> sleep apnea> obesity> testosterone. By cluster analysis the tightest correlations were age with cardiovascular, anxiety with CPPS, and diabetes with erectile dysfunction. CONCLUSION Systemic health conditions correlate strongly with urologic symptoms in men who present for urologic care. Phenotyping with ACTIONS (anxiety, cardiovascular, testosterone deficiency, insulin, obesity, neurologic, sleep apnea) can identify modifiable conditions that may impact urologic symptoms and outcome of interventions. Future validation in the general population is needed.
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Affiliation(s)
- Daniel A Shoskes
- Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44195
| | - Sarah C Vij
- Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44195.
| | - Aaron Shoskes
- Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44195
| | - Yaw Nyame
- Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44195
| | - Tianming Gao
- Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44195
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Sangaré D, Berthé HJG, Diakité ML, Samassekou A, Diakité AS, Diallo MS, Koné O, Sissoko I, Dembélé ID, Coulibaly MT, Ouattara Z, Tembely A. [Urological Complications of Pelvic Surgery at Point-G Hospital, About 23 Cases]. Mali Med 2018; 33:9-12. [PMID: 30484577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Bladder and ureteral lesions are the most common urologic complications occurring during pelvic surgery with 1% and 0.5% to 3%, respectively. These lesions are rarely recognized intraoperatively and pose a major problem to urologists, gynecologists, and general surgeons. OBJECTIVE To study the factors favoring urologic complications following pelvic surgery at the University Hospital Point-G. PATIENTS AND METHOD We conducted a retrospective study at the University Hospital Point-G between 2006 and 2015. It involved 23 patients with a whole urological lesion following pelvic surgery. These patients underwent a clinical and para-clinical examination (intravenous urography, methylene blue test) to confirm the urological lesion and to determine its management. RESULTS The average age of our patients was 32.00 years with extremes of 18 and 40 years old. The leakage of urine was found in 82.6% (19/23). Interventions that caused urologic injury were: caesarean section 52.2% (12/23), hysterectomy 30.4% (7/23), as well as a caesarean section and hysterectomy 17.4% (4/23). Methylene blue was performed in 19 patients, it was positive in 52.2% (12/23) and intravenous urography (IVU) in 7 patients. The lesions encountered were: retrotrigonal fistula vesico-vaginal 10 cases, vesico-vaginal fistula under trigonal 2 cases, uretero-vaginal fistula 7 cases, and bilateral ureteral ligation 4 cases. Fistulorraphy was performed in 52.2% followed by direct ureterovesical reimplantation. The postoperative outcome was satisfactory in 100% of cases with obtaining a good bladder tightness. The average duration of hospitalization was 12 days (+/- 4 days). CONCLUSION Pelvic surgery results in urological injuries. Caesarean section and hysterectomy are contributing factors. Vesico-vaginal fistula or ureteral lesions are common.
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Kobayashi K, Masumori N. [Epidemiology of urologic diseases in the aging population]. Nihon Rinsho 2017; 75:527-532. [PMID: 30549851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Japan is an aging society. In general, an elderly population has urological diseases. Therefore, to understand the epidemiology of urological diseases is clinically very important. In a 15-year-longitudinal community-based study of Japanese men, prostate volume in- creased and lower urinary tract symptoms deteriorated. Many elderly Japanese females have pollakisuria. The 2015 cancer statistics suggest that the most common cancer in Japanese males is prostate cancer. Urothelial carcinoma develops in a relatively elderly population. The erectile function of aging Japanese men demonstrated an age-related decline in the community-based study, with erectile rigidity declining over a 15-year period.
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Bacheva I, Umbetalina N, Bregvadze-Tabagari N, Shalygina A, Baidildina B. [EPIDEMIOLOGY, STRUCTURE AND ALGORITHM OF MANAGEMENT OF PREGNANT WOMEN WITH EXTRAGENITAL PATHOLOGY OF THERAPEUTIC PROFILE]. Georgian Med News 2017:25-31. [PMID: 28480844] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Purpose of the study - the study of the extragenital pathology (EGP) structure in pregnant women according to the requests for medical help. The screening survey was attended by 742 pregnant women. Average age was 28,4±5,5 years. A retrospective analysis of the causes of calls to pregnant ambulance carriages was carried out for 2012-2013. On the basis of obtained data was suggested an algorithm of pregnant women with EGP management. In the structure of EGP in one profile led hematology - 306 cases (41.2%), followed by nephrology - 290 (39.1%) and gastroenterology (38.8%) - 288 cases, respectively. In the structure of requests for emergency medical care for pregnant first place occupied by respiratory diseases (2012 r - 28%, 2013- 30%), followed by urinary system diseases (2012 - 19.6% 2013 - 17.2% r ). Obtained data formed the basis for the algorithm to identify risks and provide medical care for pregnant women with extragenital pathology. In the structure of the screening study prevailed hematology profile diseases, and respiratory system diseases often were the reason for emergency medical care. The result of this study became the creating of the algorithm for medical care delivery.
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Affiliation(s)
- I Bacheva
- Karaganda State Medical University, Kazakhstan; D. Tvildiani Medical University, Tbilisi, Georgia
| | - N Umbetalina
- Karaganda State Medical University, Kazakhstan; D. Tvildiani Medical University, Tbilisi, Georgia
| | - N Bregvadze-Tabagari
- Karaganda State Medical University, Kazakhstan; D. Tvildiani Medical University, Tbilisi, Georgia
| | - A Shalygina
- Karaganda State Medical University, Kazakhstan; D. Tvildiani Medical University, Tbilisi, Georgia
| | - B Baidildina
- Karaganda State Medical University, Kazakhstan; D. Tvildiani Medical University, Tbilisi, Georgia
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Bourke L, Bauld L, Bullen C, Cumberbatch M, Giovannucci E, Islami F, McRobbie H, Silverman DT, Catto JWF. E-cigarettes and Urologic Health: A Collaborative Review of Toxicology, Epidemiology, and Potential Risks. Eur Urol 2017; 71:915-923. [PMID: 28073600 DOI: 10.1016/j.eururo.2016.12.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 12/21/2016] [Indexed: 11/16/2022]
Abstract
CONTEXT Use of electronic cigarettes (ECs) is on the rise in most high-income countries. Smoking conventional cigarettes is a known risk factor for urologic malignancy incidence, progression, and mortality, as well as for other urologic health indicators. The potential impact of EC use on urologic health is therefore of clinical interest to the urology community. OBJECTIVE To review the available data on current EC use, including potential benefits in urologic patients, potential issues linked to toxicology of EC constituents, and how this might translate into urologic health risks. EVIDENCE ACQUISITION A Medline search was carried out in August 2016 for studies reporting urologic health outcomes and EC use. Snowballing techniques were also used to identify relevant studies from recent systematic reviews. A narrative synthesis of data around EC health outcomes, toxicology, and potential use in smoking cessation and health policy was carried out. EVIDENCE SYNTHESIS We found no studies to date that have been specifically designed to prospectively assess urologic health risks, even in an observational setting. Generating such data would be an important contribution to the debate on the role of ECs in public health and clinical practice. There is evidence from a recent Cochrane review of RCTs that ECs can support smoking cessation. There are emerging data indicating that potentially harmful components of ECs such as tobacco-specific nitrosamines, polyaromatic hydrocarbons, and heavy metals could be linked to possible urologic health risks. CONCLUSIONS ECs might be a useful tool to encourage cessation of conventional cigarette smoking. However, data collection around the specific impact of ECs on urologic health is needed to clarify the possible patient benefits, outcomes, and adverse events. PATIENT SUMMARY While electronic cigarettes might help some people to stop smoking, their overall impact on urologic health is not clear.
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Affiliation(s)
- Liam Bourke
- Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK.
| | - Linda Bauld
- Institute for Social Marketing and UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK
| | - Christopher Bullen
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Marcus Cumberbatch
- Academic Urology Unit, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Edward Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Farhad Islami
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA
| | - Hayden McRobbie
- Wolfson Institute of Preventative Medicine and UK Centre for Tobacco and Alcohol Studies, Queen Mary University of London, London, UK
| | - Debra T Silverman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - James W F Catto
- Academic Urology Unit, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
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Abstract
We sought to describe the incidence rate of the urologic disease in the Korean military by reviewing diagnoses made in active duty soldiers from 2008 to 2013. A total of 72,248 first visits were generated in the Defense Medical Statistics Information System (DMSIS) with its gradually increasing trend over 6 years. A sharp increase of first visit was observed after implementation of the regular health check-up for all conscripted soldiers since 2013. Urolithiasis, prostatitis, epididymoorchitis, urethritis, and varicocele were prevalent. Prostatitis was the highest diagnosis made in the outpatient service, while varicocele was ranked the highest in the inpatient service. The incidence rates of urologic disease varied from 12.3 to 34.2 cases per 1,000 person-years. The urologic disease in conscripted men showed different distribution when we separated the population into conscripted and professional soldiers. Epididymoorchitis was the highest disease followed by urolithiasis, dysuresia, and balanoposthitis in 2013. This study underscores that the urologic disease has spent significant amount of health care resources in the Korean military. This calls for further study to find any significant difference and contributing factors of the urologic disease in the military and the civilian population.
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Affiliation(s)
- Se Young Choi
- Department of Urology, Il-dong Military Hospital, Pocheon, Korea
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Gyo Yoon
- Department of Preventive Medicine, The Armed Forces Medical Command, Seongnam, Korea.
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Rajeev R, Giri B, Choudhary LP, Kumar R. Surgery for benign prostatic hyperplasia: Profile of patients in a tertiary care institution. Natl Med J India 2017; 30:7-10. [PMID: 28730999] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Medical therapy is widely used for managing benign prostatic hyperplasia (BPH) and has made an impact on the profile of patients who ultimately undergo surgery. This changing profile may impact outcomes of surgery and associated complications. To assess the impact of medical management, we evaluated the profile of patients who had surgery for BPH at our institution. METHODS A retrospective chart-review was performed of patient demographics, indications for surgery, preoperative comorbid conditions and postoperative course in patients who underwent surgery for BPH over a 5-year period. The data were analysed for demographic trends in comparison with historical cohorts. RESULTS A total of 327 patients underwent surgery for BPH between 2008 and 2012. Their mean age was 66.4 years, the mean prostate gland weight was 59.2 g and the mean duration of symptoms was 35.3 months; 34% had a prostate gland weight of >60 g; 1 59 (48.6%) patients had an absolute indication for surgery; 139 (42.5%) of these were catheterized and 6.1% of patients presented with azotaemia or upper tract changes without urinary retention. CONCLUSIONS In comparison with historical cohorts, more patients are undergoing surgery for absolute indications including retention of urine and hydroureteronephrosis. However, the patients are younger, they have fewer comorbid conditions and have a similar rate of complications after the procedure.
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Affiliation(s)
- Rahul Rajeev
- Department of Surgery, Medical School of Wisconsin, Wisconsin, USA
| | - Bhuwan Giri
- Department of Surgery, University of Minnesota, Minnesota, USA
| | - Lok Prakash Choudhary
- Department of Urology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Rajeev Kumar
- Department of Urology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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Wormser C, Aronson LR. Perioperative morbidity and long-term outcome of unilateral nephrectomy in feline kidney donors: 141 cases (1998-2013). J Am Vet Med Assoc 2016; 248:275-81. [PMID: 26799104 DOI: 10.2460/javma.248.3.275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the outcome associated with unilateral nephrectomy in feline kidney donors. DESIGN Retrospective case series. ANIMALS 141 cats. PROCEDURES Medical records of cats that underwent nephrectomy for renal donation were reviewed for information on signalment, date of renal donation, results of blood and urine analyses, infectious disease history, anesthetic protocols, intra- and postoperative complications, and postoperative analgesic protocols. Long-term follow-up data were obtained via client telephone interview and review of referring veterinarian medical records. RESULTS All donors were healthy young adult cats with a median age of 1.5 years (range, 0.8 to 2 years). No cats died or were euthanized during the perioperative period. Intraoperative complications occurred in 2 cats, and postoperative complications occurred in 17. Median time from nephrectomy to hospital discharge was 3.6 days (range, 2 to 8 days). Long-term follow-up information was available for 99 cats, with a median interval between nephrectomy and follow-up of 10 years (range, 0.25 to 15 years). Six cats had a history of urinary tract disease including stable chronic kidney disease (n = 3), acute kidney injury (2), and cystitis (1). Nine cats were dead at follow-up; death was attributed to chronic renal failure in 2 and acute ureteral obstruction in 4. CONCLUSIONS AND CLINICAL RELEVANCE Feline donor nephrectomy had an acceptably low perioperative morbidity in this series. Most cats (84%) for which follow-up information was available had no associated long-term effects. However, a small subset (7%) developed renal insufficiency or died of urinary tract disease.
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Cheraghlou S, Gahbauer EA, Leo-Summers L, Stabenau HF, Chaudhry SI, Gill TM. Restricting Symptoms Before and After Admission to Hospice. Am J Med 2016; 129:754.e7-754.e15. [PMID: 26968471 PMCID: PMC4914433 DOI: 10.1016/j.amjmed.2016.02.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 02/10/2016] [Accepted: 02/15/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND Prior work has shown that symptoms leading to restrictions in daily activities are common at the end of life. Hospice is a Medicare benefit designed to alleviate distressing symptoms in the last 6 months of life. The effect of hospice on the burden of such symptoms is uncertain. METHODS From an ongoing cohort study of 754 community-dwelling older persons, aged ≥70 years, we evaluated 241 participants who were admitted to hospice from March 1998 to December 2013. A set of 15 physical and psychological symptoms leading to restricted activity (ie, cut down on usual activities or spend at least half the day in bed) were ascertained during monthly telephone interviews in the year before and 3 months after hospice admission. RESULTS The prevalence and mean number of restricting symptoms increased progressively until about 2 months before hospice admission, before increasing precipitously to a peak around the time of hospice admission. After the start of hospice, both the prevalence and the mean number of restricting symptoms dropped markedly. For several symptoms deemed most amenable to hospice treatment, including depression and anxiety, the prevalence dropped to levels comparable to or lower than those observed 12 months before the start of hospice. The trends observed in symptom prevalence and mean number of symptoms before and after hospice did not differ appreciably according to hospice admission diagnosis or sex. The median duration of hospice (before death) was only 15 days. CONCLUSION The burden of restricting symptoms increases progressively several months before the start of hospice, peaks around the time of hospice admission, and decreases substantially after the start of hospice. These results, coupled with the short duration of hospice, suggest that earlier referral to hospice may help to alleviate the burden of distressing symptoms at the end of life.
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Affiliation(s)
| | | | | | | | | | - Thomas M Gill
- Department of Medicine, Yale School of Medicine, New Haven, Conn.
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Korneev IA, Alekseeva TA, Kogan MI, Pushkar' DY. [Epidemiology of urinary disorders in men in the Russian Federation]. Urologiia 2016:70-75. [PMID: 28247647] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIM To compare the results of population studies conducted in the Russian Federation to identify the prevalence, severity and risk factors for urinary disorders in men. MATERIALS AND METHODS Data of a survey of 1083 men were analyzed for the age, weight, height, comorbidities with their signs and symptoms, history of surgery on pelvic organs, copulative disorders, and IPSS and quality of life scores. The findings were compared with the results of a survey of 482 Russian men under the protocol of the International Society of Continence (ICS) aimed to identify patients with overactive bladder (OAB), in whom pollakiuria, nocturia, urgency, urinary incontinence, stress-incontinence, poor flow and terminal dribbling were registered. RESULTS According to findings on IPSS scores voiding disorders were diagnosed in 649 (59.9%) of respondents, with mild, moderate and severe lower urinary tract symptoms (LUTS) in 370 (34.2%), 216 (19.9 %) and 63 (5.8%) men, respectively; mean IPSS score was 5,0+/-7,0. Among men with LUTS 34.6% were not satisfied with their quality of life. The severity of LUTS was greater among older respondents (B = 0,441; p<0,001), having a high body mass index (B = 0,119; p<0.001), ischemic heart disease (B = 0,231; p<0,001), hypertension (B = 0,240; p<0,001), diabetes mellitus (B = 0,158; p<0,001), obesity (B = 0,151; p<0,001), history of surgery on pelvic organs (B = 0,259; p<0,001), suffering from erectile dysfunction (B = 0,126; p<0,001). 116 (24.1%) men surveyed under ICS protocol had LUTS consistent with OAB criteria. Symptoms of urine storage, emptying and post-micturition symptoms were found in 299 (62%), 164 (34%) and 106 (22%) patients, respectively and were more common in older men. 236 (48.9%) of respondents experienced discomfort or pain, in 72 (15%) - LUTS resulted in decreased sexual activity, but only 149 (30.9%) of men sought treatment. CONCLUSIONS LUTS in Russia are common among men of any age. They reduce the quality of life, closely associated with erectile dysfunction, metabolic disorders and diseases. Men with urinary disorders need a comprehensive examination and treatment based on an interdisciplinary approach.
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Affiliation(s)
- I A Korneev
- First Pavlov State Medical University of St. Peterburg of Minzdrav of Russia
| | - T A Alekseeva
- National Research University Higher School of Economics
| | - M I Kogan
- Rostov State Medical University of Minzdrav of Russia
| | - D Yu Pushkar'
- A.I.Evdokimov Moscow State University of Medicine and Dentistry of Minzdrav of Russia
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Abstract
BACKGROUND There is an expanding gap between the number of patients listed for kidney transplantation and the number of kidney transplantations performed annually. The use of sensitive imaging methods results in increased discovery of many urologic asymptomatic problems, such as urolithiases, renal cysts, and solid renal masses. This result has brought the question of whether all donors with these urologic disorders should be rejected for donation. METHODS We retrospectively analyzed donor and recipient records of all living kidney transplantations performed from 2004 to 2014. RESULTS Among 251 living-related donor kidney transplantations, 51 donors (20.3%) had urologic disorders. Mean donor age was significantly higher in donors with urologic disorders than in the standard donor group (50 y vs 41 y). The identified disorders were 32 renal cysts, 8 urolithiases, 3 renal tumors, 6 adrenal adenomas, and 2 microscopic hematurias. After nephrectomy, the graft kidneys with cysts were inspected carefully and all of the cortical-peripheral cysts were decorticated. Renal tumors were excised in 3 renal units. Transplantations had proceeded after the confirmation of low malignancy potentials of the lesions with safe surgical margins. Two out of 8 patients had undergone stone removal with ex vivo ureteroscopy and 1 by means of pyelotomy incision because of calix neck stenosis. None of those donors and recipients developed clinically significant renal stone disease with a mean follow-up of 28 months. Neither donors nor recipients of asymptomatic microscopic hematuria patients developed any problem with a mean 28 months' follow-up period. CONCLUSIONS Asymptomatic urologic problems are very common. The significance of these asymptomatic pathologies is unclear. Our results suggest that in a selected group, at least some of these candidates can be accepted for donation.
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Affiliation(s)
- S Tonyali
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Y Erdem
- Division of Nephrology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - S R Yilmaz
- Division of Nephrology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - I Erkan
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey
| | - F T Aki
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey.
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Hongoh S, Usui Y, Inatuchi H, Fujisaki A, Kinjo M, Yoshimura Y, Terachi T, Yamanishi T. [The User Fact-Finding on the Electric Warm-Water Lavage Toilet Seats in the Women Consulting Our Urological Outpatient Clinic]. Hinyokika Kiyo 2016; 62:53-56. [PMID: 27018405] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We conducted our original self-completed questionnaire survey on a total of 305 women who came to our urology department as an outpatient from March 2014 to September 2014. They were asked to fill in the questionnaire on their experience of usage as well as how and where they were using the washing function of the toilet seat. The effective response rate was 95.4%. Seventy-nine (230) individuals were using the warm-water washing toilet seat. There was no significant difference in age between the usage group and the non-use group. The purposes of use after defection, for defecation induction, and after urination were 90.4, 41.3, and 40.4%, respectively. Regarding the kinds of washing, a strong tendency for the use of the anal washing function to induce defection and after defection was observed, whereas a tendency was observed for the use of the bidet function after urination and for washing the vagina. Since many individuals were using the washing function for the purpose of inducing defection and after urination, which were not functions assumed appropriate by the manufacturer, it was considered necessary to discuss the appropriate usage from the standpoint of an urologist.
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Affiliation(s)
- Sachiko Hongoh
- The Department of Urology, Tokai University Hospital
- The Department of Urology, Shizuoka City Shimizu Hospital
- The Department of Urology, Yotsuya Medical Cube
| | - Yukio Usui
- The Department of Urology, Shizuoka City Shimizu Hospital
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Jiménez-Rodríguez J, Carbajal-Ramírez A, Meza-Vázquez H, Moreno-Palacios J, Serrano-Brambila E. [Prevalence of urinary tract symptoms in women with diabetes mellitus]. Rev Med Inst Mex Seguro Soc 2016; 54:70-74. [PMID: 26820202] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND The objective was to evaluate the prevalence of urinary tract symptoms and the impact in the quality of life in women with diabetes, the association with DM and neuropathy evolution time and glycemic control. METHODS A cohort of women from the DiabetIMSS program was evaluated from January 2011 to 2013. The personal history, time of DM diagnosis, neuropathy, urinary symptoms, glycemic control and quality of life impact were noted. RESULTS A total of 169 women were evaluated. The median age was 58 years (29-85) and DM main evolution time was 9 years (0.5-31). Urinary tract symptoms were present in 128 (75.7 %) patients. Stress and urge incontinence were predominantly present (45.3 and 40.6 % respectively), followed by obstructive and irritative symptoms (25 and 10.1 % respectively). The impact in the quality of life was mild-moderate in 91.1 % of the patients. At least one criteria for neuropathy was noted in 154 (91.1 %) patients. Neuropathy evolution time was longer in the symptomatic group (12 vs 4.8 months). Symptoms were mainly present in patients with more than one year of neuropathy; p < 0.05. CONCLUSION There is a high prevalence of urinary tract symptoms in diabetic women. The only associated risk factor was neuropathy. No significative association was found between the rest of the factors.
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Affiliation(s)
- Javier Jiménez-Rodríguez
- Servicio de Urología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México.
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Tarmaeva IY, Efimova NV, Baglushkina SY. [Hygienic estimation of the nutrition and the risk of morbidity associated with its violation]. Gig Sanit 2016; 95:868-872. [PMID: 29431323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Among risk factors possessing a main importance in the shaping of theA public health the leading place is featured to the rational nutrition. Presented results testify to the absence of stable group in the adult population of Irkutsk who eats regularly, with a rational multiplicity and having all essential meal reception and the recommended food package. There was revealed the role of nutrition in shaping of morbidity rate in the adult population. The risk of circulatory diseases was established to account of 2.5 (95% CI 2.1-3.6), the infectious and parasitic diseases - 2.4 (95% CI 1.7-3.5), the endocrine system - 2,2 (95% CI 1.4-3.4), and urinary system - 2.3 (95% CI 1.7 to 3.0).
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Aubin MS, Shridharani A, Barboi AC, Guralnick ML, Jaradeh SS, Prieto TE, O'Connor RC. Lower urinary tract dysfunction in patients with dysautonomia. Clin Auton Res 2015; 25:407-10. [PMID: 26530163 DOI: 10.1007/s10286-015-0320-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 06/27/2015] [Accepted: 09/18/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE With the goal of better defining the types of bladder dysfunction observed in this population, we present the chief urologic complaints, results of urodynamic studies, and treatments of patients with dysautonomia-related urinary symptoms. METHODS All patients with dysautonomia referred to our neurourology clinic between 2005 and 2015 for management of lower urinary tract dysfunction were retrospectively reviewed. Each patient's chief urologic complaint was recorded and used to initially characterize the bladder storage or voiding symptoms. Patient evaluation included history and physical examination, urinalysis, post void bladder ultrasound, and urodynamic studies. Successful treatment modalities that subjectively or objectively improved symptoms were recorded. RESULTS Of 815 patients with the diagnosis of dysautonomia, 82 (10 %) were referred for evaluation of lower urinary tract dysfunction. Mean age was 47 years (range 12-83) and 84 % were female. The chief complaint was urinary urgency ± incontinence in 61 % and hesitancy in 23 % of patients. Urodynamic findings demonstrated detrusor overactivity ± incontinence in 50 % of patients, although chief complaint did not reliably predict objective findings. Successful objective and subjective treatments were multimodal and typically non-operative. INTERPRETATION Lower urinary tract dysfunction may develop in at least 10 % of patients with dysautonomia, predominantly females. Bladder storage or voiding complaints do not reliably predict urodynamic findings. Urodynamically, most patients exhibited detrusor overactivity. The majority of patients were successfully managed with medical or physical therapy.
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Affiliation(s)
| | | | | | | | | | - Thomas E Prieto
- Froedtert and Medical College of Wisconsin, Milwaukee, WI, USA
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Sammer U, Walter M, Knüpfer SC, Mehnert U, Bode-Lesniewska B, Kessler TM. Do We Need Surveillance Urethro-Cystoscopy in Patients with Neurogenic Lower Urinary Tract Dysfunction? PLoS One 2015; 10:e0140970. [PMID: 26513149 PMCID: PMC4626398 DOI: 10.1371/journal.pone.0140970] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 10/01/2015] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To examine the value of surveillance urethro-cystoscopy in patients with neurogenic lower urinary tract dysfunction (NLUTD) in regard to the conflicting literature as it is generally agreed that patients with NLUTD are at increased risk for bladder cancer. MATERIALS AND METHODS In a cross-sectional study, a consecutive series of 129 patients (50 females, 79 males, mean age 51, range 18-88) suffering from NLUTD for at least 5 years was prospectively investigated using urethro-cystoscopy and bladder washing cytology at a single university spinal cord injury (SCI) center. RESULTS Due to suspicious urethro-cystoscopy and/or bladder washing cytology findings, 13 (10%) of 129 patients underwent transurethral resection of the bladder lesion and/or random bladder biopsies. Overall, 9 relevant histological findings were found in 5% (7/129) of our patients: bladder melanosis (n = 1), nephrogenic adenoma (n = 3), keratinizing squamous metaplasia (n = 1), intestinal metaplasia (n = 3), and muscle-invasive adenocarcinoma of the bladder (n = 1). CONCLUSIONS Using surveillance urethro-cystoscopy, we found relevant histological findings in 5% of our patients suffering from NLUTD for at least 5 years. Thus, surveillance urethro-cystoscopy might be warranted, although the ideal starting point and frequency remain to be determined in further prospective studies.
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Affiliation(s)
- Ulla Sammer
- Neuro-Urology, Spinal Cord Injury Center and Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland
| | - Matthias Walter
- Neuro-Urology, Spinal Cord Injury Center and Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland
| | - Stephanie C Knüpfer
- Neuro-Urology, Spinal Cord Injury Center and Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland
| | - Ulrich Mehnert
- Neuro-Urology, Spinal Cord Injury Center and Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland
| | - Beata Bode-Lesniewska
- Institute of Surgical Pathology, University of Zürich, University Hospital Zürich, Zürich, Switzerland
| | - Thomas M Kessler
- Neuro-Urology, Spinal Cord Injury Center and Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland
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Cameron AP, Lai J, Saigal CS, Clemens JQ. Urological Surveillance and Medical Complications after Spinal Cord Injury in the United States. Urology 2015; 86:506-10. [PMID: 26123520 PMCID: PMC4979001 DOI: 10.1016/j.urology.2015.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/02/2015] [Accepted: 06/06/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the national patterns of urologic follow up after spinal cord injury (SCI) and the occurrence and predictors of urological complications. MATERIALS AND METHODS This retrospective cohort study used a 5% sample of Medicare data 2007-2010. The minimum adequate urologic surveillance was defined as a urologist visit, serum creatinine evaluation, and upper urinary tract imaging study within the 2-year period. Patients were classified to their most severe complication in a multivariate linear regression model. RESULTS Among the 7162 patients with SCI, the majority were functionally paraplegic (82.4%) and Caucasian (80.9%). Among them, 4.9% received no screening studies over the 2-year period; 70.5% received some, but not all screening; and 24.6% received all three screening tests. Patients traveled a mean of 21.3 ± 27.5 miles to receive care. A total of 35.7% of patients saw a urologist during the 2-year period; 48.6% had some form of upper tract evaluation, with the majority being computed tomography scans; and 90.7% had serum creatinine evaluation. Of all patients, 35.8% had a minor complication during their 2-year follow up, 17.1% had a moderate complication, and 8.0% had a severe complication. In our prediction model, patient factors that correlated with increased complications included male gender, African American race, paraplegia, and receiving some or all of the neurogenic bladder recommended screening. Patients' distance of travel to their treating physician (urologist or physiatrist) did not affect the rate of complications. CONCLUSION Urological complications are common in patients with SCI who receive Medicare. Most of these patients with SCI are not receiving even the minimum recommended surveillance for these urological complications.
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Affiliation(s)
- Anne P Cameron
- Department of Urology, University of Michigan, Ann Arbor, MI.
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