WorldWideScience

Sample records for convegno degli urologi

  1. UROLOGY

    African Journals Online (AJOL)

    Africa: we are only seeing the tip of the iceberg. UROLOGY. H A Le Roux1, R J Urry1, .... using a logit model. The Globoscan data1 was used to estimate the expected number of prostate cancer cases per year based on the known population of the districts referring patients to. Edendale Hospital. Results. Eighty one patients ...

  2. Urological Cancers

    African Journals Online (AJOL)

    Zambia is a landlocked country in south central. Africa. The national cancer registry has been poorly resourced and ... determine the histological type. The data are descriptive and no statistical analysis was performed. ... frequency distribution of Urological cancers was as follows: prostate 409 (54.6%), bladder 158 (21.1%),.

  3. African Journal of Urology

    African Journals Online (AJOL)

    The African Journal of Urology is the official journal of the Pan African Urological Surgeons' Association (PAUSA) The journal is a bilingual publication - publishing articles in English and French. The African Journal of Urology covers the whole scope of urology as well as the related basic sciences. In allignment with the ...

  4. Robotic technology in urology

    Science.gov (United States)

    Murphy, D; Challacombe, B; Khan, M S; Dasgupta, P

    2006-01-01

    Urology has increasingly become a technology‐driven specialty. The advent of robotic surgical systems in the past 10 years has led to urologists becoming the world leaders in the use of such technology. In this paper, we review the history and current status of robotic technology in urology. From the earliest uses of robots for transurethral resection of the prostate, to robotic devices for manipulating laparoscopes and to the current crop of master–slave devices for robotic‐assisted laparoscopic surgery, the evolution of robotics in the urology operating theatre is presented. Future possibilities, including the prospects for nanotechnology in urology, are awaited. PMID:17099094

  5. 78 FR 63997 - Kidney, Urologic, and Hematologic Diseases Interagency Coordinating Committee; Urology...

    Science.gov (United States)

    2013-10-25

    ... Coordinating Committee; Urology Subcommittee Workshop SUMMARY: The Urology Subcommittee of the Kidney, Urologic...--Urology Subcommittee, National Institute of Diabetes and Digestive and Kidney Diseases, 6707 Democracy..., workshop held by the KUHICC Urology Subcommittee, also called the ``Urology Interagency Coordinating...

  6. Urology in ancient India.

    Science.gov (United States)

    Das, Sakti

    2007-01-01

    The practice of medical and surgical measures in the management of urological ailments prevailed in ancient India from the Vedic era around 3000 BC. Subsequently in the Samhita period, the two stalwarts - Charaka in medicine and Susruta in surgery elevated the art of medicine in India to unprecedented heights. Their elaboration of the etiopathological hypothesis and the medical and surgical treatments of various urological disorders of unparalleled ingenuity still remain valid to some extent in our contemporary understanding. The new generation of accomplished Indian urologists should humbly venerate the legacy of the illustrious pioneers in urology of our motherland.

  7. Urology in ancient India

    Directory of Open Access Journals (Sweden)

    Sakti Das

    2007-01-01

    Full Text Available The practice of medical and surgical measures in the management of urological ailments prevailed in ancient India from the Vedic era around 3000 BC. Subsequently in the Samhita period, the two stalwarts - Charaka in medicine and Susruta in surgery elevated the art of medicine in India to unprecedented heights. Their elaboration of the etiopathological hypothesis and the medical and surgical treatments of various urological disorders of unparalleled ingenuity still remain valid to some extent in our contemporary understanding. The new generation of accomplished Indian urologists should humbly venerate the legacy of the illustrious pioneers in urology of our motherland.

  8. Hematuria and urologic malignancies

    National Research Council Canada - National Science Library

    Lien, Yeong-Hau H

    2014-01-01

    ...% of total malignancies and 3.7% of malignancy-related mortality. Asymptomatic microscopic hematuria is the most common presenting sign of urologic malignancies that may lead to early diagnosis and cure of these cancers...

  9. Robotics in urologic oncology.

    Science.gov (United States)

    Jain, Saurabh; Gautam, Gagan

    2015-01-01

    Robotic surgery was initially developed to overcome problems faced during conventional laparoscopic surgeries and to perform telesurgery at distant locations. It has now established itself as the epitome of minimally invasive surgery (MIS). It is one of the most significant advances in MIS in recent years and is considered by many as a revolutionary technology, capable of influencing the future of surgery. After its introduction to urology, robotic surgery has redefined the management of urological malignancies. It promises to make difficult urological surgeries easier, safer and more acceptable to both the surgeon and the patient. Robotic surgery is slowly, but surely establishing itself in India. In this article, we provide an overview of the advantages, disadvantages, current status, and future applications of robotic surgery for urologic cancers in the context of the Indian scenario.

  10. Il teatro degli spiriti.

    Directory of Open Access Journals (Sweden)

    Chiara Pussetti

    2013-07-01

    Full Text Available Questo saggio è dedicato a un culto di possessione, in cui tutte ledonne, investite dagli spiriti degli uomini morti prima dell’iniziazione, compiono un percorso iniziatico parallelo a quello maschile, consentendo a queste anime, potenzialmente pericolose, di completare il cammino che non hanno potuto percorrere da vivi e quindi di raggiungere serenamente il mondo dei morti, come antenati protettori del villaggio

  11. Prevention of urological cancer

    Directory of Open Access Journals (Sweden)

    M S Ansari

    2003-01-01

    Full Text Available Objectives: Many urological cancers like prostate and bladder have protracted course and maybe ideal for chemoprevention strategies. This article reviews the biol-ogy, epidemiology and possible preventive strategies for the various urological cancers. Methods: The author reviewed the relevant articles published in the last 20 years and studied the biology of the various urological cancers. An attempt is made to identify the various dietary, nutritional and occupation-related factors implicated in the onset and progression of various urological cancers. The various interventions and clinical trial results are described to prove the relevance of these factors. Results: Epidemiological reports provide the strongest evidence of protective role for dietary agents in cancer of prostate, bladder and kidney. Cancers of prostate and blad-der are uniquely suitable for chemopreventive strategies. For prostate cancer strong evidence exists for a preven-tive effect of reduced fat intake, vitamin E, selenium, lycopene and soya proteins. Vitamin A administration shows a strong inverse relation to bladder cancer. Better prevention is seen with combination of high doses of vita-mins A, C, E and B6. High-energy intake is related to the higher incidence of renal cell carcinoma (RCC. While vitamins D and E supplementation has resulted in lower incidence of RCC. Conclusions: Numerous studies implicate dietary and nutritional factors in the onset and progression of various urological cancers. Hence, it is possible that bioactive compounds (anti-oxidants like vits. A, D, C, and E, min-erals like selenium and carotenoids like lycopene along with reduction of animal fat in diet can be a part of pre-ventive strategies for various urological cancers.

  12. Urology study day: Leeds 2016.

    Science.gov (United States)

    Ramage, Carmel; Kujawa, Magda; Namasivayam, Siva; Swann, Ania; Wigglesworth, Neil; Heavens, Catherine; Finan, Claire

    2017-06-22

    Last year, urology nurses and continence nurse specialists took part in the second of two study days on urology. The events were delivered by the British Journal of Nursing with programme support in association with the British Association of Urology Nurses and Hollister Inc. Below are reports of some of the presentations.

  13. Training in laparoscopic urology

    NARCIS (Netherlands)

    Laguna, Ma Pilar; de Reijke, Theodorus M.; Wijkstra, Hessel; de la Rosette, Jean

    2006-01-01

    PURPOSE OF REVIEW: Training in laparoscopy has become an important issue in the current surgical scenario. In this overview we aim to update the current knowledge in the field of laparoscopic urological training and to highlight the potential dangers of using simulation for accreditation and

  14. Ingegneria degli acquiferi

    CERN Document Server

    Molfetta, Antonio

    2012-01-01

    Il testo fornisce le conoscenze necessarie per affrontare, con un approccio quantitativo, i molteplici aspetti connessi al flusso delle risorse idriche sotterranee (acque di falda) e alla propagazione e bonifica di contaminanti nei sistemi acquiferi. Vengono illustrate le proprietà fondamentali che definiscono la capacità di immagazzinamento, trasporto e rilascio dell’acqua negli acquiferi, e successivamente, descritte le metodiche per la determinazione di tali parametri tramite l’esecuzione e l’interpretazione di prove di falda, di pozzo e di laboratorio. A partire dalla classificazione chimico fisica-tossicologica dei contaminanti vengono, quindi, analizzati i meccanismi di propagazione e illustrate le soluzioni analitiche dell’equazione del trasporto di massa nei mezzi porosi. L’ultima parte del testo è dedicata alla caratterizzazione e bonifica degli acquiferi contaminati. Il testo è rivolto sia agli studenti universitari, sia ai professionisti che debbano affrontare con un approccio quantit...

  15. The laser in urology

    Science.gov (United States)

    Hofstetter, Alfons G.

    2002-10-01

    Laser is an acronym for a physical principle and means: Light Amplification by stimulated Emission of Radiation. This principle offers a lot of tissue/light effects caused by the parameters: power density/time and the special qualities of the laser light. Nowadays for diagnosis and therapy following lasers are used in urology: Krypton- and Dye-lasers as well as the Neodymium-YAG- (nd:YAG-), Holmium-YAG (Ho:YAG-), Diode-, Argon- and the CO2-lasers.

  16. Quadriplegia: Urological Complications

    OpenAIRE

    Fenster, Howard N.; Scarrow, Gayle D.

    1989-01-01

    Unlike the general public, quadriplegics are prone to various urological complications as a direct/indirect result of spinal cord lesions. These complications include neurogenic bladder, urinary tract infections, renal and bladder calculi, obstructive uropathy, renal failure, and bladder neoplasms. A significant portion of upper urinary tract disease, including pyelonephritis, hypernephrosis, and calculi are usually secondary to neurogenic bladder related to detrusor sphincter dysfunction. Th...

  17. Met in Urological Cancers

    Energy Technology Data Exchange (ETDEWEB)

    Miyata, Yasuyoshi, E-mail: int.doc.miya@m3.dion.ne.jp; Asai, Akihiro; Mitsunari, Kensuke; Matsuo, Tomohiro; Ohba, Kojiro; Mochizuki, Yasushi; Sakai, Hideki [Department of Urology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501 (Japan)

    2014-12-16

    Met is a tyrosine kinase receptor that is considered to be a proto-oncogene. The hepatocyte growth factor (HGF)-Met signaling system plays an important role in tumor growth, invasion, and metastasis in many types of malignancies. Furthermore, Met expression has been reported to be a useful predictive biomarker for disease progression and patient survival in these malignancies. Many studies have focused on the clinical significance and prognostic role of Met in urological cancers, including prostate cancer (PCa), renal cell carcinoma (RCC), and urothelial cancer. Several preclinical studies and clinical trials are in progress. In this review, the current understanding of the pathological role of Met in cancer cell lines, its clinical significance in cancer tissues, and its predictive value in patients with urological cancers are summarized. In particular, Met-related malignant behavior in castration-resistant PCa and the different pathological roles Met plays in papillary RCC and other histological types of RCC are the subjects of focus. In addition, the pathological significance of phosphorylated Met in these cancers is shown. In recent years, Met has been recognized as a potential therapeutic target in various types of cancer; therapeutic strategies used by Met-targeted agents in urological cancers are summarized in this review.

  18. Met in Urological Cancers

    Directory of Open Access Journals (Sweden)

    Yasuyoshi Miyata

    2014-12-01

    Full Text Available Met is a tyrosine kinase receptor that is considered to be a proto-oncogene. The hepatocyte growth factor (HGF-Met signaling system plays an important role in tumor growth, invasion, and metastasis in many types of malignancies. Furthermore, Met expression has been reported to be a useful predictive biomarker for disease progression and patient survival in these malignancies. Many studies have focused on the clinical significance and prognostic role of Met in urological cancers, including prostate cancer (PCa, renal cell carcinoma (RCC, and urothelial cancer. Several preclinical studies and clinical trials are in progress. In this review, the current understanding of the pathological role of Met in cancer cell lines, its clinical significance in cancer tissues, and its predictive value in patients with urological cancers are summarized. In particular, Met-related malignant behavior in castration-resistant PCa and the different pathological roles Met plays in papillary RCC and other histological types of RCC are the subjects of focus. In addition, the pathological significance of phosphorylated Met in these cancers is shown. In recent years, Met has been recognized as a potential therapeutic target in various types of cancer; therapeutic strategies used by Met-targeted agents in urological cancers are summarized in this review.

  19. Urological complications of coitus.

    Science.gov (United States)

    Eke, N

    2002-02-01

    To ascertain the urological complications of coitus, as the proximity of the lower urinary tract to the organs of coitus exposes the tract to coital trauma. Medline was searched from 1966 to 2000 to identify reports on coital injuries. Publications and relevant references were retrieved. Those reporting urological complications were selected for analysis. In all, 1454 cases of reported coital injuries were reviewed; 790 occurred in men while 664 occurred in women, mainly in the genital area. Physical urological complications were more common in men than in women. The injuries were often sustained during voluntary coitus, but one penile fracture was sustained during an attempted rape. The presentations included penile swellings and deviations, haemorrhage, erectile dysfunction and urinary incontinence. Complications included vesicovaginal fistulae, bladder and cavernosal ruptures, and urinary tract infections. Rare complications included isolated rupture of the penile vasculature. Major risk factors included penovaginal disproportion, excessive force at coitus, urethral coitus, fellatio and anal intercourse. Urethral injuries were the commonest complications; in men these were associated with 10-38% of penile fractures. The treatments included cold compress and anti-inflammatory agents in contusions, repairs of lacerations, closure of fistulae and urethral and vaginal reconstruction. The results of treatment were essentially good. Recurrent penile fractures were reported. Coitus, although pleasurable, may be risky. The complications have been termed 'faux pas' implying that they are preventable. While the ultimate prevention is abstinence, this is an unrealistic prescription. Therefore, efforts are necessary to identify risk factors to enable preventive strategies.

  20. Diabetes and Sexual and Urologic Problems

    Science.gov (United States)

    ... Disease, & Other Dental Problems Diabetes & Sexual & Urologic Problems Diabetes & Sexual & Urologic Problems Troublesome bladder symptoms and changes ... early onset of these sexual and urologic problems. Diabetes and Sexual Problems Both men and women with ...

  1. Urological injuries following trauma

    Energy Technology Data Exchange (ETDEWEB)

    Bent, C. [Department of Diagnostic Imaging, Barts and The London NHS Trust, London (United Kingdom)], E-mail: clare.bent@bartsandthelondon.nhs.uk; Iyngkaran, T.; Power, N.; Matson, M. [Department of Diagnostic Imaging, Barts and The London NHS Trust, London (United Kingdom); Hajdinjak, T.; Buchholz, N. [Department of Urology, Barts and The London NHS Trust, London (United Kingdom); Fotheringham, T. [Department of Diagnostic Imaging, Barts and The London NHS Trust, London (United Kingdom)

    2008-12-15

    Blunt renal trauma is the third most common injury in abdominal trauma following splenic and hepatic injuries, respectively. In the majority, such injuries are associated with other abdominal organ injuries. As urological injuries are not usually life-threatening, and clinical signs and symptoms are non-specific, diagnosis is often delayed. We present a practical approach to the diagnosis and management of these injuries based on our experience in a busy inner city trauma hospital with a review of the current evidence-based practice. Diagnostic imaging signs are illustrated.

  2. Archives: African Journal of Urology

    African Journals Online (AJOL)

    Items 1 - 50 of 65 ... Archives: African Journal of Urology. Journal Home > Archives: African Journal of Urology. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. 1 - 50 of 65 Items, 1 2 ...

  3. Urologic cancer in Thailand.

    Science.gov (United States)

    Lojanapiwat, Bannakij

    2015-11-01

    Cancer is a major health burden among non-communicable diseases, which has had a high impact on the healthcare system in Thailand. Based on GLOBOCAN, the prevalence of urologic cancer is increasing in Thailand. Prostate, bladder and kidney cancers are 6th, 15th and 22nd most common cancers, respectively, in both males and females. Prostate cancer is the fourth most common cancer in male. Cancer in the lower socioeconomic groups is a challenging problem due to greater exposure to the risk factors and more limited access to the healthcare service. The cancers are usually detected in advanced stages of the cancer. The most common histopathological finding of kidney cancer is a renal cell carcinoma. Transitional cell carcinoma is the most common histopathology of bladder. There is a trend of stage migration to earlier stages at first presentation, probably due to public awareness and laboratory screening. Patients with early stage are treated with minimally invasive modalities such as endoscopic, laparoscopic or robot-assisted laparoscopic surgery. Laparoscopic radical prostatectomy and robot-assisted laparoscopic radical prostatectomy is the mainstay treatment of localized prostate cancer with the better outcome and less complication. Androgen deprivation therapy is usually for elderly or unfit patients. The strategy for early detection of early cancer is the important role of Thai urologists to manage these three common urologic cancers. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. News on pediatric urology

    Directory of Open Access Journals (Sweden)

    Giuseppe Masnata

    2015-10-01

    Full Text Available Pediatric urology is a pediatric speciality dedicated to the diagnosis and treatment of congenital and acquired genitourinary tract diseases. It is a speciality that is rapidly changing, thanks to the technological development that has been emerging in recent years. There have been important diagnostic and therapeutic news.Congenital anomalies of the kidneys and urinary tract (CAKUT include various entities of structural malformations that result from defects in their morphogenesis. Clinical research and genetic studies on the origins of CAKUT are quickly evolving, with significant growth of high-quality research.Management goals of CAKUT include prevention of febrile urinary tract infections (UTIs in newborns and toddles and renal injury, while minimizing the morbidity of treatment and follow-up. Treatment options include observation with or without continuous antibiotic prophylaxis (CAP and surgical correction. Now, randomized controlled studies show that children with normal urinary tracts or low-grade vesicoureteral reflux (VUR do not benefit from prophylaxis.All children with known mechanical or functional obstructions of the urinary tract are considered to have UTI. Functional obstruction often results from lower urinary tract dysfunction (LUTD of either neurogenic or non-neurogenic origin and dilating VUR.The role of bladder and bowel dysfunction (BBD in children with UTI and the long-term risk of renal scarring have shed new light on treatment strategies. Often it is BBD, rather than reflux, that causes UTI in children older than 2 years.Pediatric urology has evolved in recent years, with a greater focus on bladder and renal function, minimally invasive treatment, evidence-based interventions, and guideline adherence. Other topics in pediatric urology include urinary incontinence in children with special needs and the use of robot-assisted laparoscopic surgery (RALS in children, with advantages over conventional laparoscopic surgery

  5. Sexual abuse evaluation in urological practice

    NARCIS (Netherlands)

    Beck, Jacobus Johannes Hendrikus

    2013-01-01

    The primary aim of this study is to investigate the prevalence of sexual abuse in a urological outpatient clinic. Can differences been made in urological population, i.e. general urological clinic, a university urological clinic and a tertiary university pelvic floor clinic? Do urologists inquire

  6. Pediatric robotic urologic surgery-2014

    Directory of Open Access Journals (Sweden)

    James T Kearns

    2014-01-01

    Full Text Available We seek to provide a background of the current state of pediatric urologic surgery including a brief history, procedural outcomes, cost considerations, future directions, and the state of robotic surgery in India. Pediatric robotic urology has been shown to be safe and effective in cases ranging from pyeloplasty to bladder augmentation with continent urinary diversion. Complication rates are in line with other methods of performing the same procedures. The cost of robotic surgery continues to decrease, but setting up pediatric robotic urology programs can be costly in terms of both monetary investment and the training of robotic surgeons. The future directions of robot surgery include instrument and system refinements, augmented reality and haptics, and telesurgery. Given the large number of children in India, there is huge potential for growth of pediatric robotic urology in India. Pediatric robotic urologic surgery has been established as safe and effective, and it will be an important tool in the future of pediatric urologic surgery worldwide.

  7. Urologic malignancies in kidney transplantation.

    Science.gov (United States)

    Hickman, Laura A; Sawinski, Deirdre; Guzzo, Thomas; Locke, Jayme E

    2018-01-01

    With advances in immunosuppression, graft and patient outcomes after kidney transplantation have improved considerably. As a result, long-term complications of transplantation, such as urologic malignancies, have become increasingly important. Kidney transplant recipients, for example, have a 7-fold risk of renal cell carcinoma (RCC) and 3-fold risk of urothelial carcinoma (UC) compared with the general population. While extrapolation of data from the general population suggest that routine cancer screening in transplant recipients would allow for earlier diagnosis and management of these potentially lethal malignancies, currently there is no consensus for posttransplantation RCC or UC screening as supporting data are limited. Further understanding of risk factors, presentation, optimal management of, and screening for urologic malignancies in kidney transplant patients is warranted, and as such, this review will focus on the incidence, surveillance, and treatment of urologic malignancies in kidney transplant recipients. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  8. Renal oncocytoma: experience of Clinical Urology A, Urology ...

    African Journals Online (AJOL)

    Renal oncocytoma is a rare and benign renal tumor. Only few cases have been reported in Moroccan populations. In the present study, we report our experiences in the diagnosis, management and follow-up of this disease. We report on six cases of renal oncocytoma indentified between 1990 and 2008 in the urology ...

  9. Emergencies in Urology | van der Merwe | African Journal of Urology

    African Journals Online (AJOL)

    Emergencies in Urology. Authors: M. Hohenfellner and RA Santucci. Publisher Springer. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about ...

  10. Sapere digitale e pensiero critico. Intorno al convegno “Noetica versus Informatica: le nuove strutture della comunicazione scientifica” (Roma, 19-20 novembre 2013

    Directory of Open Access Journals (Sweden)

    Luigi Catalani

    2015-01-01

    Full Text Available Scopo di questo contributo è quello di provare a tirare le fila del convegno internazionale “Noetica versus Informatica: le nuove strutture della comunicazione scientifica”, svoltosi a Roma dal 19 al 20 novembre 2013. Alla luce del conflitto epistemico enunciato nel titolo, si è cercato di evidenziare i principali nodi concettuali emersi durante le quattro sessioni di lavoro, che invitano ad un’attenta riconsiderazione del ruolo della bibliografia, dei servizi bibliotecari e dei paradigmi tradizionali dell’organizzazione dell’informazione, anche alla luce delle tendenze più recenti legate allo sviluppo del web semantico, dei discovery tools, dei social network, dell’open access e delle biblioteche digitali. L’accento è posto in particolare su quei contributi capaci di attivare pensiero critico in merito allo stato attuale e alle prospettive della conoscenza nell’ecosistema digitale, considerato che appare imprescindibile l’adozione di ontologie semantiche, mappe cognitive e infrastrutture indicali capaci di far ‘esplodere’ il potenziale epistemologico dei documenti registrati.

  11. Female sexual function in urological practice

    NARCIS (Netherlands)

    Elzevier, Hendrik Willem

    2008-01-01

    In this thesis we describe in chapter two the evaluation of female sexual function in an outpatient urologic clinic related to different urological complaints. Sexual abuse appeared to be a quite frequent problem in urological practice. In chapter three sexual abused patients are evaluated in

  12. Molecular Signatures in Urologic Tumors

    Directory of Open Access Journals (Sweden)

    Spencer Larkin

    2013-09-01

    Full Text Available Urologic tumors continue to represent a huge fraction of cancer cases in the United States, with over 376,310 estimated new diagnoses in 2013. As with many types of tumors, urologic tumors vary greatly in their phenotype, ranging from minimally invasive to malignancies possessing great metastatic potential. The increasing need for more efficient and less invasive methods of cancer detection, as well as the ability to predict severity of the disease phenotype is readily evident—yet reliable methods remain elusive in a clinical setting today. Comprehensive panels of gene clusters are being developed toward the generation of molecular signatures in order to better diagnose urologic malignancies, and identify effective treatment strategies in the emerging era of personalized medicine. In this review, we discuss the current literature on the credibility and biomarker value of such molecular signatures in the context of clinical significance relating to the pathological aggressiveness of urologic tumors (prostate, bladder and renal cancer—also exploiting their predictive potential in the response to treatment.

  13. Radioguided surgery in urological malignancies

    Directory of Open Access Journals (Sweden)

    Dorothea Weckermann

    2008-01-01

    In all urological malignancies the SLN concept is only a staging procedure. When the sentinel node(s is (are negative, the other lymph nodes are negative, too. Since there are no randomized prospective trials comparing the results of sentinel lymphadenectomy with other techniques of lymph node dissection, it is not clear whether sentinel lymph node dissection also has a prognostic impact.

  14. [Report] Apprendimento, cognizione e tecnologia. Convegno di Mid‐term dell’Associazione Italiana di Scienze Cognitive  Dipartimento di Studi Umanistici, Università degli Studi di Napoli Federico II 16‐18 Maggio 2016

    Directory of Open Access Journals (Sweden)

    Rosa Spagnuolo Vigorita

    2016-06-01

    Full Text Available This report aims to analyze how the development of technological artefacts can give a remarkable support to various aspects of cognitive science. Specifically, the attention is focused on the tricky relationship between mind, body, environment and material culture in interpreting aspects of cognition. The first part gives space to the way assistive technology would ensure, to individuals with limited mobility and extended sensory disabilities, a significant improvement of living opportunities. The second part considers the essential questions about the impact that the progressive decline of real interaction, in favor of educational technologization, could involve for human evolution. 

  15. The history of urology in Cleveland, Ohio.

    Science.gov (United States)

    Sajadi, Kamran P; Goldman, Howard B

    2010-12-01

    Urology in Cleveland, as in the rest of the country, has evolved greatly over the past century. The recent passing of Resnick and Novick warrants a review of Cleveland's rich urological history. We reviewed historical and scientific literature and interviewed Cleveland urologists. Lower joined his cousin Crile as professor at Case Western Reserve University (CWRU) before they cofounded the Cleveland Clinic (CC) in 1921. Goldblatt at CWRU discovered renovascular hypertension, leading Poutasse at CC to develop renovascular arteriography and bypass surgery. Kolff brought his greatest invention, dialysis, to the United States when he joined CC. Straffon put CC's renal transplant program on the map through his success with deceased donor transplants. Persky, renowned at radical prostatectomies, chaired urology at CWRU for nearly 30 years and trained 6 future university department chairpersons. Resnick succeeded him and became one of the eminent figures in urology; an authority on numerous subjects, president of the American Urological Association and American Board of Urology (ABU) and Editor of the Journal of Urology. Novick, who became chairman at CC in 1985, was the consummate renal surgeon; he was adept at renal revascularization and transplantation, but his greatest surgical innovation was the partial nephrectomy. He likewise held many positions, including president of the ABU. Cleveland has been a driving force in the evolution of urology in the last century. Resnick and Novick led a golden age of urology for several decades until their recent untimely passings. Copyright © 2010 Elsevier Inc. All rights reserved.

  16. Fisica degli atomi e dei nuclei

    CERN Document Server

    Bernardini, Carlo

    1965-01-01

    Evidenza della struttura atomica della materia ; le proprietà degli atomi e la meccanica atomica ; gli atomi e le radiazioni elettromagnetiche ; struttura microscopica dello stato gassoso ; struttura microscopica dello stato liquido ; struttura microscopica della stato solido ; proprietà elettriche e magnetiche delle sostanze ; proprietà dei nuclei degli atomi ; le particelle elementari.

  17. Hollow waveguide for urology treatment

    Science.gov (United States)

    Jelínková, H.; Němec, M.; Koranda, P.; Pokorný, J.; Kőhler, O.; Drlík, P.; Miyagi, M.; Iwai, K.; Matsuura, Y.

    2010-02-01

    The aim of our work was the application of the special sealed hollow waveguide system for the urology treatment - In our experimental study we have compared the effects of Ho:YAG (wavelength 2100 nm) and Er:YAG (wavelength 2940 nm) laser radiation both on human urinary stones (or compressed plaster samples which serve as a model) fragmentation and soft ureter tissue incision in vitro. Cyclic Olefin Polymer - coated silver (COP/Ag) hollow glass waveguides with inner and outer diameters 700 and 850 μm, respectively, were used for the experiment. To prevent any liquid to diminish and stop the transmission, the waveguide termination was utilized.

  18. Changes in urological surgical techniques

    Directory of Open Access Journals (Sweden)

    Oktay Üçer

    2010-06-01

    Full Text Available Recently, laparoscopic and afterwards robotic techniques have constituted most of urologic surgery procedures. Open surgery may give place to robotic surgery due to possible widespread use of robots in the future. Studies, that compare these two techniques are usually designed about radical prostatectomy, since it is the most common operation performed by using these techniques. In literature,robotic surgery seems more advantageous than other techniques but the most important disadvantage of this technique is cost-effective problems. In present review,history of open, laparoscopic and robotic surgery, and comparison of advantages, disadvantages and cost of these techniques have been discussed with literature.

  19. AB14. Female urology: update and future

    Science.gov (United States)

    Deng, Donna

    2014-01-01

    The biggest controversy in female urology in the past few years is the use of mesh in vaginal surgery. The major societies of Female Urology and Urogynecology has announced position statements in regards to the use of mesh sling for incontinence surgery. Lecture will also include transvaginal and trans-abdominal methods to repair pelvic prolapse given the complications from mesh.

  20. Urologic robots and future directions.

    Science.gov (United States)

    Mozer, Pierre; Troccaz, Jocelyne; Stoianovici, Dan

    2009-01-01

    Robot-assisted laparoscopic surgery in urology has gained immense popularity with the daVinci system, but a lot of research teams are working on new robots. The purpose of this study is to review current urologic robots and present future development directions. Future systems are expected to advance in two directions: improvements of remote manipulation robots and developments of image-guided robots. The final goal of robots is to allow safer and more homogeneous outcomes with less variability of surgeon performance, as well as new tools to perform tasks on the basis of medical transcutaneous imaging, in a less invasive way, at lower costs. It is expected that improvements for a remote system could be augmented in reality, with haptic feedback, size reduction, and development of new tools for natural orifice translumenal endoscopic surgery. The paradigm of image-guided robots is close to clinical availability and the most advanced robots are presented with end-user technical assessments. It is also notable that the potential of robots lies much further ahead than the accomplishments of the daVinci system. The integration of imaging with robotics holds a substantial promise, because this can accomplish tasks otherwise impossible. Image-guided robots have the potential to offer a paradigm shift.

  1. UROLOGY

    African Journals Online (AJOL)

    Mexico, U. S. A. and >'“'**Department of Riochemistry and Molecular Biology, University of New Mexico, School of Medicine, Albuquerque, New Mexico, U. S. A.. Reprint requests to: Dr. Dan I ya, Department QfSi/irLg'ery, Jas University Teaching. Hospital, RM. B. 2076, Jos, Plateau state, Nigeria. E-'Hmili aataaaawlaaaaaa.

  2. UROLOGY

    African Journals Online (AJOL)

    Introduction. The usual complications of benign prostatic hyperplasia (BPH) include urinary retention, haemorrhage presenting as haematuria and the pathological effects of increasing intravesical pressure. These effects include bladder wall hypertrophy, diverticula, hydroureter and hydronephrosis. ' Increasing intravesical.

  3. URobotics—Urology Robotics at Johns Hopkins

    Science.gov (United States)

    Stoianovici, D

    2011-01-01

    URobotics (Urology Robotics) is a program of the Urology Department at the Johns Hopkins Medical Institutions dedicated to the development of new technology for urologic surgery (http://urology.jhu.edu/urobotics). The program is unique in that it is the only academic engineering program exclusively applied to urology. The program combines efforts and expertise from the medical and engineering fields through a close partnership of clinical and technical personnel. Since its creation in 1996, the URobotics lab has created several devices, instruments, and robotic systems, several of which have been successfully used in the operating room. This article reviews the technology developed in our laboratory and its surgical applications, and highlights our future directions. PMID:11954067

  4. Nanotechnology applications in urology: a review.

    Science.gov (United States)

    Maddox, Michael; Liu, James; Mandava, Sree Harsha; Callaghan, Cameron; John, Vijay; Lee, Benjamin R

    2014-11-01

    The objectives of this review are to discuss the current literature and summarise some of the promising areas with which nanotechnology may improve urological care. A Medline literature search was performed to elucidate all relevant studies of nanotechnology with specific attention to its application in urology. Urological applications of nanotechnology include its use in medical imaging, gene therapy, drug delivery, and photothermal ablation of tumours. In vitro and animal studies have shown initial encouraging results. Further study of nanotechnology for urological applications is warranted to bridge the gap between preclinical studies and translation into clinical practice, but nanomedicine has shown significant potential to improve urological patient care. © 2014 The Authors. BJU International © 2014 BJU International.

  5. [Results of an investigation by questionnaire into interest in neuro-urology of urology residents].

    Science.gov (United States)

    Caremel, R; Bernhard, J-C; Bigot, P; Koutlidis, N; Xylinas, E; Faïs, P-O; Rouache, L; Genevois, S; Mazzola, C; Bessede, T; Gosseine, P-N; Celhay, O; Faivre D'Arcier, B; Benchikh, A; Pignot, G; Guillotreau, J

    2010-06-01

    To evaluate the interest borne towards neuro-urology within the community of the urology residents. Between January and May 2009, all urology residents received an anonymous questionnaire by e-mail estimating their interest for neuro-urology. The analyzed data were: epidemiologic data; participation in theoretical learning and training courses practices; interest and investment in the speciality; opinion on the current formation. The qualitative variables were compared by the chi-2 test. P values neuro-urology staff, and 80 % were in a service which dealt with suffering patients of neurological bladder. The percentage of urologist residents interested by neuro-urology was 69,2 %, and 61,5 % of them wished to practice this activity in their future exercise. This wish was significantly higher for those resulting from the ENC (pneuro-urology (pneuro-urology were considered as being insufficient for respectively 73,9 % and 64,2 % of the urologist residents. In contrast, the average note allotted to the neuro-urology module of the ECU was of 7,47 out of 10. Neuro-urology seems to be particularly attractive for the urologist residents, and many wished to integrate it in their future exercise. The motivation was more important for those who wished to carry out a career in hospital. Even if the quality of the teaching was very noted, their modalities were considered to be insufficient by most of them. Copyright 2010. Published by Elsevier Masson SAS.

  6. Advances in Pediatric Urologic Laparoscopy

    Directory of Open Access Journals (Sweden)

    M. C. Smaldone

    2007-01-01

    Full Text Available The spectrum of laparoscopic surgery in children has undergone a dramatic evolution. Initially used as a diagnostic modality for many pediatric urologists, complex as well as reconstructive procedures are now being performed laparoscopically. Laparoscopic orchiopexy and nephrectomy are well established and are being performed at many centers. Laparoscopic partial nephrectomy, adrenalectomy, and dismembered pyeloplasty series have reported shortened hospital stays and operative times that are comparable to that of open techniques or are decreasing with experience. The initial experiences with laparoscopic ureteral reimplantation and laparoscopic-assisted bladder reconstructive surgery have been described, reporting encouraging results with regards to feasibility, hospital stay, and cosmetic outcome. This report will provide a directed review of the literature to establish the current indications for laparoscopy in pediatric urologic surgery.

  7. Urological manifestations of Duchenne muscular dystrophy.

    Science.gov (United States)

    Askeland, Eric J; Arlen, Angela M; Erickson, Bradley A; Mathews, Katherine D; Cooper, Christopher S

    2013-10-01

    Duchenne muscular dystrophy is a dystrophinopathy affecting males that is associated with multiple organ system complications. To our knowledge urological complications of Duchenne muscular dystrophy have been described only anecdotally to date. We reviewed the medical charts of 135 patients with Duchenne or Duchenne-Becker muscular dystrophy for demographics and disease progression, urological diagnoses, intervention and followup. Of 135 patients 67 (50%) had at least 1 documented urological diagnosis and 38 (28%) had multiple manifestations. Lower urinary tract symptoms were the most common urological diagnosis (32% of patients). Survival analysis revealed a median age at onset of lower urinary tract symptoms of 23 years (95% CI 17.7-23.9). Intervention was required in 12 patients (9%), most commonly due to nephrolithiasis. Urological morbidity increased with Duchenne muscular dystrophy progression when stratified by clinical progression. Lower urinary tract symptoms were more common in nonambulatory patients (40.7% vs 19%, p = 0.007), those with a diagnosis of scoliosis (44% vs 19.7%, p = 0.003) and/or scoliosis spine surgery (60% vs 22%, p <0.001), and those on invasive respiratory support (53% vs 29%, p = 0.046). Likewise, nephrolithiasis was more common in nonambulatory patients (10% vs 0%, p = 0.017), those with scoliosis (12% vs 0%, p = 0.004) and/or scoliosis spine surgery (20% vs 1%, p <0.001), and those on invasive respiratory support (29% vs 3%, p <0.001). Only 28% of patients with a urological manifestation were referred to urology. As these patients transition into adolescence and adulthood, the increased prevalence of urological manifestations warrants increased awareness and referral to urologists. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  8. Allosteric regulation of DegS protease subunits through a shared energy landscape.

    Science.gov (United States)

    Mauldin, Randall V; Sauer, Robert T

    2013-02-01

    The PDZ domains of the trimeric DegS protease bind unassembled outer-membrane proteins (OMPs) that accumulate in the Escherichia coli periplasm. This cooperative binding reaction triggers a proteolytic cascade that activates a transcriptional stress response. To dissect the mechanism of allosteric activation, we generated hybrid DegS trimers with different numbers of PDZ domains and/or protease-domain mutations. By studying the chemical reactivity and enzymatic properties of these hybrids, we show that all subunits experience a strongly coupled energetic landscape. For example, OMP peptide binding to a single PDZ domain stimulates active site chemical modification and proteolytic cleavage in the attached and neighboring protease domains. OMP peptide binding relieves inhibitory PDZ interactions, whereas the interfaces between protease domains in the trimeric DegS core mediate positively cooperative activation driven by both substrate binding and inhibition relief.

  9. Allosteric regulation of DegS protease subunits though a shared energy landscape

    Science.gov (United States)

    Mauldin, Randall V.; Sauer, Robert T.

    2012-01-01

    The PDZ domains of the trimeric DegS protease bind unassembled outer-membrane proteins (OMPs) that accumulate in the E. coli periplasm. This cooperative binding reaction triggers a proteolytic cascade that activates a transcriptional stress response. To dissect the mechanism of allosteric activation, we generated hybrid DegS trimers with different numbers of PDZ domains and/or protease-domain mutations. By studying the chemical reactivity and enzymatic properties of these hybrids, we show that all subunits experience a strongly coupled energetic landscape. For example, OMP-peptide binding to a single PDZ domain stimulates active-site chemical modification and proteolytic cleavage in the attached and neighboring protease domains. OMP-peptide binding relieves inhibitory PDZ interactions, whereas the interfaces between protease domains in the trimeric DegS core mediate positively cooperative activation driven both by substrate binding and inhibition relief. PMID:23201899

  10. Telemedicine in Urology: State of the Art.

    Science.gov (United States)

    Ellimoottil, Chandy; Skolarus, Ted; Gettman, Matthew; Boxer, Richard; Kutikov, Alexander; Lee, Benjamin R; Shelton, Jeremy; Morgan, Todd

    2016-08-01

    Whereas telemedicine is recognized as one of the fastest-growing components of the healthcare system, the status of telemedicine use in urology is largely unknown. In this narrative review, we detail studies that investigate the use of televisits and teleconsultations for urologic conditions. Moreover, we discuss current regulatory and reimbursement policies. Finally, we discuss the significant barriers to widespread dissemination and implementation of telemedicine and reasons why the field of urology may be positioned to become a leader in the provision of telemedicine services. Published by Elsevier Inc.

  11. 21 CFR 876.5160 - Urological clamp for males.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Urological clamp for males. 876.5160 Section 876...) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5160 Urological clamp for males. (a) Identification. A urological clamp for males is a device used to close the urethra of a male to...

  12. 21 CFR 876.4530 - Gastroenterology-urology fiberoptic retractor.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology fiberoptic retractor. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4530 Gastroenterology-urology fiberoptic retractor. (a) Identification. A gastroenterology-urology fiberoptic retractor...

  13. 21 CFR 876.4370 - Gastroenterology-urology evacuator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology evacuator. 876.4370... (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4370 Gastroenterology-urology evacuator. (a) Identification. A gastroenterology-urology evacuator is a device used to remove...

  14. Minimally invasive management of urological fistulas.

    Science.gov (United States)

    Núñez Bragayrac, Luciano A; Azhar, Raed A; Sotelo, Rene

    2015-03-01

    Urological fistulas are an underestimated problem worldwide and have devastating consequences for patients. Many urological fistulas result from surgical complications and/or inadequate perinatal obstetric healthcare. Surgical correction is the standard treatment. This article reviews minimally invasive surgical approaches to manage urological fistulas with a particular emphasis on the robotic techniques of fistula correction. In recent years, many surgeons have explored a minimally invasive approach for the management of urological fistulas. Several studies have demonstrated the feasibility of laparoscopic surgery and the reproducibility of reconstructive surgery techniques. Introduction of the robotic platform has provided significant advantages given the improved dexterity and exceptional vision that it confers. Fistulas are a concern worldwide. Laparoscopic surgery correction has been developed through the efforts of several authors, and difficulties such as the increased learning curve have been overcome with innovations, including the robotic platform. Although minimally invasive surgery offers numerous advantages, the most successful approach remains the one with the surgeon is most familiar.

  15. Factors influencing residents' pursuit of urology fellowships.

    Science.gov (United States)

    Freilich, Drew A; Nguyen, Hiep T; Phillips, John L

    2011-11-01

    To assess the predictors of residents' pursuit of fellowship training by surveying current urology residents and recent graduates. Postgraduate fellowship training of urologists could be an important source of urologic physician-scientists and continued innovation in urologic care. A Web-based survey was electronically mailed to urology residents and recent graduates of urologic residency. Variables concerning sex, marital status, debt load, research and clinical exposure, publications, and postgraduate careers were recorded. Of the 71 respondents, 46 (65%) were married and 45% had children/dependents. Of the 69% who applied for fellowship, the "most important" factors influencing the pursuit of fellowship were intellectual appeal (82%), mentors (79%), the desire for an additional point of view for surgical training (58%), and the desire to pursue a career in academics (52%). Forty of those completing a fellowship (87%) versus two of those completing residency alone (13%) would pursue a career in academics. Residents with a mentor were 20 times more likely to pursue a urology fellowship. A shorter residency (5 years), encouragement by a program director, and manuscript publication during residency were also independent predictors. Mentorship, a shorter residency, and manuscript publication during residency were independent predictors of pursuing fellowship training. Debt load, age, marital status, and a desire to pursue a career in academic medicine were not significant factors. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. The impact of robotic surgery in urology.

    Science.gov (United States)

    Giedelman, C A; Abdul-Muhsin, H; Schatloff, O; Palmer, K; Lee, L; Sanchez-Salas, R; Cathelineau, X; Dávila, H; Cavelier, L; Rueda, M; Patel, V

    2013-01-01

    More than a decade ago, robotic surgery was introduced into urology. Since then, the urological community started to look at surgery from a different angle. The present, the future hopes, and the way we looked at our past experience have all changed. Between 2000 and 2011, the published literature was reviewed using the National Library of Medicine database and the following key words: robotic surgery, robot-assisted, and radical prostatectomy. Special emphasis was given to the impact of the robotic surgery in urology. We analyzed the most representative series (finished learning curve) in each one of the robotic approaches regarding perioperative morbidity and oncological outcomes. This article looks into the impact of robotics in urology, starting from its background applications before urology, the way it was introduced into urology, its first steps, current status, and future expectations. By narrating this journey, we tried to highlight important modifications that helped robotic surgery make its way to its position today. We looked as well into the dramatic changes that robotic surgery introduced to the field of surgical training and its consequence on its learning curve. Basic surgical principles still apply in Robotics: experience counts, and prolonged practice provides knowledge and skills. In this way, the potential advantages delivered by technology will be better exploited, and this will be reflected in better outcomes for patients. Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.

  17. Autoimmune disease and subsequent urological cancer.

    Science.gov (United States)

    Liu, Xiangdong; Ji, Jianguang; Forsti, Asta; Sundquist, Kristina; Sundquist, Jan; Hemminki, Kari

    2013-06-01

    We examined the subsequent risk and prognosis of urological cancer in individuals diagnosed with autoimmune disease. We systematically analyzed the risk and prognosis of prostate, kidney and bladder cancers in individuals diagnosed with any of 33 autoimmune diseases based on a national Swedish database for 1964 through 2008. The SIR and HR were calculated for subsequent urological cancers between 1964 and 2008 in individuals hospitalized for autoimmune disease. An increased SIR for urological cancer was recorded after 26 autoimmune diseases. An increased HR for cancer specific survival was noted after 4 autoimmune diseases and for overall survival after 18. The highest SIRs were seen for kidney cancer after polyarteritis nodosa (2.85) and polymyositis/dermatomyositis (2.68), and for bladder cancer after polymyositis/dermatomyositis (2.45). The highest risk of prostate cancer (1.70) was observed after polyarteritis nodosa. SIRs were lower during followup from 1990 to 2008 compared to the previous period. Individuals diagnosed with prostate and kidney cancers showed an improved cancer specific prognosis, in contrast to the poorer overall prognosis for all 3 urological cancers. The risk of urological cancer was increased after all autoimmune diseases. The most significant changes after individual autoimmune diseases were toward higher risk. Survival data were reassuring since autoimmune disease only marginally influences the prognosis of cancer specific mortality. However, overall survival was decreased for the 3 types of cancer. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  18. Duplicate presentations on prostate cancer at American Urological Association and European Association of Urology annual meetings.

    Science.gov (United States)

    Pop, George H; Fesperman, Susan F; Ball, David A; Yeung, Lawrence L; Vieweg, Johannes; Dahm, Philipp

    2009-08-01

    We determined the rate of duplicate research presentations at recent American Urological Association and European Urological Association annual meetings. We cross-referenced all clinical research presentations related to prostate cancer presented at the 2006 American Urological Association and European Urological Association annual meetings with those presented at the corresponding annual meetings in 2005, 2006 and 2007 using a defined search strategy based on author names, abstract titles, study design and objectives. All data abstraction was performed in duplicate by 2 independent reviewers to ensure accuracy. We identified 282 and 312 abstracts on prostate cancer clinical research at the 2006 European Urological Association and American Urological Association annual meetings, respectively. The overall duplication rate of American Urological Association abstracts was 19.2% (60 of 312). Of duplicated abstracts 80.0% (48 of 60) were presented at the European Urological Association annual meeting the same year. Duplication of European Urological Association abstracts was identified in 20.9% (59 of 282). Authors who presented the same research (71 duplicate abstracts) at the 2 meetings altered the presentations in various ways, including a different study title in 40.8%, a different first and senior author in 14.1% and 18.3%, and increased or decreased sample size in 8.5% and 14.1%, respectively. Approximately a fifth of clinical research abstracts on prostate cancer presented at the American Urological Association annual meeting were also presented at the European Urological Association meeting and vice versa. Inconsistencies between duplicate abstracts raise concerns about the integrity of the underlying studies. Stricter submission guidelines and improved dissemination of research findings from the 2 meetings may help limit this practice.

  19. Summary of European Association of Urology (EAU) Guidelines on Neuro-Urology.

    Science.gov (United States)

    Groen, Jan; Pannek, Jürgen; Castro Diaz, David; Del Popolo, Giulio; Gross, Tobias; Hamid, Rizwan; Karsenty, Gilles; Kessler, Thomas M; Schneider, Marc; 't Hoen, Lisette; Blok, Bertil

    2016-02-01

    Most patients with neuro-urological disorders require life-long medical care. The European Association of Urology (EAU) regularly updates guidelines for the diagnosis and treatment of these patients. To provide a summary of the 2015 updated EAU Guidelines on Neuro-Urology. Structured literature searches in several databases were carried out to update the 2014 guidelines. Levels of evidence and grades of recommendation were assigned where possible. Neurological disorders often cause urinary tract, sexual, and bowel dysfunction. Most neuro-urological patients need life-long care for optimal life expectancy and quality of life. Timely diagnosis and treatment are essential to prevent upper and lower urinary tract deterioration. Clinical assessment should be comprehensive and usually includes a urodynamic investigation. The neuro-urological management must be tailored to the needs of the individual patient and may require a multidisciplinary approach. Sexuality and fertility issues should not be ignored. Numerous conservative and noninvasive possibilities of management are available and should be considered before a surgical approach is chosen. Neuro-urological patients require life-long follow-up and particular attention has to be paid to this aspect of management. The current EAU Guidelines on Neuro-Urology provide an up-to-date overview of the available evidence for adequate diagnosis, treatment, and follow-up of neuro-urological patients. Patients with a neurological disorder often suffer from urinary tract, sexual, and bowel dysfunction and life-long care is usually necessary. The update of the EAU Guidelines on Neuro-Urology, summarized in this paper, enables caregivers to provide optimal support to neuro-urological patients. Conservative, noninvasive, or minimally invasive approaches are often possible. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  20. Urologic manifestations of postpolio syndrome.

    Science.gov (United States)

    Johnson, V Y; Hubbard, D; Vordermark, J S

    1996-07-01

    To determine the character and prevalence of bladder dysfunction among persons with a history of polio, we conducted a survey of randomly selected polio survivors. The survey solicited information on the acute episode of polio and the nature of late-onset neurologic symptoms that could be attributed to postpolio syndrome. There were 242 female and 88 male respondents to the study. Symptoms attributable to postpolio syndrome were present in 87.2% of female subjects and 73.9% of male subjects. Respondents with postpolio syndrome had a significantly greater prevalence of urologic symptoms than seen among respondents without postpolio syndrome, although no dominant pattern of voiding dysfunction was noted. The early onset of erectile dysfunction was more common among male subjects with postpolio syndrome than among male subjects without postpolio syndrome. Genuine stress incontinence was seen in 36.3% of the survey population. Sixteen women with postpolio syndrome underwent surgical repair for urinary incontinence, with a success rate of 60.5%. Bladder disorders are common among persons with PPS, but further clinical and urodynamic data are necessary to define the nature and magnitude of this dysfunction.

  1. Robotic surgery in pediatric urology

    Directory of Open Access Journals (Sweden)

    Adam Howe

    2017-01-01

    Full Text Available While robotic surgery has shown clear utility and advantages in the adult population, its role in pediatrics remains controversial. Pediatric-sized robotic instruments and equipment are not readily available yet, so certain modifications can be made in order to make robotic surgery successful in children. While the cost of robotic surgery remains high compared to open procedures, patients experience greater satisfaction and quality of life with robotic surgery. Robotic pyeloplasty is a standard of care in older children, and has even been performed in infants and re-do surgery. Other robotic procedures performed in children include heminephroureterectomy, ureteroureterostomy, ureteral reimplantation, urachal cyst excision, bladder diverticulectomy, and bladder reconstructive procedures such as augmentation, appendicovesicostomy, antegrade continence enema, bladder neck reconstruction and sling, as well as other procedures. Robotic surgery has also been used in oncologic cases such as partial nephrectomy and retroperitoneal lymph node dissection. Future improvements in technology with production of pediatric-sized robotic instruments, along with increases in robotic-trained pediatric urologists and surgeon experience along each's learning curve, will help to further advance the field of robotic surgery in pediatric urology.

  2. Testimonianze di vittime degli anni di piombo

    DEFF Research Database (Denmark)

    Cecchini, Leonardo

    Testimonianze di vittime degli anni di piombo In un articolo pubblicato nel 2008 sulla webzine Nazione indiana Christian Raimo criticava quello che poi Giovanni De Luna qualche anno dopo nel suo libro La Repubblica del dolore (2011) ha chiamato “paradigma vittimario”; cioè la presenza predominante...

  3. Contrast induced nephropathy in urology

    Directory of Open Access Journals (Sweden)

    Viji Samuel Thomson

    2009-01-01

    Full Text Available Intravenous contrast agents have a distinct role in urological imaging: to study precise anatomical delineation, vascularity, and to assess the function of the renal unit. Contrast induced nephropathy (CIN is a known adverse effect of intravenous contrast administration. The literature on incidence, pathophysiology, clinical features, and current preventive strategies available for CIN relevant to urologists was reviewed. A search of the PubMed database was done using the keywords nephropathy and media, prevention and control or prevention Contrast media (explode, all adverse effects, and kidney diseases (explode. An online search of the EMBASE database for the time ranging from 1977 to February 2009 was performed using the keywords ionic contrast medium, adverse drug reaction, major or controlled clinical study, human, nephrotoxicity, and kidney disease. Current publications and data most relevant to urologists were examined. CIN was the third most common cause of hospital-acquired renal failure. The incidence is less common with intravenous contrast administration as compared with intra-arterial administration. The pathogenesis of contrast mediated nephropathy is due to a combination of toxic injury to renal tubules and medullary ischemic injury mediated by reactive oxygen species. CIN most commonly manifests as a nonoliguric and asymptomatic transient decline in renal function. Patients who developed CIN were found to have increased mortality, longer hospital stay, and complicated clinical course. An overview of risk factors and risk prediction score for prognostication of CIN are elaborated. Preventive strategies including choice of contrast agents, maximum tolerated dose, role of hydration, hydration regime, etc. are discussed. The role of N- acetyl cysteine, Theophylline, Fenoldapam, Endothelin receptor antagonists, iloprost, atrial natriuretic peptide, and newer therapies such as targeted renal therapy (TRT are discussed. A working

  4. The operational cost of a urology unit.

    Science.gov (United States)

    Abeygunasekera, Anuruddha M; Duminda, M T; Chamintha, Thushara; Jayasingha, Ruwan

    2008-06-01

    To assess the operational cost of a urology unit, individual cost for certain index operations in urology, and to develop a framework to audit finances of a unit. A financial audit. Urology unit in a teaching hospital. Data of cost in providing urology services during one month were collected. It included three main areas: ward, operating theatre and outpatient clinic. Direct costs included staff wages, drugs, consumables, investigations and food. Indirect expenses such as administration, water, electricity and cleaning services were also calculated. For each type of operation a relative value was assigned depending on the nature of the operation. When direct expenses were not available, the hospital was divided into different cost centres and apportioning of the cost was done accordingly. The monthly operational cost of running a 19 bed urology unit with three operating sessions a week was Rs. 1 294 259. Staff wages constituted 61.2% of the cost. The cost of performing a pyelolithotomy was Rs. 18 669. Transurethral resection of the prostate (TURP) was done at a cost of Rs. 21 271. When the basic principles and the framework are understood, clinicians can perform financial audit and cost analysis of their units.

  5. Iatrogenic urological triggers of autonomic dysreflexia

    DEFF Research Database (Denmark)

    Liu, N; Zhou, M; Biering-Sørensen, F

    2015-01-01

    STUDY DESIGN: This is a systematic review. OBJECTIVE: The objective of this study was to review the literature on iatrogenic urological triggers of autonomic dysreflexia (AD). SETTING: This study was conducted in an international setting. METHODS: A systematic review was conducted from Pub......Med search using AD/ autonomic hyperreflexia and spinal cord injury (SCI). Studies selected for review involved iatrogenic urological triggers of AD in individuals with SCI, including original articles, previous practice guidelines, case reports and literature reviews. Studies that did not report AD or blood...... pressure (BP) assessments during urological procedures were excluded. RESULTS: Forty studies were included for analysis and categorized into four groups: (1) urodynamics and cystometry; (2) cystoscopy and transurethral litholapaxy; (3) extracorporeal shock-wave lithotripsy (ESWL); and (4) other procedures...

  6. Robot-assisted surgery: applications in urology

    Directory of Open Access Journals (Sweden)

    Mathew C Raynor

    2010-05-01

    Full Text Available Mathew C Raynor, Raj S PruthiDivision of Urologic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USAAbstract: The past decade has seen a dramatic shift in the surgical management of certain urologic conditions with the advent of a robotic surgical platform. In fact, the surgical management of prostate cancer has seen the most dramatic shift, with the majority of cases now being performed robotically. Technical refinements over the years have led to improved outcomes regarding oncologic and functional results. Recently, robotic surgery has also been utilized for the surgical management of bladder cancer, renal cancer, and other benign conditions. As further experience is gained and longer-term outcomes are realized, robotic surgery will likely play an increasing role in the surgical management of many urologic conditions.Keywords: robot-assisted surgery, robotic surgery, cystectomy, prostatectomy, partial nephrectomy

  7. A novel cadaveric simulation program in urology.

    Science.gov (United States)

    Ahmed, Kamran; Aydin, Abdullatif; Dasgupta, Prokar; Khan, Muhammad Shamim; McCabe, John E

    2015-01-01

    To evaluate the urology human cadaver training program developed by the British Association of Urological Surgeons. This prospective, observational comparative study recruited urology residents, with different levels of experience, in 2 sessions of a 3-day modular cadaveric operative urology training. Participants performed various procedures on fresh-frozen cadaveric specimens, as per module, supervised by certified urological surgeons. At the conclusion of each module, all residents and faculty were invited to complete an evaluation survey. The training days were hosted by the British Association of Urological Surgeons at the University of Manchester Surgical Skills and Simulation Centre. A total of 81 urology residents were recruited, with a maximum of 14 participants attending each module, over 2 sessions. We allocated 2 participants to each cadaver with access to all necessary equipment and guidance. A total of 102 evaluation surveys were received from the trainees and faculty; a response rate of 94%. All procedures scored a mean of 3 on 5 for face validity, which is higher than the acceptability range. Regarding content validity, participants and faculty rated all aspects ≥3 on 5. Respondents held a positive view of the cadaver sessions and believed them to be useful for learning anatomy and steps of an operation (mean = 4.54) and as a confidence booster for performing a procedure (mean = 4.33). Furthermore, it was thought that the training program significantly improved skills (mean = 4.11), gave transferrable skills for the operating room (mean = 4.21), and was feasible to be incorporated into training programs (mean = 4.29). Human cadaveric simulation was rated as the best mode of simulation-based training for all the procedures in the curriculum. This study on cadaveric simulation training demonstrated face and content validities. It also showed feasibility, acceptability, a high value for educational influence and cost-effectiveness for cadaveric

  8. [Oncology and urology: relations between specialities].

    Science.gov (United States)

    Lopatkin, N A; Apolikhin, O I; Darenkov, S P; Chernyshev, I V

    2006-01-01

    The article presents the analysis of present-day medical care for patients with urogenital cancer (UGC) in the Russian Federation (RF). In 2004 cancer treatment service in the RF has 8 Research Cancer and Radiological Institutes, 110 inpatient and 7 outpatient cancer clinics. According to the statistics for 1998, UGC patients are treated in 32 specialized departments in 24 regions. The rest regions provide such care in urological departments and clinics. In view of the importance of oncourology nowadays, we propose to set up an oncourological section at All-Russia Urology Society as a center of integration of efforts of specialists in oncourology.

  9. Extracorporeal shock wave therapy (ESWT) in urology

    DEFF Research Database (Denmark)

    Fojecki, Grzegorz Lukasz; Thiessen, Stefan; Osther, Palle Jörn Sloth

    2017-01-01

    PURPOSE: The objective was to evaluate high-level evidence studies of extracorporeal shock wave therapy (ESWT) for urological disorders. METHODS: We included randomized controlled trials reporting outcomes of ESWT in urology. Literature search on trials published in English using EMBASE, Medline......i) responders in 2 of 4 trials and 3 of 4 trials, respectively. Three studies on chronic pelvic pain (CPP) engaging 200 men reported positive changes in National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). There was considerable heterogeneity between trials both with regard...

  10. "Open" minimally invasive surgery in pediatric urology.

    Science.gov (United States)

    Hidalgo-Tamola, Josephine; Shnorhavorian, Margarett; Koyle, Martin A

    2009-06-01

    Minimally invasive surgery (MIS) offers alternative operative approaches to standard open surgical techniques. However, MIS has been defined primarily as substituting laparoendoscopic alternatives for the traditional open surgical approach. The concept of MIS methodology may also be applied to open surgery in an effort to decrease incision size, potentially reduce morbidity and enhance convalescence, without compromising 'gold standard' outcomes. Pediatric urological applications of open MIS include pediatric renal surgery, ureteral reimplantation, ureteral surgery, inguinal-scrotal and genital surgery. A thorough review of the pediatric urology literature was performed and studies were identified describing open MIS, including outcomes and complications.

  11. Citation indices for social media articles in urology.

    Science.gov (United States)

    Calopedos, Ross J S; Garcia, Cindy; Rashid, Prem; Murphy, Declan G; Lawrentschuk, Nathan; Woo, Henry H

    2017-05-01

    To evaluate the impact of publications on urological participation in social media (SoMe) by virtue of citations in the urological and non-urological literature. On 15 March 2016, a PubMed search was undertaken using the names of the major SoMe platforms in current use and associated with the field of urology. The search term 'urolog*' was used to specifically capture articles that could be associated with 'urology', 'urologist' or 'urological'. Exclusion criteria for analysis included non-English language articles, articles published for the first time online in any form after 1 March 2015, articles irrelevant to the topic of SoMe, and letters of correspondence. Included articles were then searched in Google Scholar and citations analysed to determine if citations were from the urological literature or non-urological literature. Citations from non-urological journals were considered to be as such even if authored by urologists and on the subject of urology and SoMe. Prior to exclusions as defined in the methods, our PubMed search yielded 232 articles of which 17 were non-English language and 66 had been published after 1 March 2015. Allowing for 12 months after the most recent articles were published, we found that the mean number of total citations in any journal was 20.8. There were more citations in journals not specific to urology, with 8.3 citations in urological journals, compared to 12.6 citations in non-urological journals. Urological SoMe journal articles are highly cited, particularly in the non-urological literature. It is likely that the magnitude of citations has positively contributed to the impact factors of the almost all journals publishing these manuscripts. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  12. JOURNALS ANALYSIS IN UROLOGY AND PLASTIC SURGERY.

    Science.gov (United States)

    Antunes, Alberto Azoubel

    2015-01-01

    Find out the main journals used in Urology and Plastic Surgery. Was consulted the WebQualis database and selected the "consult" after the "rating" and finally by "journal title." Also was crossed the following keywords: urology, urologic, urological, prostate, prostatic, plastic, reconstructive, aesthetic. The journals classified in the field of Capes Medicine III were selected, and registered their respective strata. To confirm the 2014 impact factor, was consulted the http://www.impactfactorsearch.com/ database; simply typing the journal title its impact factor appears automatically. Was found 23 journals in Urology and 12 in Plastic Surgery. The average impact factor of urological journals was 2,256 and in Plastic Surgery 1,060. Among the urological journals, seven (30.4%) were in the A WebQualis rating and among Plastic Surgery only one (8.3%) was found in this stratum. There are quantitative and qualitative differences between journals in Urology and Plastic Surgery. These data can help to develop appropriate assessment methods for each specialty, considering the different features of the presented papers. Procurar destacar os principais periódicos utilizados na urologia e na cirurgia plástica. Foi consultada a base de dados WebQualis. Selecionou-se a opção "consultar", depois a opção "classificação" e por fim por "título do periódico". Cruzaram-se também os seguintes descritores: urology, urologic, urological, prostate, prostatic, plastic, reconstructive, aesthetic. Os periódicos classificados na área da Medicina III da Capes foram selecionados, e seus respectivos estratos registrados. Para confirmação do fator de impacto de 2014, consultou-se a base de dados http://www.impactfactorsearch.com/, onde a digitação do nome do periódico revela automaticamente seu impacto. Foram encontrados 23 periódicos urológicos e 12 na cirurgia plástica. O fator de impacto médio dos urológicos foi de 2.256 e o da cirurgia plástica de 1.060. Entre os peri

  13. UROLOGIC DAY-CARE SURGERY: SCOPE AND PROBLEMS IN A

    African Journals Online (AJOL)

    faced during implementation of day-care urologic surgery in a tertiary-care center in. Nigeria. Patients and Methods This was a prospec- tive study of all consecutive urologic day cases seen at the urology unit of Jos Uni- versity Teaching Hospital, Nigeria, from. January 2003 to December 2004. A total of. 270 patients aged ...

  14. Original Article The Pattern of Urological Cancers in Zambia

    African Journals Online (AJOL)

    ra

    were urological malignancies affecting the kidney, bladder, prostate, testis or penis. The male- to-female ratio of the urological cancers was 10.7 to 1. Cancer of the prostate was the most common urological malignancy (54.6%), followed by bladder cancer (21.1%) and penile cancer. (18.6%). The histological type of bladder ...

  15. The Pattern of Urological Cancers in Zambia | Bowa | African ...

    African Journals Online (AJOL)

    Results: In total, 8829 cancers were diagnosed during the study period, of which 749 (8.5%) were urological malignancies affecting the kidney, bladder, prostate, testis or penis. The maleto- female ratio of the urological cancers was 10.7 to 1. Cancer of the prostate was the most common urological malignancy (54.6%), ...

  16. Bacillus subtilis Two-Component System Sensory Kinase DegS Is Regulated by Serine Phosphorylation in Its Input Domain

    DEFF Research Database (Denmark)

    Jers, Carsten; Kobir, Ahasanul; Søndergaard, Elsebeth Oline

    2011-01-01

    Bacillus subtilis two-component system DegS/U is well known for the complexity of its regulation. The cytosolic sensory kinase DegS does not receive a single predominant input signal like most two-component kinases, instead it integrates a wide array of metabolic inputs that modulate its activity......S phosphorylation can be carried out by at least two B. subtilis Hanks-type kinases in vitro, and this stimulates the phosphate transfer towards DegU. The consequences of this process were studied in vivo, using phosphomimetic (Ser76Asp) and non-phosphorylatable (Ser76Ala) mutants of DegS. In a number...

  17. Urological injuries following gynecological operations - our experience

    African Journals Online (AJOL)

    during or after surgery but others pass unnoticed. Aims and Objectives: To study the urological injuries that follow gynecological operations in our centre. Design: Retrospective study. Setting: Nnamdi Azikiwe University Teaching Hospital,. Nnewi Nigeria, a third generation tertiary institution serving rural, semi-urban, and ...

  18. Quantitative Analysis of Technological Innovation in Urology.

    Science.gov (United States)

    Bhatt, Nikita R; Davis, Niall F; Dalton, David M; McDermott, T E D; Flynn, Robert J; Thomas, Arun Z; Manecksha, Rustom P

    2017-10-09

    To assess major areas of technological innovation in urology in the last 20 years using patent and publication data. Patent and MEDLINE databases were searched between 1980 and 2012 electronically using the terms urology OR urological OR urologist AND "surgeon" OR "surgical" OR "surgery". The patent codes obtained were grouped in technology clusters, then further analyzed with individual searches, and growth curves were plotted. Growth rates and patterns were analyzed, and patents were correlated with publications as a measure of scientific support and of clinical adoption. The initial search revealed 417 patents and 20,314 publications. The top 5 technology clusters in descending order were surgical instruments including urinary catheters (UCs), minimally invasive surgery (MIS), lasers, robotic surgery and image guidance. MIS and robotic surgery were the most emergent cluster in the last 5 years. Publication and patent growth rates were closely correlated (Pearson coefficient 0.78, pinnovation and adoption into clinical practice. Patent metrics identify emergent technological innovations and such trends are valuable to understand progress in the field of urology. New surgical technologies like robotic surgery and MIS showed exponential growth in the last decade with good scientific vigilance. Copyright © 2017. Published by Elsevier Inc.

  19. Urological injuries following obstetrical and gynecological surgeries ...

    African Journals Online (AJOL)

    Background: Gynaecological operations have been reported to be associated with injuries to the ureter. This study was aimed at reviewing the urological complications resulting from obstetric and gynaecological surgeries in respect to frequency, clinical presentations, and time of diagnosis. The study was undertaken at ...

  20. Sexual Activity and Urological Morbidities Among Nigerian ...

    African Journals Online (AJOL)

    Interviewer administered questionnaires were used to obtain information on their characteristics, pattern of urological and sexual activities. Descriptive, bivariate and multivariable tests were ... Urge incontinence was the most commonly reported followed by dysuria and stress incontinence. Less than a quarter of them had ...

  1. UROLOGY IN AFRICA AND THE INTERNET

    African Journals Online (AJOL)

    The field of medicine in general and es- pecially urology has experienced dramatic im- provements since the second World War. The history of medicine in the last fifty years ranks as one of the most impressive epochs of human achievement1. Unfortunately, the contri- bution of the African continent in such history is limited.

  2. Pediatric resident exposure to urology: identifying a need.

    Science.gov (United States)

    Sarkissian, Hagop; Hardy, Sarah; Plante, Mark; Mingin, Gerald

    2013-10-01

    We evaluated current trends of pediatric urology exposure during the 3-year pediatric residency period nationwide. We also evaluated the opinions of urology and pediatric residency program directors regarding the need for additional exposure to pediatric urology. From February to October 2011 we administered 2 concurrent electronic surveys. One set was sent to urology residency program directors and the other was sent to pediatric residency program directors. The surveys consisted of 6 and 12 questions, respectively. The questions were created to best evaluate exposure to pediatric urology from the perspective of each cohort. Response data were analyzed using the chi-square test and case-control methods. Of the 117 accredited urology residency program directors and 190 pediatric residency program directors 51 (43.5%) and 78 (41.1%), respectively, completed the survey. Urology program directors answered favorably by a margin of 66% toward increased involvement with pediatric residents, while 84.6% of pediatric residency directors would like increased exposure to pediatric urology. Furthermore, 87% of pediatric residency directors reported that they do not require residents to have a formal pediatric urology rotation. However, in 65% of pediatric programs residents received some form of didactic education. These results show the desire on the part of urology and pediatric residency program directors for pediatric residents to have greater exposure to pediatric urology, particularly didactic and bedside teaching in the management of pediatric urological disorders. Increasing pediatric resident exposure to pediatric urological pathology and treatment during training would have a positive impact on the subsequent diagnosis and care of pediatric urological conditions. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Cloning and sequencing the degS-degU operon from an alkalophilic Bacillus-brevis

    CSIR Research Space (South Africa)

    Louw, M

    1994-10-01

    Full Text Available two types of media were used, Luria broth plus 1% sucrose (Amory et al. 1987) and MMCH medium con- taining 2% sucrose (Kunst et al. 1988). Auxotrophic requirements were added at a concentration of 100 mg/1...U(HY) mutation as well as to B. subtilis strains overexpressing various accessory poly- peptides, such as degQ or degR on multicopy plasmids (Amory et al. 1987; Nagami and Tanaka 1986; Tanaka et al. 1987; Yang et al. 1986...

  4. [The history of urologic journalism in Spain (II). Chronology of Spanish publications specialized in urologic topics].

    Science.gov (United States)

    Maganto Pavón, E

    1996-11-01

    The history of Spanish urological periodicals, like that of the surgical specialties, encompasses several periods as the specialties emerge, are then defined and finally established. It is difficult to determine precisely when the urological specialty began in Spain, since there were surgeons with some dedication to Urology early in the 19th century. Perhaps it began in 1884, when the first service dedicated to the diseases of the urinary tract was created at the Instituto de Terapéutica Operatoria (Institute of Surgical Therapeutics) of the Hospital de la Princesa in Madrid. Although some periodicals with urological descriptions that date back to an earlier period (1800-1850) can be found, it is widely recognized that regular publication of literature and periodicals on the urinary tract started in the mid-19th century, when 'El Especialista' (The Specialist) first appeared in Madrid in 1859. This was the first non monographic specialized periodical where the section 'Genitourinary Disorders' appeared for the first time together with three other specialties. During this second period, journal names were nonspecific or too comprehensive to the point that other medical fields became indiscernible, but they became more explicit as the specialties became more defined. In 1887, the first issue of 'Gaceta de Enfermedades de los Organos Génito-Urinarios' (Gazette of Diseases of the Genitourinary Organs) was published in Madrid. It was the first Spanish journal dedicated exclusively to urological topics. It ushered in a third period, which can be defined as the period of specialized monographic publications, that concluded in 1911 with the founding of the Asociación Española de Urología (Spanish Urological Society). The present article reviews the historical and bibliographical data concerning the six periodicals that were established during these two latter periods.

  5. Yonsei Experience in Robotic Urologic Surgery - Application in Various Urological Procedures

    Science.gov (United States)

    Park, Sung Yul; Jeong, Wooju; Choi, Young Deuk; Chung, Byung Ha; Hong, Sung Joon

    2008-01-01

    Purpose The da Vinci® robot system has been used to perform complex reconstructive procedures in a minimally invasive fashion. Robot-assisted laparoscopic radical prostatectomy has recently established as one of the standard cares. Based on experience with the robotic prostatectomy, its use is naturally expanding into other urologic surgeries. We examine our practical pattern and application of da Vinci® robot system in urologic field. Patients and Methods Robotic urologic surgery has been performed during a period from July 2005 to August 2008 in a total of 708 cases. Surgery was performed by 7 operators. In our series, radical prostatectomy was performed in 623 cases, partial nephrectomy in 43 cases, radical cystectomy in 11 cases, nephroureterectomy in 18 cases and other surgeries in 15 cases. Results In the first year, robotic urologic surgery was performed in 43 cases. However, in the second year, it was performed in 164 cases, and it was performed in 407 cases in the third year. In the first year, only prostatectomy was performed. In the second year, partial nephrectomy (2 cases), nephroureterectomy (3 cases) and cystectomy (1 case) were performed. In the third year, other urologic surgeries than prostatectomy were performed in 64 cases. The first robotic surgery was performed with long operative time. For instance, the operative time of prostatectomy, partial nephrectomy, cystectomy and nephroureterectomy was 418, 222, 340 and 320 minutes, respectively. Overall, the mean operative time of prostatectomy, partial nephrectomy, cystectomy and nephrourectectomy was 179, 173, 309, and 206 minutes, respectively. Conclusion Based on our experience at a single-institution, robot system can be used both safely and efficiently in many areas of urologic surgeries including prostatectomy. Once this system is familiar to surgeons, it will be used in a wide range of urologic surgery. PMID:19108011

  6. Training in minimally invasive surgery in urology: European Association of Urology/International Consultation of Urological Diseases consultation.

    Science.gov (United States)

    van der Poel, Henk; Brinkman, Willem; van Cleynenbreugel, Ben; Kallidonis, Panagiotis; Stolzenburg, Jens-Uwe; Liatsikos, Evangelos; Ahmed, Kamran; Brunckhorst, Oliver; Khan, Mohammed Shamim; Do, Minh; Ganzer, Roman; Murphy, Declan G; Van Rij, Simon; Dundee, Philip E; Dasgupta, Prokar

    2016-03-01

    To describe the progress being made in training for minimally invasive surgery (MIS) in urology. A group of experts in the field provided input to agree on recommendations for MIS training. A literature search was carried out to identify studies on MIS training, both in general and specifically for urological procedures. The literature search showed the rapidly developing options for e-learning, box and virtual training, and suggested that box training is a relatively cheap and effective means of improving laparoscopic skills. Development of non-technical skills is an integral part of surgical skills training and should be included in training curricula. The application of modular training in surgical procedures showed more rapid skills acquisition. Training curricula for MIS in urology are being developed in both the USA and Europe. Training in MIS has shifted from 'see-one-do-one-teach-one' to a structured learning, from e-learning to skills laboratory and modular training settings. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

  7. Postoperative Pain Management in Urologic Patients

    Directory of Open Access Journals (Sweden)

    Yu.I. Kondrakova

    2009-06-01

    Full Text Available The quality of postoperative anesthesia in urologic patients has been analyzed. Correlation between pain intensity and postoperative complications has been revealed. Nonsteroid antiinflammatory and narcotic drugs don’t provide high-quality anesthesia after urological operations. Continued postoperative pain is the cause of development of pathological reactions and complications. An important role of prevention and treatment of postoperative pain comes to prolonged epidural analgesia composed of multimodal pain management. Usage of similar tactics significantly decreases the risk of negative reactions for organs and systems in response to operative stress, excludes the necessity of narcotic drugs, prevents the development of complications during the early postoperative period and provides comfortable conditions for patients.

  8. [Magnetic resonance urography in pediatric urology].

    Science.gov (United States)

    Schindele, D; Furth, C; Liehr, U B; Porsch, M; Baumunk, D; Janitzky, A; Wendler, J J; Genseke, P; Ricke, J; Schostak, M

    2012-12-01

    Magnetic resonance urography (MRU) provides high resolution imaging of the urogenital system and the use of paramagnetic contrast agents enables a functional depiction. This review summarizes existing data concerning this diagnostic procedure in pediatric urology. A systematic search and assessment of the literature was performed.A total of 12 studies were reviewed in detail. In mostly small study populations a great heterogeneity concerning methodology, use of comparative examinations and standards of reference was noted. Besides the quality of anatomical imaging, the functional study of renal excretory function and differential renal function was also assessed. Only a few studies performed statistical analyses.The authors' rating of MRU was mostly positive. Due to methodical weaknesses, lack of independent standards of reference and statistical analyses the overall level of evidence was low. Further high quality studies will be necessary to assess the value of MRU for the diagnostic workup in pediatric urology.

  9. Holmium laser for multifunctional use in urology

    Science.gov (United States)

    Watson, Graham M.; Shroff, Sunil; Thomas, Robert; Kellett, Michael

    1994-05-01

    The holmium laser pulsed at 350 microsecond cuts tissue and fragments calculi. It has been assessed for minimally invasive urological intervention. It is useful for partly excising and partly coagulating tumors, incising strictures and the obstructed PUJ. It partly drill and partly fragments urinary calculi however hard. Other lasers are more effective at any one particular application, but this laser is a useful compromise as a multifunctional device.

  10. Analysis of closed medical litigation in urology

    Directory of Open Access Journals (Sweden)

    Su Hwan Shin

    2017-09-01

    Full Text Available Purpose: The objective of this study was to provide a descriptive understanding of the characteristics of malpractice litigation re-lated to urology by examining court cases.Materials and Methods: A total of 6,074 court cases related to medical malpractice litigation filed between 2005 and 2010 were received from the Lower Courts, the Appellate Courts, and the Supreme Court of Korea. Of the received cases, 34 urology-related civil proceedings were analyzed. The following information was compiled and investigated from the cases: background, age and sex of patient, categorization of the defendant, opinion of the court, amount claimed and awarded in damages, type of medical treatment involved, and negative effects resulting from the medical accident.Results: The average amount in damages paid out to plaintiffs in this research was 27,186,504±32,371,008 Korean won (KRW (range, 1,000,000–100,000,000 KRW. A total of 9 of the 34 analyzed cases (26.5% ruled in favor of the plaintiff, with all 9 cases involving a surgery. An analysis of the surgery sites further revealed that the penis was the most frequently litigated over site of surgery, making up 14 of the 35 sites (40.0%.Conclusions: Information regarding urology malpractice lawsuits should be made available to help prevent further disputes and litigation. Continuous efforts must be expended in the prevention of accidents and disputes, alongside research into urology-re-lated cases beyond 2010. Extensive cause analysis and recurrence prevention methods must also be researched to enhance overall patient safety.

  11. UROLOGICAL INJURIES IN OBSTETRICS AND GYNAECOLOGY

    OpenAIRE

    Vandana,; Usha,; Kanchan; Priyanka,

    2013-01-01

    ABSTRACT: To review the frequency of iatrogenic urological injury during obstetric and gynaecological operations carried out between January 2009 to Janua ry 2013 at Government Medical College, Haldwani. Each case was reviewed for predisposing factors, location, type of injury, time of injury, method of recognition and management. 12 injuries were documented in 1063 gynaecological procedures and 3079 obstetr ic procedures. All were bladder injuries and occurred while s...

  12. [Application of 3D printing in urology].

    Science.gov (United States)

    Alyaev, Yu G; Bezrukov, E A; Fiev, D N; Sirota, E S; Pesegov, S V; Byadretdinov, I Sh

    2017-09-01

    The purpose of this article is to outline the role and possible applications of 3D printing in urology. At present, this technique provides the opportunity to choose the individual strategy of patient management, to conduct preoperative planning and surgical rehearsal; for medical specialists to reduce the learning curve in mastering modern complex surgical techniques, and for doctors and students to improve understanding of pathological processes in the kidney and the prostate gland.

  13. Minimal Invasive Urologic Surgery and Postoperative Ileus

    Directory of Open Access Journals (Sweden)

    Fouad Aoun

    2015-07-01

    Full Text Available Postoperative ileus (POI is the most common cause of prolonged length of hospital stays (LOS and associated healthcare costs. The advent of minimal invasive technique was a major breakthrough in the urologic landscape with great potential to progress in the future. In the field of gastrointestinal surgery, several studies had reported lower incidence rates for POI following minimal invasive surgery compared to conventional open procedures. In contrast, little is known about the effect of minimal invasive approach on the recovery of bowel motility after urologic surgery. We performed an overview of the potential benefit of minimal invasive approach on POI for urologic procedures. The mechanisms and risk factors responsible for the onset of POI are discussed with emphasis on the advantages of minimal invasive approach. In the urologic field, POI is the main complication following radical cystectomy but it is rarely of clinical significance for other minimal invasive interventions. Laparoscopy or robotic assisted laparoscopic techniques when studied individually may reduce to their own the duration and prevent the onset of POI in a subset of procedures. The potential influence of age and urinary diversion type on postoperative ileus is contradictory in the literature. There is some evidence suggesting that BMI, blood loss, urinary extravasation, existence of a major complication, bowel resection, operative time and transperitoneal approach are independent risk factors for POI. Treatment of POI remains elusive. One of the most important and effective management strategies for patients undergoing radical cystectomy has been the development and use of enhanced recovery programs. An optimal rational strategy to shorten the duration of POI should incorporate minimal invasive approach when appropriate into multimodal fast track programs designed to reduce POI and shorten LOS.

  14. The Current State of Medical Malpractice in Urology.

    Science.gov (United States)

    Sherer, Benjamin A; Coogan, Christopher L

    2015-07-01

    Medical malpractice can present an unwelcome professional, emotional, and economic burden to the practicing urologist. To date, there is a paucity of data specific to urologic malpractice in the literature. We performed a comprehensive literature search to identify and evaluate recent studies related to urologic malpractice. We also analyzed 6249 closed urologic claims from the largest available specialty-specific data set gathered by Physician Insurers Association of America from 1985 to 2012. The resulting comprehensive review seeks to raise awareness of current trends in the malpractice environment specific to urologic surgery while also helping urologists identify opportunities for risk management and improved patient care. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Paediatric urology training: what does the future hold?

    Science.gov (United States)

    Burke, M J; Nason, G J; Aslam, A; Redmond, E; Kelly, M E; Giri, S K; Flood, H D

    2015-09-01

    Paediatric urology training is not a mandatory part of higher surgical training in urology in Ireland. It is predicted there will be a shortfall of surgeons trained in paediatric surgery in the coming years leading to a reliance on specialist paediatric surgical centres. The aim of this study was to assess the attitudes of urological trainees regarding the current state of paediatric urology training and to address the potential future changes to training structures. A voluntary anonymous internet-based survey was emailed to all urological trainees. Parameters assessed included sex, level of training, attitudes towards paediatric urology training and levels of competence regarding core paediatric urological procedures. 69.2 % (n = 18) responded to the survey. 94.4 % (n = 17) would favour mandatory paediatric training-of these, 52.9 % (n = 9) would favour this in a dedicated paediatric hospital with a paediatric urologist. 66.7 % (n = 12) would like to provide a paediatric urology service as a consultant. 55.6 % (n = 10) felt they were competent to perform circumcision or scrotal exploration independently and manage all associated complications. No trainee felt themselves to be competent to perform orchidopexy independently and manage all complications. Our study demonstrates a promising desire to provide paediatric services in the future. A greater emphasis on structured paediatric urology training is required to maintain the standard currently offered by adult urologists.

  16. Looking forward, looking back-10 years in urology.

    Science.gov (United States)

    Albersen, Maarten; Cartwright, Rufus; Choyke, Peter; Goldenberg, S Larry; Goldman, Howard; Lawrentschuk, Nathan; Linehan, W Marston; Murphy, Declan; Nagler, Harris; Scardino, Peter; Shortliffe, Linda; Stenzl, Arnulf; Theodorescu, Dan

    2014-11-01

    When Nature Reviews Urology launched in 2004, the field of urology was vastly different to that which we work in today, and the past 10 years have seen the field change immensely. As a specialty on the forefront of cutting-edge innovation, urologists are often the first to embrace new technologies and ideas. In this Viewpoint, members of the Nature Reviews Urology advisory board were asked what they thought was the most important change, issue or innovation in urology in the past 10 years, and what they expected to be the most important in the next decade. Here are their opinions.

  17. Educazione linguistica e bisogni degli alunni (stranieri.

    Directory of Open Access Journals (Sweden)

    Marina Chini

    2009-12-01

    Full Text Available Normal 0 14 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabella normale"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman";} L’articolo focalizza l’attenzione sui bisogni linguistici e comunicativi specifici degli allievi nativi e immigrati, al fine di evidenziare alcuni suggerimenti che è possibile trarne sul piano dell’educazione linguistica, intesa nel senso dell’insegnamento rivolto allo sviluppo e al potenziamento delle abilità linguistico-comunicative, ma anche metalinguistiche, svolto trasversalmente dai docenti di discipline linguistiche e non.  Tenendo conto di principi e suggerimenti emersi dalla riflessione glottodidattica e linguistica degli ultimi decenni si forniscono criteri in base ai quali i docenti possono rilevare i bisogni linguistici dei loro allievi, bisogni che si correlano a valenze di carattere comunicativo, pragmatico, espressivo e culturale-matetico, ma che sono anche di natura sociale, relazionale e affettiva, identitaria e psicologica oltre che cognitiva.  Normal 0 14 MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabella normale"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman";} The article focuses on the specific linguistic and communicative needs of native and immigrant pupils, in order to draw attention to inspiration  that can be gained for general linguistic education, seen as teaching that aims to develop and strengthen linguistic-communicative abilities but also meta-linguistic ones – teaching that is carried

  18. The Study on Profile of Urological Malignancies Among Patients Admitted to Urological Surgical Wards at Muhimbili National Hospital

    OpenAIRE

    Masonda, Yohana Paulo

    2011-01-01

    Cancer is a big problem in many countries of Africa who are without resources to cope with it. This study dealt with the urological cancers involving; renal, urinary bladder affecting male and female, and prostate, penile and testicular cancers only affecting males. Urological cancers are becoming a major problem in both men and women, and the most affected age group is between 51-70 years. The aim of the study was to determine the profile of urological malignancies, demography, and clinical ...

  19. La poesia sabiana degli Anni Venti

    Directory of Open Access Journals (Sweden)

    Atilij Rakar

    1975-11-01

    Full Text Available Muovendo da un confronto fra il Saba del primo Canzoniere e le Figure e canti coi quali l'opera del poeta triestino continua negli anni venti, l'autore cerca di individuare i caratteri che meglio definiscono la poesia sabiana di questo secondo periodo. Messi in evidenza alcuni temi su cui verte il discorso sabiano fin delle Poesie dell'adolescenza e giovanili, le opere degli anni venti si rivelano come esiti di un poliforme compendio in cui il poeta vuol chiarire il senso del cammino percorso e comp:tendere quelle che sono le ragioni prime del suo poetare. Si manifestano qui, anche in maniera esplicita, alcuni motivi fondamentali del Canzionere: basti pensare, ad esempio, a Il borgo che offre la chiave per l'interprezazione di tutto un filone della tematica sabiana, o alle Fughe, con le quali il poeta vuol esprimere l'essenza del proprio sentire. La poetica delle »figure« e dei »canti« composti negli anni venti, non segnerebbe dunque una conversione di Saba ai »miti della forma«, come inducono a credere anche certe apostrofi del poeta stesso, rna può esser definita solo se vista in funzione dei contenuti che determinano il suo formarsi.

  20. What is next in robotic urology?

    Science.gov (United States)

    Cathelineau, Xavier; Sanchez-Salas, Rafael; Sivaraman, Arjun

    2014-12-01

    The application of robotic technology in surgical practice was developed during the past three decades, but its clinical application has made a significant impact during the last 10 years. Urologists have embraced surgical robots throughout their evolution, and robot-assisted urologic surgeries have matured into everyday clinical practice in many parts of the world. Long-term data from robot-assisted radical prostatectomies (RARP), an early robotic urologic surgery, has shown that the results are comparable to contemporary open radical prostatectomy (ORP) cohorts. Robot-assisted partial nephrectomy (RAPN) is largely restricted to high-volume academic centers; comparative studies have demonstrated significant advantages in favor of RAPN over laparoscopic partial nephrectomy (LPN) to achieve adequate warm ischemia time, surgical margins free of cancer cells, and no peri-operative complications. Robot-assisted radical cystectomy shows results that are comparable to contemporary open radical cystectomy. Several authors have reported the feasibility of robotic intracorporeal urinary diversion. The available long-term outcomes of robot-assisted urological surgeries are comparable to conventional open surgical methods and are associated with fewer complications. Surgical robots continue to evolve, and robotic engineers alongside surgeons strive hard to synthesize and evaluate novel robotic platforms, downsize hardware, and develop flexible instruments and newer technologies. Robotic applications available at this point represent the infancy of this technology. Future developments in robotics are profoundly limited to human imagination and can potentially scale to unimaginable heights. We would expect robots coupled with imaging and energies, aiming to provide accurate and reliable treatments which will be finely targeted by biogenetic information.

  1. Training of European urology residents in laparoscopy: results of a pan-European survey

    NARCIS (Netherlands)

    Furriel, Frederico T. G.; Laguna, Maria P.; Figueiredo, Arnaldo J. C.; Nunes, Pedro T. C.; Rassweiler, Jens J.

    2013-01-01

    To assess the participation of European urology residents in urological laparoscopy, their training patterns and facilities available in European Urology Departments. A survey, consisting of 23 questions concerning laparoscopic training, was published online as well as distributed on paper, during

  2. [German Urological Associations under National Socialism].

    Science.gov (United States)

    Krischel, M; Moll, F; Fangerau, H

    2011-09-01

    The Deutsche Gesellschaft für Urologie (German Urological Association), established in 1907, was a German-Austrian medical society in which Jewish physicians held important positions. When the Nazis seized power in 1933, the Austrian Hans Rubritius was president of the society. The non-German presidency and the exclusion of Jewish colleagues from the professional society and medical practice led to a halt of the society's activities. At the same time in the mid 1930s, German urologists founded the Gesellschaft Reichsdeutscher Urologen (Association of Reichs-German Urologists) whose members aligned themselves with Nazi health policies and in turn received professional and personal benefits.

  3. Comparison of prostate cancer diagnosis in patients receiving unrelated urological and non-urological cancer care.

    Science.gov (United States)

    Corcoran, Anthony T; Smaldone, Marc C; Egleston, Brian L; Simhan, Jay; Ginzburg, Serge; Morgan, Todd M; Walton, John; Chen, David Y T; Viterbo, Rosalia; Greenberg, Richard E; Uzzo, Robert G; Kutikov, Alexander

    2013-07-01

    To evaluate prostate cancer diagnosis rates and survival outcomes in patients receiving unrelated (non-prostate) urological care with those in patients receiving non-urological care. We conducted a population-based study using the Surveillance Epidemiology and End Results (SEER) database to identify men who underwent surgical treatment of renal cell carcinoma (RCC; n = 18,188) and colorectal carcinoma (CRC; n = 45,093) between 1992 and 2008. Using SEER*stat software to estimate standardized incidence ratios (SIRs), we investigated rates of prostate cancer diagnosis in patients with RCC and patients with CRC. Adjusting for patient age, race and year of diagnosis on multivariate analysis, we used Cox and Fine and Gray proportional hazards regressions to evaluate overall and disease-specific survival endpoints. The observed incidence of prostate cancer was higher in both the patients with RCC and those with CRC: SIR = 1.36 (95% confidence interval [CI] 1.27-1.46) vs 1.06 (95% CI 1.02-1.11). Adjusted prostate cancer SIRs were 30% higher (P cancer-adjusted mortalities (sub-distribution Hazard Ratio (sHR) = 1.17, P prostate cancer-specific mortality (sHR = 0.827, P = 0.391). Rates of prostate cancer diagnosis were higher in patients with RCC (a cohort with unrelated urological cancer care) than in those with CRC. Despite higher overall mortality in patients with RCC, prostate cancer-specific survival was similar in both groups. Opportunities may exist to better target prostate cancer screening in patients who receive non-prostate-related urological care. Furthermore, urologists should not feel obligated to perform prostate-specific antigen screening for all patients receiving non-prostate-related urological care. © 2013 BJU International.

  4. Factors affecting UK medical students' decision to train in urology: a national survey.

    Science.gov (United States)

    Jayakumar, Nithish; Ahmed, Kamran; Challacombe, Ben

    2016-10-01

    Our aim was to understand the specific factors which influence medical students' choice to train in urology, in order to attract the best and the brightest into the specialty during a challenging time for surgical training in the United Kingdom A cross-sectional web-based survey was generated to evaluate: 1) perceptions of urology; 2) attitudes about urology as a career; 3) exposure to urology at medical school; and 4) proficiency in common urological procedures. The survey was sent to all 33 medical schools in the UK and advertised to all medical students. The survey received 488 responses were received from 14 medical schools; 59.8% of respondents did not consider a career in urology. Factors affecting a career choice in urology included: 1) year of study; 2) male gender; 3) favorable perceptions of urology; 4) favorable attitudes about urology as a career; 5) more hours of urology teaching in preclinical years; 6) attendance at urology theatre sessions; 7) confidence in performing urological procedures; and 8) more attempts at male catheterization. The commonest reason for not considering urology was inadequate exposure to urology. Students in Year 3 were more likely to consider urology than final-year students, due to multifactorial reasons. Year of study is a novel factor affecting students' consideration of urology as a career. This paper clearly shows that early and sustained exposure to urology positively correlated with considering a career in urology. Urologists must be more active in promoting the specialty to medical students.

  5. First urology simulation boot camp in the United Kingdom

    Directory of Open Access Journals (Sweden)

    C.S. Biyani

    2017-09-01

    Conclusion: This first UK Urology Simulation Boot Camp has demonstrated feasibility and effectiveness in enhancing trainee’s experience. Given these positive feedbacks there is a good reason to expect that future courses will improve the overall skills of a new urology trainee.

  6. Urological malignancies in Port Harcourt, Nigeria: a 14-year review ...

    African Journals Online (AJOL)

    Background: Urological malignancies are complex, covering the urinary system in both sexes and the genital system of males. They are common in this setting and posing a lot of problems to the patients. In most cases, the disease terminates in the death of the patient. Aim: To study the pattern and frequency of urological ...

  7. Urological Tumours in Jos University Teaching Hospital, Jos, Nigeria

    African Journals Online (AJOL)

    This is a hospital based retrospective histopathological study of urological tumours in 10 years. Specimens consisted of all surgical excisions, trucut and fine needle biopsies of kidney, prostate, urinary bladder, testis and penis. Urological tumours accounted for 11.45% of all malignant tumours during the period of study.

  8. Immunological therapy in urological malignancy: novel combination strategies.

    Science.gov (United States)

    Finley, David S; Pouliot, Frederic; Chin, Arnold I; Shuch, Brian; Pantuck, Alan J; Belldegrun, Arie S; Dekernion, Jean B

    2011-02-01

    At present, immunotherapy in urological malignancy is experiencing a renaissance, particularly with the emergence of a host of innovative cancer vaccines. Herein, we will review promising immunotherapeutic approaches and evaluate the data supporting their inclusion in novel combination strategies. © 2010 The Japanese Urological Association.

  9. The morbidity and mortality of surgically treated urological patients ...

    African Journals Online (AJOL)

    Objective: To determine the morbidity and mortality of surgically treated urological patients at Moi Teaching and Referral Hospital (MTRH) and compare them with those of other tertiary centres. Design: A fi ve year hospital based, retrospective study reviewing files of patients who underwent surgery for urological problems in ...

  10. European Association of Urology guidelines on vasectomy.

    Science.gov (United States)

    Dohle, Gert R; Diemer, Thorsten; Kopa, Zsolt; Krausz, Csilla; Giwercman, Aleksander; Jungwirth, Andreas

    2012-01-01

    The European Association of Urology presents its guidelines for vasectomy. Vasectomy is highly effective, but problems can arise that are related to insufficient preoperative patient information, the surgical procedure, and postoperative follow-up. These guidelines aim to provide information and recommendations for physicians who perform vasectomies and to promote the provision of adequate information to the patient before the operation to prevent unrealistic expectations and legal procedures. An extensive review of the literature was carried out using Medline, Embase, and the Cochrane Database of Systematic Reviews from 1980 to 2010. The focus was on randomised controlled trials (RCTs) and meta-analyses of RCTs (level 1 evidence) and on well-designed studies without randomisation (level 2 and 3 evidence). A total of 113 unique records were identified for consideration. Non-English language publications were excluded as well as studies published as abstracts only or reports from meetings. The guidelines discuss indications and contraindications for vasectomy, preoperative patient information and counselling, surgical techniques, postoperative care and subsequent semen analysis, and complications and late consequences. Vasectomy is intended to be a permanent form of contraception. There are no absolute contraindications for vasectomy. Relative contraindications may be the absence of children, age European Association of Urology. Published by Elsevier B.V. All rights reserved.

  11. The role of lasers in modern urology

    Science.gov (United States)

    Dołowy, Łukasz; Dembowski, Janusz; Zdrojowy, Romuald; Kołodziej, Anna

    2015-01-01

    Introduction The functioning of modern urological departments and the high level of service they provide is possible through, among other things, the use of modern laser techniques. Material and methods Open operations have been replaced by minimally invasive procedures, and classical surgical tools by advanced lasers. The search for new applications with lasers began as technology developed. Among many devices available, holmium, diode and thulium lasers are currently the most popular. Results Depending on the wavelength, the absorption by water and hemoglobin and the depth of penetration, lasers can be used for coagulation, vaporization and enucleation. In many centres, after all the possibilities of pharmacological treatment have been exhausted, lasers are used as the primary treatment for patients with benign prostatic hyperplasia, with therapeutic results that are better than those obtained through open or endoscopic operations. The use of lasers in the treatment of urolithiasis, urinary strictures and bladder tumours has made treatment of older patients with multiple comorbidities safe, without further necessity to modify the anticoagulant drug treatment. Laser procedures are additionally less invasive, reduce hospitalization time and enable a shorter bladder catheterization time, sometimes even eliminating the need for bladder catherterization completely. Such procedures are also characterized by more stable outcomes and a lower number of reoperations. Conclusions There are also indications that with the increased competition among laser manufacturers, decreased purchase and maintenance costs, and increased operational safety, laser equipment will become mandatory and indispensable asset in all urology wards. PMID:26251737

  12. New trends in minimally invasive urological surgery

    Directory of Open Access Journals (Sweden)

    Prabhakar Rajan

    2009-10-01

    Full Text Available Purpose: The perceived benefits of minimally-invasive surgery include less postoperative pain, shorter hospitalization, reduced morbidity and better cosmesis while maintaining diagnostic accuracy and therapeutic outcome. We review the new trends in minimally-invasive urological surgery. Materials and method: We reviewed the English language literature using the National Library of Medicine database to identify the latest technological advances in minimally-invasive surgery with particular reference to urology. Results: Amongst other advances, studies incorporating needlescopic surgery, laparoendoscopic single-site surgery , magnetic anchoring and guidance systems, natural orifice transluminal endoscopic surgery and flexible robots were considered of interest. The results from initial animal and human studies are also outlined. Conclusion: Minimally-invasive surgery continues to evolve to meet the demands of the operators and patients. Many novel technologies are still in the testing phase, whilst others have entered clinical practice. Further evaluation is required to confirm the safety and efficacy of these techniques and validate the published reports.

  13. Emerging role of robotics in urology

    Directory of Open Access Journals (Sweden)

    Kumar Rajeev

    2005-01-01

    Full Text Available Robotic assistance is one of the latest additions to the field of laparoscopic surgery. The most commonly used robotic device in Urology is the da Vinci ® system of which over 200 devices are installed worldwide including 3 in India. This robot consists of three or four arms, one of which is used to hold and manipulate the laparoscopic camera while the others are used to manipulate specialized laparoscopic instruments with endowrist ® technology that allows 7 degrees of freedom. The robot is currently used primarily for radical prostatectomies where complex dissection and reconstruction can be performed in less than 2 hours with excellent outcomes. There is a progressive increase in the number of surgeries being performed by this device which allows laparoscopy naοve surgeons to offer the benefits of minimally invasive surgery to their patients. The other surgeries where this device has been used to benefit are pyeloplasty, cystectomy with urinary diversion, nephrectomy and ureteric re-implant. The principal drawbacks of the device are the steep cost of machine and disposables. However, the benefits achieved in terms of improved surgical precision, magnified 3 dimensional vision, scaling of movements, remote surgery and as a teaching tools will help the robot establish a definitive place in the urologic armamentarium.

  14. The Prevalence of the 22 deg Halo in Cirrus Clouds

    Science.gov (United States)

    Diedenhoven, vanBastiaan

    2014-01-01

    Halos at 22 deg from the sun attributed to randomly-orientated, pristine hexagonal crystals are frequently observed through ice clouds. These frequent sightings of halos formed by pristine crystals pose an apparent inconsistency with the dominance of distorted, nonpristine ice crystals indicated by in situ and remote sensing data. Furthermore, the 46 deg halo, which is associated with pristine hexagonal crystals as well, is observed far less frequently than the 22 deg halo. Considering that plausible mechanisms that could cause crystal distortion such as aggregation, sublimation, riming and collisions are stochastic processes that likely lead to distributions of crystals with varying distortion levels, here the presence of the 22 deg and 46 deg halo features in phase functions of mixtures of pristine and distorted hexagonal ice crystals is examined. We conclude that the 22 deg halo feature is generally present if the contribution by pristine crystals to the total scattering cross section is greater than only about 10% in the case of compact particles or columns, and greater than about 40% for plates. The 46 deg halo feature is present only if the mean distortion level is low and the contribution of pristine crystals to the total scattering cross section is above about 20%, 50% and 70%, in the case of compact crystals, plates and columns, respectively. These results indicate that frequent sightings of 22 deg halos are not inconsistent with the observed dominance of distorted, non-pristine ice crystals. Furthermore, the low mean distortion levels and large contributions by pristine crystals needed to produce the 461 halo features provide a potential explanation of the common sighting of the 22 deg halo without any detectable 46 deg halo.

  15. [The non-scrotal testes: current standpoints of the Paediatric Urology Workgroup of the Dutch Urological Association

    NARCIS (Netherlands)

    Gier, R.P.E. de

    2008-01-01

    Recently, in The Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine), three papers expressing with conflicting opinions on the management of primary and acquired non-scrotal testes (NST) in boys were published. In this paper, the Paediatric Urology Workgroup of the Dutch Urological

  16. Comparing English and Mo/Deg Nominal Group Qualifiers

    Directory of Open Access Journals (Sweden)

    Anto Sylvester Kwabena

    2014-03-01

    Full Text Available The task of this study is primarily to investigate the differences between English and Mo/Deg nominal group (NG qualifiers to identify any similarities within the NG qualification structures of these languages. In otherwise, the study finds answers to the questions:  “What are the qualifying elements within the Mo/Deg and English NGs?” and “What are the differences and similarities between the Mo/Deg NG qualification and that of English?” Using homogeneous sampling, the study purposefully sampled thirty (30 educated Mos/Dega (speakers of the Mo/Deg language. Short simple English sentences containing NG qualifiers designed by the researcher were given to them to translate into Mo/Deg. This was to see how the qualifiers are used in the language. Also, some of these sentences were given to some members of the staff of the Mo/Deg project of GILLBT to translate into Mo/Deg for further correct use of the qualifiers in the Mo/Deg language. The translated versions were then collected as data and analysed based on the Systemic Grammar principles of the NG structure. The results showed that the adjectival groups (AdjG, the clause, the numerals, and the determiners (pre-central, central, and post-central occur at the qualifier position in Mo/Deg, whereas in English, it is the prepositional groups (PG, the adjectival groups (AdjG (under some conditions, and the clause, which occupy the qualifier slot. However, it was also found out that the common linguistic units which occur in both languages as qualifiers are the adjectival groups and the clause.

  17. Syntactic Survey of Determiners in Mo/Deg Language

    Directory of Open Access Journals (Sweden)

    Anto Sylvester Kwabena

    2014-08-01

    Full Text Available This study is descriptive, and it is set out to primarily investigate the use and order of determiners in the Mo/Deg language. The study finds answers to the questions, “What determiner types are there in the Mo/Deg language, and in what order do they collocate with the head of the noun phrase?” Using purposive sampling, the study gathered data from forty (40 literate native speakers of the Mo/Deg language who were also very proficient in English. Short simple English sentences containing noun phrases with pre-determiners of all kind, central determiners of all types, and post-determiners of all kind were designed and given to the respondents to rewrite in Mo/Deg. This was to observe the order of determiners in the language. Also, some of these sentences were given to some staff of the Mo/Deg project of the Ghana Institute of Linguistics, Literacy and Bible Translation (GILLBT to translate into Mo/Deg since they are deemed to have deeper knowledge of the language. This was to ensure further correctness of the use and order of determiners in the language. The translations comprised the data which was analysed using the Systemic Grammar principles of the NG structure. The results showed that the Mo/Deg language has pre-determiner items and that these pre-determiners are not followed by any other words like adjectives. It further showed that it is permissible for some members of the same pre-determiner class to co-occur. The study further found out that the Mo/Deg language has three types of post-head determiners: the post-head post-determiners, the post-head central determiners, and the post-head pre-determiners. It therefore concluded that the Mo/Deg language has a very complex determiner structure.

  18. [Urological dysfunction after sexual abuse and violence].

    Science.gov (United States)

    Berberich, H J; Neubauer, H

    2004-03-01

    Criminal statistics say that 300,000 children are sexually abused in the Federal Republic of Germany every year: 70-75% are abused by their own fathers or another psychological parent. Most victims are girls aged 7-12 years. Sexual abuse during childhood can lead to severe psychosomatic dysfunctions both in children and adults. Possible long-term results are depression, anxiety, emotional and cognitive problems, personal dysfunction, eating and sleeping disorders, alcohol or drug abuse, relationship problems, social maladaptation, and somatizations. Many urological dysfunctions without organic findings can be caused by sexual abuse. Among others, chronic pelvic pain (CPPS), enuresis, incontinence, and sexual dysfunction can occur. When children or adults see the urologist because of their symptoms there is always the danger of reproducing the abusive event by invasive diagnostic methods.Sometimes harming themselves the patients bring this situation about unconsciously. With the following article we want to heighten the awareness among urologists.

  19. [Supportive care for urological metastatic patients].

    Science.gov (United States)

    Lebret, T; Di Palma, M; Ripoll, J; Méjean, A

    2008-11-01

    Supportive cancer care is defined as "all the care and support necessary for the patient throughout the illness together with specific oncological treatment". This includes side effect treatments, advice to facilitate access to all therapeutic approaches (i. e. home care) and to keep the patient in the social community. Acute pain centers and palliative care units are at the core of this new approach. In urology, the example of patients with bone metastasis demonstrates the usefulness of this concept. In fact it participates in: antalgic treatment, prevention of bone events (bisphosphonates), adaptation of daily life with a handicap, access to physiotherapy, psychological help. It also includes financial allowances. In France, supportive care centers are being set up in most hospital to facilitate the coordination of all the multidisciplinary teams.

  20. European Association of Urology guidelines on priapism.

    Science.gov (United States)

    Salonia, Andrea; Eardley, Ian; Giuliano, François; Hatzichristou, Dimitrios; Moncada, Ignacio; Vardi, Yoram; Wespes, Eric; Hatzimouratidis, Konstantinos

    2014-02-01

    Priapism is defined as a penile erection that persists beyond or is unrelated to sexual interest or stimulation. It can be classified into ischaemic (low flow), arterial (high flow), or stuttering (recurrent or intermittent). To provide guidelines on the diagnosis and treatment of priapism. Systematic literature search on the epidemiology, diagnosis, and treatment of priapism. Articles with highest evidence available were selected to form the basis of these recommendations. Ischaemic priapism is usually idiopathic and the most common form. Arterial priapism usually occurs after blunt perineal trauma. History is the mainstay of diagnosis and helps determine the pathogenesis. Laboratory testing is used to support clinical findings. Ischaemic priapism is an emergency condition. Intervention should start within 4-6h, including decompression of the corpora cavernosa by aspiration and intracavernous injection of sympathomimetic drugs (e.g. phenylephrine). Surgical treatment is recommended for failed conservative management, although the best procedure is unclear. Immediate implantation of a prosthesis should be considered for long-lasting priapism. Arterial priapism is not an emergency. Selective embolization is the suggested treatment modality and has high success rates. Stuttering priapism is poorly understood and the main therapeutic goal is the prevention of future episodes. This may be achieved pharmacologically, but data on efficacy are limited. These guidelines summarise current information on priapism. The extended version are available on the European Association of Urology Website (www.uroweb.org/guidelines/). Priapism is a persistent, often painful, penile erection lasting more than 4h unrelated to sexual stimulation. It is more common in patients with sickle cell disease. This article represents the shortened EAU priapism guidelines, based on a systematic literature review. Cases of priapism are classified into ischaemic (low flow), arterial (high flow), or

  1. The urology residency matching program in practice.

    Science.gov (United States)

    Teichman, J M; Anderson, K D; Dorough, M M; Stein, C R; Optenberg, S A; Thompson, I M

    2000-06-01

    We evaluate behaviors and attitudes among resident applicants and program directors related to the American Urological Association (AUA) residency matching program and recommend changes to improve the match. Written questionnaires were mailed to 519 resident applicants and 112 program directors after the 1999 American Urological Association match. Subjects were asked about their observations, behaviors and opinions towards the match. Questionnaires were returned by 230 resident applicants and 94 program directors (44% and 83% response rates, respectively.) Of the resident applicants 75% spent $1,001 to $5,000 for interviewing. Of the program directors 47% recalled that applicants asked how programs would rank the applicant and 61% of applicants recalled that program directors asked applicants how they would rank programs. Dishonesty was acknowledged by 31% of program directors and 44% of resident applicants. Of program directors 82% thought applicants "lied", while 67% of applicants thought that programs "lied" (quotations indicate questionnaire language). Participants characterized their own dishonesty as "just playing the game" or they "did not feel badly." Of program directors 81% and of applicants 61% were "skeptical" or "did not believe" when informed they were a "high" or "number 1" selection. Being asked about marital status was recalled by 91% of male and 100% of female (p = 0. 02), if they had children by 53% of male and 67% of female, (p = 0. 03), and intent to have children by 25% of male and 62% of female (p gender. Interviews are costly for applicants. We recommend that 1) programs adopt policies to enhance fairness, 2) applications be filed electronically, 3) programs assist resident applicants with interview accommodation to reduce financial burden and 4) a post-interview code of limited or noncommunication be adopted.

  2. Urologic surgery laparoscopic access: vascular complications.

    Science.gov (United States)

    Branco, Anibal Wood

    2017-01-01

    Vascular injury in accidental punctures may occur in large abdominal vessels, it is known that 76% of injuries occur during the development of pneumoperitoneum. The aim of this video is to demonstrate two cases of vascular injury occurring during access in laparoscopic urologic surgery. The first case presents a 60-year old female patient with a 3cm tumor in the superior pole of the right kidney who underwent a laparoscopic partial nephrectomy. After the Verres needle insertion, output of blood was verified. During the evaluation of the cavity, a significant hematoma in the inferior vena cava was noticed. After the dissection, a lesion in the inferior vena cava was identified and controlled with a prolene suture, the estimated bloos loss was 300ml. The second case presents a 42-year old female live donor patient who had her right kidney selected to laparoscopic live donor nephrectomy. After the insertion of the first trocar, during the introduction of the 10mm scope, an active bleeding from the mesentery was noticed. The right colon was dissected and an inferior vena cava perforation was identified; a prolene suture was used to control the bleeding, the estimated blood loss was 200mL, in both cases the patients had no previous abdominal surgery. Urologists must be aware of this uncommon, serious, and potentially lethal complication. Once recognized and in the hands of experienced surgeons, some lesions may be repaired laparoscopically. Whenever in doubt, the best alternative is the immediate conversion to open surgery to minimize morbidity and mortality. Copyright® by the International Brazilian Journal of Urology.

  3. Knowledge and attitude of European urology residents about ionizing radiation.

    Science.gov (United States)

    Söylemez, Haluk; Sancaktutar, Ahmet Ali; Silay, Mesrur Selcuk; Penbegül, Necmettin; Bozkurt, Yaşar; Atar, Murat; Altunoluk, Bülent; Bodakci, Mehmet Nuri; Hatipoglu, Namık Kemal

    2013-01-01

    To evaluate the attitude and knowledge of urology residents concerning ionizing radiation, we undertook a survey of European urology residents. The questionnaire was sent to 1184 urology residents within the database of the European Society of Residents in Urology (ESRU) by e-mail between November 2011 and January 2012. The questionnaire was composed of demographic questions and questions about the frequency of radiation exposure and use of radiation safety measures during fluoroscopy-guided endourologic procedures. In addition, there were questions about education programs and respondents' knowledge about diagnostic imaging modalities. A total of 124 questionnaires were returned from urology residents in 20 different European countries. All of the respondents reported that they were routinely exposed to ionizing radiation, and 69 (72.5%) were exposed more than 3 times per week. Despite the common but not sufficient use of lead aprons (75%), use of other radiation protection measures was very low. Although 55% of the respondents had attended an education program in Europe about radiation safety, attendance was highest in Poland (82.6%). The level of knowledge about ionizing radiation was low among urology residents, and approximately half of responders had no idea that commonly used imaging modalities have a fatal cancer risk. The results of this study showed the lack of knowledge and awareness about the importance of ionizing radiation protection among urology residents in Europe. We therefore suggest radiation safety courses in every step of medical life for doctors, especially for endourologists. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. [The demographic development in Germany : challenge and chances for urology].

    Science.gov (United States)

    Schneider, A W; Fichtner, J

    2014-08-01

    Urology is affected by the demographic development in Germany more than any other medical discipline. Despite a relatively stable total population, by the year 2040 there will be an absolute and relevant increase in urological diseases caused only by the demographic development in the population. This is particularly true for the increase in oncological treatment just in the field of the discipline of urology. Even now the current numbers for tumor development in Germany (RKI 2014) in the urological oncology segment of all tumor diseases show an increasing trend with more than 23 %. This significant increase in performance is in contrast to the age development of the specialists in this discipline. In total but especially due to the significantly over-aged specialist medical profession in urology, this leads to a substantial bottleneck of specialists in the discipline of urology. This deficiency of personnel resources in urology is aggravated by the requirements of Generation Y for a well-adjusted work-life balance and the associated feminization of the medical profession. This requires intelligent strategies for.

  5. The use of smartphone applications by urology trainees.

    Science.gov (United States)

    Nason, G J; Burke, M J; Aslam, A; Kelly, M E; Akram, C M; Giri, S K; Flood, H D

    2015-10-01

    Mobile phone technology is continuously advancing- the smartphone allows users instant access to information via the internet. Downloadable applications (apps) are becoming widespread across medical specialities. The aim of this study was to assess the use of smartphone apps among urology trainees in Ireland. An anonymous electronic survey was distributed via Survey Monkey(®) to all urology trainees in Ireland assessing their ownership and use of smartphones and downloadable apps. A search of urology apps was performed using the Apple App Store and the Android Market. 36 (81.8%) of trainees responded with 100% ownership of smartphones. 28 (77%) report downloading apps with 11 (30.6%) reporting paying for them. The mean number of apps downloaded was 4 (Range 1-12). 16 (44.4%) trainees think apps for smartphones are very useful in clinical practice, 14 (42.4%) think they are useful. A total of 126 urology apps were available. 76 (60.3%) were designed for physicians, 46 (36.5%) for patients, 2 (1.6%) for students and 2 (1.6%) for urological nurses. There are an ever increasing number of urology apps available. Urology trainees are using smartphones as an educational and reference tool and find them a useful aide in clinical practice. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  6. Twitter in urology and other surgical specialties at global conferences.

    Science.gov (United States)

    Chung, Amanda; Woo, Henry

    2016-04-01

    Over recent years, Twitter has demonstrated an expanding role in scientific discussion, surgical news and conferences. This study evaluates the role of Twitter in urological conferences, with comparison to other surgical specialties. A retrospective analysis of Twitter metrics during the two largest recent English-speaking conferences for each surgical specialty was performed. Using www.symplur.com, all 'tweets' under the official conference hashtag from 0000 hour the first day to 24.00 hour the final day were assessed. The number of impressions, 'tweeters' and rates of 'tweeting' were analysed. Nine of 18 conferences examined had official hashtags registered with Symplur Healthcare Hashtags. Plastic and urological surgery had both major conferences registered. Only one of two conferences for each cardiothoracic, general, orthopaedic, otolaryngology and paediatric was registered. Both major neurosurgical and vascular conferences were unregistered. Urological conferences were associated with significantly more Twitter activity than non-urological surgical conferences in all parameters, with greater than triple the number of impressions, tweets and 'tweeters'. Urological surgical conferences were associated with 337% more tweets and 164% more impressions per conference day, than non-urological surgical conferences. Twitter has been used to supplement surgical conferences. In this regard, the urological community leads the way compared to the remainder of surgical specialty communities. © 2015 Royal Australasian College of Surgeons.

  7. [Anti-infectious treatments in urology: general remarks].

    Science.gov (United States)

    Bruyère, F; Karsenty, G; Guy, L; Bastide, C; Bernard, L

    2013-11-01

    To define the general use of anti-infectious treatments in urology. A review of national guidelines and articles published on the subject in the Medline database, selected by keywords, depending on the scientific relevance was performed. While the epidemiology clearly shows the non-reduction of the anti-infectious treatments use in France, the resistance increases to highlight foo-resistant germs. Urology is not an exception to this observation, and different means are set to improve the prescription made by urologists. The epidemiological observation confirms the urgent need to improve the prescription of anti-infectious treatments particularly in urology. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  8. RSS MONTHLY 1-DEG MERGED WIND CLIMATOLOGY NETCDF V7

    Data.gov (United States)

    National Aeronautics and Space Administration — The RSS Monthly 1-deg Merged Wind Climatology netCDF dataset provides one degree gridded data for the monthly means of wind speed and wind direction, a 20 year...

  9. Spanish adaptation of the recommendations for the appropriate use of social networks in urology of the European Association of Urology.

    Science.gov (United States)

    Rodríguez-Socarrás, M E; Gómez-Rivas, J; Álvarez-Maestro, M; Tortolero, L; Ribal, M J; Garcia Sanz, M; Roupret, M

    2016-09-01

    To adapt to Spanish the recommendations for the appropriate use of social media (SoMe) in the urological setting prepared by the European Association of Urology (EAU). The use of SoMe has become fairly popular in the international urological community. Due to the nature of the medical content shared among healthcare professionals through SoMe, however, there is the risk of medical and legal problems. For this reason, various international urological associations such as the American Urological Association, the British Association of Urological Surgeons and EAU have published their recommendations for the appropriate use of social media. Efforts have been made to adapt and summarise the recommendations of the EAU in Spanish and to publish them in Actas Urológicas Españolas (@actasurologicas), the official journal of the Spanish Urological Association (@InfoAEU) and the American Confederation of Urology (@CAU_URO). SoMe include well-known platforms such as Twitter, Facebook and YouTube, which have undoubtedly changed the way in which people communicate and interact. SoMe offer clear advantages for communicating between professionals, working in teams, disseminating knowledge and creating professional profiles and are increasingly used by patients and healthcare practitioners. The introduction of SoMe in the urological community has started a revolution in how scientific articles are shared, how people participate in congresses and how international urological associations communicate with their followers. However, SoMe is generally an open public setting, with potential risks for confidentiality and the doctor-patient relationship due to the nature of the shared information. The present recommendations include tools for creating professional profiles, protecting confidentiality and creating honest and responsible content. SoMe represents a fascinating area for the communication and dissemination of knowledge, with considerable applicability in health care and the

  10. Quality assessment of economic analyses in pediatric urology.

    Science.gov (United States)

    Kokorowski, Paul J; Routh, Jonathan C; Nelson, Caleb P

    2013-02-01

    To describe and evaluate economic analyses or economic evaluations in pediatric urologic literature, including study types such as cost-effectiveness analysis, which are increasingly common in the medical literature. We performed a systematic literature review of the MEDLINE, EMBASE, and Cochrane databases (1990-2011) to identify economic analyses of pediatric urologic topics. Studies were evaluated using published quality metrics. We examined the analysis type, data sources, perspective, methodology, sensitivity analyses, and the reporting of methods, results, limitations, and conclusions. We identified 2945 nonduplicated studies, 60 of which met inclusion criteria. Economic analyses of pediatric urologic topics increased in number during the study period, from 1 study (2%) in 1990 to 7 (12%) in 2010 (P urologic literature, there is a need for standardization in methods and reporting. Future investigations should attempt to follow standardized reporting guidelines and should pay particular attention to reporting of methods and results, including a comprehensive discussion of limitations. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. A new era of Asian urology: a SWOT analysis.

    Science.gov (United States)

    Kumar, Rajeev

    2016-11-01

    Economic prosperity and increasing connectivity have made Asia an emerging centre of growth in health care, including in the field of urology. Large and varied patient populations, the availability of a trained workforce, the use of English as a common communication language, and overall low costs have contributed to this change. Rapid growth of regional urological associations and journals has fuelled the aspirations and abilities of Asian urologists to not only keep abreast of but often lead the change in urological disease management. Asian urology has immense potential to expand in areas in which it currently lags behind, the most important being research. The increasing ability to travel aids in developing networks for collaboration. However, Asian urologists will need to look at sustainable models of engagement and temper the need for short-term results if these opportunities are to reach their maximal potential.

  12. Urology Tag Ontology Project: Standardizing Social Media Communication Descriptors.

    Science.gov (United States)

    Kutikov, Alexander; Woo, Henry H; Catto, James W

    2016-02-01

    Standardizing social media hashtag descriptors is likely to facilitate communication and promote collaboration in both health care provider and patient communities. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  13. 'Image and treat': an individualized approach to urological tumors

    DEFF Research Database (Denmark)

    Bouchelouche, Kirsten; Capala, Jacek

    2010-01-01

    The current treatment options for advanced urologic cancers demonstrate limited efficacy. To obtain optimal clinical results, there is a need for new, individualized, therapeutic strategies, which have only recently been applied to these malignancies. Nuclear medicine plays an important role...... in establishing imaging biomarkers necessary for personalized medicine. This review focuses on the current status of the 'image and treat' approach combining molecular imaging with targeted radionuclide therapy of urological malignancies...

  14. Exposure to and Attitudes Regarding Transgender Education Among Urology Residents.

    Science.gov (United States)

    Dy, Geolani W; Osbun, Nathan C; Morrison, Shane D; Grant, David W; Merguerian, Paul A

    2016-10-01

    Transgender individuals are underserved within the health care system but might increasingly seek urologic care as insurers expand coverage for medical and surgical gender transition. To evaluate urology residents' exposure to transgender patient care and their perceived importance of transgender surgical education. Urology residents from a representative sample of U.S. training programs were asked to complete a cross-sectional survey from January through March 2016. Respondents were queried regarding demographics, transgender curricular exposure (didactic vs clinical), and perceived importance of training opportunities in transgender patient care. In total, 289 urology residents completed the survey (72% response rate). Fifty-four percent of residents reported exposure to transgender patient care, with more residents from Western (74%) and North Central (72%) sections reporting exposure (P ≤ .01). Exposure occurred more frequently through direct patient interaction rather than through didactic education (psychiatric, 23% vs 7%, P Urology resident exposure to transgender patient care is regionally dependent. Perceived importance of gender-confirming surgical training varies by sex and geography. A gap exists between the direct transgender patient care urology residencies provide and the didactic transgender education they receive. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  15. [Survey of urology nurses on occupation protection from intravesical chemotherapy].

    Science.gov (United States)

    Ding, E; Xu, Xiulian; Jian, Xiangdong

    2015-03-01

    To investigate the awareness of self protection and practice of nurses from urology department when giving intravesical chemotherapy to patients with urinary bladder cancer. One survey via a self-designed questionnaire and an on-the-spot examination of anticancer drugs preparing were done and compared among 42 nurses from urology department and 48 nurses from oncology department. All nurses from oncology department were trained with anticancer drugs-associated knowledge and 83.3% nurses from urology department had received some training (Pnurses from department of medical oncology were familiar with all the five parts of chemotherapy drugs protection protocol, while only 40.5%nurses from department of urology were aware of them. During the on-the-spot examination, 50.0% and 21.4% nurses respectively from oncology department and urology department could complete seven anticancer drugs preparation procedure correctly (P nurses from urology department had weak awareness of self protection and were lack of chemotherapy associated training and standard practice when giving intravesical chemotherapy. It is imperative to work out a protection plan to educate the nurses and establish the protocols for preparing anticancer drugs to reduce the occurrence of occupational hazard.

  16. Telmisartan inhibits human urological cancer cell growth through early apoptosis

    Science.gov (United States)

    MATSUYAMA, MASAHIDE; FUNAO, KIYOAKI; KURATSUKURI, KATSUYUKI; TANAKA, TOMOAKI; KAWAHITO, YUTAKA; SANO, HAJIME; CHARGUI, JAMEL; TOURAINE, JEAN-LOUIS; YOSHIMURA, NORIO; YOSHIMURA, RIKIO

    2010-01-01

    Angiotensin II receptor blockers (ARBs) are widely used as hypertensive therapeutic agents. In addition, studies have provided evidence that ARBs have the potential to inhibit the growth of several types of cancer cells. It was reported that telmisartan (a type of ARB) has peroxisome proliferator-activated receptor (PPAR)-γ activation activity. We previously reported that the PPAR-γ ligand induces growth arrest in human urological cancer cells through apoptosis. In this study, we evaluated the effects of telmisartan and other ARBs on cell proliferation in renal cell carcinoma (RCC), bladder cancer (BC), prostate cancer (PC) and testicular cancer (TC) cell lines. The inhibitory effects of telmisartan and other ARBs (candesartan, valsartan, irbesartan and losartan) on the growth of the RCC, BC, PC and TC cell lines was investigated using an MTT assay. Flow cytometry and Hoechst staining were used to determine whether the ARBs induced apoptosis. Telmisartan caused marked growth inhibition in the urological cancer cells in a dose- and time-dependent manner. Urological cancer cells treated with 100 μM telmisartan underwent early apoptosis and DNA fragmentation. However, the other ARBs had no effect on cell proliferation in any of the urological cancer cell lines. Telmisartan may mediate potent anti-proliferative effects in urological cancer cells through PPAR-γ. Thus, telmisartan is a potent target for the prevention and treatment of human urological cancer. PMID:22993542

  17. Senior medical student opinions regarding the ideal urology interview day.

    Science.gov (United States)

    Jacobs, Jesse C; Guralnick, Michael L; Sandlow, Jay I; Langenstroer, Peter; Begun, Frank P; See, William A; O'Connor, Robert Corey

    2014-01-01

    Applicant interviews for urology residency positions are a stressful and costly process for students, faculty, and staff. We conducted a prospective survey to better determine what urology applicants perceive as an ideal interview process to gain sufficient knowledge about a training program. A questionnaire was anonymously completed by all urology residency applicants interviewing at the Medical College of Wisconsin from 2007 to 2013. Questionnaire subject headings included "ideal interview format," "factors contributing to understanding the residency program," and "factors contributing to final rank list order." Questionnaires were distributed to and completed by 221 senior medical students applying for a urology residency position. Most respondents (>80%) reported they would prefer to partake in 5 to 7 faculty interviews in an office setting with the total interview process spanning half to three-fourths of the workday. Spending time with current residents was considered the most valuable tool to acquire knowledge about a residency program. The most important criteria when ranking a program were resident satisfaction, resident operative experience, and perceived strength of faculty. Academic urology programs may wish to consider applicant ideals when organizing residency interviews. Interaction with current residents appears to be the most valuable resource allowing applicants to garner knowledge about a urology training program. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  18. Gastroenterology-Urology Devices; Manual Gastroenterology-Urology Surgical Instruments and Accessories. Final rule; technical amendment.

    Science.gov (United States)

    2017-03-01

    The Food and Drug Administration (FDA) is amending the identification of manual gastroenterology-urology surgical instruments and accessories to reflect that the device does not include specialized surgical instrumentation for use with urogyencologic surgical mesh specifically intended for use as an aid in the insertion, placement, fixation, or anchoring of surgical mesh during urogynecologic procedures ("specialized surgical instrumentation for use with urogynecologic surgical mesh"). These amendments are being made to reflect changes made in the recently issued final reclassification order for specialized surgical instrumentation for use with urogynecologic surgical mesh.

  19. Urology on the internet - introduction and update

    Directory of Open Access Journals (Sweden)

    Inumpudi Anand

    2000-01-01

    Full Text Available The Internet, which has truly united the developed and developing nations, is an extensive network of inter-linked computers storing immense bytes of information, which can be accessed by anyone transcending all geographi-cal barriers and this has become the ultimate frontier to access information. The Urology and Andrology informa-tion on Internet is exponentially growing. The urologist need not know the intricacies of the hardware and soft-ware but can start right away navigating through this web. We reviewed methods available to take advantage of this network to provide a glimpse to busy urologists to accrue the benefits easily and efficiently rather than to be lost in the information-ocean by surfing individually. By getting connected to Internet, an urologist of any part of the world gains enormous information by interacting with other urologists of the rest of the world. This could be of use to gain knowledge and to offer the best and the most modern treatment to the patient. Internet has revolutionised the scientific publication by virtue of its faster and accurate transmission of manuscripts. We can send manuscripts by this channel and also access journals obviating the lag period inherent in snail mail. The on-line journals have virtually brought the library to the desktop.

  20. Validation of the Clavien-Dindo Grading System in Urology by the European Association of Urology Guidelines Ad Hoc Panel.

    Science.gov (United States)

    Mitropoulos, Dionysios; Artibani, Walter; Biyani, Chandra Shekhar; Bjerggaard Jensen, Jørgen; Rouprêt, Morgan; Truss, Michael

    2017-03-07

    Since 2012 uniformed reporting of complications after urological procedures has been advocated by the European Association of Urology (EAU) guidelines. The Clavien-Dindo grading system was recommended to report the outcomes of urologic procedures. To validate the Clavien-Dindo grading system in urology. Members of the EAU working group compiled a list of case scenarios including those with minor and major complications. A survey was administered online via Survey Monkey to the members of EAU committees for the appropriate grading according to the Clavien-Dindo classification of surgical complications. Scenarios with intraoperative complications were intentionally included to assess respondents' awareness of the Clavien-Dindo applicability. Survey data collected were used to calculate agreement rates and to estimate the overall inter-rater agreement on all cases using Fleiss' kappa (κ). Differences in agreement rates for each scenario among groups with different criteria about the system were estimated using the chi-square test. Evaluable responses were received from 81 out of 174 invited raters (46.5%). Of them 56.9% believed that the Clavien-Dindo system was adequate for grading postoperative complications. The agreement rate was over a score of ≥80% in nine cases, 60-79% in 10 cases, 40-59% in 14 cases, and urology and should be used systematically. However, it does not apply for intraoperative complications, and there is a need for an additional tool. A rigorous methodology is mandatory when surgeons report about complications after surgery. In this study, the European Association of Urology Guidelines Panel has validated the use of the Clavien-Dindo grading system in urology. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  1. [The history of urologic journalism in Spain (III). Chronology of Spanish specialized publications in urologic topics (continuation)].

    Science.gov (United States)

    Maganto Pavón, E

    1996-11-01

    The fourth period, which can be defined as the period of specialized publications, commenced with the founding of the Asociación Española de Urología (Spanish Urological Society) in 1911. As in other European countries, the expressions 'Genitourinary Disorders' or 'Genitourinary Organs' were replaced and all publications dealing with the genitourinary tract, its disorders or their surgical management, adopted the generic term 'Urology', although the terms relating to other specialties were retained. From 1924 until the Spanish Civil War in 1936, there was always a representative and official journal of the Asociación Española de Urología. Fifteen new journals, which are analyzed in the present article, were published during this long and fruitful period abruptly broken by the Spanish Civil War. This period culminated in 1977, when Actas Urológicas Españolas, the official journal of the Society, was established. Most of the journals of this last period have disappeared, but some have endured, like Archivos Españoles de Urología, which is now in its 50th year. Despite the formidable and sustained competition of the foreign specialized journals, their activity continues with the same vigour that denotes the perseverance, thrust and intellectual vitality of Spanish urologists who have unfalteringly supported these publications. In my view, Spanish urological publications have a brilliant and enduring future.

  2. [Hygiene in Urological Surgeries - Results of the Health Authority's Visit to all Urological Surgeries in Braunschweig].

    Science.gov (United States)

    Buhr-Riehm, B; Lenz, T

    2015-07-01

    Following a patient complaint, the Health Department carried out a hygiene inspection of a urological practice in Braunschweig in February 2013. The topic of the complaint was that a patient assumed having acquired a resistant pathogen in the practice. In the subsequent visit, significant hygiene defects were found, particularly with regard to the processing of medical devices. This led to a decision to commit all urological practices in Braunschweig to hygiene inspections as part of a priority project. In retrospect, the hygiene surveys were justified. Deficiencies included inadequate preparation of medical products, procedures in practice inconsistent with hygiene plans, poor knowledge of hygiene procedures among assistant staff and doctors, lack of expertise of assistant staff and lack of hygiene risk awareness by doctors. Positive experiences were: open communication in a good atmosphere with the Practice managers, willingness to change, good cooperation between the Health Authority and the Labor Inspectorate and Physicians' Association. The claimed deficits were corrected by spring 2014 by the practice operators. The consulting expertise of the health authorities was made use of continuously. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Quaderni di filologia e lingue romanze 7 (1992, Supplemento Terza serie, Attidel Convegno "Relazione di viaggi fra Italia e Spagna" Macerata, Università degli Studi, 15-17 dicembre 1992, 259 pp.; 8(1993, 273 pp.; 9(1994, 285 pp.; 10(1995, 346 pp.

    Directory of Open Access Journals (Sweden)

    Pavao Tekavčić

    1996-12-01

    Full Text Available Il periodico maceratese, nato nel 1979, continua ad apparire a ritmo annuale re­ golare. Avendo recensito i voll. 1985-1992 nel numero 34 di «Linguistica», presen­ tiamo qui le annate citate nel titolo, concentrandoci sempre sui contributi di interesse linguistico (o almeno filologico, che continuano ad essere in minoranza di fronte a quelli di argomento letterario.

  4. The contribution of Irish urology to clinical practice.

    Science.gov (United States)

    O'Brien, Matthew F; Galvin, David J; Mulhall, John P

    2009-11-01

    Historically, Irish doctors have made significant contributions to Medicine and Surgery including Colles, Graves, and Corrigan. Herein, we detail the contribution of Irish people to Urology. Internet, specific Medline database searches, and individual searches of medical history and urologic history texts and from individual institutions were performed. Sir Francis Cruise, in 1865, perfected the panendoscope using the principle of reflected light from a kerosene lamp, enabling high-quality cystoscopy for the first time. In 1901, Sir Peter Freyer described the suprapubic transvesical prostatectomy, dramatically reducing perioperative mortality for prostate surgery to 3% in 1912. Terence Millin developed a novel in situ rectus fascia pubovaginal sling for incontinence, and revolutionized open prostate surgery with one of the seminal articles in the history of urology. He reported the retropubic extravesical enucleation of the prostate in 20 cases in The Lancet in 1945. Future work on radical retropubic prostatectomy was based on his unique approach to the prostate. In 1956, the first dedicated urology unit was designed and opened in Ireland by Dr. Thomas JD Lane. He reported an overall mortality of 2.3%, in 1540 consecutive prostatectomies, thereby emphasizing the importance of a specialized unit. In the contemporary era, Ralph DeVere White, current president of the Society of Urological Oncology, and John M. Fitzpatrick the current editor of BJU International, the first Irish persons to hold these positions have contributed to the field of urology. Irish urologists have made considerable contributions to urology throughout modern history, particularly in the areas of endoscopy and prostate surgery.

  5. The family of Deg/HtrA proteases in plants

    Directory of Open Access Journals (Sweden)

    Schuhmann Holger

    2012-04-01

    Full Text Available Abstract Background The Deg/HtrA family of ATP-independent serine endopeptidases is present in nearly all organisms from bacteria to human and vascular plants. In recent years, multiple deg/htrA protease genes were identified in various plant genomes. During genome annotations most proteases were named according to the order of discovery, hence the same names were sometimes given to different types of Deg/HtrA enzymes in different plant species. This can easily lead to false inference of individual protease functions based solely on a shared name. Therefore, the existing names and classification of these proteolytic enzymes does not meet our current needs and a phylogeny-based standardized nomenclature is required. Results Using phylogenetic and domain arrangement analysis, we improved the nomenclature of the Deg/HtrA protease family, standardized protease names based on their well-established nomenclature in Arabidopsis thaliana, and clarified the evolutionary relationship between orthologous enzymes from various photosynthetic organisms across several divergent systematic groups, including dicots, a monocot, a moss and a green alga. Furthermore, we identified a “core set” of eight proteases shared by all organisms examined here that might provide all the proteolytic potential of Deg/HtrA proteases necessary for a hypothetical plant cell. Conclusions In our proposed nomenclature, the evolutionarily closest orthologs have the same protease name, simplifying scientific communication when comparing different plant species and allowing for more reliable inference of protease functions. Further, we proposed that the high number of Deg/HtrA proteases in plants is mainly due to gene duplications unique to the respective organism.

  6. Expert witness testimony in urology malpractice litigation.

    Science.gov (United States)

    Sunaryo, Peter L; Svider, Peter F; Jackson-Rosario, Imani; Eloy, Jean Anderson

    2014-04-01

    To evaluate the credentials of urologists choosing to testify as expert witnesses. As health care reform has become an increasingly important topic in national debate, medical malpractice and related issues have come to the forefront of topics for discussion by the medical community. Physicians are often recruited to testify as expert witnesses in malpractice cases. Defining what constitutes an expert in this setting has been an area of controversy. The Westlaw legal database was searched for medical malpractice litigation. Data regarding number of years of experience and practice setting were obtained for urologists using private practice and hospital listings, academic faculty profiles, and state medical licensing databases. Scholarly impact, as measured by the h-index, was calculated by the Scopus database. Plaintiff expert witnesses were found to have slightly more years of experience vs defendant expert witnesses (35.7 vs 32.2 years, P = .01), but had a lower h-index (6.8 vs 10.2, P = .03), were less likely to practice in the academic setting (39% vs 60%, P = .001), and were more likely to testify multiple times. Urologists testifying for plaintiffs and defendants both had over 30 years of experience on average, with those in the latter having slightly less experience. Defendant witnesses, however, had greater scholarly impact and were more likely to practice in an academic setting. Organizations such as the American Urological Association may wish to re-evaluate guidelines on expert witness testimony, particularly regarding those who testify frequently. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Our Initial Experiences with Laparoscopic Urologic Surgery

    Directory of Open Access Journals (Sweden)

    Selçuk Altın

    2016-03-01

    Full Text Available Objective: Retrospectively, to evaluate outcomes and complications of urological laparoscopic surgery cases performed in our clinic. Methods: A total of 115 patients who received laparo­scopic surgery between January 2012 and January 2015 were retrospectively evaluated. Included patients were assessed in terms of demographic characteristics, pre­operative diagnosis, type of laparoscopic approach, dura­tion of surgery and hospitalization, complications before and after surgery, and postoperative requirement for open surgery. Results: 61 of included patients were women, 54 were male, and the mean age was 52.4±11.7 years. Sixty-eight patients underwent transperitoneal and 47 patients re­ceived retroperitoneal procedures. While 29 patients re­ceived renal cyst excision, 25 had simple nephrectomy, 22 had ureterolithotomy, 19 had radical nephrectomy, 15 had pyelolithotomy and 5 had pyeloplasty. Four (3,4% of the 115 patients required converting to open surgery. Except these patients, no major complication or mortal­ity was encountered. The mean duration of surgery for the most commonly applied procedures were as follows: renal cyst excision 62 (50-110 min, simple nephrectomy 125 (95-140 min, ureterolithotomy 108 (90-130 min, rad­ical nephrectomy 141 (105-175 min, pyelolithotomy 116 (95-140 min, and pyeloplasty 166 (150-190 min. The mean hospital stay was 3.7±2.8 (2-11 days. Conclusion: The success and complication rates of the laparoscopic surgeries performed in our clinic were con­sistent with those reported in the literature. In the light of technological advances and increasing experience, as well as based on the higher tolerance exhibited by pa­tients, we believe that laparoscopic surgery is a minimally invasive method that is a safe alternative to open surgery.

  8. [The clinic Heilanstalt Weidenplan in Halle (Saale), origin of the German urology. Otto Kneise's founding of the first independent urology department in Germany].

    Science.gov (United States)

    Zacher, W; Stolze, K-J

    2014-07-01

    The routine use of cystoscope initiated the development of the modern urology. Otto Kneise (1875-1953) extended the targets of cystoscopy by including examinations of the male bladder and prostate. He achieved the goal that "cystoscopy is part of general work in urology and not a pure gynecological act". He, thus, founded the specialty gynecological urology in the field urology, which prevented it from becoming an independent field. Under the leadership of Otto Kneise, the first independent urology department in Germany was created in the hospital Heilanstalt Weidenplan.

  9. Recent trends in the urology workforce in the United States.

    Science.gov (United States)

    Pruthi, Raj S; Neuwahl, Simon; Nielsen, Matthew E; Fraher, Erin

    2013-11-01

    The present study examines the current status of urology physician manpower in the United States, in the context of trends in the demographics, geographic distribution, and practice make-up of urologists. Physicians were identified as surgeons and classified into surgical groups using a combination of American Medical Association primary and secondary self-reported specialties and American Board of Medical Specialties certifications. From these groups, urologic surgeons were isolated for analysis. The supply of urologists per capita has declined since 1981 - most dramatically since 1991. With an average age of 52.5 years, urology is one of the oldest surgical specialties. Over 7% of urologists are older than 70 years and 44% are older than 55 years, suggesting an aging urology workforce. The number of female urologists has grown almost a 1000-fold and represents a growing and younger cohort of the workforce. The number of rural urologists and the number of international medical graduates have continued to decline since 1981. Over the past 10 years, an increasing number of urologists are now in group practices (over 60%), and these tended to be younger and in urban settings. In contrast to most other surgical specialties, there has been a decrease in the supply of urologists relative to population growth, which is expected to be exacerbated by an aging and relatively older urology physician workforce, particularly in rural areas, a slight increase in female urologists, and the gravitation of younger urologists toward group practice in urban areas. Copyright © 2013. Published by Elsevier Inc.

  10. What can we learn from pediatric urology certification logs?

    Science.gov (United States)

    Kogan, Barry A; Feustel, Paul J

    2011-07-01

    To use the billing logs submitted to obtain insight into the operative practice of pediatric urology. The American Board of Urology recently offered a certificate of special qualification in pediatric urology. As a part of the application process, the candidates for this certificate submitted billing logs. We reviewed the practice logs of practitioners applying for a certificate of added competence in pediatric urology in 2007 and 2008. The de-identified logs were grouped by case severity and type. In addition, the numbers of cases by a given practitioner were grouped by percentiles. We also analyzed the data for differences in experience, geography, and practice type. A total of 230 logs from the first 2 years of applications were analyzed. The median number of cases was 505 annually, with the most common procedure being circumcision (55 annually), followed by orchiopexy (40 annually) and hernia repair (40 annually). Major procedures were rarer (eg, proximal hypospadias, 2 annually; pyeloplasty, 8 annually; nephrectomy/partial nephrectomy, 4 annually; and genital reconstruction, 1 annually). In 2006 and 2007, the typical applicant for a subspeciality certificate in pediatric urology had a surgical practice that was primarily of penile and groin cases, with few major cases. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Readability assessment of online urology patient education materials.

    Science.gov (United States)

    Colaco, Marc; Svider, Peter F; Agarwal, Nitin; Eloy, Jean Anderson; Jackson, Imani M

    2013-03-01

    The National Institutes of Health, American Medical Association, and United States Department of Health and Human Services recommend that patient education materials be written at a fourth to sixth grade reading level to facilitate comprehension. We examined and compared the readability and difficulty of online patient education materials from the American Urological Association and academic urology departments in the Northeastern United States. We assessed the online patient education materials for difficulty level with 10 commonly used readability assessment tools, including the Flesch Reading Ease Score, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, Gunning Frequency of Gobbledygook, New Dale-Chall Test, Coleman-Liau index, New Fog Count, Raygor Readability Estimate, FORCAST test and Fry score. Most patient education materials on the websites of these programs were written at or above the eleventh grade reading level. Urological online patient education materials are written above the recommended reading level. They may need to be simplified to facilitate better patient understanding of urological topics. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  12. Robotics in urological surgery: evolution, current status and future perspectives.

    Science.gov (United States)

    Sivaraman, A; Sanchez-Salas, R; Prapotnich, D; Barret, E; Mombet, A; Cathala, N; Rozet, F; Galiano, M; Cathelineau, X

    2015-09-01

    Robotic surgery is rapidly evolving and has become an essential part of surgical practice in several parts of the world. Robotic technology will expand globally and most of the surgeons around the world will have access to surgical robots in the future. It is essential that we are updated about the outcomes of robot assisted surgeries which will allow everyone to develop an unbiased opinion on the clinical utility of this innovation. In this review we aim to present the evolution, objective evaluation of clinical outcomes and future perspectives of robot assisted urologic surgeries. A systematic literature review of clinical outcomes of robotic urological surgeries was made in the PUBMED. Randomized control trials, cohort studies and review articles were included. Moreover, a detailed search in the web based search engine was made to acquire information on evolution and evolving technologies in robotics. The present evidence suggests that the clinical outcomes of the robot assisted urologic surgeries are comparable to the conventional open surgical and laparoscopic results and are associated with fewer complications. However, long term results are not available for all the common robotic urologic surgeries. There are plenty of novel developments in robotics to be available for clinical use in the future. Robotic urologic surgery will continue to evolve in the future. We should continue to critically analyze whether the advances in technology and the higher cost eventually translates to improved overall surgical performance and outcomes. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. ‘An interventional urology list’ – a novel concept for UK urological services

    Science.gov (United States)

    Masood, Junaid; Ismail, Mohamed; El-Husseiny, Tamer; Moraitis, Konstantinos; Albanis, Stephanos; Papatsoris, Athanasios; Buchholz, Noor

    2010-01-01

    INTRODUCTION Almost all patients in the UK with obstructed and/or infected kidneys are referred to interventional radiology for percutaneous nephrostomy and/or placement of an anterograde JJ stent. Although this ‘tradition’ is going strong in the UK, urologists throughout the world have evolved their practice to encompass such interventional procedures in their remit. We have set up a local anaesthetic list ‘interventional urology list’ in our ESWL suite. We present our 4-year experience and discuss the benefits that this interventional list brings to our patients, our trainees, our interventional radiology colleagues and to the hospital trust. PATIENTS AND METHODS From May 2005 to May 2009, we have been running this list, twice-weekly, performing procedures such as nephrostomies, anterograde stents, nephrostograms and stent exchanges all under local anaesthetic. RESULTS A total of 580 procedures have been carried out on this list over this period. Our success rate for nephrostomy insertion is 96% with three failures, as a result of patient discomfort. No major complications and three minor complications were reported. We had four failed anterograde stenting procedures (out of 80). All other procedures including nephrostograms, stent exchanges/removals/insertions, as well as renal cyst aspiration and sclerotisation were successfully carried out. CONCLUSIONS Our results of percutaneous nephrostomy and antegrade stenting are favourable when compared with published data on nephrostomies. This novel set up has resulted in several improvements to the service we offer patients and also provided significant improvement in training for our residents. We encourage other departments to try and develop this type of ‘interventional urology list’. PMID:20977835

  14. The emerging role of social media in urology.

    Science.gov (United States)

    Leveridge, Michael J

    2014-01-01

    Social media have become so integrated into modern communications as to be universal in our personal and, increasingly, professional lives. Recent examples of social media uptake in urology, and the emergence of data to quantify it, reveal the expansion of conventional communication routes beyond the in-person forum. In every domain of urologic practice, from patient interaction through research to continuing professional development, the move online has unlocked another layer of conversation, dissemination, and, indeed, caveats. Social media have a democratizing effect, placing patients, trainees, practitioners, and thought leaders in the same arena and on equal footing. If uptake of social media in medicine even remotely parallels its rise to ubiquity in other areas, it will only expand and evolve in the coming years. For these reasons, this article presents an overview of the most recent data on the impact and potential complications of social media usage in the urologic community.

  15. Alternative approaches to expanding pediatric urology services and productivity.

    Science.gov (United States)

    Canon, Stephen; Basham, Kyle; Canon, Honor Lee; Purifoy, Jody Ann; Swearingen, Christopher

    2012-10-01

    We critically assessed the outcomes of a new model of pediatric urology delivery using alternative approaches to expand care without increasing the number of pediatric urologists. The approaches included the use of advanced practice nurse practitioners, pediatric physician specialists, part-time contract pediatric urologists from neighboring institutions and part-time contract adult urologists from our university. Data were collected from the Division of Pediatric Urology at Arkansas Children's Hospital during 2009 and 2010. The only pediatric urologist at our institution retired in December 2009 with an immediate transition to a new pediatric urologist in January 2010. Comparisons were made in the numbers of clinic visits, inpatient admissions/consultations, surgical volume and patient satisfaction scores. Average clinic monthly visits in 2009 and 2010 were 153 and 271, respectively (p productivity and maximize the quality of delivery of these services. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  16. Image-guided urological interventions: What the urologists must know

    Directory of Open Access Journals (Sweden)

    Chandan J Das

    2015-01-01

    Full Text Available Advances in imaging technology, especially in the last two decades, have led to a paradigm shift in the field of image-guided interventions in urology. While the traditional biopsy and drainage techniques are firmly established, image-based stone management and endovascular management of hematuria have evolved further. Ablative techniques for renal and prostate cancer and prostate artery embolization for benign prostatic hypertrophy have evolved into viable alternative treatments. Many urologic diseases that were earlier treated surgically are now effectively managed using minimally invasive image-guided techniques, often on a day care basis using only local anesthesia or conscious sedation. This article presents an overview of the technique and status of various image-guided urological procedures, including recent emerging techniques.

  17. Analysis of content legibility for smartphones of websites of the korean urological association and other urological societies in Korea.

    Science.gov (United States)

    Lee, Joo Yong; Kang, Dong Hyuk; Moon, Hong Sang; Kim, Yong Tae; Yoo, Tag Keun; Choi, Hong Yong; Lee, Tchun Yong; Lee, Seung Wook

    2011-02-01

    We performed an analysis of the smartphone legibility of the websites of the Korean Urological Association (KUA) and other urological societies. This study was conducted on the websites of the KUA and nine other urological societies. Each website was accessed via iPhone Safari and Android Chrome, respectively, to evaluate the establishment and readability of the mobile web pages. The provision of Really Simple Syndication (RSS) feeds by the websites and whether the websites had Twitter and Facebook accounts were evaluated. In addition, a validation test on the web standards was performed by using the World Wide Web Consortium (W3C®) Markup Validation Service, and subsequently the numbers of errors and warnings that occurred were analyzed. When accessed via Safari, two websites were legible, four were somewhat legible, and four were somewhat illegible. When accessed via Chrome, two websites were legible, six were somewhat legible, and two were somewhat illegible. One website provided an RSS feed and two websites managed members via separate Twitter accounts. No website supported mobile web pages. The result of the W3C® Markup Validation test on 10 websites showed a mean error rate of 221.6 (range, 13-1,477) and a mean warning rate of 127.13 (range, 0-655). The smartphone legibility level of the websites of urological societies was relatively low. Improved smartphone legibility and web standard compliance of the websites of urological societies are required to keep up with the popularity of smartphones.

  18. Future of robotic surgery in urology.

    Science.gov (United States)

    Rassweiler, Jens J; Autorino, Riccardo; Klein, Jan; Mottrie, Alex; Goezen, Ali Serdar; Stolzenburg, Jens-Uwe; Rha, Koon H; Schurr, Marc; Kaouk, Jihad; Patel, Vipul; Dasgupta, Prokar; Liatsikos, Evangelos

    2017-12-01

    To provide a comprehensive overview of the current status of the field of robotic systems for urological surgery and discuss future perspectives. A non-systematic literature review was performed using PubMed/Medline search electronic engines. Existing patents for robotic devices were researched using the Google search engine. Findings were also critically analysed taking into account the personal experience of the authors. The relevant patents for the first generation of the da Vinci platform will expire in 2019. New robotic systems are coming onto the stage. These can be classified according to type of console, arrangement of robotic arms, handles and instruments, and other specific features (haptic feedback, eye-tracking). The Telelap ALF-X robot uses an open console with eye-tracking, laparoscopy-like handles with haptic feedback, and arms mounted on separate carts; first clinical trials with this system were reported in 2016. The Medtronic robot provides an open console using three-dimensional high-definition video technology and three arms. The Avatera robot features a closed console with microscope-like oculars, four arms arranged on one cart, and 5-mm instruments with six degrees of freedom. The REVO-I consists of an open console and a four-arm arrangement on one cart; the first experiments with this system were published in 2016. Medicaroid uses a semi-open console and three robot arms attached to the operating table. Clinical trials of the SP 1098-platform using the da Vinci Xi for console-based single-port surgery were reported in 2015. The SPORT robot has been tested in animal experiments for single-port surgery. The SurgiBot represents a bedside solution for single-port surgery providing flexible tube-guided instruments. The Avicenna Roboflex has been developed for robotic flexible ureteroscopy, with promising early clinical results. Several console-based robots for laparoscopic multi- and single-port surgery are expected to come to market within the

  19. Urological applications of the holmium laser

    Science.gov (United States)

    Beaghler, Marc A.; Poon, Michael W.; Ruckle, Herbert C.; Stewart, Steven C.; Weil, Dane

    1998-07-01

    While the role of endoscopy was initially diagnostic, the advent of improved endoscopes and working instruments have increased its therapeutic applications. One of the most recent advances is the holmium laser. It has a broad range of urological applications due to its ability to fragment all urinary calculi and its soft tissue effects. This laser is based on laser energy delivered in a pulsatile fashion at 2100 nm. The purpose of this study is to report our experience with the holmium laser. A retrospective study of patients undergoing endourological procedures with the holmium laser was performed. One hundred and forty patients underwent 157 procedures. The holmium laser was used for the treatment of urinary calculi in 122 patients. Stone location included 61 renal, 64 ureteral, and 17 bladder stones. Renal stone burden was 17 mm (range 3-50), ureteral stone size averaged 10 mm (range 3 - 35), and mean bladder stone size was 31 mm (range 10 - 60). Other uses included treatment of transitional cell carcinoma of the renal pelvis, ureter, and bladder, incision of ureteral strictures, ureterocele, and prostate, and ablation of renal hemangiomas. Intraoperative and post operative complications were noted. Follow-up for calculi consisted of a plain film of the abdomen at one week and an ultrasound or intravenous pyelogram at six to eight weeks post procedure. No ureteral perforations or strictures occurred. The Holmium laser was capable of fragmenting all urinary calculi in this study. No complications were directly attributable to the Holmium laser. In our initial experience, the Holmium laser is safe and effective in the treatment of urinary pathology. It is the most effective lithotrite available and is able to incise and coagulate soft tissue as well. This combination allows the urologist to treat a variety of urinary pathology using a single modality. Its main limitation is the ability to access lower pole lesions in the upper urinary tract due to the fiber

  20. Ketamine cystitis: Its urological impact and management

    Directory of Open Access Journals (Sweden)

    Yao Chou Tsai

    2015-09-01

    Full Text Available Ketamine, an n-methyl-d-aspartic acid receptor complex antagonist, has been used as an anesthetic and/or analgesic. However, in the past decade, ketamine has been illegally available as a recreational drug in Asian countries and Taiwan. Due to the characteristic of being short-acting, youngsters widely assume that ketamine is not as harmful as other drugs, such as heroin. Consequently, many young patients used this drug for a longer duration before they presented with severe urinary frequency and urgency symptoms. Subsequently, other cases have been reported in Taiwan, Hong Kong, Singapore, Malaysia, and Europe. Ketamine abuse is increasing, with rates of 0.30% in 2006 to 0.40% in 2007 among those in the 16–59 year age group. In general, affected patients tend to be young with a peak age range of 16–35 years. The incidence of lower urinary tract symptoms in ketamine abuse patients is around 30%. The actual underlying pathomechanism of ketamine cystitis (KC and associated pelvic pain remains unclear. It is speculated that chronic contact and stimulation to the bladder or ureteral mucosa due to metabolites of ketamine will result in submucosal edema, vascular ectasia, fibrosis, detrusor muscle inflammation, and fibrosis. Presentations of KC include remarkable dysuria, urinary frequency/urgency, urge incontinence, and bladder pain. Urine culture usually fails to yield any microbiology in KC with bladder pain alone. The majority of patients can enjoy clinical improvement after cessation of ketamine and urological treatment similar to interstitial cystitis/bladder pain syndrome (IC/BPS. However, patients who are still abusing ketamine and/or who have a longer duration of ketamine abuse might suffer from severe bladder pain, which does not respond to empirical oral or intravesical treatments such as hyaluronic acid. Among these patients, most have a remarkably impaired quality of life and are at risk of developing upper urinary tract damage

  1. Leadership in Canadian urology: what is the right stuff?

    Science.gov (United States)

    Robinson, Michael; Macneily, Andrew; Afshar, Kourosh; McInnes, Colin; Lennox, Peter; Carr, Nicholas; Skarlicki, Daniel; Masterson, John; Arneja, Jugpal

    2013-01-01

    There are little data characterizing leadership roles within Canadian Urology. The importance of these positions in urology underscores the need for further investigation to provide insight for recruitment, development, and success. All Canadian Urology Program Directors and Division/Department Heads were invited to complete an online leadership survey as part of a larger national cohort from 11 other surgical specialties. Response rate was 62% (13/21), the majority of whom were Caucasian (77%) and male (92%). Only 8% of respondents in urology hold an advanced degree compared with 45% in other specialties. Additional leadership training was done by 54% of the respondents. Residency was completed in Canada by 92%, but 62% completed fellowships abroad. A majority reported no well-defined job description for their role (54%). The top responsibility reported by leaders was mentoring residents (67%), followed by advising staff (62%). Excellence in patient care and teaching were seen as the most important professional characteristics, whereas integrity was the personal quality felt most important. Leaders reported 17% of their income came from their leadership role, equivalent to the time required for position duties (19%). "Time management" was listed as the greatest challenge faced (54%). Leadership style was reported as "democratic" by 92%. Leaders in urology most often self-rated their leadership skills lower than leaders from other surgical specialties (7 vs 8/10). Positions of leadership in urology are disproportionately represented by Caucasian males and comparatively few hold relevant advanced degrees. Excellence in the areas of teaching and patient care, and high personal integrity are felt to be the most important characteristics for success. Time management issues are viewed as the greatest challenge. These preliminary data may prove useful for the mentoring, recruitment, and success of future leaders in our specialty. Copyright © 2013 Association of Program

  2. Late urologic morbidity in 177 consecutive patients after radiotherapy for cervical carcinoma: a longitudinal study

    DEFF Research Database (Denmark)

    Lajer, Henrik; Thranow, Ingrid R.; Skovgaard, Lene Theil

    2002-01-01

    Radiotherapy; carcinoma of the uterine cervix; Urologic morbidity; Franco-Italian glossary; Actuarial estimate......Radiotherapy; carcinoma of the uterine cervix; Urologic morbidity; Franco-Italian glossary; Actuarial estimate...

  3. 'I will not cut . . . ': the oath that defined urology.

    Science.gov (United States)

    Herr, Harry W

    2008-09-01

    To explore different interpretations of the clause embedded in the Hippocratic Oath, prohibiting surgery for stones, and its relevance for urology. Various translations of the Oath, from the original Greek edition to historical revisions, were reviewed. Controversy surrounds different translations and interpretations of the Oath about the practice of lithotomy among ancient healers. The reasons Hippocratic physicians were prohibited from performing lithotomy are several, but the consensus is that untrained physicians pledged not to undertake such a complicated procedure, but to refer their patients to other healers who specialized in that practice. The Hippocratic Oath actually defined, identified and legitimized urology as the first medical speciality.

  4. THE STATE OF UROLOGIC CANCER CARE IN MOSCOW

    Directory of Open Access Journals (Sweden)

    V. I. Shirokorad

    2014-07-01

    Full Text Available In 2003 malignant neoplasms (MN of the urinary system and male genital organs affected more than 43,000 people in Russia, amounting to 9.4% in the structure of total cancer morbidity. In 2012, the incidence of urologic cancers at only three sites (prostate, kidney, and bladder was 12.1%. In the same year, Moscow showed the proportion of patients with new-onset urologic cancer, which accounted for one sixth (16.5% of the total MN morbidity and almost one fifth (18.5% of the total number of registered cancer patients.

  5. The building of Urology as a specialty in Mallorca.

    Science.gov (United States)

    Mercant-Ramírez, Jaume

    2014-12-01

    The research of the origin and development of the Medicalhyphen;surgical specialties in our environment has been, to my knowledge, limited. The aim of this work is to review it in reference to Urology, one of the first specialties developed in Mallorca during the second half of the XIX Century and the beginning of the XX century. Evidence acquisition has been performed through research of the archives of the Royal Academy of Medicine of the Balearic Islands (RAMIB) and the Medical College and the study of the Balearic Journal of Medical sciences. Furthermore, the biographies of the main precursors and pioneers of Urology in Mallorca have been reconstructed.

  6. Microcomputers and microprocessors in urology: present and future.

    Science.gov (United States)

    Glen, E S

    1983-12-01

    Urology departments have a heavy outpatient workload requiring efficient secretarial, appointments and records services. Microcomputers are relatively inexpensive and can facilitate efficient routine clinical and research work. Unlike mainframe computers, formal training is not usually required, a simple introduction being sufficient for the enthusiast. An Apple computer is used in this department for word processing incorporating standard letters, paragraphs and phrases. With more sophisticated programs urological screening by computer interrogation could be linked to an appointments system to coordinate investigations, minimising hospital visits. Microprocessors can facilitate a wide variety of measurement recording and data handling. Urodynamic measurements can be computed and graphs superimposed to facilitate interpretation.

  7. American Urological Association and European Association of Urology guidelines in the management of benign prostatic hypertrophy: revisited.

    Science.gov (United States)

    Juliao, Armando A; Plata, Mauricio; Kazzazi, Amir; Bostanci, Yakup; Djavan, Bob

    2012-01-01

    The purpose of this review is to provide a complete revision of two of the most widely used clinical guidelines in the management of lower urinary tract symptoms induced by benign prostatic hyperplasia and their importance and compliance among urologists. Updates of the American Association of Urology and European Association of Urology clinical practice guidelines (CPGs) were reviewed and analyzed. Literature concerning compliance and application of these two CPGs in the different working scenarios of practicing has been evaluated. Urology has moved to an era in which costs and quality of care are being scrutinized, and compliance to CPGs will be assessed. Practicing urologists do not have the time to keep up to date with the continuous incoming literature and CPGs are a great tool to give the highest quality of care to our patients.

  8. Modello metodologico per il monitoraggio degli incidenti stradali in Trentino

    Directory of Open Access Journals (Sweden)

    P. Fateh-Moghadam

    2003-05-01

    Full Text Available

    Obiettivi: realizzazione di un’infrastruttura informatica, per l’unificazione tempestiva dei flussi sugli incidenti stradali (ISTAT-ACI e sanitari con la georeferenziazione degli eventi a partire dall’anno 2000.

    Materiali e Metodi: dall’archivio di Trentino emergenza sono stati estratti gli interventi per incidente stradale selezionando la combinazione: descrizione patologica: “traumatismi”, tipologia luogo: “strada”, tipologia incidente. Dai dati di ogni Pronto soccorso è stato costruito un archivio unico contenente il totale degli accessi e sono stati estratti gli accessi per “incidente stradale” e quelli per lesioni accidentali in generale. Dall’archivio SDO si sono selezionati sia i ricoveri con il criterio “3” alla variabile mtraav (=incidente stradale che quelli per traumatismi.

    Nell’ambito del progetto “Metodi informatici predittivi per la mitigazione del rischio da incidenti stradali” (Mitris, finanziato dal Ministero della Salute, è stata realizzata l’immissione tramite interfaccia internet o decodifica automatica dei verbali informatizzati delle Forze dell’ordine, e la contestuale realizzazione di un interfaccia WebGIS
    in grado di visualizzare la localizzazione degli incidenti stradali.

    Risultati: tramite la combinazione “data nascita”,
    “data incidente”, “sesso” è stato eseguito un primo collegamento tra gli archivi. Aggiungendo alla data incidente uno o più giorni, è stato costruito un nuovo archivio PS contenente il 97,4% degli eventi raccolti dalle forze dell’Ordine e contenuti nel data base Mitris. Approccio analogo è stato seguito per il linkage con SDO e 118. Tramite interfaccia WebGIS è stata creata una mappa degli incidenti interrogabile on-line, che oltre alla semplice localizzazione riporta dinamica e esiti con possibilità di produrre statistiche e grafici. Il sistema copre attualmente

  9. [Proposals for the introduction of history, art and literature issues on the urology subject].

    Science.gov (United States)

    Tundidor Bermúdez, A M

    2008-10-01

    To contribute to the humanistic education of medical students. A bibliographic review was done on history, art and literature items in relation with Urology. The introduction of cultural items in the Urology subject, as a motivation and complement of the biomedical items, is proposed and illustrated by examples. The Urology subject can contribute to the humanistic education of medical students.

  10. Women in Urology Residency, 1978-2013: A Critical Look at Gender Representation in Our Specialty.

    Science.gov (United States)

    Halpern, Joshua A; Lee, Una J; Wolff, Erika M; Mittal, Sameer; Shoag, Jonathan E; Lightner, Deborah J; Kim, Soo; Hu, Jim C; Chughtai, Bilal; Lee, Richard K

    2016-06-01

    To evaluate changes over time in female representation among urology residents compared to those within other specialties. Urology match data were obtained from the American Urological Association from 1996 to 2015. Trends in match rates of male and female urology applicants were assessed. Data for gender representation among residencies were extracted from reports in the Journal of the American Medical Association from 1978 to 2013. We compared the annual percentage of women among urology residents vs residents of other specialties over time. Mean number of male vs female urology applicants per year was 285.0 ± 27.1 vs 76.5 ± 21.8 (P urology rose from 0.9% to 23.8%. Between 2009 and 2013, obstetrics and gynecology and orthopedics had the highest and lowest average proportion of women, respectively (80.7% and 13.5%). The largest growth occurred in urology among all other specialties (P urology residency have similar match rates. Although urology demonstrated the greatest fold-increase in proportion of women among all specialties during the study period, women have remained a minority among urology residents. Gender representation within urology is a reflection of many factors and demonstrates a need for further improvement. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. An update on the current status of medical student urology education in the United States.

    Science.gov (United States)

    Slaughenhoupt, Bruce; Ogunyemi, Oreoluwa; Giannopoulos, Maria; Sauder, Christina; Leverson, Glen

    2014-10-01

    To provide an updated report on the status of urology education in the United States. Forty-one randomly selected accredited medical schools in the United States were surveyed concerning their urology curriculum. All schools were included in the randomization, even those that had not produced any successful urology applicants during the past 5 years. In 48% of the schools, there were no urology lectures or coursework required before third-year clinical rotations. Two schools (5%) had a mandatory urology clinical clerkship. All schools offered an elective urology clerkship during either the third or fourth year of medical school. Fifty-five percent of medical schools used a core curriculum, and 31% based their curriculum on the American Urological Association's medical student core curriculum. Twenty-nine percent used Web-based resources during their clerkship, and 21% had a urology interest group. This survey further reveals that there is a decline in exposure of medical students in the United States to formal urology teaching. In an attempt to minimize any possible adverse impact and to ensure that students are being exposed to the most important urologic topics and skills needed, some medical schools have instituted the use of a core curriculum in their clerkships. Despite the persistent decline in required medical student exposure to urology, urology residency programs remain extremely competitive. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Feasibility and safety of augmented reality-assisted urological surgery using smartglass.

    Science.gov (United States)

    Borgmann, H; Rodríguez Socarrás, M; Salem, J; Tsaur, I; Gomez Rivas, J; Barret, E; Tortolero, L

    2017-06-01

    To assess the feasibility, safety and usefulness of augmented reality-assisted urological surgery using smartglass (SG). Seven urological surgeons (3 board urologists and 4 urology residents) performed augmented reality-assisted urological surgery using SG for 10 different types of operations and a total of 31 urological operations. Feasibility was assessed using technical metadata (number of photographs taken/number of videos recorded/video time recorded) and structured interviews with the urologists on their use of SG. Safety was evaluated by recording complications and grading according to the Clavien-Dindo classification. Usefulness of SG for urological surgery was queried in structured interviews and in a survey. The implementation of SG use during urological surgery was feasible with no intrinsic (technical defect) or extrinsic (inability to control the SG function) obstacles being observed. SG use was safe as no grade 3-5 complications occurred for the series of 31 urological surgeries of different complexities. Technical applications of SG included taking photographs/recording videos for teaching and documentation, hands-free teleconsultation, reviewing patients' medical records and images and searching the internet for health information. Overall usefulness of SG for urological surgery was rated as very high by 43 % and high by 29 % of surgeons. Augmented reality-assisted urological surgery using SG is both feasible and safe and also provides several useful functions for urological surgeons. Further developments and investigations are required in the near future to harvest the great potential of this exciting technology for urological surgery.

  13. 21 CFR 876.4730 - Manual gastroenterology-urology surgical instrument and accessories.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual gastroenterology-urology surgical... OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4730 Manual gastroenterology-urology surgical instrument and accessories. (a) Identification...

  14. Urological Surveillance and Medical Complications after Spinal Cord Injury in the United States

    NARCIS (Netherlands)

    Cameron, Anne P.; Lai, Julie; Saigal, Christopher S.; Clemens, J. Quentin; Wijmenga, T. J.

    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

  15. Has the creation of a urology residency programme translated in to ...

    African Journals Online (AJOL)

    BACKGROUND: Surgical residency programmes are supposed to enhance resident operative experience. The impact of urology residency was assessed at our institution before and after establishing a structured urology training programme in 2006. MATERIALS /METHODS: Log books of final year Urological residents ...

  16. Reasons for cancellations of urologic day care surgery | Dakum ...

    African Journals Online (AJOL)

    Objective: The numerous economic and social benefits associated with the practice of day care surgery could be eroded by frequent cancellations. We therefore determined the reasons for such cancellations in a tertiary care centre in Nigeria. Patients and Methods: This was a prospective study of all consecutive urologic ...

  17. First urology simulation boot camp in the United Kingdom

    African Journals Online (AJOL)

    C.S. Biyani

    2017-08-12

    Aug 12, 2017 ... ative experience and confidence level in common urological procedures. The course included seven modules covering basic scrotal procedures, laparoscopic skills, ureteroscopy, transurethral resection of the. Abstract was presented at the EAU Congress Munich abstract. Eur Urol Suppl 15(3);e357 (2016).

  18. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Science.gov (United States)

    2010-04-01

    ... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Diagnostic Devices § 876.1075... and that are covered by classification regulations in other parts of the device classification... device used to remove, by cutting or aspiration, a specimen of tissue for microscopic examination. This...

  19. Dedicated research time in urology residency: current status.

    Science.gov (United States)

    Peyton, Charles C; Badlani, Gopal H

    2014-04-01

    To gauge the importance of dedicated research time during urology residency and how this influences rank-list preferences when applying for residency. An American Urological Association survey was emailed to US resident members. The online form consisted of 14 questions addressing demographics, career plans, and training program characteristics. Two additional Likert-scale question series evaluated rank-list preferences and the value of dedicated research time during residency. A total of 263 of 956 urology residents (27.5%) responded to the survey. More than 70% responders valued the opportunity to be involved with scholarly research and agreed that doing so will enhance their education and/or training. About 88.2% interviewed with at least 1 program with a dedicated research year. About 33.5% preferred or were indifferent to applying to 6-year programs with dedicated research time vs a traditional 5-year program. About 76.4% residents preferred doing an extra year of research in fellowship as opposed to residency. Dedicated research time is one of many components influencing rank-list preference. Residents value the opportunity to participate in research, but there is limited interest in an additional year during residency. However, one-third of applicants favor or are willing to accept an additional year of research in urology residency. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Health Policy 2016 – Implications for Geriatric Urology

    Science.gov (United States)

    Suskind, Anne M.; Clemens, J. Quentin

    2016-01-01

    Purpose of Review The U.S. healthcare system is undergoing fundamental changes in an effort to improve access to care, curtail healthcare spending, and improve quality of care. These efforts largely focused on Medicare, and therefore will have a fundamental impact on the care of geriatric patients. This article reviews contemporary health policy issues, with a focus on how these issues may impact the care of geriatric urology patients. Recent Findings The Affordable Care Act (ACA) has broadened the scope of Medicare coverage. Future Medicare reimbursement will be increasingly tied to care coordination, quality reporting, and demonstration of appropriate outcomes. Additional research is needed to better define the comparative effectiveness of urologic therapies in geriatric patients. Workforce projections indicate that there is a shortage of urologists in many areas of the country, and that this shortage will worsen over time unless a new funding model is instituted for graduate medical education. Summary Medicare spending drives many health policy decisions. Therefore, few health policy topics are unique to geriatrics or geriatric urology. However, certain health policy topics (e.g., care coordination, risk-stratification) are particularly germaine to the elderly patients. Urologists with a particular interest in geriatric urology should be familiar with these issues. PMID:26765043

  1. Evaluation of a case-based urology learning program.

    Science.gov (United States)

    Mishra, Kirtishri; Snow-Lisy, Devon C; Ross, Jonathan; Goldfarb, David A; Goldman, Howard; Campbell, Steven C

    2013-12-01

    To address the challenges that today's trainees encounter, such as information overload and reduced immersion in the field, and recognizing their preference for novel educational resources, an electronic case-based urology learning program was developed. Each case was designed to illustrate the basic principles of the disease process and the fundamentals of evaluation and management using the Socratic method, recapitulating a prototypical patient encounter. A 21-question survey was developed after review of published reports of classroom and clinical learning environment surveys. The target group was 2 pilot urology training programs (the Cleveland Clinic and University Hospitals-Case Medical Center). The responses were entirely anonymous. A total of 32 trainees participated (8 fellows and 24 residents), representing a 53% response rate. Most trainees (79%) were able to process cases within an average of ≤ 10 minutes. Of the trainees, 91% reported referring back to particular cases for patient care, to review for examinations, or for studying. Most trainees believed a case-based urology learning program would be a potentially important resource for clinical practice (69%) and for preparing for the in-service (63%) or board (69%) examinations. Most trainees believed the program met its goals of illustrating the basics principles of the disease process (88%), outlining the fundamentals of evaluation and management (94%), and improving the trainees' knowledge base (91%). An electronic case-based urology learning program is feasible and useful and stimulates learning at all trainee levels. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Should we train urologists in female urology? A European view.

    NARCIS (Netherlands)

    Heesakkers, J.P.F.A.; Costantini, E.; Oelke, M.

    2009-01-01

    PURPOSE OF REVIEW: Training in female urology in Europe so far has been a national focus of individual European countries. Because of reasons like differentiation in pathology, activities of other specialisms like gynaecology and reimbursement issues, the way in which extra training in female

  3. Biofilms on Indwelling Urologic Devices: Microbes and Antimicrobial ...

    African Journals Online (AJOL)

    Background: Biofilms (BFs) are a potential source of highly resistant infections, frequently formed on devicesand pose problems for management. Aim: This study was to develop rational approach for prevention of indwelling urologic device associated biofilm colonization. Subjects and Methods: From randomly selected ...

  4. Utility of smartphone camera in patient management in urology.

    Science.gov (United States)

    Sidana, Abhinav; Noori, Selaiman; Patil, Nilesh

    2014-10-01

    To describe the utility of the smartphone camera in patient management in urology. Clinical scenarios were collected retrospectively in which photographs that were taken on smartphone and transmitted by multimedia messaging service (MMS) served an important role in making a diagnosis and/or helped in the self-monitoring of urologic issues by patients. Scenario 1 - a 39-year-old male that presented to the emergency room (ER) with scrotal pain, bruising, and swelling 1 day after bilateral vasectomy. The on call urologist requested that the ER physician send a photograph of the wound using his smartphone. After examining the photograph, the urologist concluded that the hematoma could be managed conservatively. Scenario 2 - a 40-year-old female who underwent transurethral resection of bladder tumor a month ago and had recurrence of gross hematuria. The surgeon asked the patient to monitor her urine color and to use her smartphone to periodically send a photograph of her urine until it turned clear. At our institution urology consults have been requested for postoperative patients owning to unfamiliarity with postoperative urology examination. By communicating with the on call urologist through MMS images of incisions or urine color, management of these patients has become more timely and efficient. Smartphone camera use can also decrease the in house time spent by on call residents, thus aiding in conforming to duty hours restrictions. Furthermore, this technology has potential for helping patients monitor their disease course, thus reducing hospital visits, anxiety, and healthcare costs.

  5. Future robotic platforms in urologic surgery: recent developments.

    Science.gov (United States)

    Herrell, S Duke; Webster, Robert; Simaan, Nabil

    2014-01-01

    To review recent developments at Vanderbilt University of new robotic technologies and platforms designed for minimally invasive urologic surgery and their design rationale and potential roles in advancing current urologic surgical practice. Emerging robotic platforms are being developed to improve performance of a wider variety of urologic interventions beyond the standard minimally invasive robotic urologic surgeries conducted currently with the da Vinci platform. These newer platforms are designed to incorporate significant advantages of robotics to improve the safety and outcomes of transurethral bladder surgery and surveillance, further decrease the invasiveness of interventions by advancing LESS surgery, and to allow for previously impossible needle access and ablation delivery. Three new robotic surgical technologies that have been developed at Vanderbilt University are reviewed, including a robotic transurethral system to enhance bladder surveillance and transurethral bladder tumor, a purpose-specific robotic system for LESS, and a needle-sized robot that can be used as either a steerable needle or small surgeon-controlled micro-laparoscopic manipulator.

  6. [Artificial neural networks for decision making in urologic oncology].

    Science.gov (United States)

    Remzi, M; Djavan, B

    2007-06-01

    This chapter presents a detailed introduction regarding Artificial Neural Networks (ANNs) and their contribution to modern Urologic Oncology. It includes a description of ANNs methodology and points out the differences between Artifical Intelligence and traditional statistic models in terms of usefulness for patients and clinicians, and its advantages over current statistical analysis.

  7. Acute and chronic urine retention among adults at the urology ...

    African Journals Online (AJOL)

    The study was carried out at the Urology and Accident and Emergency Units of KATH. A complete work-up to establish the cause of urine retention preceded data collection. The subject's demographic data, causes and management of urine retention with outcomes were recorded on data sheet. Data was analyzed using ...

  8. [Education of medical students in urology in Germany: present status].

    Science.gov (United States)

    Strunk, T; Mueller, S C

    2011-02-01

    There is a growing demand for doctors in Germany and diseases of the genitourinary tract have become more prevalent in recent years. Politicians plan to increase the number of students in an already heavily overloaded system but data on quality and structure of medical education in Urology are lacking. The purpose of this study was to investigate the extent and quality of undergraduate medical education in urology. Departments of Urology at German University Hospitals were surveyed using a questionnaire. Questions covered four different fields of medical education and answers were analyzed by descriptive statistics. Of the teachers involved in medical education 97% are physicians and 4% of these have special didactic qualifications. On average 1 teacher is responsible for 13 students and 44% of departments also have to carry out medical duties during teaching lessons. More than half of the departments offer modern learning forms, such as e-learning, problem-oriented learning or skills laboratory training. Urology departments at German University Hospitals spend much time on medical education. Nearly all physicians are involved in medical education, whether they are experienced or not and in many cases teaching is carried out in parallel to patient care. In more than half of the cases modern education tools were employed which implies a good standard of quality but there are no data on outcome.

  9. 'Image and treat': an individualized approach to urological tumors

    DEFF Research Database (Denmark)

    Bouchelouche, Kirsten; Capala, Jacek

    2010-01-01

    The current treatment options for advanced urologic cancers demonstrate limited efficacy. To obtain optimal clinical results, there is a need for new, individualized, therapeutic strategies, which have only recently been applied to these malignancies. Nuclear medicine plays an important role in e...

  10. African Journal of Urology - Vol 20, No 2 (2014)

    African Journals Online (AJOL)

    Editorial: African Journal of Urology:Continuing progress · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. I Khalaf, A Mosharafa, 74–75. http://dx.doi.org/10.1016/j.afju.2014.03.030 ...

  11. [The disseminated intravascular coagulation syndrome in urological diseases].

    Science.gov (United States)

    Lopatkin, N A; Rumiantsev, V B; Bukaev, Iu N; Golovanov, S A

    1997-01-01

    The authors consider causes and mechanisms underlying DIC syndrome onset in complications of urological diseases. The syndrome may originate from azotemia-induced intoxication, injury to the kidneys and urinary tracts, complications of surgical interventions. Etiologically and pathogenetically validated approaches to DIC syndrome treatments, their regimens, combinations and dosages are presented.

  12. The Profile and Urological Service Needs of Outpatients Attending a ...

    African Journals Online (AJOL)

    MTRH), a 750 bed tertiary centre in the Western region of Kenya catering for approximately half of the Kenyan population. Subjects: Ninety-four first time attendees to the urology clinic seen in the year 2011. Main outcome measures: The primary ...

  13. the profile and urological service needs of outpatients attending a ...

    African Journals Online (AJOL)

    a 750 bed tertiary centre in the Western region of Kenya catering for approximately half of the Kenyan population. Subjects: Ninety-four first time attendees to the urology clinic seen in the year 2011. Main outcome measures: The primary outcome measures were the demographic data and diagnosis while the secondary ...

  14. The spectrum of urological disease in patients with spina bifida.

    LENUS (Irish Health Repository)

    Cahill, R A

    2012-02-03

    BACKGROUND: [corrected] Urological complications are the major cause of ill health during childhood and adult life of patients with spina bifida but the significance of urinary tract disease on the individual and the healthcare services is underemphasised. AIM: To assess the effects of spina bifida on the individual and the healthcare services. METHODS: A retrospective review was performed to assess the frequency and significance of urological conditions requiring hospital attendance in patients with spina bifida currently attending a specialised multidisciplinary clinic over a period of six months. RESULTS: Urinary sepsis accounted for the majority of admissions (62%), while 38 of 62 patients required 60 surgical procedures. Targeting the primary urological abnormality (the dysfunctional and usually poorly compliant bladder) allows implementation of effective treatments, including regular intermittent bladder catherisation (52%) in order to preserve upper renal tract function. Associated postural abnormalities complicated both conservative and interventional therapies. CONCLUSION: This study highlights the surgical commitment for units caring for patients with spina bifida, the important considerations for the future healthcare services, and the range and severity of urological diseases encountered by these patients.

  15. NCCU/BBRI-Duke/Urology Partnership In Prostate Cancer Research

    Science.gov (United States)

    2011-06-01

    Mukhopadhyay, PhD, NCCU/BBRI Collaborator: Judd Moul, MD, Duke/Urology A. Specific Aims 1) To define the role of CB1 and CB2 cannabinoid receptors in...the results from this pilot study suggests that CB2R-FAK-MMP signaling axis is functional in E006AA African-American prostate cancer cell lines

  16. Errors and risks of urological X-ray diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Blech, M.; Truss, F.

    1987-12-28

    Classical methods of radiologic diagnosis like excretory urogram, retrograde ureteropyelography or urethrography - only to mention a few - are as much as ever corner pillars of the whole urologic diagnosis. Similar to other diagnostic methods certain risks and complications, which is intented to summarize, also exist in this area. Problems related to intravenous infusion of contrast medium or radioprotection are not discussed in this article.

  17. Identifying content for simulation-based curricula in urology

    DEFF Research Database (Denmark)

    Nayahangan, Leizl Joy; Hansen, Rikke Bolling; Lindorff-Larsen, Karen Gilboe

    2017-01-01

    Objective: Simulation-based training is well recognized in the transforming field of urological surgery; however, integration into the curriculum is often unstructured. Development of simulation-based curricula should follow a stepwise approach starting with a needs assessment. This study aimed...

  18. A nationwide population study of trazodone use in urology patients

    Directory of Open Access Journals (Sweden)

    Wei-Ming Cheng

    2013-08-01

    Conclusion: Despite the fact that trazodone was not officially approved for patients with urological conditions, this medication has been used as an ED treatment in Taiwan at least since 1997; the prescriptions of trazodone were more prevalent among the elderly, and this trend increased, then evened out, and eventually reached its maximum point in 2003, correlating with the introduction of PDE-5 inhibitors.

  19. Evolving attitudes toward robotic surgery among Canadian urology residents.

    Science.gov (United States)

    Locke, Jennifer; Robinson, Michael; MacNeily, Andrew; Goldenberg, S Larry; Black, Peter C

    2017-07-01

    Robotic-assisted laparoscopic surgery (RAS) has not been adopted as rapidly or widely in Canada as in the U.S. In 2011, Canadian urology residents felt that RAS represented an expanding field that could potentially negatively impact their training. We re-evaluate trainee exposure and attitudes to RAS in Canadian residency training five years later. All Canadian urology residents were asked to participate in an online survey designed to assess current resident exposure to and perception of RAS. The response rate was 39% (61/157). Seventy-seven percent of residents reported being involved in at least one RAS procedure (52% in 2011), and the majority had exposure to <10 cases. For those in hospitals with access to RAS, 96% desired more console time, while only 50% of those without access wanted more console experience. Of all residents, 50% felt that RAS will become the gold standard in certain urological surgeries (34% in 2011), but only 28% felt that RAS would play an increasingly important role in urology (59% in 2011). Despite an increase in exposure to RAS in residency programs over the past five years, console experience remains limited. Although these residents desire more access to RAS, many voice uncertainty of the role of RAS in Canada. We cannot conclude whether RAS is perceived by residents to be beneficial or detrimental to their training nationwide. Moving forward in the robotic era, it will be important to either modify residency curricula to address RAS experience or to limit RAS to fellowship training.

  20. Future robotic platforms in urologic surgery: Recent Developments

    Science.gov (United States)

    Herrell, S. Duke; Webster, Robert; Simaan, Nabil

    2014-01-01

    Purpose of review To review recent developments at Vanderbilt University of new robotic technologies and platforms designed for minimally invasive urologic surgery and their design rationale and potential roles in advancing current urologic surgical practice. Recent findings Emerging robotic platforms are being developed to improve performance of a wider variety of urologic interventions beyond the standard minimally invasive robotic urologic surgeries conducted presently with the da Vinci platform. These newer platforms are designed to incorporate significant advantages of robotics to improve the safety and outcomes of transurethral bladder surgery and surveillance, further decrease the invasiveness of interventions by advancing LESS surgery, and allow for previously impossible needle access and ablation delivery. Summary Three new robotic surgical technologies that have been developed at Vanderbilt University are reviewed, including a robotic transurethral system to enhance bladder surveillance and TURBT, a purpose-specific robotic system for LESS, and a needle sized robot that can be used as either a steerable needle or small surgeon-controlled micro-laparoscopic manipulator. PMID:24253803

  1. An approach to urological injuries associated with pelvic surgery ...

    African Journals Online (AJOL)

    Injuries during pelvic floor surgery may involve the ureter, bladder and urethra. Detailed knowledge of the anatomy of these structures and the application of this knowledge during surgery, together with appropriate pre-operative imaging will help to reduce morbidity from urological injuries during pelvic floor surgery.

  2. Challenges facing academic urology training programs: an impending crisis.

    Science.gov (United States)

    Gonzalez, Chris M; McKenna, Patrick

    2013-03-01

    To determine the most pressing issues facing academic urology training centers. The supply of urologists per capita in the United States continues to decrease. Stricter resident requirements, restriction of resident duty hours, and a Graduate Medical Education (GME) funding cap on resident education has led to significant challenges for academic centers. A 32-question survey was sent to Society of University Urologists members. Respondents defined themselves as academic faculty tenure track, program director, academic chair, program director and academic chair, clinical faculty nontenure track, and community faculty member. A total of 143 of 446 members(32%) responded. A lack of funding was indicated as an obstacle to adding new residency positions (65% respondents) and recruiting new faculty (60% respondents). Residency positions not funded by GME (40% respondents) required either clinical or hospital dollars to support these slots. Most respondents (51%) indicated resident research rotations are funded with clinical dollars. Surgical skills laboratories are commonly used (85% respondents) and are supported mostly with hospital or clinical dollars. The majority of respondents (84%) indicated they would expand simulation laboratories if they had better funding. Other than urodynamics and ultrasound, urology residency training programs reported little income from ancillary dollars. There is a significant workforce shortage within urology training programs. Clinical revenue and hospital funding seem to be the main financial support engines to supplement the GME funding shortage, proficiency training, and faculty salary support for teaching. The current system of GME funding for urology residency programs is not sustainable. Published by Elsevier Inc.

  3. Urology and the scientific method in ancient Egypt.

    Science.gov (United States)

    Gordetsky, Jennifer; O'Brien, Jeanne

    2009-03-01

    To examine the practice of urology in ancient Egypt using various sources, including the Edwin Smith and Ebers Papyri. The sources of knowledge of ancient Egyptian medicine include medical papyri, paleopathology, art, and hieroglyphic carvings. A brief overview of the medical system in ancient Egypt was completed, in addition to an examination of the training and specialization of the physician in the ancient world. Urologic diseases treated in ancient Egypt and some of the first documented urologic surgeries are presented. Finally, we studied the role of the physician-priest and the intertwined use of religion and magic in ancient Egyptian medicine. The same medical conditions urologists treat in the office today were methodically documented thousands of years ago. Medical papyri show evidence that the ancient Egyptians practiced medicine using a scientific method based on the clinical observation of disease. This has been exemplified by the Edwin Smith Surgical Papyrus, a collection of surgical cases that gives a diagnosis, treatment, and prognosis for each ailment, and the discovery of medical specialization in ancient Egypt, giving us perhaps the world's first urologists. Intertwined with the scientific method was also the rich mysticism and religion of ancient Egypt, which were integral components of the healing process. We present an overview of the practice of urology in ancient Egypt, in terms of both pharmacologic and surgical intervention, as well as with a look into the religion of medicine practiced at that time.

  4. Diagnosis of erectile dysfunction | Raheem | African Journal of Urology

    African Journals Online (AJOL)

    African Journal of Urology. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 15, No 1 (2009) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load here if your Web ...

  5. The Burden of Specialist Urologic Care in Abuja, Federal Capital ...

    African Journals Online (AJOL)

    The Burden of Specialist Urologic Care in Abuja, Federal Capital City, Nigeria: A Single Surgeons 4-Year Case Load. ... West African Journal of Medicine ... The mean ages for male children less than 1 year old was 6.9months and 3.1years for those older while the mean age the only 2 female children seen was 11years.

  6. Immagini dinamiche: appunti per un catalogo degli usi didattici

    Directory of Open Access Journals (Sweden)

    Filippo Bruni

    2013-03-01

    Full Text Available Le immagini dinamiche costituiscono un’importante risorsa per le attività didattiche. A partire da una riflessione storica, si evidenzia in primo luogo l’importanza di un loro uso efficace alla luce della classificazione operata da Clark e Lyons. In secondo luogo si segnalano alcune attività emergenti legate alla documentazione, al digital storytelling e alla formazione degli insegnanti.

  7. Technical Note: Using DEG CPCs at upper tropospheric temperatures

    CERN Document Server

    Wimmer, D; Nieminen, T; Duplissy, J; Ehrhart, S; Almeida, J; Rondo, L; Franchin, A; Kreissl, F; Manninen, H E; Kulmala, M; Curtius, J; Petäjä, T

    2014-01-01

    Over the last few years, several Condensation Particle Counters (CPC) capable of measuring in the sub-3 nm size range have been developed. Here we study the performance of Diethylene glycol (DEG) based CPCs at different temperatures during Cosmics Leaving Outdoor Droplets (CLOUD) measurements at CERN. The data shown here is the first set of verification measurements for sub-3 nm CPCs under upper tropospheric temperatures using atmospherically relevant aerosol particles. To put the results in perspective we calibrated the DEG-CPC at room temperature, resulting in a cut-off diameter of 1.4 nm. All diameters refer to mobility equivalent diameters in this manuscript. At upper tropospheric temperatures between −25 °C and −65 °C, we found cut-off sizes in the range of 2.5 and 2.8 nm. Due to low number concentration after size classification, the cut-off diameters have a high uncertainty (±0.3 nm) associated with them. Operating two laminar flow DEG CPCs with different cut-off sizes together with other aeroso...

  8. Robotic-assisted laparoscopic surgery: recent advances in urology.

    Science.gov (United States)

    Autorino, Riccardo; Zargar, Homayoun; Kaouk, Jihad H

    2014-10-01

    The aim of the present review is to summarize recent developments in the field of urologic robotic surgery. A nonsystematic literature review was performed to retrieve publications related to robotic surgery in urology and evidence-based critical analysis was conducted by focusing on the literature of the past 5 years. The use of the da Vinci Surgical System, a robotic surgical system, has been implemented for the entire spectrum of extirpative and reconstructive laparoscopic kidney procedures. The robotic approach can be applied for a range of adrenal indications as well as for ureteral diseases, including benign and malignant conditions affecting the proximal, mid, and distal ureter. Current evidence suggests that robotic prostatectomy is associated with less blood loss compared with the open surgery. Besides prostate cancer, robotics has been used for simple prostatectomy in patients with symptomatic benign prostatic hyperplasia. Recent studies suggest that minimally invasive radical cystectomy provides encouraging oncologic outcomes mirroring those reported for open surgery. In recent years, the evolution of robotic surgery has enabled urologic surgeons to perform urinary diversions intracorporeally. Robotic vasectomy reversal and several other robotic andrological applications are being explored. In summary, robotic-assisted surgery is an emerging and safe technology for most urologic operations. The acceptance of robotic prostatectomy during the past decade has paved the way for urologists to explore the entire spectrum of extirpative and reconstructive urologic procedures. Cost remains a significant issue that could be solved by wider dissemination of the technology. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Evaluation of urology residents' perception of surgical theater educational environment.

    Science.gov (United States)

    Binsaleh, Saleh; Babaeer, Abdulrahman; Rabah, Danny; Madbouly, Khaled

    2015-01-01

    To evaluate surgical theater learning environment perception in urology residents in Saudi Arabia and to investigate association of learning environment perception and stages of residency program, sectors of health care system, and regions of Saudi Arabia. A cross-sectional survey using the surgical theater educational environment measure (STEEM) inventory. The STEEM inventory was used to measure theater learning environment perception of urology residents in Saudi Arabia. Respondents' perception was compared regarding different residency stages, sectors of the health care system, and regions of Saudi Arabia. Internal reliability of the inventory was assessed using the Cronbach α coefficient. Correlation analysis was done using the Spearman ρ coefficient. Of 72 registered residents, 33 (45.8%) completed the questionnaire. The residents perceived their environment less than acceptable (135.9 ± 16.7, 67.95%). No significant differences in perception were found among residents of different program stages, different sectors of health care system, or different regions in Saudi Arabia. Residents from the eastern region perceived the training and teaching domain better (p = 0.025). The inventory showed a high internal consistency with a Cronbach α of 0.862. STEEM survey is an applicable and reliable instrument for assessing the learning environment and training skills of urology residency program in Saudi Arabia. Urology residents in Saudi Arabia perceived the theater learning environment as less than ideal. The perceptions of theater learning environment did not change significantly among different stages of the program, different sectors of health care system, or different training regions of Saudi Arabia assuring the uniformity of urology training all over Saudi Arabia. The training programs should address significant concerns and pay close attention to areas in surgical theater educational environment, which need development and enhancement, mainly planned fashion

  10. Book review. La forma degli animali. Adolf Portmann

    Directory of Open Access Journals (Sweden)

    Manuel Graziani

    2013-09-01

    Full Text Available Nel 1931 il biologo Adolf Portmann era già talmente noto a livello internazionale per le sue ricerche da guadagnarsi la cattedra in zoologia nell'università della sua città natale, Basilea, all'età di appena 34 anni. All'attività di docente universitario ha sempre affiancato un'originale riflessione sul significato delle scienze della vita, imponendosi come una delle figure chiave nel dibattito tra biologia teoretica, estetica e antropologia filosofica. La forma degli animali, la sua opera più celebre, si pone al confine tra varie discipline e conserva un grande interesse ancora oggi che il dialogo tra estetica e biologia si è fatto nuovamente intenso. Pubblicata nel 1948 e in forma ampliata nel 1960 (da cui deriva questa prima edizione italiana a cura di Pietro Conte l'opera rappresenta il frutto più maturo delle sue ricerche "interdisciplinari".Un saggio che nasce dall'insoddisfazione nei confronti dei paradigmi scientifici consolidati e che ripropone l'idea morfologica in biologia sulla scorta del pensiero di J. W. Goethe il quale affermava che "tutto ciò che è deve anche dar cenno di sé e mostrarsi". Adolf Portmann è un convinto sostenitore che dalla forma si possano dedurne le complessive caratteristiche interne ed esterne degli animali. Secondo questa prospettiva la peculiare fisionomia dell'organismo dipende dalla congiunzione delle sue parti e dalle loro reciproche funzioni. Tuttavia l'autore non vede nello studio della forma l'alternativa al funzionalismo quanto, piuttosto, il suo necessario bilanciamento come dichiara nell'introduzione: "… per giungere alla conoscenza della vita animale di strade ce ne sono molte, e tutte possono contribuire ad arricchire la nostra esperienza. Questo lavoro si occupa della forma degli animali e si propone di mettere in luce la peculiare natura dell'aspetto visibile. Ci sono persone che si dedicano allo studio degli animali, conoscono moltissime specie, hanno imparato centinaia di nomi e

  11. Atti del convegno "Questioni di storia inglese tra Cinque e Seicento: cultura, politica e religione", (Scuola Normale Superiore di Pisa, 11-12 aprile 2002, a cura di Stefano Villani, Stefania Tutino, Chiara Franceschini.

    Directory of Open Access Journals (Sweden)

    Stefano Villani

    2003-01-01

    Full Text Available Mario Rosa, Introduzione. Paolo Cristofolini, Ricordo di un amico. Daniela Bianchi, L'intero libro di Dio, chiamato Bibbia. Alle origini dell'identità puritana. Ginevra Crosignani, Thomas Wright, i suoi scritti ritrovati e il dibattito con Robert Parsons, S. J., sulla partecipazione al servizio e al sermone anglicano. Stefania Tutino, Thomas Pounde, Andrew Willet e la questione cattolica all'inizio del regno di Giacomo I. Chiara Franceschini, Nostalgie di un esule. Note su Giacomo Castelvetro (1546-1616. Eleonora Belligni, Marcantonio De Dominis tra l'Inquisizione romana e Giacomo I: nuove prospettive storiografiche dopo Cantimori. Mauro Simonazzi, La melanconia nell'Inghilterra moderna: Edward Jorden, Timothie Bright e Thomas Adams. Mario Caricchio, Giles Calvert, un "editore d'area" nella rivoluzione inglese. Stefano Villani, "Una piccola epitome di Inghilterra". La comunità inglese di Livorno negli anni di Ferdinando II: questioni religiose e politiche. Luisa Simonutti, William Popple e William Penn. Dalla libertà di coscienza alle libertà civili. Giovanni Tarantino, Libertà di coscienza, 'aritmetica politica' e interesse nazionale: le ragioni economiche della tolleranza nel regno di Giacomo II Stuart. Guglielmo Sanna, Contrattualismo e obbedienza politica nella cultura anglicana degli inizi del Settecento. Dario Pfanner, Charles Blount (1654-1693: la voce di un libero pensatore nella Londra di fine Seicento. Tomaso Cavallo, Aggressore dell'umanità e apologeta della tirannide? L'Hobbes degli enciclopedisti.

  12. Using the SUBcellular database for Arabidopsis proteins to localize the Deg protease family

    Science.gov (United States)

    Tanz, Sandra K.; Castleden, Ian; Hooper, Cornelia M.; Small, Ian; Millar, A. Harvey

    2014-01-01

    Sub-functionalization during the expansion of gene families in eukaryotes has occurred in part through specific subcellular localization of different family members. To better understand this process in plants, compiled records of large-scale proteomic and fluorescent protein localization datasets can be explored and bioinformatic predictions for protein localization can be used to predict the gaps in experimental data. This process can be followed by targeted experiments to test predictions. The SUBA3 database is a free web-service at http://suba.plantenergy.uwa.edu.au that helps users to explore reported experimental data and predictions concerning proteins encoded by gene families and to define the experiments required to locate these homologous sets of proteins. Here we show how SUBA3 can be used to explore the subcellular location of the Deg protease family of ATP-independent serine endopeptidases (Deg1–Deg16). Combined data integration and new experiments refined location information for Deg1 and Deg9, confirmed Deg2, Deg5, and Deg8 in plastids and Deg 15 in peroxisomes and provide substantial experimental evidence for mitochondrial localized Deg proteases. Two of these, Deg3 and Deg10, additionally localized to the plastid, revealing novel dual-targeted Deg proteases in the plastid and the mitochondrion. SUBA3 is continually updated to ensure that researchers can use the latest published data when planning the experimental steps remaining to localize gene family functions. PMID:25161662

  13. Setting up a pediatric robotic urology program: A USA institution experience.

    Science.gov (United States)

    Murthy, Prithvi B; Schadler, Eric D; Orvieto, Marcelo; Zagaja, Gregory; Shalhav, Arieh L; Gundeti, Mohan S

    2018-02-01

    Implementing a robotic urological surgery program requires institutional support, and necessitates a comprehensive, detail-oriented plan that accounts for training, oversight, cost and case volume. Given the prevalence of robotic surgery in adult urology, in many instances it might be feasible to implement a pediatric robotic urology program within the greater context of adult urology. This involves, from an institutional standpoint, proportional distribution of equipment cost and operating room time. However, the pediatric urology team primarily determines goals for volume expansion, operative case selection, resident training and surgical innovation within the specialty. In addition to the clinical model, a robust economic model that includes marketing must be present. This review specifically highlights these factors in relationship to establishing and maintaining a pediatric robotic urology program. In addition, we share our data involving robot use over the program's first nine years (December 2007-December 2016). © 2017 The Japanese Urological Association.

  14. Current status of robot-assisted surgery in urology: a multi-national survey of 297 urologic surgeons.

    Science.gov (United States)

    Guru, Khurshid A; Hussain, Abid; Chandrasekhar, Rameela; Piacente, Pamela; Hussain, Abid; Chandrasekhar, Rameela; Piacente, Pamela; Bienko, Marlene; Glasgow, Mark; Underwood, Willie; Wilding, Gregory; Mohler, James L; Menon, Mani; Peabody, James O

    2009-08-01

    The surgical robot is becoming an important tool for performance of minimally invasive surgical procedures around the world. We surveyed opinions about and utilization of robot-assisted surgery among urologic surgeons from 44 countries. A total of 297 surveys were completed from September to November 2008 by participating urologic surgeons polled at various national and international urologic meetings. The survey evaluated surgeon background, personal experience with minimally invasive surgery, institutional status regarding robotic surgery surgeons' attitudes towards robot-assisted surgery, in general, and prostate, bladder and kidney oncologic procedures, specifically. Two hundred ninety-seven participants completed the survey of which 35% were in training for and 54% in practice of urology. Although 57% of these participants were older than 40, 62% had never sat on a robotic surgical console but 61% believed they would perform robot-assisted surgery. Seventy-eight percent of respondents felt it was required or beneficial to have training in robot-assisted surgery. Only 21% of respondents were currently performing robot-assisted radical prostatectomy. Sixty-one percent of respondents felt robot-assisted radical prostatectomy was the current gold standard or as good as laparoscopic prostatectomy. Only 10% had performed robot-assisted radical cystectomy and 70% of these surgeons have transferred skills from robot-assisted radical prostectomy. Ten percent were performing robot-assisted radical nephrectomies and 30% had transferred skills for laparoscopic partial nephrectomy to robot-assisted partial nephrectomy. Robot-assisted surgery has begun to integrate into the minimally invasive armamentarium for urologic surgery and is applied for more procedures as experience is gained.

  15. Ergonomic Status of Laparoscopic Urologic Surgery: Survey Results from 241 Urologic Surgeons in China

    Science.gov (United States)

    Liang, Boluo; Qi, Lin; Yang, Jinrui; Cao, Zhenzhen; Zu, Xiongbing; Liu, Longfei; Wang, Long

    2013-01-01

    Background The prolonged and frequent use of laparoscopic equipment raises ergonomic risks that may cause physical distress for surgeons. We aimed to assess the prevalence of urologic surgeons’ physical distress associated with ergonomic problems in the operating room (OR) and their awareness of the ergonomic guidelines in China. Methods A sample of 300 laparoscopic urologists in China was assessed using a questionnaire on demographic information, ergonomic issues in the OR, musculoskeletal symptoms, and awareness of the ergonomic guidelines for the OR. Results There were 241 survey respondents (86.7%) with valid questionnaires. Among the respondents, only 43.6% placed the operating table at pubic height during the actual operation. The majority of the respondents (63.5%) used only one monitor during the procedure. Only 29.9% placed the monitor below the eye level. More than half of the respondents (50.6%) preferred to use manual control instead of the foot pedal. Most of the respondents (95.0%) never used the body support. The respondents experienced discomfort in the following regions, in ascending order: leg (21.6%), hand (30.3%), wrist (32.8%), shoulder (33.6%), back (53.1%), and neck (58.1%). The respondents with over 250 total operations experienced less discomfort than those with less than 250 total operations. Most of the respondents (84.6%) were unaware of the ergonomic guidelines. However, almost all of the respondents (98.3%) regarded the ergonomic guidelines to be important in the OR. Conclusions Most of the laparoscopic urologists were not aware of the ergonomic guidelines for the OR; hence, they have been suffering from varying degrees of physical discomfort caused by ergonomic issues. There is an urgent need for education regarding ergonomic guidelines in the OR for laparoscopic urologists in China. PMID:23936202

  16. Book review. La forma degli animali. Adolf Portmann

    OpenAIRE

    Manuel Graziani

    2013-01-01

    Nel 1931 il biologo Adolf Portmann era già talmente noto a livello internazionale per le sue ricerche da guadagnarsi la cattedra in zoologia nell'università della sua città natale, Basilea, all'età di appena 34 anni. All'attività di docente universitario ha sempre affiancato un'originale riflessione sul significato delle scienze della vita, imponendosi come una delle figure chiave nel dibattito tra biologia teoretica, estetica e antropologia filosofica. La forma degli animali, la sua opera...

  17. Attitude and perception of urology by medical students at the end of their medical school: An appraisal from Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Saleh Binsaleh

    2015-01-01

    Conclusions: Knowledge of medical school graduates is insufficient in many urologic subjects, and there is a need for more urology exposure. Social reasons and lack of knowledge about urology hinder the choice of urology specialty as a future career. Clearance of learning objectives, immediate and prompt feedback on performance and adequate emphasis of common problems and ambulatory care are some aspects that should be taken into account by curriculum planners as they consider improvements to urology rotation program.

  18. International Consultation on Urological Diseases and European Association of Urology International Consultation on Minimally Invasive Surgery in Urology: laparoscopic and robotic adrenalectomy.

    Science.gov (United States)

    Ball, Mark W; Hemal, Ashok K; Allaf, Mohamad E

    2017-01-01

    The aim of this study was to provide an evidence-based systematic review of the use of laparoscopic and robotic adrenalectomy in the treatment of adrenal disease as part of the International Consultation on Urological Diseases and European Association of Urology consultation on Minimally Invasive Surgery in Urology. A systematic literature search (January 2004 to January 2014) was conducted to identify comparative studies assessing the safety and efficacy of minimally invasive adrenal surgery. Subtopics including the role of minimally invasive surgery for pheochromocytoma, adrenocortical carcinoma (ACC) and large adrenal tumours were examined. Additionally, the role of transperitoneal and retroperitoneal approaches, as well as laparoendoscopic single-site (LESS) and robotic adrenalectomy were reviewed. The major findings are presented in an evidence-based fashion. Large retrospective and prospective data were analysed and a set of recommendations provided by the committee was produced. Laparoscopic surgery should be considered the first-line therapy for benign adrenal masses requiring surgical resection and for patients with pheochromocytoma. While a laparoscopic approach may be feasible for selected cases of ACC without adjacent organ involvement, an open surgical approach remains the 'gold standard'. Large adrenal tumours without preoperative or intra-operative suspicion of ACC may be safely resected via a laparoscopic approach. Both transperitoneal and retroperitoneal approaches to laparoscopic adrenalectomy are safe. The approach should be chosen based on surgeon training and experience. LESS and robotic adrenalectomy should be considered as alternatives to laparoscopic adrenalectomy but require further study. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  19. Application of Virtual, Augmented, and Mixed Reality to Urology.

    Science.gov (United States)

    Hamacher, Alaric; Kim, Su Jin; Cho, Sung Tae; Pardeshi, Sunil; Lee, Seung Hyun; Eun, Sung-Jong; Whangbo, Taeg Keun

    2016-09-01

    Recent developments in virtual, augmented, and mixed reality have introduced a considerable number of new devices into the consumer market. This momentum is also affecting the medical and health care sector. Although many of the theoretical and practical foundations of virtual reality (VR) were already researched and experienced in the 1980s, the vastly improved features of displays, sensors, interactivity, and computing power currently available in devices offer a new field of applications to the medical sector and also to urology in particular. The purpose of this review article is to review the extent to which VR technology has already influenced certain aspects of medicine, the applications that are currently in use in urology, and the future development trends that could be expected.

  20. Application of Virtual, Augmented, and Mixed Reality to Urology

    Science.gov (United States)

    2016-01-01

    Recent developments in virtual, augmented, and mixed reality have introduced a considerable number of new devices into the consumer market. This momentum is also affecting the medical and health care sector. Although many of the theoretical and practical foundations of virtual reality (VR) were already researched and experienced in the 1980s, the vastly improved features of displays, sensors, interactivity, and computing power currently available in devices offer a new field of applications to the medical sector and also to urology in particular. The purpose of this review article is to review the extent to which VR technology has already influenced certain aspects of medicine, the applications that are currently in use in urology, and the future development trends that could be expected. PMID:27706017

  1. [Urology and Sexology in Berlin 1880-1933: Original citations for the establishment of this frontier of urology - protagonists as reflected in their publications].

    Science.gov (United States)

    Moll, Friedrich H; Fangerau, Heiner

    2016-02-01

    The connections between urology and sexology are often not obvious today. At the end of the 19th century both specialties developed in parallel especially in Berlin and had a fruitful relationship. Urologic journals and books were an ideal forum for publication especially for sexologists.

  2. Program directors' criteria for selection into urology residency.

    Science.gov (United States)

    Weissbart, Steven J; Stock, Jeffrey A; Wein, Alan J

    2015-04-01

    To investigate urology residency program directors' criteria for resident selection. In 2014, the urology residency program directors were surveyed using an email questionnaire. The generated questionnaire included the following 3 components: (1) assessing the factors used in selecting applicants for interviewing and matching, (2) rating the factors resulting in a negative decision for applicants for interviewing and matching, and (3) investigating the factors that gave applicants special attention or consideration from program directors. Analysis of variance testing and post hoc Student t tests were used to assess for differences in the mean importance score of the factors. Urology reference letters and United States Medical Licensing Examination (USMLE) scores were ranked as the most important factors for applicant selection. A USMLE Step 1 score ≤220 and a USMLE Step 2 score ≤220 were the most deleterious factors to applicants, with a previous match failure being no less deleterious to an applicant than a USMLE Step 1 or 2 score ≤220. Program directors gave special attention or consideration to gender (25%), minority status (36.8%), being from the same medical school as the program director (61.8%), completing an away rotation at the program director's institution (86.8%), being a child of an academic urologist (47.4%), and being a child of an academic nonurologic physician (15.8%). Although program directors consider a variety of factors during the residency selection process, USMLE performance, urology references, and completing an away rotation at the program directors' institution appear to be the most important factors to program directors during the residency selection process. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Use of a semiconductor-diode laser in urology

    Science.gov (United States)

    Watson, Graham M.

    1994-05-01

    The gallium arsenide semiconductor laser can emit in the near infrared where the depth of penetration into tissue is great although scattering is less than with the Nd:YAG laser. The laser is highly compact. It runs off a normal electrical outlet with no cooling requirement. It is therefore quiet and convenient. The laser has been assessed in a wide variety of applications in our urological department.

  4. The top 100 cited articles in urology: An update.

    Science.gov (United States)

    Nason, Gregory J; Tareen, Farhan; Mortell, Alan

    2013-01-01

    In this paper, we identify and analyze the top 100 cited articles in urology since 1965 and assess changes in the top 100 since 2007. We selected highest impact journals in both urological and general medicine journals from the 2011 edition of Journal Citation Reports: Science edition. We identified and analyzed the 100 most cited articles using the Science Citation Index Expanded (1965-present). The top 100 articles were cited a mean of 892 times (range: 529-2088) and published between 1966 and 2009, with 21 published since 2000. In 2012, 19 new articles appeared in the updated top 100 cited articles. Also, 16 journals were represented, led by the New England Journal of Medicine (n=36), the Journal of Urology (n=16) and the Lancet (n=12). In total, 81 articles were published from North America (USA=77, Canada=4). From the United States, the following institutes were among the top 5 represented: Johns Hopkins University (n=12), Harvard University, Memorial Sloan Kettering Cancer Centre, National Institute of Health and Washington University (all 5). Only one institute outside the United States published more than one article in the top 100 (Institut Gustave Roussy, France). Nine urologists were first authors of 2 or more articles. Oncology (n=54) and transplantation (n=22) were the most common subspecialties represented. It is important to acknowledge the top cited articles as they mark key topics and advances in urology. There has been a 19% change in the top 100 cited articles in the past 5 years. Oncology and transplantation remain the most highly cited topics.

  5. Global Burden of Urologic Cancers, 1990-2013.

    Science.gov (United States)

    Dy, Geolani W; Gore, John L; Forouzanfar, Mohammad H; Naghavi, Mohsen; Fitzmaurice, Christina

    2017-03-01

    Kidney, prostate, and bladder cancers increase with age and are influenced partly by modifiable risk factors. Urological cancer rates may increase substantially amid a growing, aging population. To describe kidney, bladder, and prostate cancer incidence, mortality, and risk factor-attributable bladder and kidney cancer deaths between 1990 and 2013, by age, sex, and development status. Cancer mortality data were derived from global vital registries. Incidence data from cancer registries were transformed to mortality estimates using separately estimated mortality incidence ratios. These sources served as input data for an ensemble modeling approach to estimate bladder, prostate, and kidney cancer mortality. Cause-specific mortality estimates were transformed into incidence estimates using mortality incidence ratios. In 2013, 2.1 million kidney, bladder, and prostate cancers cases occurred worldwide, increasing 2.5-fold since 1990. Mortality increased 1.6-fold between 1990 and 2013. Eight-two percent of new cases in 2013 occurred in individuals aged 60 yr and older. Men from developed countries had the highest age-standardized death rates among all three cancers. Smoking-attributable kidney cancer deaths decreased while obesity-related deaths rose, most prominently in women from developing countries. Smoking-related bladder cancer deaths increased among women from developed countries and decreased among men. Urologic cancer burden has increased globally amid population growth and aging. High income countries face the highest incidence and death rates; however, obesity-attributed kidney cancer deaths are increasing in developing countries. Efforts to expand the global oncologic workforce and reduce preventable factors may lessen cancer disparities in developing countries. We describe the impact of population growth, aging, and lifestyle factors such as smoking and obesity, on kidney, bladder, and prostate cancer rates worldwide. More new cancer cases and deaths occur

  6. Checkpoint inhibitors in the treatment of urological malignancies

    OpenAIRE

    Popovic, Lazar S; Matovina-Brko, Gorana; Popovic, Maja

    2017-01-01

    Checkpoint inhibitors are monoclonal antibodies attach to several different receptors on T-cells or tumour cells expressing receptors for cytotoxic T-lymphocyte antigen 4 (CTLA-4), programmed death-1 (PD-1) and their ligand (PD-L1). Since 2010, numerous trials on different tumour types have been conducted, which was resulted in these drugs being approved for the treatment of melanoma, lung cancer, Hodgkin's lymphoma and head and neck cancers. Urological cancers, especially urothelial and rena...

  7. The emerging use of Twitter by urological journals.

    Science.gov (United States)

    Nason, Gregory J; O'Kelly, Fardod; Kelly, Michael E; Phelan, Nigel; Manecksha, Rustom P; Lawrentschuk, Nathan; Murphy, Declan G

    2015-03-01

    To assess the emerging use of Twitter by urological journals. A search of the Journal of Citation Reports 2012 was performed to identify urological journals. These journals were then searched on Twitter.com. Each journal website was accessed for links to social media (SoMe). The number of 'tweets', followers and age of profile was determined. To evaluate the content, over a 6-month period (November 2013 to April 2014), all tweets were scrutinised on the journals Twitter profiles. To assess SoMe influence, the Klout score of each journal was also calculated. In all, 33 urological journals were identified. Eight (24.2%) had Twitter profiles. The mean (range) number of tweets and followers was 557 (19-1809) and 1845 (82-3692), respectively. The mean (range) age of the twitter profiles was 952 (314-1758) days with an average 0.88 tweets/day. A Twitter profile was associated with a higher mean impact factor of the journal (mean [sd] 3.588 [3.05] vs 1.78 [0.99], P = 0.013). Over a 6-month period, November 2013 to April 2014, the median (range) number of tweets per profile was 82 (2-415) and the median (range) number of articles linked to tweets was 73 (0-336). Of these 710 articles, 152 were Level 1 evidence-based articles, 101 Level 2, 278 Level 3 and 179 Level 4. The median (range) Klout score was 47 (19-58). The Klout scores of major journals did not exactly mirror their impact factors. SoMe is increasingly becoming an adjunct to traditional teaching methods, due to its convenient and user-friendly platform. Recently, many of the leading urological journals have used Twitter to highlight significant articles of interest to readers. © 2014 The Authors. BJU International © 2014 BJU International.

  8. A prospective audit of emergency urology activity in a university teaching hospital.

    Science.gov (United States)

    Redmond, E J; Forde, J C; Abdelrahman, M A; Kelly, N P; Akram, C; Giri, S K; Flood, H D

    2015-06-01

    Urology cover is commonly available out-of-hours in most teaching hospitals. However, increased pressure to reduce hospital expenditure has forced many institutions to consider removing middle grade cover outside of normal working hours. The aim of this study was to audit the emergency urology activity in our institution over a 12-month period. A prospective logbook was maintained for all urology referrals from the emergency department between August 2012 and March 2013. The diagnosis and patient outcome was recorded for each referral. The emergency theatre logbook was retrospectively evaluated for all emergency urology procedures carried out over the same time period. A basic cost analysis was performed to calculate the cost of providing the on-call service. A total of 752 patients were referred to the urology service over a 12-month period. The most common reasons for referral were renal colic and scrotal pain. Approximately 41 % of referrals were discharged directly from the emergency department. There were 167 emergency operations performed in total. The majority of emergency operations and referrals from the emergency department took place outside of normal working hours. A basic cost analysis revealed an associated cost saving of €58,120. Emergency urology activity constitutes a large proportion of the workload at our institution. Restricting emergency urology cover would limit essential training opportunities for urology trainees, increases length of stay and delay treatment of urological emergencies. Urology "out of hours" cover is a cost-efficient method of service provision.

  9. Prevalence of Proteinuria and Other Abnormalities in Urinalysis Performed in the Urology Clinic.

    Science.gov (United States)

    Bezinque, Adam; Noyes, Sabrina L; Kirmiz, Samer; Parker, Jessica; Dey, Sumi; Kahnoski, Richard J; Lane, Brian R

    2017-05-01

    To compare the prevalence of proteinuria in the urology clinic with other outpatient settings. Chronic kidney disease is classified according to cause, glomerular filtration rate, and proteinuria. Proteinuria may be more prevalent in patients with known chronic kidney disease, renal disorders (benign or malignant), or after urologic surgery. A cross-sectional study of 3 populations undergoing urinalysis (UA) testing was carried out: general outpatients (n = 20,334), urology outpatients (n = 5023), and kidney cancer patients (n = 1016). Proteinuria was classified under Kidney Disease: Improving Global Outcomes guidelines: A1 (300 mg). Proteinuria was detected throughout a community-based health system in 8.6% of UA (8.2%: A2; 0.4%: A3). In comparison, 18.6% of urology office-performed UA had proteinuria (16.0%: A2, 2.5%: A3) (P urology). Kidney cancer patients were more likely to have proteinuria (17.9%: A2, 3.8%: A3). The proportion with A3 was significantly higher in urology and kidney cancer patients when compared with other outpatients (each P urology patients (P urology clinic, including hematuria (20.9%), pyuria (21.8%), and bacteriuria (3.1%). The value of UA in the urology clinic as a screening test for proteinuria and other conditions appears high, with >56% having at least 1 abnormality. The population risk of proteinuria in the urology clinic is 18.5%, which is higher than that observed in non-urology clinics. Patients with kidney cancer appear more likely to have proteinuria than the average urology patient. We recommend evaluation of urology patients with UA to identify proteinuria. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Urological complications of renal transplant in patients with prolonged anuria.

    Science.gov (United States)

    Wu, Yi-Ju; Veale, Jeffrey L; Gritsch, Hans Albin

    2008-11-15

    Because of the shortage of deceased donor kidneys, some patients are on dialysis for over 10 years before renal transplantation. Many of these patients are anuric. We reviewed the urological complications in renal transplant recipients with anuria on hemodialysis for more than 10 years, compared with preemptive transplant recipients. The records of 4012 renal transplants from January 1988 to September 2007 were retrospectively reviewed. A total of 2735 deceased donor transplants were performed during this period. We identified a group of patients who were on hemodialysis for over 10 years and made less than 500 mL of urine per day. We compared the rate of urologic complications in this group with patients who were never on dialysis and had normal bladder function based on history and physical examination. Seventy-two patients met the strict inclusion criteria. There were 41 recipients in the anuric group and 31 recipients in the preemptive group. The surgical complications were not significantly different between the two groups (P=0.503). However, the anuric group required five more hospital admissions for complicated urinary tract infections (P=0.044). Renal transplant recipients who have been anuric for a prolonged period have higher rates of complicated urinary tract infections, but the long-term risks of urological complications are not significantly different.

  11. Manipulating the epigenome for the treatment of urological malignancies.

    LENUS (Irish Health Repository)

    O'Rourke, Colm J

    2013-05-01

    Urological malignancies (cancers of the prostate, bladder, kidney and testes) account for 15% of all human cancers and more than 500,000 deaths worldwide each year. This group of malignancies is spread across multiple generations, affecting the young (testicular) through middle and old-age (kidney, prostate and bladder). Like most human cancers, urological cancers are characterized by widespread epigenetic insult, causing changes in DNA hypermethylation and histone modifications leading to silencing of tumor suppressor genes and genomic instability. The inherent stability yet dynamic plasticity of the epigenome lends itself well to therapeutic manipulation. Epigenetic changes are amongst the earliest lesions to occur during carcinogenesis and are essentially reversible (unlike mutations). For this reason, much attention has been placed over the past two decades on deriving pharmacological compounds that can specifically target and reverse such epi-mutations, either halting cancer on its developmental trajectory or reverting fully formed cancers to a more clinically manageable state. This review discusses DNA methyltransferase and histone deacetylase inhibitors that have been extensively studied in preclinical models and clinical trials for advanced and metastatic urological cancers.

  12. The impact of rolling theatre closures on core urology training.

    Science.gov (United States)

    Good, D W; Khan, N; Kiely, E; Brady, C

    2013-05-01

    Since 2008, government funding of the Health Service Executive (HSE) has decreased significantly. Our hospital, Cork University Hospital (CUH), implemented "cost saving" measures including scheduled operating theatre closures. We studied their affect on urological surgical activity at the hospital. A retrospective review was performed using theatre log books and theatre records to determine the number, type and training status of procedures performed for years 2009 and 2011. Scheduled theatre closures in 2011 resulted in 33 more theatre session cancelations compared to 2009. There was a reduction in the total number of procedures performed from 555 cases in 2009 to 443 in 2011 a 20.2(%) reduction. The number of "training" cases reduced from 325 (58.9%) in 2009 to 216 (48.7%) in 2011 a 10.2% reduction (Table 2). Eight out of the nine "core urology training" procedures reduced in number from 2009 to 2011 (Table 1). We have shown that scheduled theatre closures have reduced the number of procedures performed and have impacted on urology training. Scheduled theatre closures are expected to become more frequent in the future. Potential solutions to lessen the impact include providing simulation training using the Royal College of Surgeons in Ireland (RCSI) mobile skills unit during these theatre closures.

  13. Robot-assisted urological surgery: Current status and future perspectives.

    Science.gov (United States)

    Ghani, Khurshid R; Trinh, Quoc-Dien; Sammon, Jesse; Jeong, Wooju; Dabaja, Ali; Menon, Mani

    2012-03-01

    To discuss the current status of robot-assisted urological surgery. We searched PubMed for articles published from 2008 using the search terms 'advances', 'robotic surgery equipment' and 'instrumentation'. We also searched PubMed for articles describing the latest developments in reconstructive techniques for lower and upper urinary tract procedures. Finally, we searched PubMed for original articles containing the terms 'robotic surgery training' and 'credentialing'. With each release of hardware or ancillary instrumentation, the reconstructive abilities of the da Vinci surgical system (Intuitive Surgical, Sunnyvale, CA, USA) improve. Recent developments in reconstructive capabilities of robotic urological surgery include posterior reconstruction during robot-assisted radical prostatectomy, barbed sutures for urethrovesical anastomosis, sliding-clip renorrhaphy for robot-assisted partial nephrectomy, and repair of pelvic organ prolapse. The safe implementation of robotic surgery is aided by new guidelines in credentialing and proctoring, and the introduction of virtual reality simulators for training. Robotic urological surgery is rapidly developing and expanding globally. To achieve the highest levels of safety for patients, surgeons must ensure that the implementation of robotic surgery is an integrative and effective process.

  14. [Investigating Demodex folliculorum in patients with urological cancer].

    Science.gov (United States)

    Inci, Mehmet; Kaya, Ozlem Aycan; Inci, Melek; Yula, Erkan; Gökçe, Hasan; Rifaioğlu, M Murat; Demirtaş, Onur; Yengil, Erhan

    2012-01-01

    In this study, it was aimed to determine frequency of Demodex folliculorum infestation in patients with urological cancers. This study evaluated 49 patients with urological cancers; 31 sex-matched healthy individuals as a control group were included in the study between March 2011 and April 2012 at the Hospital of Mustafa Kemal University, School of Medicine, Urology Clinic. The demographic characteristics of the patients were recorded. Samples from the perineal region of the subjects were taken by standard method of superficial skin biopsy and evaluated by microscopy. Presence of five or more Demodex sp. in a cm 2 was considered as positive. Mean age was found to be 60.2±18.6 years. D. folliculorum was found to be positive in 11 (22.4%) of the patients with cancer and in 1 (3.2%) of the subjects in the control group. It was found that D. folliculorum frequency was significantly higher in the cancer group compared to the control group. No significant difference was found among the cancer groups in terms of D. folliculorum detection. In the cancer group, mean age was significantly higher in D. folliculorum positive patients than negative ones. It should be kept in mind that D. folliculorum incidence may increase in immunosuppressive states, such as cancer.

  15. Malfunction of the da Vinci robotic system in urology.

    Science.gov (United States)

    Chen, Cheng-Che; Ou, Yen-Chuan; Yang, Cheng-Kuang; Chiu, Kun-Yuan; Wang, Shian-Shiang; Su, Chung-Kuang; Ho, Hao-Chung; Cheng, Chen-Li; Chen, Chuan-Shu; Lee, Jian-Ri; Chen, Wen-Min

    2012-08-01

    To analyze the incidence of malfunction of the da Vinci robotic system in a single center and to provide potential solutions. A total of 400 patients underwent da Vinci robotic urological surgery at Taichung Veterans General Hospital in Taichung, Taiwan, from December 2005 to April 2011. Episodes of malfunction of the robotic system were analyzed by period of operation, type of procedure, type of malfunction and management of the event. Overall, 14 cases of malfunction occurred (3.5% of the entire series). Among them, five (1.25%) occurred before the surgery and nine (2.25%) intraoperatively. Operative procedures included radical prostatectomy, bilateral pelvic lymph node dissection, dismembered pyeloplasty, partial nephrectomy, nephroureterectomy, and radical and partial cystectomies. Areas of malfunctions included the robotic arm system and joint (11/14), optical system (1/14), power system and connector (1/14), endoscopic instrument (1/14), and software (1/14). In 10 cases, the failure was recoverable, whereas in four cases there was a critical failure, requiring a conversion to standard laparoscopy in three of them, and the rescheduling of the surgery in one case. The da Vinci robotic system is extremely reliable for use in urology. Malfunction is rare and the risk of critical failure is very low. Managing mechanical failure before or during the surgery is the key to maintaining the safety of patients undergoing robotic surgical procedures. © 2012 The Japanese Urological Association.

  16. [Transparency regime: semiotics of radiographical images in urological diagnostics].

    Science.gov (United States)

    Martin, M; Fangerau, H

    2012-10-01

    Shortly after Röntgen discovered x-rays urology became one of the main test fields for the application of this new technology. Initial scepticism among physicians, who were inclined to cling to traditional manual methods of diagnosing, was replaced by enthusiasm for radiographic technologies and the new method soon became the standard in, for example the diagnosis of concrements. Patients favoring radiographic procedures over the use of probes and a convincing documentation of stones in radiograms were factors that impacted the relatively rapid integration of radiology into urology. The radiographic representation of soft tissues and body cavities was more difficult and the development of contrast agents in particular posed a serious problem. Several patients died during this research. A new diagnostic dimension was revealed when radiography and cystography were combined to form the method of retrograde pyelography. However, the problem of how urologists could learn how to read the new images remained. In order to allow trainee physicians to practice interpreting radiograms atlases were produced which offered explanatory texts and drawings for radiographic images of the kidneys, the bladder etc. Thus, urologists developed a self-contained semiotics which facilitated the appropriation of a unique urological radiographical gaze.

  17. Recent advances in robotic surgery in female urology.

    Science.gov (United States)

    Sung, Hyun Hwan; Park, Bong Hee; Ryu, Dong Soo; Lee, Kyu Sung

    2013-12-01

    Pelvic organ prolapse and lower urinary tract fistulas are two disorders frequently managed in female urology. New techniques have been adapted and improved to decrease morbidity and improve clinical outcomes of these disorders. The adaptation of minimally-invasive approaches for the management of pelvic organ prolapse and lower urinary tract fistulas began with laparoscopy. However, laparoscopic surgery has not gained widespread popularity as a result of the associated technical challenges, such as intracorporeal suturing and pelvic dissection. Robotic surgery has been widely carried out in urological oncology since 2001, and has been widely adapted because of its advantages over conventional laparoscopy for the management of pelvic organ prolapse and lower urinary tract fistulas. The current literature has shown the safety, feasibility and favorable clinical outcomes of robotic surgery for the treatment of these disorders. Robotic surgery in the management of pelvic organ prolapse and lower urinary tract fistula repairs might offer a promising advancement and benefits. However, further long-term data should be followed to assess the durability of this newer, and minimally-invasive approach. © 2013 The Japanese Urological Association.

  18. [Urological comorbidities in patients with rheumatoid arthritis : literature review].

    Science.gov (United States)

    Friedl, A; Mustak, M; Höltl, W; Erlacher, L

    2013-11-01

    Patients with rheumatoid arthritis (RA) have an increased risk of urolithiasis which is further negatively impacted by a reduced bone density. Interstitial cystitis also tends to occur more often in patients with rheumatic diseases. The high incidence of bacterial urogenital infections is influenced by the use of immunomodulating drugs. Many RA patients have to undergo numerous tests until a diagnosis is reached and are then treated as outpatients on a tightly controlled schedule. Despite a closely controlled rheumatological follow-up, urological screening and determination of a baseline prostate-specific antigen (PSA) value (in men over 45 years old) should not be neglected. In patients with an increased risk of renal and bladder neoplasms or when such a diagnosis is known, the benefit of long-term use of high doses of non-steroidal anti-inflammatory drugs (NSAID, aspirin type) should be carefully weighed up with a risk profile and after specialist urological assessment. Patients who suffer from sexual dysfunction due to physical limitations and prolonged medical therapy should undergo urological and gynecological assessment to exclude contributing causes. The use of aphrodisiacs and erection-enhancing drugs (e.g. PDE5 inhibitors, local injection with prostaglandins and vacuum therapy) require prior approval by a medical specialist and also cardiovascular stability. Acute urinary retention is more common in chronic inflammatory musculoskeletal diseases.

  19. Non-Traumatic Urologic Emergencies in Men: A Clinical Review

    Directory of Open Access Journals (Sweden)

    Kessler, Chad S

    2009-11-01

    Full Text Available Although true urologic emergencies are extremely rare, they are a vital part of any emergency physician’s (EP knowledge base, as delays in treatment lead to permanent damage. The four urologic emergencies discussed are priapism, paraphimosis, testicular torsion, and Fournier’s gangrene. An overview is given for each, including causes, pathophysiology, diagnosis, treatment, and new developments. The focus for priapism is on diagnosis and distinguishing high-flow from low-flow forms, as the latter requires emergent treatment. For paraphimosis, we describe various methods of relieving the stricture, from manual reduction to surgery in extreme cases. For testicular torsion, the most important factor in salvaging the testicle is decreasing time to treatment. This is accomplished through experience and understanding which signs and symptoms strongly suggest it, so that time-consuming tests are avoided. Lastly, Fournier’s gangrene is potentially fatal. While aggressive medical and surgical therapy will improve chances of survival and outcome, it is vital for the emergency department (ED physician to diagnose Fournier’s. It often presents in the elderly, immunocompromised, or those with depressed mental status. The goal of this paper is to arm EPs with information to recognize urological emergencies and intervene quickly to preserve tissue, fertility, and life.[West J Emerg Med. 2009;10(4:281-287.

  20. [Hydronephrosis in pregnancy: importance of urologic actions and their volume].

    Science.gov (United States)

    Micelyte, Stase; Glinskis, Gintaras; Cekauskas, Zenonas; Dasevicius, Voldemaras

    2002-01-01

    In the present study, the data from 216 women with a complicated hydronephrosis of pregnancy who were treated at the Urology Department of the Vilnius City University Hospital between 1992 and 2001 have been subjected by us to a retrospective analysis and to an evaluation of the need for an interventional treatment and of the volume of the latter in the light of the special literature of the last decade of the XX(th) century. Both urologic observation and urologic management are required in the pregnancy hydronephrosis complicated by strong flank pains due to an acute dilatation of the upper urinary tract or by urolithiasis or pyelonephritis. An ultrasonographic investigation is the diagnostic mean of choice. The conservative management (hydration, spasmoanalgetics and antibiotics) gave positive results in 57% of cases, the retrograde stenting of the ureters was carried out in 41% of cases and the percutaneous or open nephrostomy (performed in 3 and 1 patients, correspondingly) in 2% of cases. During the management of the patients with a complicated hydronephrosis of pregnancy, the interdiscipline training of urologists and obstetricians-gynecologists as well as their close collaboration are of decisive importance.

  1. Zoogeografia storica e attuale dei carnivori e degli ungulati italiani

    Directory of Open Access Journals (Sweden)

    Marco Masseti

    2003-10-01

    Full Text Available Come per la maggior parte degli altri paesi europei, anche l'attuale composizione delle specie a mammiferi italiane si prefigura in gran parte come il risultato della plurima e prolungata azione antropica condotta sull'ambiente naturale. Questa, avviatasi alcuni millenni or sono, condiziona oggi più che mai la ridefinizione degli equilibri ecologici del nostro Paese. All'interno dell'attuale teriofauna terrestre italiana viene segnalata la presenza di 18 specie di carnivori e di 9 artiodattili, che può rivelarsi in alcuni casi come il risultato di acclimatazioni e/o naturalizzazioni di specie esotiche avvenute in cronologie diverse, anche di epoca molto recente. All'interno dei confini biogeografici dell'Italia andrebbero anche annoverate quelle popolazioni del cervo pomellato medio-orientale, Axis axis (Erxleben, 1777, che sono state naturalizzate in epoca storica assai recente in Istria ed in alcune isole del golfo del Quarnaro (Brioni Maggiore, Cherso e Plauno. Considerazioni analoghe potrebbero forse essere condotte anche per la diffusione artificiale di Herpestes auropunctatus Hodgson, 1836, su alcune isole della Croazia. Le specie fitofaghe riferibili ai gruppi tassonomici dei lagomorfi e degli artiodattili, e che vengono convenzionalmente comprese nella categoria della cosiddetta "selvaggina", sono tra quelle che hanno più subito un'alterazione condotta in profondità dei quadri faunistici originari, proprio in virtù dell'interesse economico e culturale che ancora rappresentano. Nel caso particolare di queste specie di interesse venatorio ci troviamo quasi sempre di fronte a popolazioni che sono state sottoposte ad intensa gestione e che hanno subito frequenti estinzioni locali seguite da reiterate reintroduzioni. Attualmente, data l'espansione sia naturale che artificiale degli ecotipi indigeni e di quelli alloctoni, si osserva ormai una sovrapposizione degli areali, per cui sembra piuttosto difficile riuscire in

  2. [Urological moulages: forgotten three-dimensional documents between university collections and panopticum -- a dying presentation form even in urological museology].

    Science.gov (United States)

    Moll, F H; Görgen, A; Fangerau, H

    2013-08-01

    The use of wax models traces its roots back to antiquity and appears to have reached the peak of perfection in the eighteenth century especially in Italy. From the beginning of the nineteenth century wax models and moulages were used in the new medical specialties, such as dermatology or urology depending on a new model of visualization in natural sciences. The moulage passed from local use into international acceptance with the institutionalization of the medical specialties and increase in scientific communication in the second half of the nineteenth century. By the 1970s moulages had all but lost their pre-eminent position as teaching and visual aids to depict dermatological and venereal diseases Unfortunately urology was not mentioned in the field of history of medicine or ethnic studies.

  3. Extracellular Vesicles and Their Role in Urologic Malignancies.

    Science.gov (United States)

    Junker, Kerstin; Heinzelmann, Joana; Beckham, Carla; Ochiya, Takahiro; Jenster, Guido

    2016-08-01

    Research has increased significantly on small vesicles secreted by healthy and diseased cells. Recent discoveries have revealed their functional and biomarker roles in urologic diseases. Whether and how this knowledge of extracellular vesicles (EVs) affects translational research and clinical practices have become pertinent questions. To provide an overview of the currently available literature on the rising field of EVs, focusing on function and pathogenesis in urologic cancers and the usefulness of EVs as biomarkers. A systematic literature search was conducted using PubMed to identify original articles, review articles, and editorials regarding EVs in different types of urologic tumor diseases. Articles published between 2005 and 2015 were reviewed and selected with the consensus of all authors. Besides soluble factors, different types of EVs are involved in the complex cross talk between different cell types. EVs regulate normal physiologic processes like spermatogenesis and renal function, as well as disease-specific processes including bladder, kidney, and prostate cancer. The content of EVs is derived from the cytoplasm of the donor cell. The proteins and RNAs within these EVs can be isolated from body fluids (eg, urine and blood) and represent potential diagnostic and prognostic biomarkers. EVs are also candidate therapeutic targets and potentially useful as therapeutic vehicles. The current data suggest that EVs are important regulators of cell-cell communication. The growing knowledge about their roles in urologic malignancies provides the basis for novel therapeutic strategies. In addition, nucleic acid and the protein content of EVs holds promise for the discovery of urine- or serum-based biomarkers for kidney, bladder, and prostate cancer. Normal and cancer cells secrete small vesicles that contain proteins and RNAs from the cell of origin. Changes in the diseased cells can be detected by examining the altered content of these vesicles when secreted in

  4. Current opinions regarding care of the mature pediatric urology patient.

    Science.gov (United States)

    Szymanski, K M; Misseri, R; Whittam, B; Large, T; Cain, M P

    2015-10-01

    With continued improvements in pediatric urology care of patients with complex congenital genitourinary conditions, many survive into adulthood. This fact has created a challenging situation of transitioning from pediatric to adult care. Establishing long-term follow-up with appropriate specialists is a critical part of a successful transition to adulthood for this population. This study sought to elucidate current practices and opinions regarding the management of adult complex genitourinary patients by pediatric urologists, in order to determine if a consensus for adult care exists. An anonymous, 15-question online survey was created to address practice patterns and opinions regarding the transition of care of complex genitourinary patients. An invitation to participate was distributed via email to 200 pediatric urologists who were members of the American Urological Association. Complex genitourinary patients were defined broadly as those with a history of: spina bifida, bladder exstrophy, cloacal exstrophy, cloacal anomalies, posterior urethral valves or disorders of sex development. Fisher's exact test was used for analysis. The response rate was 31.0% (62/200). Two-thirds (67.7%) cared for adults with complex genitourinary conditions. Overall, 51.6% of pediatric urologists felt that general urologists best follow adult patients, but only 6.5% recommended this for patients with prior complex genitourinary reconstruction (P urology who routinely performs such procedures would provide optimal care. Follow-up by a primary care physician alone was not recommended. Recommendations did not change if patients had developmental delay or lived independently (P = 0.47 and P = 0.72, respectively). Overall, 69.4% would refer mature complex genitourinary patients to a urologist with interest and training in adolescent/transitional urology, if one was available. However, only 45.2% had such an individual available in their practice (P urology community, responses from

  5. Environmental oil spill sensitivity atlas for the West Greenland (68 deg.-72 deg. N) coastal zone, 2nd revised edition

    Energy Technology Data Exchange (ETDEWEB)

    Clausen, D.; Johansen, Kasper L.; Mosbech, A.; Boertmann, D.; Wegeberg, S.

    2012-12-15

    This oil spill sensitivity atlas covers the shoreline and the offshore areas of West Greenland between 68 deg. N and 72 deg. N. The coastal zone is divided into 199 shoreline segments and the offshore zone into 8 areas. A sensitivity index value is calculated for each segment/area, and each segment/area is subsequently ranked according to four degrees of sensitivity. Besides this general ranking a number of smaller areas are especially selected as they are of particular significance, they are especially vulnerable to oil spills and they have a size making oil spill response possible. The shoreline sensitivity ranking are shown on 37 maps (in scale 1:250,000), which also show the different elements included and the selected areas. Coast types, logistics and proposed response methods along the coasts are shown on another 37 maps. The sensitivities of the offshore zones are depicted on 4 maps, one for each season. Based on all the information, appropriate oil spill response methods have been assessed for each area. (Author)

  6. A survey of women urology residents regarding career choice and practice challenges.

    Science.gov (United States)

    Jackson, Imani; Bobbin, Mark; Jordan, Mark; Baker, Stephen

    2009-11-01

    To determine the reasons why urology has become an increasingly popular career choice for women medical students and to uncover challenges they face during their training period. A mailed survey was sent to all 176 female urology residents. Fifty-five surveys were received, for a return rate of 31%. General surgery was the most common alternative specialty choice considered by female urology trainees, although there was wide representation from other disciplines. Diversity of procedures was the most frequently cited reason for choosing urology. The majority of respondents interested in fellowships expect to seek training in pediatric or female/reconstructive urology. More than half of these residents have been confronted with negative behavior by male patients and by male colleagues in relation to their gender. Understanding the perspectives, concerns, and predilections of women urology applicants and trainees is essential to maximize the contributions women will make to the specialty and its patients.

  7. Expert Involvement Predicts mHealth App Downloads: Multivariate Regression Analysis of Urology Apps

    OpenAIRE

    Pereira-Azevedo, Nuno; Os?rio, Lu?s; Cavadas, Vitor; Fraga, Avelino; Carrasquinho, Eduardo; Cardoso de Oliveira, Eduardo; Castelo-Branco, Miguel; Roobol, Monique J.

    2016-01-01

    Background Urological mobile medical (mHealth) apps are gaining popularity with both clinicians and patients. mHealth is a rapidly evolving and heterogeneous field, with some urology apps being downloaded over 10,000 times and others not at all. The factors that contribute to medical app downloads have yet to be identified, including the hypothetical influence of expert involvement in app development. Objective The objective of our study was to identify predictors of the number of urology app...

  8. Trends in matching to urology residency in Canada: are we becoming noncompetitive?

    Science.gov (United States)

    Melnyk, Megan; Nelson, Hilary; Mickelson, Jennifer; Macneily, Andrew E

    2013-01-01

    Urology is perceived as a competitive specialty choice. Declining undergraduate exposure and the preference for "lifestyle specialties" may jeopardize urology's popularity. Our objective was to assess trends in application and matching rates to urology compared with other surgical specialties. We reviewed data collected by Canadian Residency Matching Service (CaRMS) and the Canadian Post-MD Education Registry since expansion in Canadian medical school enrollment began (2002-2011). The following were examined: applicant preference, number of positions, gender patterns, and match results. "Surgery" included general surgery, orthopedics, plastics, ENT, and urology. From 2002 to 2011 CaRMS applicants increased from 1117 to 2528 (126%). The number of applicants selecting surgery first increased from 178 to 338(90%). The number of surgery positions increased from 138 to 275 (100%). Urology positions increased from 15 to 31 (113%). Applicants to urology increased only 40% (30-42). The proportion of all CARMs applicants selecting urology as their first choice decreased from 2.7% (30) to 1.7% (42). The ratio of first choice urology applicants to positions decreased from 2 to 1.35. The probability of matching urology as first choice increased from 50% to 76%. Female medical graduates increased from 51% to 58%. The female applicants selecting surgery first increased from 21% (49) to 41% (173). In contrast, females selecting urology first rose from 13% (4) to 17% (7). Urology in Canada is becoming less competitive. Residency positions have doubled since 2002 whereas the number of applicants remains static. This trend was not reflected in other surgical specialities. Factors accounting for this may include poor undergraduate exposure, demand for specialties with controllable lifestyles, gender shifts in undergraduate medicine, and lack of role models. The need for undergraduate exposure to urology and vetting numbers of residency positions remains a matter of paramount

  9. The Gatekeeper Disparity: Why Do Some Medical Schools Send More Medical Students into Urology?

    Science.gov (United States)

    Kutikov, Alexander; Bonslaver, Jason; Casey, Jessica T.; Degrado, Justin; Dusseault, Beau N.; Fox, Janelle A.; Lashley-Rogers, Desri; Richardson, Ingride; Smaldone, Marc C.; Steinberg, Peter L.; Trivedi, Deep B.; Routh, Jonathan C.

    2010-01-01

    Introduction Urology continues to be a highly desirable specialty, despite decreasing exposure of students to Urology in U.S. medical schools. In this study, we set out to assess how U.S. medical schools compare to one another with regard to the number of students that each sends into Urological training and to evaluate the reasons why some medical schools consistently send more students into urology than others. Materials and Methods The authors obtained AUA Match data for the 5 Match seasons from 2005–2009. A survey of all successful participants was then performed. The survey instrument was designed to determine what aspects of the medical school experience influenced students to choose to specialize in Urology. A bivariate and multivariate analysis was then performed to assess which factors correlated with more students entering Urology from a particular medical school. Results Between 2005 and 2009, 1,149 medical students from 130 medical schools successfully participated in the Urology match. Of the 132 allopathic medical schools, 128 sent at least 1 student into Urology (mean 8.9, median 8, SD 6.5). A handful of medical schools were remarkable outliers, sending significantly more students into Urology than other institutions. Multivariate analysis revealed that a number of medical-school related variables including strong mentorship, medical school ranking, and medical school size correlated with more medical students entering Urology. Conclusion Some medical schools launch more Urologic careers than others. Although reasons for these findings are multifactorial, recruitment of Urologic talent pivots on these realities. PMID:21168862

  10. Michel de Montaigne. Per una lettura degli Essais

    Directory of Open Access Journals (Sweden)

    Giovanni Bottiroli

    2012-12-01

    Full Text Available Si riflette sullo stile di pensiero degli Essais, in cui, come afferma lo stesso Montaigne «vi è gran libertà di parlare in ogni senso, e pro e contro». Si rileva la capacità del pensatore di conferire un nuovo significato a termini tradizionali, recuperati in accezioni inedite. Emerge per esempio una nozione di forma che sa includere il molteplice senza irrigidirlo nell‟Uno. Ciò che Montaigne ri-fiuta è la concezione tradizionale di forma come essenza rigida, come insieme di tratti o di proprietà; l‟identità del soggetto umano – l‟ humaine condition – è invece una condizione flessibile, cioè aperta a destini divergenti. Il pensiero di Montaigne si può interpretare dunque come un pensiero della flessibilità.

  11. LA FORMAZIONE DEGLI ETNICI NELLA RIFLESSIONE LINGUISTICA DI FRANCESCO CHERUBINI

    Directory of Open Access Journals (Sweden)

    Federica Guerini

    2016-09-01

    Full Text Available Il presente contributo si propone di fornire una descrizione della struttura del Vocabolario Patronimico di Francesco Cherubini e delle fonti empiriche consultate per la sua compilazione. Si accennerà poi a due questioni ricorrenti nel dibattito sulla formazione degli etnici in italiano, ovvero, la presenza di varianti allomorfiche o suppletive, e la motivazione morfo-pragmatica sottesa all’impiego di alcuni suffissi derivativi nella formazione di etnici e aggettivi deonomastici, cercando di chiarire quale attenzione tali tematiche abbiano ricevuto nella riflessione linguistica di Francesco Cherubini. Si formuleranno infine alcune osservazioni conclusive, evidenziando luci ed ombre del Vocabolario Patronimico e sottolineando alcuni degli spunti che tale opera ancora può offrire agli studiosi contemporanei. The formation of ethnic words in Francesco Cherubini’s reflection on language  The aim of this paper is to describe the structure and contents of Francesco Cherubini’s Vocabolario Patronimico, as well as the empirical sources consulted for its compilation. We will address two of the most common issues in the debate on the formation of ethnic nouns and adjectives in Italian, namely the existence of allomorphs and supplementary variants, and the morpho-pragmatic motivation displayed by some of the derivative suffixes occurring in ethnic nouns and adjectives derived from both personal and place names. We will offer a few observations on the place occupied by the above-mentioned issues in Cherubini’s thought and, by analyzing the strengths and weaknesses of the Vocabolario Patronimico, we will draw attention to a few topics which may be of some interest to contemporary scholars.

  12. What every graduating medical student should know about urology: the stakeholder viewpoint.

    Science.gov (United States)

    Kerfoot, B Price; Turek, Paul J

    2008-04-01

    What should every medical student know about urology upon graduating from medical school? To answer this question, we conducted a survey of key stakeholders in an effective medical student education in urology. Directors of the generalist residencies in the United States (emergency medicine, family medicine, internal medicine, and pediatrics), directors of urology residencies, medical student educators in urology, and applicants to the 2006 urology residency match were invited to complete an online survey. Participants were asked to select the 5 most important topics to be included in a core urology curriculum for all medical students. Among 1859 stakeholders surveyed, response rates by stakeholder cohort ranged from 67% to 26% (overall 44%). There was marked homogeneity among participant groups as to what respondents considered to be the most important topics for a core urology curriculum for medical students. Based on aggregate data, the 8 most commonly cited topics included urinary stone disease (75% of respondents), hematuria (65%), urinary tract infections in adults (53%), benign prostatic hyperplasia (52%), urinary incontinence (45%), prostate cancer (45%), screening with prostate-specific antigen (33%), and testis torsion (24%). This survey has identified the most important urology topics about which medical students should learn before graduation. Work is currently under way under the aegis of the American Urological Association to develop materials to standardize student education in these core topics across the United States.

  13. Perception, career choice and self-efficacy of UK medical students and junior doctors in urology

    Science.gov (United States)

    Jones, Patrick; Rai, Bhavan Prasad; Qazi, Hasan A.R.; Somani, Bhaskar K.; Nabi, Ghulam

    2015-01-01

    Introduction: There is a growing concern about the reduced clinical exposure to urology at undergraduate level in the United Kingdom. As a consequence, the competencies of junior doctors are considered inadequate. The views of these doctors in training towards urology remain under reported. Methods: A modified Delphi method was employed to construct a questionnaire. Given the rise of social media as a platform for scientific discussion, participants were recruited via a social networking site. Outcomes assessed included career preference, exposure to urology, perceived male dominance, and confidence at core procedures. Results: In total, 412 and 66 responses were collected from medical students and junior doctors, respectively. Overall, 41% of participants felt that they had received a good level of clinical exposure to urology as part of their training and 15% were considering a career in this speciality. Female students were significantly less likely to consider urology as a career option (p urology as a male-dominated speciality. Conclusions: Urology is perceived as male dominated and is the least likely surgical speciality to be pursued as a career option according to our survey. Increased exposure to urology at the undergraduate level and dedicated workshops for core urological procedures are needed to address these challenges. PMID:26425216

  14. [Ways of improving preparing research and teaching personnel and clinicians in urology in the Russian Federation].

    Science.gov (United States)

    Lopatkin, N A; Ianenko, E K; Kul'ga, L G

    2002-01-01

    The article covers basic principles of urologists' and researchers' training for state healthcare system. The role of a student research group in proper students selection for further special education in urology is pointed out. The article contains a plan of training in clinical residency including theoretical basis of urology and allied fields, diagnostic tools and practical skills, especially in urgent cases. The principles of postgraduate research personnel training in the field of urology are highlighted also. Special attention is paid to regional specialists training. The residents in surgery are preferred for further training in urology.

  15. Pain management practice patterns for common pediatric urology procedures.

    Science.gov (United States)

    Morrison, Kasey; Herbst, Katherine; Corbett, Sean; Herndon, C D Anthony

    2014-01-01

    To characterize practice patterns among members of the Society for Pediatric Urology. A survey instrument assessing pain management was e-mailed to all members of the Society for Pediatric Urology. Five hundred fifteen invitations were sent, 134 were included, for a 26% response rate. Pain management strategies were assessed for 7 case scenarios. Surveys were included if the responder answered a minimum of 2 case scenarios. Question Pro survey engine was used to process the survey. Local/regional block was the most frequent intraoperative anesthesia (54%-90%). Epidural/caudal use varied from 19% to 42%. For postop opioids, a dichotomy exists between those without age restriction and those who wait until the patient is 6 months old. Sixty three percent responded that ketorolac was prescribed only if the patient had normal renal function, 20% after confirmation of adequate urine output for bilateral procedures, 3% when postoperative creatinine was normal, and 14% did not use ketorolac at all. In regards to age limitations, most did not indicate a limit (53%), whereas a large number required the child to be older than 6 months (26%). Regarding local blocks, most urologists perform the block themselves (61%) for simple/complex penile surgery or inguinal surgery. Of this group, only 33% actually bill for the administration of the block. After a caudal block, a minority (26%) of respondents require the patient to void before discharge for ambulatory procedures. There is no clear consensus in pain management for common pediatric urologic procedures. These disparities should be the aim of future studies. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Adverse events resulting from lasers used in urology.

    Science.gov (United States)

    Althunayan, Abdulaziz M; Elkoushy, Mohamed A; Elhilali, Mostafa M; Andonian, Sero

    2014-02-01

    To collate world reports of adverse events (AEs) resulting from lasers used in urology. The Manufacturer and User Facility Device Experience (MAUDE) database of the United States Food and Drug Administration (FDA) was searched using the term "Laser for gastro-urology use." In addition, the Rockwell Laser Industries (RLI) Laser Accident Database was searched for the following types of lasers: neodymium-doped yttrium aluminum garnet (Nd:YAG), holmium:yttrium aluminum garnet (Ho:YAG), potassium titanyl phosphate (KTP), diode and thulium:YAG (Tm:YAG). Both databases were last accessed on October 1, 2012. Overall, there were 433 AEs; 166 in MAUDE database (1992-2012) and 267 in RLI database (1964-2005). Most of the AEs (198/433 or 46%) resulted from generator failure or fiber tip breaking. Whereas there were 20 (4.6%) AEs harming medical operators, there were 159 (37%) AEs harming nonmedical operators using Nd:YAG, KTP, and diode lasers. Eye injuries ranging from mild corneal abrasions to total vision loss were reported in 164 AEs with the use of Nd:YAG, KTP, and diode lasers. Overall, there were 36 (8.3%) AEs resulting in patient harm, including 7 (1.6%) mortalities, 3 deaths from ureteral perforation using the Ho:YAG laser, and 4 deaths from air emboli using the Nd:YAG laser. Other reported patient injuries included bladder perforation resulting in urinary diversion in a patient, in addition to minor skin burns, internal burns, and bleeding in others. There were no AEs reported with the use of Tm:YAG laser. Most of the AEs reported relate to equipment failure. There were no eye injuries reported with the use of Ho:YAG lasers. Caution must be exercised when using lasers in urology, including wearing appropriate eye protection when using Nd:YAG, KTP, and diode lasers.

  17. Risk factors for persistent pain after urological surgery.

    Science.gov (United States)

    Artus, M; Laviolle, B; Maurice, A; Malledant, Y; Beloeil, H

    2014-05-01

    Ten to 50% of patients with post-surgical pain develop chronic pain depending on the type of surgery. The objective of this study was to assess the incidence of persistent post-surgical pain (PPSP) and to identify risk factors following urology surgery. Retrospective observational study. Two hundred and twenty-eight patients scheduled for urology surgery. Reasons for non-inclusions: patients who underwent a procedure not defined as being associated with PPSP. Surgical urologic procedures potentially associated with PPSP were defined. All patients who had one of these procedures during the study period received a questionnaire by mail at least 3 months after the surgery. The files of these patients were retrospectively studied. Eight percent of the patients had preoperative pain. PPSP, assessed approximately 6 months after the surgery, was reported by 24% of the patients. Twenty-five (36%) of them reported neuropathic pain. Patients with PPSP had significantly more preoperative pain and an increased postoperative morphine consumption. Postoperative NSAID administration led to less persistent pain. Multivariate logistic regression analysis identified two independent risk factors of developing persistent pain: preoperative pain (OR=21.6, 95% CI 6.7-69.5, P<0.0001), morphine consumption 48 hours after surgery higher than 6mg (OR=2.3, 95% CI 1.2-4.3, P=0.0118). These findings confirm the role of preoperative pain and morphine consumption in the genesis of PPSP and call for establishing clinical perioperative pathways tailored to the patient. Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  18. Urological surgery and antiplatelet drugs after cardiac and cerebrovascular accidents.

    Science.gov (United States)

    Eberli, Daniel; Chassot, Pierre-Guy; Sulser, Tullio; Samama, Charles Marc; Mantz, Jean; Delabays, Alain; Spahn, Donat R

    2010-06-01

    The perioperative treatment of patients on dual antiplatelet therapy after myocardial infarction, cerebrovascular event or coronary stent implantation represents an increasingly frequent issue for urologists and anesthesiologists. We assess the current scientific evidence and propose strategies concerning treatment of these patients. A MEDLINE and PubMed search was conducted for articles related to antiplatelet therapy after myocardial infarction, coronary stents and cerebrovascular events, as well as the use of aspirin and/or clopidogrel in the context of surgery. Early discontinuation of antiplatelet therapy for secondary prevention is associated with a high risk of coronary thrombosis, which is further increased by the hypercoagulable state induced by surgery. Aspirin has recently been recommended as a lifelong therapy. Clopidogrel is mandatory for 6 weeks after myocardial infarction and bare metal stents, and for 12 months after drug-eluting stents. Surgery must be postponed beyond these waiting periods or performed with patients receiving dual antiplatelet therapy because withdrawal therapy increases 5 to 10 times the risk of postoperative myocardial infarction, stent thrombosis or death. The shorter the waiting period between revascularization and surgery the greater the risk of adverse cardiac events. The risk of surgical hemorrhage is increased approximately 20% by aspirin and 50% by clopidogrel. The risk of coronary thrombosis when antiplatelet agents are withdrawn before surgery is generally higher than the risk of surgical hemorrhage when antiplatelet agents are maintained. However, this issue has not yet been sufficiently evaluated in urological patients and in many instances during urological surgery the risk of bleeding can be dangerous. A thorough dialogue among surgeon, cardiologist and anesthesiologist is essential to determine all risk factors and define the best possible strategy for each patient. Copyright 2010 American Urological Association

  19. Augmented reality assisted surgery: a urologic training tool.

    Science.gov (United States)

    Dickey, Ryan M; Srikishen, Neel; Lipshultz, Larry I; Spiess, Philippe E; Carrion, Rafael E; Hakky, Tariq S

    2016-01-01

    Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass ® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training.

  20. Augmented reality assisted surgery: a urologic training tool

    Directory of Open Access Journals (Sweden)

    Ryan M Dickey

    2016-01-01

    Full Text Available Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass ® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training.

  1. Urological surgery in elderly patients: results and complications

    Directory of Open Access Journals (Sweden)

    Brodak M

    2015-02-01

    Full Text Available Milos Brodak, Jan Tomasek, Jaroslav Pacovsky, Lukas Holub, Petr Husek Department of Urology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic Purpose: Owing to the large aging population, a growing number of elderly patients are undergoing surgical treatment. Surgical procedures in elderly patients are associated with a higher risk of complications. The aim of this study was to evaluate the efficacy and safety of urological surgeries in old patients.Methods: The authors carried out a retrospective study, evaluating results and early postoperative complications in patients aged 75 years and older. The cohort of patients included 221 patients who underwent surgical procedures in the department of urology between January 2011 and December 2012. The average age of patients was 78. The results and complications were categorized based on the type of surgery performed, and the Dindo–Clavien scale.Results: The median follow-up was 18 months. All surgeries for malignant tumors were performed successfully with no residual disease. Totally, 48 (22% complications were recorded. The most serious were as follows: one patient (<0.5% died; and four (<2% patients underwent reoperation. The most common complications involved infection, mainly sepsis and surgical site infections. Other complications included mild respiratory insufficiency, delirium, bleeding, etc.Conclusion: Surgeries in elderly patients were effective and safe. The cornerstone of safety is careful preparation and treatment of comorbidities. Complications occurred mainly as a result of emergency procedures during emergency procedures and in major surgeries such as cystectomy and nephrectomy. The standard use of low molecular-weight heparin caused no incidence of thromboembolic disease. Keywords: urinary tract, aged, postoperative complications, Dindo–Clavien classification

  2. Unprofessional content on Facebook accounts of US urology residency graduates.

    Science.gov (United States)

    Koo, Kevin; Ficko, Zita; Gormley, E Ann

    2017-06-01

    To characterize unprofessional content on public Facebook accounts of contemporary US urology residency graduates. Facebook was queried with the names of all urologists who graduated from US urology residency programmes in 2015 to identify publicly accessible profiles. Profiles were assessed for unprofessional or potentially objectionable content using a prospectively designed rubric, based on professionalism guidelines by the American Urological Association, the American Medical Association, and the Accreditation Council for Graduate Medical Education. Content authorship (self vs other) was determined, and profiles were reviewed for self-identification as a urologist. Of 281 graduates, 223 (79%) were men and 267 (95%) held MD degrees. A total of 201 graduates (72%) had publicly identifiable Facebook profiles. Of these, 80 profiles (40%) included unprofessional or potentially objectionable content, including 27 profiles (13%) reflecting explicitly unprofessional behaviour, such as depictions of intoxication, uncensored profanity, unlawful behaviour, and confidential patient information. When unprofessional content was found, the content was self-authored in 82% of categories. Among 85 graduates (42%) who self-identified as a urologist on social media, nearly half contained concerning content. No differences in content were found between men and women, MD and DO degree-holders, or those who did or did not identify as a urologist (all P > 0.05). The majority of recent residency graduates had publicly accessible Facebook profiles, and a substantial proportion contained self-authored unprofessional content. Of those identifying as urologists on Facebook, approximately half violated published professionalism guidelines. Greater awareness of trainees' online identities is needed. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  3. [European Association of Urology guidelines on laser technologies].

    Science.gov (United States)

    Herrmann, T R W; Liatsikos, E N; Nagele, U; Traxer, O; Merseburger, A S

    2013-02-01

    The European Association of Urology (EAU) Guidelines Office has set up a guideline working panel to analyse the scientific evidence published in the world literature on lasers in urologic practice. Review the physical background and physiologic and technical aspects of the use of lasers in urology, as well as current clinical results from these new and evolving technologies, together with recommendations for the application of lasers in urology. The primary objective of this structured presentation of the current evidence base in this area is to assist clinicians in making informed choices regarding the use of lasers in their practice. Structured literature searches using an expert consultant were designed for each section of this document. Searches were carried out in the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Medline and Embase on the Dialog/DataStar platform. The controlled terminology of the respective databases was used, and both Medical Subject Headings and EMTREE were analysed for relevant entry terms. One Cochrane review was identified. Depending on the date of publication, the evidence for different laser treatments is heterogeneous. The available evidence allows treatments to be classified as safe alternatives for the treatment of bladder outlet obstruction in different clinical scenarios, such as refractory urinary retention, anticoagulation, and antiplatelet medication. Laser treatment for bladder cancer should only be used in a clinical trial setting or for patients who are not suitable for conventional treatment due to comorbidities or other complications. For the treatment of urinary stones and retrograde endoureterotomy, lasers provide a standard tool to augment the endourologic procedure. In benign prostatic obstruction (BPO), laser vaporisation, resection, or enucleation are alternative treatment options. The standard treatment for BPO remains transurethral resection of the prostate for

  4. Urological injuries during obstetric and gynaecological surgical procedures.

    Directory of Open Access Journals (Sweden)

    Raut V

    1991-01-01

    Full Text Available Urological injuries during obstetric and gynaecological operations carried out between Jan. ′88 to Dec. ′88, at a hospital involved in resident teaching programmes were analysed retrospectively. Each case was reviewed for predisposing factors, location and type of injury, time and method of recognition and management. Fifteen injuries were documented in 892 gynaecological procedures and 296 obstetric procedures. Twelve injuries occurred during gynaecological operations whereas 3 occurred during obstetric operations. Thirteen were bladder injuries and two were ureteric injuries. Infiltrating carcinoma of cervix, pelvic adhesions, adhesions because of previous operations and distorted anatomy, were the important risk factors.

  5. The Management of Unplanned Erection during Endoscopic Urological Surgery

    Science.gov (United States)

    Gray, Martin; Vasdev, Nikhil; Gowrie-Mohan, Shan; McNicholas, Tom

    2017-01-01

    Penile erection at the time of urological surgery is a rare but problematic event which can delay, complicate or even lead to the cancellation of planned surgery. Erection may occur irrespective of the type of anesthetic method employed. Several techniques for treatment of this troublesome complication have been described in the literature, all with varying levels of success and potential adverse effects. In our experience over the last 25 years, we have found that intracavernous injection of ephedrine into the penis has a 100% success rate in safely producing detumescence with minimum side effects and should therefore be considered early among the treatment options for this condition. PMID:28878592

  6. Interventional urology: endourology in small animal veterinary medicine.

    Science.gov (United States)

    Berent, Allyson C

    2015-07-01

    The use of novel image-guided techniques in veterinary medicine has become more widespread, especially in urologic diseases. With the common incidence of urinary tract obstructions, stones disease, renal disease, and urothelial malignancies, combined with the recognized invasiveness and morbidity associated with traditional surgical techniques, the use of minimally invasive alternatives using interventional radiology and interventional endoscopy techniques has become incredibly appealing to owners and clinicians. This article provides a brief overview of some of the most common procedures done in endourology in veterinary medicine to date, providing as much evidence-based medicine as possible when comparing with traditional surgical alternatives. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Ethics and contemporary urology practice: Setting out principles

    Directory of Open Access Journals (Sweden)

    A Mohan

    2009-01-01

    Full Text Available Several situations of great ethical implications are encountered by physicians in daily urological practice. Informed consent for interventions, selection of patients for operative demonstrations and educational workshops, enrollment of patients in clinical trials, and the use of technology are some issues that call for stringent application of ethical principles in decision making. The issues of autonomy, privacy, rights, duties, and privileges that arise have to pass the tests prescribed by contemporary social mores and regulations. Some of the issues encountered, principles applicable, and covenants and documents that guide decision making are discussed.

  8. Attitudes of GP trainees towards the training received in urology on the GP training scheme.

    Science.gov (United States)

    Redmond, E J; Kelly, N P; McCarthy, C; Ní Mhurchú, E; Hayes, H; Flynn, C; O'Shea, D; Giri, S K; Flood, H D

    2016-02-01

    The majority of patients with scrotal problems or urinary symptoms will first present to their general practitioner (GP). The importance of the initial examination performed by the GP is often underestimated; however, it frequently determines the course of investigation and ultimately treatment. Unfortunately, medical schools have devoted increasingly less time to teaching urology over the past decade. The impact of this decline in teaching on a GP trainee's assessment of urological complaints remains unclear. The aim of this study was to investigate the self-reported competency of GP trainees in assessing urological presentations. A questionnaire was circulated to 101 GP trainees from five separate training programmes. Respondents rated their confidence in evaluating four different urological presentations. They were also invited to give their opinion regarding the teaching of urology on their current scheme and whether they would be in favour of the addition of urology as an optional rotation. Only 18 trainees (19 %) felt urology was adequately covered on their curriculum. A small yet significant number of respondents felt uncomfortable in their assessment of testicular (28 %, 28/101) or prostate (35 %, 35/101) pathology and male (17 %, 17/101) or female (10 %, 10/101) urinary symptoms. Twenty-six trainees (26 %) would choose a rotation in urology if available. Another ten trainees felt that attending urology outpatient clinics would benefit training. This study highlights a number of concerns among GP trainees in relation to their training in urology. These issues should be addressed to ensure that the training scheme sufficiently prepares GPs to manage common urological conditions.

  9. mHealth in Urology: A Review of Experts’ Involvement in App Development

    Science.gov (United States)

    Pereira-Azevedo, Nuno; Carrasquinho, Eduardo; Cardoso de Oliveira, Eduardo; Cavadas, Vitor; Osório, Luís; Fraga, Avelino; Castelo-Branco, Miguel; Roobol, Monique J.

    2015-01-01

    Introduction Smartphones are increasingly playing a role in healthcare and previous studies assessing medical applications (apps) have raised concerns about lack of expert involvement and low content accuracy. However, there are no such studies in Urology. We reviewed Urology apps with the aim of assessing the level of participation of healthcare professionals (HCP) and scientific Urology associations in their development. Material and Methods A systematic search was performed on PubMed, Apple's App Store and Google's Play Store, for Urology apps, available in English. Apps were reviewed by three graders to determine the app’s platform, target customer, developer, app type, app category, price and the participation of a HCP or a scientific Urology association in the development. Results The search yielded 372 apps, of which 150 were specific for Urology. A fifth of all apps had no HCP involvement (20.7%) and only a third had been developed with a scientific Urology association (34.7%). The lowest percentage of HCP (13.4%) and urological association (1.9%) involvement was in apps designed for the general population. Furthermore, there was no contribution from an Urology society in "Electronic Medical Record" nor in "Patient Information" apps. A limitation of the study is that only Android and iOS apps were reviewed. Conclusions Despite the increasing Mobile Health (mHealth) market, this is the first study that demonstrates the lack of expert participation in the design of Urology apps, particularly in apps designed for the general public. Until clear regulation is enforced, the urological community should help regulate app development. Maintaining a register of certified apps or issuing an official scientific seal of approval could improve overall app quality. We propose that urologists become stakeholders in mHealth, shaping future app design and promoting peer-review app validation. PMID:25984916

  10. Survey on the perception of urology as a specialty by medical students.

    Science.gov (United States)

    Kim, Soojin; Farrokhyar, Forough; Braga, Luis H

    2016-01-01

    Upon inquiring with medical students and urologists across Canada, it is evident that urology is perceived as a male-dominant specialty, among other stereotypes. These misperceptions may hamper the recruitment of the best and brightest trainees. With that in mind, we surveyed medical students at our institution to obtain an objective assessment of their perception of urology and to determine the cause for misperceptions. A 25-factor, validated, anonymous, cross-sectional, self-reported, electronic survey was sent to all medical students at McMaster University to assess their perception of urology. The survey was piloted among students and educational leaders to optimize face and content validity, and minimize measurement bias. Six variables (years in training, role model, a family member or friend in urology, gender, and exposure) were selected a priori and entered into a logistic regression model to determine factors associated with a positive impression of the specialty. The overall response rate was 70%. Of the respondents, 66% had no exposure to urology and 61% found the amount of exposure to be inadequate. Urology staff and resident involvement in education was considered to be poor by over 30% of medical students. Over 70% perceived urology to be a specialty with a great gender imbalance. On multivariate analysis, exposure to urology was the most important factor (pstudents' positive perception of the specialty, in addition to male gender, earlier years in training, and positive role models. Concerns regarding inadequate urology exposure and poor staff and resident involvement in undergraduate education were seen as potential causes for misperceptions of the specialty. Increasing exposure to urology, encouraging female students, constant effort to approach senior students, and providing mentorship are found to be important factors in establishing a positive perception of urology.

  11. mHealth in Urology: A Review of Experts' Involvement in App Development.

    Science.gov (United States)

    Pereira-Azevedo, Nuno; Carrasquinho, Eduardo; Cardoso de Oliveira, Eduardo; Cavadas, Vitor; Osório, Luís; Fraga, Avelino; Castelo-Branco, Miguel; Roobol, Monique J

    2015-01-01

    Smartphones are increasingly playing a role in healthcare and previous studies assessing medical applications (apps) have raised concerns about lack of expert involvement and low content accuracy. However, there are no such studies in Urology. We reviewed Urology apps with the aim of assessing the level of participation of healthcare professionals (HCP) and scientific Urology associations in their development. A systematic search was performed on PubMed, Apple's App Store and Google's Play Store, for Urology apps, available in English. Apps were reviewed by three graders to determine the app's platform, target customer, developer, app type, app category, price and the participation of a HCP or a scientific Urology association in the development. The search yielded 372 apps, of which 150 were specific for Urology. A fifth of all apps had no HCP involvement (20.7%) and only a third had been developed with a scientific Urology association (34.7%). The lowest percentage of HCP (13.4%) and urological association (1.9%) involvement was in apps designed for the general population. Furthermore, there was no contribution from an Urology society in "Electronic Medical Record" nor in "Patient Information" apps. A limitation of the study is that only Android and iOS apps were reviewed. Despite the increasing Mobile Health (mHealth) market, this is the first study that demonstrates the lack of expert participation in the design of Urology apps, particularly in apps designed for the general public. Until clear regulation is enforced, the urological community should help regulate app development. Maintaining a register of certified apps or issuing an official scientific seal of approval could improve overall app quality. We propose that urologists become stakeholders in mHealth, shaping future app design and promoting peer-review app validation.

  12. mHealth in Urology: A Review of Experts' Involvement in App Development.

    Directory of Open Access Journals (Sweden)

    Nuno Pereira-Azevedo

    Full Text Available Smartphones are increasingly playing a role in healthcare and previous studies assessing medical applications (apps have raised concerns about lack of expert involvement and low content accuracy. However, there are no such studies in Urology. We reviewed Urology apps with the aim of assessing the level of participation of healthcare professionals (HCP and scientific Urology associations in their development.A systematic search was performed on PubMed, Apple's App Store and Google's Play Store, for Urology apps, available in English. Apps were reviewed by three graders to determine the app's platform, target customer, developer, app type, app category, price and the participation of a HCP or a scientific Urology association in the development.The search yielded 372 apps, of which 150 were specific for Urology. A fifth of all apps had no HCP involvement (20.7% and only a third had been developed with a scientific Urology association (34.7%. The lowest percentage of HCP (13.4% and urological association (1.9% involvement was in apps designed for the general population. Furthermore, there was no contribution from an Urology society in "Electronic Medical Record" nor in "Patient Information" apps. A limitation of the study is that only Android and iOS apps were reviewed.Despite the increasing Mobile Health (mHealth market, this is the first study that demonstrates the lack of expert participation in the design of Urology apps, particularly in apps designed for the general public. Until clear regulation is enforced, the urological community should help regulate app development. Maintaining a register of certified apps or issuing an official scientific seal of approval could improve overall app quality. We propose that urologists become stakeholders in mHealth, shaping future app design and promoting peer-review app validation.

  13. Assessing urology and nephrology research activity in Arab countries using ISI web of science bibliometric database.

    Science.gov (United States)

    Sweileh, Waleed M; Zyoud, Sa'ed H; Al-Jabi, Samah W; Sawalha, Ansam F

    2014-04-23

    Bibliometric analysis is increasingly being used for research assessment. The main objective of this study was to assess research output in Urology and Nephrology subject from the Arab countries. Original scientific articles or reviews published from the 21 Arab countries in "Urology and Nephrology" subject were screened using the ISI Web of Science database. Research productivity was evaluated based on a methodology developed and used in other bibliometric studies by analyzing the annual productivity, names of journals, citations; top 10 active institution and authors as well as country contribution to Urology and Nephrology research. Three thousand and seventy six documents in "urology and nephrology" subject category were retrieved from 104 journals. This represents 1.4% of the global research output in "urology and nephrology". Four hundred and two documents (12.66%) were published in Annales D Urologie Journal. The h-index of the retrieved documents was 57. The total number of citations, at the time of data analysis, was 30401 with an average citation of 9.57 per document. Egypt, with a total publication of 1284 (40.43%) ranked first among the Arab countries in "urology and nephrology" subject category. Mansoura University in Egypt was the most productive institution with a total of 561 (15.33%) documents. Arab researchers collaborated most with researchers from the United States of America (226; 7.12%) in urology and nephrology research. The present data reveals a good contribution of some Arab countries to the field of "urology and nephrology". More efforts are needed by some other Arab countries to bridge the gap in urology and nephrology research. Overall, the quality of urology/nephrology research is considered relatively high as measured by h-index. Cooperation in urology/nephrology research should be encouraged in the Arab world to bridge the gap with that from developed countries.

  14. Phosphorylation of DegU is essential for activation of amyE ...

    Indian Academy of Sciences (India)

    Bovine Serum Albumin (66 kDa). 5. Horse Reddish Peroxidase (40 kDa). 6. Lysozyme (15 kDa). Supplementary figure 1. Gel filtration analysis of DegU. Plot of Kav (Materials and methods) vs log molecular weight of five standards and the test (DegU). Positions of all samples have been marked with numbers (DegU is in red ...

  15. A 360-deg Digital Image Correlation system for materials testing

    Science.gov (United States)

    Genovese, K.; Cortese, L.; Rossi, M.; Amodio, D.

    2016-07-01

    The increasing research interest toward natural and advanced engineered materials demands new experimental protocols capable of retrieving highly dense sets of experimental data on the full-surface of samples under multiple loading conditions. Such information, in fact, would allow to capture the possible heterogeneity and anisotropy of the material by using up-to-date inverse characterization methods. Although the development of object-specific test protocols could represent the optimal choice to address this need, it is unquestionable that universal testing machines (UTM) remain the most widespread and versatile option to test materials and components in both academic and industrial contexts. A major limitation of performing standard material tests with UTM, however, consists in the scarce information obtainable with the commonly associated sensors since they provide only global (LVDTs, extensometers, 2D-video analyzers) or local (strain gages) measures of displacement and strain. This paper presents a 3D Digital Image Correlation (DIC) system developed to perform highly accurate full-surface 360-deg measurements on either standard or custom-shaped samples under complex loading within universal testing machines. To this aim, a low cost and easy to setup video rig was specifically designed to overcome the practical limitations entailed with the integration of a multi-camera system within an already existing loading frame. In particular, the proposed system features a single SLR digital camera moved through multiple positions around the specimen by means of a large rotation stage. A proper calibration and data-processing procedure allows to automatically merge the experimental data obtained from the multiple views with an accuracy of 10-2 m m . The results of a full benchmarking of the metrological performances of the system are here reported and discussed together with illustrative examples of full-360-deg shape and deformation measurements on a Grade X65 steel

  16. LA FORMAZIONE DEGLI INSEGNANTI PER UNA EDUCAZIONE PLURILINGUE E INTERCULTURALE

    Directory of Open Access Journals (Sweden)

    Edoardo Lugarini

    2012-07-01

    Full Text Available Dalla la Guida per lo sviluppo e l’attuazione di curricoli per una educazione plurilingue e interculturale del Consiglio d’Europa è possibile trarre una serie di indicazioni per disegnare un profilo professionale e, di conseguenza, una serie di indicazioni per la formazione iniziale e in servizio dell’insegnate di lingua (L1, L2, LS. In questo intervento si suggeriscono, senza alcuna pretesa di esaustività, degli indicatori relativi alle competenze professionali che l’insegnante dovrebbe possedere per poter svolgere la sua attività nella scuola italiana di oggi in considerazione dei bisogni linguistici delle nuove generazioni e degli obiettivi linguistici proposti dal Consiglio d’Europa nell’ambito delle politiche educative orientate a favorire la mobilità, una più efficace comunicazione internazionale, il rispetto dell’identità e della diversità delle culture, a sviluppare l’educazione alla cittadinanza democratica ed europea. Dalle riflessioni condotte emerge la necessità di una formazione disciplinare e didattica articolata e complessa che renda l’insegnante “professionista riflessivo” e “ricercatore sperimentale”TRAINING TEACHERS FOR MULTILINGUISTIC, INTERCULTURAL EDUCATIONFrom the Council of Europe’s Guide for the development and implementation of curricula for multilingual and intercultural education, it is possible to draw a series of explicit or implicit characteristics for teachers, and consequently, a series of indications for initial and in-service language (L1, L2, FL teacher training. This paper offers a brief view of the professional competences teachers should possess in order to carry out their roles in Italian schools considering the linguistic needs of the young generations and the language objectives set out by the Council of Europe regarding education policies that promote mobility, more effective International communication and respect for cultural identity and diversity, in an effort to

  17. Analysis of National Institutes of Health Funding to Departments of Urology.

    Science.gov (United States)

    Silvestre, Jason; Agarwal, Divyansh; Lee, David I

    2016-05-01

    To elucidate the current portfolio of National Institutes of Health (NIH) funding to departments of urology at U.S. medical schools. The NIH Research Portfolio Online Reporting Tools Expenditures and Results was used to generate a comprehensive analysis of NIH research grants awarded to urology departments during 2014. Costs, mechanisms, and institutes were summarized with descriptive statistics. Demographic data were obtained for principal investigators and project abstracts were categorized by research type and area. Fiscal totals were calculated for 2005-2014 and compared with other surgical departments during 2014. One hundred one investigators at 36 urology departments received $55,564,952 in NIH funding during 2014. NIH-funded investigators were predominately male (79%) and PhD scientists (52%). Funding totals did not vary by terminal degree or sex, but increased with higher academic rank (P urologic research. The R01 grant accounted for 41.0% of all costs. The top 3 NIH-funded clinical areas were urologic oncology (62.1%), urinary tract infection (8.8%), and neurourology (7.6%). A minority of costs supported clinical research (12.9%). In 2014, urology had the least number of NIH grants relative to general surgery, ophthalmology, obstetrics & gynecology, otolaryngology, and orthopedic surgery. NIH funding to urology departments lags behind awards to departments of other surgical disciplines. Future interventions may be warranted to increase NIH grant procurement in urology. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Current Status of Hemostatic Agents and Sealants in Urologic Surgical Practice

    Science.gov (United States)

    Kommu, Sashi S; McArthur, Robert; Emara, Amr M; Reddy, Utsav D; Anderson, Christopher J; Barber, Neil J; Persad, Raj A; Eden, Christopher G

    2015-01-01

    There has been a recent and near exponential increase in the use of hemostatic agents and sealants to supplement the rapidly evolving methods in the surgical management of urologic patients. This article reviews the use of hemostatic agents and sealants in current urologic practice. PMID:26543429

  19. mHealth in urology : A review of experts' involvement in app development

    NARCIS (Netherlands)

    Pereira-Azevedo, N. (Nuno); Carrasquinho, E. (Eduardo); De Oliveira, E.C. (Eduardo Cardoso); Cavadas, V. (Vitor); Osório, L. (Luís); Fraga, A. (Avelino); Castelo-Branco, M. (Miguel); Roobol, M.J. (Monique J.)

    2015-01-01

    textabstractIntroduction: Smartphones are increasingly playing a role in healthcare and previous studies assessing medical applications (apps) have raised concerns about lack of expert involvement and low content accuracy. However, there are no such studies in Urology. We reviewed Urology apps with

  20. 75 FR 57968 - Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2010-09-23

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Gastroenterology and Urology Devices Panel of the Medical... Administration (FDA). The meeting will be open to the public. Name of Committee: Gastroenterology and Urology...

  1. 78 FR 25747 - Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2013-05-02

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Gastroenterology and Urology Devices Panel of the Medical... Administration (FDA). The meeting will be open to the public. Name of Committee: Gastroenterology and Urology...

  2. A prospective audit of emergency urology activity in a university teaching hospital

    LENUS (Irish Health Repository)

    2014-06-01

    Urology cover is commonly available out-of-hours in most teaching hospitals. However, increased pressure to reduce hospital expenditure has forced many institutions to consider removing middle grade cover outside of normal working hours. The aim of this study was to audit the emergency urology activity in our institution over a 12-month period.

  3. Twitter Activity Associated With U.S. News and World Report Reputation Scores for Urology Departments.

    Science.gov (United States)

    Ciprut, Shannon; Curnyn, Caitlin; Davuluri, Meena; Sternberg, Kevan; Loeb, Stacy

    2017-10-01

    To analyze the association between US urology department Twitter presence and U.S. News and World Report (USNWR) reputation scores, to examine the content, informational value, and intended audience of these platforms, and to identify objectives for Twitter use. We identified Twitter accounts for urology departments scored in the 2016-2017 USNWR. Correlation coefficients were calculated between Twitter metrics (number of followers, following, tweets, and Klout influence scores) with USNWR reputation scores. We also performed a detailed content analysis of urology department tweets during a 6-month period to characterize the content. Finally, we distributed a survey to the urology department accounts via Twitter, inquiring who administers the content, and their objectives for Twitter use. Among 42 scored urology departments with Twitter accounts, the median number of followers, following, and tweets were 337, 193, and 115, respectively. All of these Twitter metrics had a statistically significant positive correlation with reputation scores (P twitter use among urology departments was visibility and reputation, and urologists are considered the most important target audience. There is statistically significant correlation between Twitter activity and USNWR reputation scores for urology departments. Our results suggest that Twitter provides a novel mechanism for urology departments to communicate about academic and educational topics, and social media engagement can enhance reputation. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Impact of sarcopenia in the management of urological cancer patients.

    Science.gov (United States)

    Fukushima, Hiroshi; Koga, Fumitaka

    2017-05-01

    Sarcopenia, the degenerative and systemic loss of skeletal muscle mass, develops as a consequence of the progression of cancer cachexia. Recent studies suggest that sarcopenia may be used as a biomarker in the management of patients with several cancers. Areas covered: In this article, the authors review 1) the methods to simply and optimally evaluate and define sarcopenia using computed tomography images in daily clinical practice and 2) the impact of sarcopenia in the management of urological cancers, specifically focusing on the usefulness in predicting treatment-related complications and prognosis. The authors also discuss the prognostic importance of changes in skeletal muscle mass in the course of treatment and the potential roles of nutritional support and exercise to prevent progression of sarcopenia. Expert commentary: Sarcopenia is associated with treatment-related complications and unfavorable prognosis in urological cancer patients. Nutritional support and exercise might be helpful in improving sarcopenia. The impact of these interventions on clinical outcomes would be elucidated by ongoing or future clinical studies.

  5. Dhat syndrome, an emergent condition within urology in Spain.

    Science.gov (United States)

    Menéndez, Violeta; Fernández-Suárez, Antonio; Placer, José; García-Linares, María; Tarragon, Sandra; Liso, Elisenda

    2013-08-01

    Dhat syndrome (DS) consists of vague somatic symptoms and at times sexual dysfunction which the patient falsely attributes to involuntary emissions of semen outside of sexual relations. Describe and analyse the occurrences of DS in patients attending the clinic and clarify the existence of this condition within the Spanish Urological service. Patients reporting semen loss in urine or involuntarily outside of sexual relations were studied during a period from May 2006 to December 2007. Variables of age, nationality, marital status, family situation, medical history, reasons for the consultation, physical condition and additional tests were studied. All treatments and its effectiveness were also recorded. DS affected predominantly southern Asian continent citizens (n = 32). The average age was 35.44. Seventeen patients reported semen loss during urination; 20 at the end of urination; 11 spontaneously; 5 while sleeping; 4 during defecation; 1 while showering; 1 while eating meat; and 3 produced by noticing stained clothing. In 28 cases, the supposed loss of semen was linked to sex-related symptoms. All examinations and tests ruled out the existence of actual loss of semen. In urology consultations, we have been witnessing the unusual appearance of DS, a condition known by psychologists and psychiatrists and practically unheard of by urologists. A previously unknown condition in Spain, immigration from Asia, is causing the appearance of this syndrome. Its rapid identification will prevent patients from paying costly and unnecessary tests and provide alternative therapies, within a multidisciplinary approach involving psychologists and psychiatrists.

  6. Checkpoint inhibitors in the treatment of urological malignancies.

    Science.gov (United States)

    Popovic, Lazar S; Matovina-Brko, Gorana; Popovic, Maja

    2017-01-01

    Checkpoint inhibitors are monoclonal antibodies attach to several different receptors on T-cells or tumour cells expressing receptors for cytotoxic T-lymphocyte antigen 4 (CTLA-4), programmed death-1 (PD-1) and their ligand (PD-L1). Since 2010, numerous trials on different tumour types have been conducted, which was resulted in these drugs being approved for the treatment of melanoma, lung cancer, Hodgkin's lymphoma and head and neck cancers. Urological cancers, especially urothelial and renal-cell carcinomas, are immunogenic tumours. Since the late 70s, the bacillus Calmette-Gurin (BCG) vaccine has been used for intravesical instillation in non-muscle invasive bladder cancer from the mid-90s up until the discovery of tyrosine kinase inhibitors (TKIs) in 2007, interleukin-2 (IL-2) and interferon alpha (IFNα), which were the standard of care for metastatic renal-cell cancer. Two checkpoint inhibitors are already approved by the Food and Drug Administration: atezolizumab for metastatic urothelial cancer and nivolumab for metastatic renal-cell carcinoma. There are many drugs are in different phases of clinical development. Here we review the current status of checkpoint inhibitors in the treatment of urological tumours.

  7. The importance of Internet usage for urologic patients.

    Science.gov (United States)

    Sahin, Cahit; Tuncer, Murat; Yazici, Ozgur; Kafkasli, Alper; Can, Utku; Eryildirim, Bilal; Koca, Orhan; Sarica, Kemal

    2014-12-30

    To evaluate Internet usage frequency, rate of searched diseases and impact of Internet derived data on future patient physician relationship in patients applying to an Urology Department. A well prepared questionnaire has been given to 1000 referring cases, out of which 589 accepted to participate on a volunteer basis to a face to face interview. Patients were divided into subgroups with respect to age, gender and as well as their educational and economical status. Regarding Internet, questions inquired the use of Internet, the point of view about it, opinions about healthcare system and most commonly urological diseases searched in Internet. Of 589 patients participating, 38.2% reported access to the Internet; in relation to subgroup analysis of data, there was a statistically significant relationship between the use of Internet and age (p Internet and the majority of these cases share all these information with their physicians during their visit. These findings indicate that all physicians should consider this fact seriously and make their future plans in the light of internet based activities which provides numerous advantages.

  8. [Ablative therapy in urology: Good practice and perspective].

    Science.gov (United States)

    Gangi, A; Cathelineau, X; Tricard, T; Lang, H

    2017-11-01

    To expose the main point of discussion from present ablative therapies' guidelines and propose global perspectives. A review of the scientific literature was performed in Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com/) using different associations of keywords "ablative therapy" ; "prostate cancer"; "kidney cancer"; "guidelines"; "hybrid operating room". Publications obtained were selected based on methodology, language and relevance. Present guidelines on ablative therapies in urology are, considering authors and organs, either particularly prudent (EAU guidelines for prostate and kidney) or relatively optimistic (CIRSE guidelines). This discrepancy is related to a low level of proof. So, a new approach is mandatory: more homogeneous in methodology, and especially more open to a new organization sparing economic efficiency. The objective will be to get multifunctional and multidisciplinaries platforms, in facts and in minds. It will induce, in the future, a deep reflection about training and boundaries' specialties. Ablative therapies represent a crucial stake for urology and a clear example of medicosurgical evolution in future, based on new technologies (energy, robotic, imaging). A serious and deep reflection is necessary to prepare it and be deeply involved in. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  9. Urological robotic surgery: preliminary experience with the Zeus system.

    Science.gov (United States)

    Miyake, Osamu; Kiuchi, Hiroshi; Yoshimura, Kazuhiro; Okuyama, Akihiko

    2005-10-01

    We performed robotic or robotically-assisted laparoscopic surgery for urological diseases, and evaluated the ef ficacy and safety of this surgery. Between November 2003 and June 2004, we performed laparoscopic surgery with the Zeus system in eight cases. Three adrenalectomy cases of cortical adenoma presenting with Cushing syndrome and primary aldosteronism, and two cases of nephrectomy for renal cell carcinoma in dialyzed patients were performed solely with Zeus. In two cases of ureteral stenosis, Zeus was used for ureteral anastomosis after partial ureterectomy by manual laparoscopy. In one prostatectomy case, vesico-urethral anastomosis was performed with Zeus after extraperitoneal prostatectomy by manual laparoscopy. All of the cases were successfully treated without any complications during or after operation. All patients were discharged from hospital within 12 days postoperatively. As for adrenalectomy, nephrectomy and pyeloplasty, this may be the fi rst report in Japan. Our preliminary experiences suggest that such a robot system, which is being developed day by day, might become more beneficial in future in urological laparoscopic surgery.

  10. Influence of social networks on congresses of urological societies and associations: Results of the 81th National Congress of the Spanish Urological Association.

    Science.gov (United States)

    Gómez-Rivas, J; Rodríguez-Socarrás, M E; Tortolero-Blanco, L; Garcia-Sanz, M; Alvarez-Maestro, M; Ribal, M J; Cózar-Olmo, M

    2017-04-01

    To measure social network activity during the 81th National Congress of the Spanish Urological Association (AEU) and to compare it with the activity during other congresses of national and international urological associations. We designed and registered the official hashtag #AEU16 for the 81 th National Congress of the AEU on the Symplur website. The following measurements were recorded: number of participants, number of tweets, tweets by participant, tweets per hour and views. The number of participants in the social network activity during the congress was 207. The measurements of activity in Twitter consisted of a total of 1866 tweets, a mean rate of 16 tweets/h, 9 tweets per participant and 1,511,142 views. The activity during the international congresses is as follows: 2016 American Urological Association annual congress (views: 28,052,558), 2016 European Association of Urology annual congress (views: 13,915,994), 2016 Urological Society of Australia and New Zealand (views: 4,757,453), 2015 Société Internationale d'Urologie annual congress (views: 1,023,038). The activity during the national congresses was recorded as follows: 2016 Annual Conference of The British Association of Urological Surgeons (views: 2,518,880), 81th National Congress of the AEU (views: 1,511,142), 109th Congress of l'Association Française d'Urologie (views: 662,828), 67th German Congress of Urology (views: 167,347). We found 10 posts in Facebook and 2 communications via Periscope TV related to #AEU16. The social network activity during the 81 th National Congress of the AEU was notable given the results of this study. The use of social networks has expanded among urological associations, congresses and meetings, giving them a global character. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Come e cosa desidera la narrativa italiana degli anni Zero

    Directory of Open Access Journals (Sweden)

    Gianluigi Simonetti

    2013-05-01

    Full Text Available L'articolo analizza il trattamento del tema del desiderio - erotico e amoroso - nel romanzo italiano degli ultimi anni, impegnandosi nell'esame ravvicinato di alcuni testi esemplari. La campionatura vuole da un lato isolare alcune opere rappresentative della situazione attuale della narrativa contemporanea, dall'altro  proporre un'ipotesi categoriale che seziona il campo di studio in tre parti; il sondaggio sembra infatti suggerire che le dinamiche del desiderio vengono rese in maniera specifica nei diversi ambiti della letteratura di consumo, in quella di 'nobile intrattenimento' e in quella 'forte' e letterariamente più ambiziosa. L'analisi formale risulta insomma integrata a una prospettiva di stroria dello stile, secondo un metodo che permette di utilizzare la figuralità letteraria come 'indicatore sociologico' di processi politici (e forse antropologici in atto.

  12. DEG/ENaC but not TRP channels are the major mechanoelectrical transduction channels in a C. elegans nociceptor.

    OpenAIRE

    Geffeney, Shana L.; Cueva, Juan G.; Glauser, Dominique A.; Doll, Joseph C.; Lee, Tim Hau-Chen; Montoya, Misty; Karania, Snetu; Garakani, Arman M.; Pruitt, Beth L.; Goodman, Miriam B.

    2011-01-01

    Many nociceptors detect mechanical cues, but the ion channels responsible for mechanotransduction in these sensory neurons remain obscure. Using in vivo recordings and genetic dissection, we identified the DEG/ENaC protein, DEG-1, as the major mechanotransduction channel in ASH, a polymodal nociceptor in Caenorhabditis elegans. But, DEG-1 is not the only mechanotransduction channel in ASH: loss of deg-1 revealed a minor current whose properties differ from those expected of DEG/ENaC channels....

  13. Oxidation of Pb-17Li in air between 25deg C and 650deg C - comparison with lead

    Energy Technology Data Exchange (ETDEWEB)

    Feuerstein, H.; Hoerner, L.; Horn, S.; Beyer, J.; Oschinski, J.; Graebner, H.; Welter, P.; Bender, S.

    1992-09-01

    The oxidation of solid lead is diffusion-controlled at all temperatures. On solid Pb-17Li, however, protective oxides are formed only below 158deg C. The weight gain of samples is proportional to the time at higher temperatures. The effect of `internal oxidation`, the diffusion of oxygen into the solid metal, has to be considered. On the other hand, Li atoms diffuse in oxides and the metal as well. The formed oxides have semiconductor properties, the oxidation rate is higher at room temperature under light than in a closed cabinet. Nevertheless solid Pb-17Li may be kept at room temperature in air for many years without excessive oxidation. Only a few investigations were performed so far to study the behavior of impurities during oxidation. Probably oxidation cannot be used for the purification of the molten eutectic. On the other hand adding very small amounts of Al (and Be) could reduce oxidation rates to zero. However, more investigations are needed to decide if such an inhibitor can be useful for a fusion reactor blanket. (orig./EF). [Deutsch] Die Oxidation von festem Blei ist bei allen Temperaturen diffusionskontrolliert. Auf festem Pb-17Li hingegen werden nur unterhalb von 158deg C schuetzende Oxide gebildet. Bei hoeherer Temperatur ist die Gewichtszunahme von Proben proportional zur Zeit. Sauerstoffatome diffundieren in das feste Metall, ein Prozess, der als `internal oxidation` bezeichnet wird. Andererseits diffundieren Li-Atome zur Oberflaeche. Die auf Pb-17Li gebildeten Oxide haben Halbleitereigenschaften. Unter Belichtung wird eine erhoehte Oxidationsrate gefunden. Trotzdem kann festes Pb-17Li jahrelang an Luft aufbewahrt werden, ohne dass eine zu starke Oxidation auftritt. Nur in wenigen Versuchen wurde bisher das Verhalten von Verunreinigungen waehrend der Oxidation untersucht. Wegen der bevorzugten Oxidation von Lithium koennen Verunreinigungen nicht durch Oxidation aus dem Pb-17Li abgetrennt werden. Andererseits koennte es moeglich sein, durch

  14. Survey on the perception of urology as a specialty by medical students

    Science.gov (United States)

    Kim, Soojin; Farrokhyar, Forough; Braga, Luis H.

    2016-01-01

    Introduction: Upon inquiring with medical students and urologists across Canada, it is evident that urology is perceived as a male-dominant specialty, among other stereotypes. These misperceptions may hamper the recruitment of the best and brightest trainees. With that in mind, we surveyed medical students at our institution to obtain an objective assessment of their perception of urology and to determine the cause for misperceptions. Methods: A 25-factor, validated, anonymous, cross-sectional, self-reported, electronic survey was sent to all medical students at McMaster University to assess their perception of urology. The survey was piloted among students and educational leaders to optimize face and content validity, and minimize measurement bias. Six variables (years in training, role model, a family member or friend in urology, gender, and exposure) were selected a priori and entered into a logistic regression model to determine factors associated with a positive impression of the specialty. Results: The overall response rate was 70%. Of the respondents, 66% had no exposure to urology and 61% found the amount of exposure to be inadequate. Urology staff and resident involvement in education was considered to be poor by over 30% of medical students. Over 70% perceived urology to be a specialty with a great gender imbalance. On multivariate analysis, exposure to urology was the most important factor (purology exposure and poor staff and resident involvement in undergraduate education were seen as potential causes for misperceptions of the specialty. Increasing exposure to urology, encouraging female students, constant effort to approach senior students, and providing mentorship are found to be important factors in establishing a positive perception of urology PMID:27800058

  15. Attitude and perception of urology by medical students at the end of their medical school: An appraisal from Saudi Arabia

    Science.gov (United States)

    Binsaleh, Saleh; Al-Jasser, Abdulrahman; Almannie, Raed; Madbouly, Khaled

    2015-01-01

    Objectives: To evaluate the attitude and perception of the graduates of King Saud University (KSU) College of Medicine regarding the quality of their urology rotation, urology exposure during this rotation, confidence about managing common conditions, and career prospects. Materials and Methods: In 2013, a questionnaire regarding the students’ perceptions of urology rotation was developed and E-mailed to all final (5th) year medical students and interns of KSU College of Medicine, Riyadh, Saudi Arabia. Individual responses were recorded, tabulated and compared using descriptive statistics. Results: The overall response rate was 67.7%. Respondents included 101 (49.8%) males and 102 (50.2%) females. All the respondents but 18 (8.9%) were enrolled in a urology rotation during undergraduate years. Only 27 (13.3%) were willing to choose urology specialty as a future career. Significant gender differences were found regarding choice of urology as a future career (P = 0.002) and the need for more urology exposure during surgical rotation (P = 0.002). Conclusions: Knowledge of medical school graduates is insufficient in many urologic subjects, and there is a need for more urology exposure. Social reasons and lack of knowledge about urology hinder the choice of urology specialty as a future career. Clearance of learning objectives, immediate and prompt feedback on performance and adequate emphasis of common problems and ambulatory care are some aspects that should be taken into account by curriculum planners as they consider improvements to urology rotation program. PMID:25835262

  16. Fatigue resistance of unnotched and post impact(+/- 30 deg/0 deg) 3-D braided composites. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Portanova, M.A.

    1994-01-01

    The fatigue resistance of a multiaxial braided (3-D) graphite/expoxy composite in both unnotched and post impacted conditions has been evaluated. The material tested is a (+/- 30/0 deg) multiaxial braid constructed from AS4/12K tow graphite fibers and British Petroleum E905L epoxy resin. These materials were braided as dry preforms and the epoxy was added using a resin transfer molding process (RTM). The unnotched and post-impact specimens were tested in compression-compression fatigue at 10 Hz with a stress ratio of R=10. The unnotched tension-tension fatigue specimens were tested at S Hz with a stress ration of R=0.1. Damage initiation and growth was documented through the application of radiography and ultrasonic through transmission (C-scans). Visible inspection of surface and edge damage was also noted to describe the initiation and progression of damage in these materials. The mechanisms leading to damage initiation were established and failure modes were determined. Stiffness and strength degradation were measured as a function of applied cycles. These 3-D braided composite results were compared to strain levels currently used to design primary structure in commercial aircraft composite components made from prepreg tape and autoclave cured.

  17. Proteolytic activity of recombinant DegP from Chromohalobacter salexigens BKL5

    Directory of Open Access Journals (Sweden)

    Dewi Fitriani

    2017-09-01

    Conclusions: Recombinant DegP from C. salexigens BKL5 showed proteolytic activity when β-casein was used as a substrate. In silico analysis indicated that recombinant DegP had characteristics similar to those of halophilic proteins depending on its amino acid composition.

  18. Characterization of Toxoplasma DegP, a rhoptry serine protease crucial for lethal infection in mice.

    Directory of Open Access Journals (Sweden)

    Gaelle Lentini

    Full Text Available During the infection process, Apicomplexa discharge their secretory organelles called micronemes, rhoptries and dense granules to sustain host cell invasion, intracellular replication and to modulate host cell pathways and immune responses. Herein, we describe the Toxoplasma gondii Deg-like serine protein (TgDegP, a rhoptry protein homologous to High temperature requirement A (HtrA or Deg-like family of serine proteases. TgDegP undergoes processing in both types I and II strains as most of the rhoptries proteins. We show that genetic disruption of the degP gene does not impact the parasite lytic cycle in vitro but affects virulence in mice. While in a type I strain DegPI appears dispensable for the establishment of an infection, removal of DegPII in a type II strain dramatically impairs the virulence. Finally, we show that KO-DegPII parasites kill immunodeficient mice as efficiently as the wild-type strain indicating that the protease might be involved in the complex crosstalk that the parasite engaged with the host immune response. Thus, this study unravels a novel rhoptry protein in T. gondii important for the establishment of lethal infection.

  19. Phosphorylation of DegU is essential for activation of amyE

    Indian Academy of Sciences (India)

    Alpha ()-amylase (amyE) is one of the major exo-enzymes secreted by Bacillus subtilis during the post-exponential phase. The DegS-DegU two-component system regulates expression of majority of post-exponentially expressed genes in B. subtilis. It has been demonstrated that varying levels of the phosphorylated form ...

  20. Perceived Role of Social Media in Urologic Knowledge Acquisition Among Young Urologists: A European Survey.

    Science.gov (United States)

    Rivas, Juan Gomez; Socarras, Moises Rodriguez; Patruno, Giulio; Uvin, Pieter; Esperto, Francesco; Dinis, Paulo Jorge; Roupret, Morgan; Borgmann, Hendrik

    2017-07-27

    Social media (SoMe) are increasingly being integrated into personal and professional life, with urology being a leading medical specialty in SoMe adoption. We aimed to assess the perceived role of SoMe in urologic knowledge acquisition among young urologists across Europe. Members of the European Society of Residents in Urology designed a 20-item online survey via surveymonkey.com. The survey was designed in accordance with Checklist for Reporting Results of Internet E-Surveys (CHERRIES) guidelines and was distributed via e-mail and social media in 23 European countries to urology residents and young urologists. Statistical Package for the Social Sciences (SPSS) software was used for descriptive statistics and statistical analysis. For comparative analysis the Mann-Whitney U test was used. A total of 316 young urologists with a mean age of 31.2±3.9 yr responded to the survey. Of the respondents, 99% use SoMe in a personal and/or professional way. YouTube and LinkedIn are the most frequently used platforms for professional use. SoMe were ranked in third place as an information source for urologic news/updates, lying behind journals and websites but ahead of congresses and books. Video content from YouTube or other sources was ranked as a preferred tool to see/understand surgical techniques ahead of websites and reference books. 61% follow urologic associations, 47% follow urologic events, 44% follow urologic journals, and 39% follow urologic experts on SoMe. The perceived influence of SoMe on urology knowledge was rated as moderate to high by 63% and as low to none by 37% of young urologists. Of the respondents, 44% apply guidelines on the appropriate use of SoMe in urology. SoMe play a significant role in knowledge acquisition by young urologists in Europe. Physicians, organizations, and institutions should strive to spread and provide valuable educational content through SoMe. Social media can be valuable for education in urology because it is useful to keep

  1. Patologie sociali, resistenze e difese degli insegnanti nell’istituzione scolastica: Considerazioni cliniche e pedagogiche

    Directory of Open Access Journals (Sweden)

    Tommaso Fratini

    2014-12-01

    Full Text Available L’articolo prende in esame il tema di alcune resistenze e difese degli insegnanti all’interno dell’istituzione scolastica. Partendo dall’attuale condizione di emergenza della scuola italiana e rifacendosi al concetto di patologia sociale di Giuseppe Di Chiara, viene argomentato come tali resistenze coprano le angosce persecutorie degli insegnanti nel loro lavoro scolastico quotidiano nel rapporto con gli allievi. L’articolo, tra le varie forme di patologia istituzionale, affronta principalmente il tema di quelle che presiedono alle resistenze degli insegnanti al lavoro introspettivo con il proprio mondo interno, conseguenza e ulteriore cagione di sensi di colpa nel rapporto con gli allievi e di fenomeni di burnout lavorativo degli stessi insegnanti. Tali fenomeni vanno nella direzione del rinforzo sia di un atteggiamento di chiusura verso la collaborazione con professionisti esterni all’istituzione scolastica, sia di un atteggiamento di minore empatia e vicinanza emotiva con la realtà interna degli allievi.

  2. Accelerated transformation of brushite to octacalcium phosphate in new biomineralization media between 36.5 deg. C and 80 deg. C

    Energy Technology Data Exchange (ETDEWEB)

    Temizel, Neslihan; Girisken, Giray; Tas, A. Cuneyt, E-mail: cuneyt-tas@ouhsc.edu

    2011-07-20

    This study investigated the hydrothermal transformation of brushite (dicalcium phosphate dihydrate, DCPD, CaHPO{sub 4}.2H{sub 2}O) into octacalcium phosphate (OCP, Ca{sub 8}(HPO{sub 4}){sub 2}(PO{sub 4}){sub 4}.5H{sub 2}O) in seven different newly developed biomineralization media, all inspired from the commercial DMEM solutions, over the temperature range of 36.5 deg. C to 90 deg. C with aging times varying between 1 h and 6 days. DCPD powders used in this study were synthesized in our laboratory by using a wet-chemical technique. DCPD was found to transform into OCP in the Ca{sup 2+}, Mg{sup 2+}, Na{sup +}, K{sup +}, HCO{sub 3}{sup -}, Cl{sup -} and H{sub 2}PO{sub 4}{sup -} containing aqueous biomineralization media in less than 72 h at 36.5 deg. C, without stirring. The same medium was able to convert DCPD into OCP in about 2 h at 75-80 deg. C, again without a need for stirring. Samples were characterized by using powder X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), and scanning electron microscopy (SEM). - Research highlights: {yields} New biomineralization solutions developed to convert DCPD into OCP at 36.5 deg. C to 80 deg. C. {yields} DCPD powder was the starting material. {yields} OCP was synthesized under static conditions (no need for stirring). {yields} OCP was synthesized in sealed glass media bottles in solutions free of Hepes or Tris. {yields} OCP can be synthesized at 75-80 deg. C in only 2 hours in the above solutions without stirring.

  3. Temperature dependent dynamics of DegP-trimer: A molecular dynamics study

    Directory of Open Access Journals (Sweden)

    Nivedita Rai

    2015-01-01

    Full Text Available DegP is a heat shock protein from high temperature requirement protease A family, which reacts to the environmental stress conditions in an ATP independent way. The objective of the present analysis emerged from the temperature dependent functional diversity of DegP between chaperonic and protease activities at temperatures below and above 28 °C, respectively. DegP is a multimeric protein and the minimal functional unit, DegP-trimer, is of great importance in understanding the DegP pathway. The structural aspects of DegP-trimer with respect to temperature variation have been studied using molecular dynamics simulations (for 100 ns and principal component analysis to highlight the temperature dependent dynamics facilitating its functional diversity. The DegP-trimer revealed a pronounced dynamics at both 280 and 320 K, when compared to the dynamics observed at 300 K. The LA loop is identified as the highly flexible region during dynamics and at extreme temperatures, the residues 46–80 of LA loop express a flip towards right (at 280 and left ( at 320 K with respect to the fixed β-sheet connecting the LA loop of protease for which Phe46 acts as one of the key residues. Such dynamics of LA loop facilitates inter-monomeric interaction with the PDZ1 domain of the neighbouring monomer and explains its active participation when DegP exists as trimer. Hence, the LA loop mediated dynamics of DegP-trimer is expected to provide further insight into the temperature dependent dynamics of DegP towards the understanding of its assembly and functional diversity in the presence of substrate.

  4. Urologic and male genital manifestations of granulomatosis with polyangiitis.

    Science.gov (United States)

    Alba, Marco A; Moreno-Palacios, Jorge; Beça, Sara; Cid, María C

    2015-10-01

    Granulomatosis with polyangiitis (GPA) is a systemic necrotizing granulomatous vasculitis, which predominantly affects small-sized blood vessels. Major organ involvement includes the upper/lower respiratory tract and kidneys. In contrast, genitourinary disease is rare in GPA patients, reported in <1% of cases in large cohorts. Manifestations at this level include prostatitis, destructive urethritis, genital ulcers, orchitis and renal masses. Also, high-dose cyclophosphamide, one of the main immunosuppressive drugs used for GPA treatment, is associated with bladder toxicity, i.e., hemorrhagic cystitis and cancer. Here, we review the main urogenital symptoms associated with this ANCA-associated vasculitis. In addition, cyclophosphamide-induced urologic complications are detailed. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Functional and therapeutic significance of EZH2 in urological cancers

    Science.gov (United States)

    Liu, Xiaobing; Wu, Qingjian; Li, Longkun

    2017-01-01

    The enhancer of zeste homolog 2 (EZH2) is a core subunit of the polycomb repressor complex 2 (PRC2), which is overexpressed in numerous cancers and mutated in several others. Notably, EZH2 acts not only a critical epigenetic repressor through its role in histone methylation, it is also an activator of gene expression, acting through multiple signaling pathways in distinct cancer types. Increasing evidence suggests that EZH2 is an oncogene and is central to initiation, growth and progression of urological cancers. In this review, we highlight the critical role of EZH2 as a master regulator of tumorigenesis in the prostate, bladder and the kidney through epigenetic control of transcription as well as a modulation of various critical signaling pathways. We also discuss the promise and challenges for EZH2 inhibitors as future anticancer therapeutics, some of which are currently in clinical trials. PMID:28410242

  6. Urological outcome after myelomeningocele: 20 years of follow-up

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens; Biering-Sorensen, Fin; Cortes, Dina

    2011-01-01

    Study Type - Therapy (case series)¿Level of Evidence 4 OBJECTIVES: To evaluate the urological outcome in a long-term follow-up of individuals with myelomeningocele and relate the findings obtained to urodynamic variables in childhood. MATERIAL AND METHODS: Individuals with myelomeningocele born....... In childhood and at follow-up, kidney function was estimated with renography and isotope-glomerular filtration rate examinations. RESULTS: In total, 52 individuals (28 boys and 24 girls) aged 19-41 years (median, 29 years) had follow-up. Of these, 37 (71%) individuals had bilateral normal kidney function...... at follow-up; seven (14%) had normal total renal function but unilateral deteriorated kidney, and eight individuals (15%) had deteriorated kidney function. Adult individuals with bilateral kidney deterioration had a significant higher frequency of diagnosed detrusor overactivity at childhood urodynamics (63...

  7. [German Society of Urology Congress, Hamburg and the Presidential Medal].

    Science.gov (United States)

    Albrecht, K; Schultheiss, D

    2017-02-01

    The German Society of Urology (DGU) e. V. meeting has been an integral part of knowledge sharing among national and international experts since 1907. Hamburg was the host city for this meeting nine times (until 2015), including the 47th Annual Meeting of the DGU in 1995 under the presidency of Prof. Dr. U. Jonas (Hannover). As part of the 47th conference, a new insignia in the form of the Presidential Medal was given to the designated successor for the first time. The medal, which is in the form of a chain, was made in a small workshop in Idar-Oberstein, Germany.

  8. Functional and therapeutic significance of EZH2 in urological cancers.

    Science.gov (United States)

    Liu, Xiaobing; Wu, Qingjian; Li, Longkun

    2017-06-06

    The enhancer of zeste homolog 2 (EZH2) is a core subunit of the polycomb repressor complex 2 (PRC2), which is overexpressed in numerous cancers and mutated in several others. Notably, EZH2 acts not only a critical epigenetic repressor through its role in histone methylation, it is also an activator of gene expression, acting through multiple signaling pathways in distinct cancer types. Increasing evidence suggests that EZH2 is an oncogene and is central to initiation, growth and progression of urological cancers. In this review, we highlight the critical role of EZH2 as a master regulator of tumorigenesis in the prostate, bladder and the kidney through epigenetic control of transcription as well as a modulation of various critical signaling pathways. We also discuss the promise and challenges for EZH2 inhibitors as future anticancer therapeutics, some of which are currently in clinical trials.

  9. The phosphorylation state of the DegU response regulator acts as a molecular switch allowing either degradative enzyme synthesis or expression of genetic competence in Bacillus subtilis.

    Science.gov (United States)

    Dahl, M K; Msadek, T; Kunst, F; Rapoport, G

    1992-07-15

    Two classes of mutations were identified in the degS and degU regulatory genes of Bacillus subtilis, leading either to deficiency of degradative enzyme synthesis (degS or degU mutations) or to a pleiotropic phenotype which includes overproduction of degradative enzymes and the loss of genetic competence (degS(Hy) or degU(Hy) mutations). We have shown previously that the DegS protein kinase and the DegU response regulator form a signal transduction system in B. subtilis. We now demonstrate that the DegS protein kinase also acts as a DegU phosphatase. We present evidence that the DegU response regulator has two active conformations: a phosphorylated form which is necessary for degradative enzyme synthesis and a nonphosphorylated form required for expression of genetic competence. The degU146-encoded response regulator, allowing expression of genetic competence, has been purified and seems to be modified within the putative phosphorylation site (D56----N) since it is no longer phosphorylated by DegS. Both the degU146 mutation as well as the degS220 mutation, which essentially abolishes DegS protein kinase activity, lead to deficiency of degradative enzyme synthesis, indicating the requirement of phosphorylated DegU for the expression of this phenotype. We also purified the degU32(Hy)-encoded protein and showed that this response regulator is phosphorylated by the DegS protein kinase in vitro. In addition, the phosphorylated form of the degU32(Hy)-encoded protein presented a strongly increased stability as compared with the wild type DegU protein, thus leading to hyperproduction of degradative enzymes in vivo.

  10. Early detection of prostate cancer: European Association of Urology recommendation.

    Science.gov (United States)

    Heidenreich, Axel; Abrahamsson, Per-Anders; Artibani, Walter; Catto, James; Montorsi, Francesco; Van Poppel, Hein; Wirth, Manfred; Mottet, Nicolas

    2013-09-01

    The recommendations and the updated EAU guidelines consider early detection of PCa with the purpose of reducing PCa-related mortality and the development of advanced or metastatic disease. This paper presents the recommendations of the European Association of Urology (EAU) for early detection of prostate cancer (PCa) in men without evidence of PCa-related symptoms. The working panel conducted a systematic literature review and meta-analysis of prospective and retrospective clinical studies on baseline prostate-specific antigen (PSA) and early detection of PCa and on PCa screening published between 1990 and 2013 using Cochrane Reviews, Embase, and Medline search strategies. The level of evidence and grade of recommendation were analysed according to the principles of evidence-based medicine. The current strategy of the EAU recommends that (1) early detection of PCa reduces PCa-related mortality; (2) early detection of PCa reduces the risk of being diagnosed and developing advanced and metastatic PCa; (3) a baseline serum PSA level should be obtained at 40-45 yr of age; (4) intervals for early detection of PCa should be adapted to the baseline PSA serum concentration; (5) early detection should be offered to men with a life expectancy ≥ 10 yr; and (6) in the future, multivariable clinical risk-prediction tools need to be integrated into the decision-making process. A baseline serum PSA should be offered to all men 40-45 yr of age to initiate a risk-adapted follow-up approach with the purpose of reducing PCa mortality and the incidence of advanced and metastatic PCa. In the future, the development and application of multivariable risk-prediction tools will be necessary to prevent over diagnosis and over treatment. Copyright © 2013 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  11. ["Fast-track" in pediatric urologic surgery: pronenephrectomy].

    Science.gov (United States)

    Tardáguila, A R; Romero, R; Parente, A; Rivas, S; Fanjul, M; Corona, C; Angulo, J M

    2013-04-01

    INTRODUCTION AND OBJETIVES: Minimal invasive surgery trends to get prompt recovery in terms of inmediate deambulation and early discharge from hospital, without increasing patient's discomfort neither postoperative complications. This "fast-track" protocol is being progresively introduced in a crescent number of urological procedures. We are evaluating the viability of applying it in retroperitoneoscopic prone- position nephrectomy. We have performed a retrospective review of the clinical reports of the patients submitted to prone nephrectomy with hospitalization between 2007 and 2011 and we present patients submitted to this procedure in an outpatient basis (less than 8 hours hospital stay) from 2011. We have recorded epidemiological factors, diagnosis, surgical time, first postoperative week analgesic requirements, parents cofort and postoperative complications. All the procedures were performed retroperitoneoscopically in prone position using two trocars. We included 34 nephrectomies with a mean surgical time of 107 minutes. Mean postoperative stay was under 24 hours in 23 patients, two of them were discharged in the first 8 hours after the procedure. Hospital stay over this time was due to concomitant pre-existent pathology in 6 patients and to non urological fever in the remaining 3. Analgesia was excellent in every patient with endovenous non-steroid drugs, registering no pain after administering them orally. There were no complications. We believe that "fast-track" requirements can be applied to prone-retroperitoneoscopic nephrectomy in pediatric population, as long as they have no associated pathology. In our experience this surgical procedure can be included in day-case surgery, increasing patient's confort and with a positive economical impact.

  12. Urological applications of Ho/Nd:Yag laser

    Science.gov (United States)

    Grifoni, Riccardo; Pierangeli, Tiziana; Gioacchini, Andrea; Muraro, Giovanni B.

    2001-10-01

    The introduction of Ho:Yag laser has brought many advantages in urology. By this work we want show you our experience with this technology. Between April 1998 and May 2000 we treated 137 patients. Of these 28 had urinary lithiasis (18 bladder and 10 ureteral stones 3 in the upper, 2 in the middle and 5 in the distal tract), 40 were affected by enlargement of prostatic gland: 32 had B.P.H., 8 P.C.; 36 had T.C.C. and 33 strictures of urethra (27) or bladder neck (6). For ureteral lithiasis we used 200 micrometer fiber, energy of 0.5 - 1.4 J with 10 Hz of frequency. In case of bladder stones a 550 or 1000 micrometer using a power of 80 W. The prostatic gland were resected by a 550 micrometer fiber, 2.2 - 2.8 J, 25 - 30 Hz and 70 -80 W. The superficial bladder tumors were removed by 1.4 J with 10 - 15 Hz and 10 - 14 W. In the large tumors we completed the procedure by Nd:YAG at the base of the tumor. Urethra and bladder neck strictures were treated by 1.2 - 1.8 J and 10 - 30 Hz. We successful treated 26 patients with urinary lithiasis obtained the complete vaporization of the stones, 2 had endoscopic ancillary procedures. Out of 32 patients with B.P.H. 41% had the complete resection of the gland the others the resection of the 3d lobe. We removed 114 superficial bladder tumors and only 4 patients had a local recurrence. Of the patients with the strictures 4 had more than one treatment and about 87% had good result. From our experience the use of Holmium:Yag laser has been very efficacy to treat different urological diseases, also in patients with important comorbid disorders and its use reduce the stay in hospital and so the costs.

  13. Evaluating the quality of Internet health resources in pediatric urology.

    Science.gov (United States)

    Fast, Angela M; Deibert, Christopher M; Hruby, Gregory W; Glassberg, Kenneth I

    2013-04-01

    Many patients and their parents utilize the Internet for health-related information, but quality is largely uncontrolled and unregulated. The Health on the Net Foundation Code (HONcode) and DISCERN Plus were used to evaluate the pediatric urological search terms 'circumcision,' 'vesicoureteral reflux' and 'posterior urethral valves'. A google.com search was performed to identify the top 20 websites for each term. The HONcode toolbar was utilized to determine whether each website was HONcode accredited and report the overall frequency of accreditation for each term. The DISCERN Plus instrument was used to score each website in accordance with the DISCERN Handbook. High and low scoring criteria were then compared. A total of 60 websites were identified. For the search terms 'circumcision', 'posterior urethral valves' and 'vesicoureteral reflux', 25-30% of the websites were HONcode certified. Out of the maximum score of 80, the average DISCERN Plus score was 60 (SD = 12, range 38-78), 40 (SD = 12, range 22-69) and 45 (SD = 19, range 16-78), respectively. The lowest scoring DISCERN criteria included: 'Does it describe how the treatment choices affect overall quality of life?', 'Does it describe the risks of each treatment?' and 'Does it provide details of additional sources of support and information?' (1.35, 1.83 and 1.95 out of 5, respectively). These findings demonstrate the poor quality of information that patients and their parents may use in decision-making and treatment choices. The two lowest scoring DISCERN Plus criteria involved education on quality of life issues and risks of treatment. Physicians should know how to best use these tools to help guide patients and their parents to websites with valid information. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  14. Accreditation Council for Graduate Medical Education competency-based on-line computer course in pediatric oncology for urology residents.

    Science.gov (United States)

    DaJusta, Daniel G; Mueller, Thomas J; Barone, Joseph G

    2008-05-01

    To develop an on-line course in pediatric urology for our urology residents, to expose residents to required pediatric urology content within the confines of an 80-hour work week. An on-line, Accreditation Council for Graduate Medical Education competency-based course in pediatric urology was designed using a commercially based platform. The computer-based teaching course was flexible and provided virtually limitless opportunities for course design, structure, and content. Computer-based teaching platforms may be a useful alternative teaching method to facilitate urology resident education within the confines of an 80-hour work week.

  15. Bringing excellence into urology: How to improve the future training of residents?

    Science.gov (United States)

    Miernik, Arkadiusz; Sevcenco, Sabina; Kuehhas, Franklin Emmanuel; Bach, Christian; Buchholz, Noor; Adams, Fabian; Wilhelm, Konrad; Schoenthaler, Martin

    2013-01-01

    The problem The demographic development of society leads to an increased demand for physicians. Particularly in the surgical disciplines, there is a noticeably declining interest among graduates from medical schools worldwide. For reasons discussed in detail, this applies especially to urology. Solutions We indicate possibilities on how to counteract this trend, by improving the training for urology residents. Whereas some major changes for the better have already been introduced into the curricula in some countries, others will have to be further specified in the future. This article gives an overview of the requirements of a specific training programme, from a planning phase to its certification. Aspects such as the selection of candidates, the goals of a good training programme, and an implementation strategy are presented. Essential elements of a urology resident programme for effective coaching, improving medical skills (e.g. in surgical laboratories), knowledge revision, progress evaluation, and retrospection are discussed critically, giving an understanding of the crucial requirements of a good and attractive education in urology. Conclusion A structured and well organised training programme might attract additional medical students towards urology and contribute significantly to the further development of the speciality. This can be seen as an initiative to counteract the decline of urology as an attractive field of interest to upcoming generations of physicians, and therefore to ensure urological care of the highest quality that patients deserve. PMID:26019915

  16. Laparoscopic skill laboratory in urological surgery: tools and methods for resident training

    Directory of Open Access Journals (Sweden)

    Fabio C. M. Torricelli

    2011-02-01

    Full Text Available PURPOSE: Laparoscopy has certainly brought considerable benefits to patients, but laparoscopic surgery requires a set of skills different from open surgery, and learning in the operating room may increase surgical time, and even may be harmful to patients. Several training programs have been developed to decrease these potential prejudices. PURPOSES: to describe the laparoscopic training program for urological residents of the "Hospital das Clinicas" of the Sao Paulo Medical School, to report urological procedures that are feasible in dry and wet labs, and to perform a critical analysis of the cost-benefit relation of advanced laparoscopic skills laboratory. MATERIALS AND METHODS: The laparoscopic skill lab has two virtual simulators, three manual simulators, and four laparoscopic sets for study with a porcine model. The urology residents during their first year attend classes in the virtual and manual simulator and helps the senior urological resident in activities carried out with the laparoscopic sets. During the second year, the urological resident has six periods per week, each period lasting four hours, to perform laparoscopic procedures with a porcine model. Results: In a training program of ten weeks, one urological resident performs an average of 120 urological procedures. The most common procedures are total nephrectomy (30%, bladder suture (30%, partial nephrectomy (10%, pyeloplasty (10%, ureteral replacement or transuretero anastomosis (10%, and others like adrenalectomy, prostatectomy, and retroperitoneoscopy. These procedures are much quicker and caused less morbidity. CONCLUSION: Laparoscopic skills laboratory is a good method for achieving technical ability.

  17. Training for MIS in pediatric urology: proposition of a structured training curriculum.

    Science.gov (United States)

    Escolino, Maria; Turrà, Francesco; Settimi, Alessandro; Esposito, Ciro

    2016-10-01

    In Europe there are a lot of training centers for minimally invasive surgery (MIS) but a standardized MIS training program in pediatric urology doesn't exist at the moment. We performed a literature review with the last goals to propose a structured training curriculum in MIS urology for pediatric surgeons. Pediatric urologists have to obtain a valid MIS training curriculum completing the following 4 steps: (I) Theoretical part (theoretical courses, masterclass) to acquire theoretical knowledge; (II) experimental training (simulation on pelvic trainer, virtual reality simulators, animal models, 3-D ex-vivo models) to acquire basic laparoscopic skills; (III) stages in European centers of reference for pediatric MIS urology to learn all surgery aspects; (IV) personal operative experience. At the end of the training period, the trainee would be expected to perform several MIS urological procedures independently, under supervision of an expert tutor. At the end of the training program, each center will analyze the candidate training booklet and release for each applicant a certification after an exam. We think that this MIS training program in pediatric urology may assure an integrated acquisition of basic and advanced laparoscopic skills during residency training in pediatric urology. Each European country should adopt this program so as to secure a standardized technical qualification in MIS urology for all future pediatric urologists.

  18. MUNICIPAL-PRIVATE PARTNERSHIP – A MECHANISM FOR THE DEVELOPMENT OF MUNICIPAL OUTPATIENT UROLOGY

    Directory of Open Access Journals (Sweden)

    A. R. Gevorkyan

    2017-01-01

    Full Text Available The relevance of the study is determined by the need to attract private investment in the field of municipal health care with the aim of improving the system of outpatient urological care.Purpose. To determine the vectors of development, planning, the basic conditions for the implementation of municipalprivate partnership (IMPP in the system of municipal outpatient urological care.Materials and methods. To achieve this goal, general scientific methods of analysis, synthesis, generalization, interpretation of scientific data, as well as systemic and structural-functional approaches were applied in the work.Results. The article provides the scientific substantiation of the role of municipal-private partnership in the development of municipal outpatient urology. Methodical approaches to the formation of the outpatient center of urology with the mechanisms of the mixed economy, developing business processes involving private investor resources in the reproduction processes and increasing the efficiency of the municipal system of outpatient urological care are outlined.Conclusions. The article defines the vectors of development, planning, the main conditions for the implementation of municipal-private partnershipsin the system of municipal outpatient urological carein order to attract privateinvestments and develop an outpatient urology system. 

  19. Gender and Subspecialty of Urology Faculty in Department-based Leadership Roles.

    Science.gov (United States)

    Han, Julia; Stillings, Stephanie; Hamann, Harold; Terry, Russell; Moy, Louis

    2017-12-01

    To characterize the current gender and subspecialty of those holding academic departmental administrative and educational leadership roles in urology. We conducted a cross-sectional observational study of U.S. Urology Residency Programs in 2016-2017. Inclusion criteria were participation in the Urology Residency Match Program and having a department of urology website. From June 1, 2016 to August 20, 2016, each department's website was queried. If information was missing or unclear, we reviewed faculty biographies and contacted residency program coordinators. We queried 124 urology residency programs. For administrative leadership roles, women comprised 3.3% of chairs, 4.5% of vice chairs, and 7.9% of division directors. For educational leadership roles, women comprised 9.4% of fellowship directors, 8.1% of residency directors, and 27.4% of medical student clerkship directors. The most common subspecialties for chairs included oncology (49.2%), endourology (16.4%), and female urology (7.4%). Among division directors, female urology had the highest representation of women (27.8%) followed by pediatric urology (9.8%), reconstruction (5%), endourology (4.3%), and andrology (4%). Overall, women are disproportionately underrepresented when it comes to educational and administrative positions of urology departmental leadership. There is also a wide yet narrowing gender gap as more women are pursuing careers in this field. Given this upward trend we may see more women in positions of leadership over time. Future efforts should be made to help promote the advancement of women to positions of leadership. Published by Elsevier Inc.

  20. Analisi degli errori in produzioni scritte di apprendenti sinofoni

    Directory of Open Access Journals (Sweden)

    Gloria Limonta

    2009-12-01

    Full Text Available Normal 0 14 MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabella normale"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman";} Il presente articolo propone un’analisi degli errori rilevati in un corpus di testi prodotti da un gruppo di studenti universitari sinofoni. Scopo di tale analisi è individuare le possibili interferenze della lingua madre (cinese mandarino all’interno de processo di acquisizione della L2 (italiano, al fine di comprendere più approfonditamente le principali difficoltà linguistiche incontrate da apprendenti sinofoni nell’acquisizione dell’italiano. Nel primo capitolo si prendono brevemente in considerazione gli aspetti della lingua cinese che si distanziano maggiormente dal sistema linguistico dell’italiano e che per questo rappresentano frequenti fonti di errore nel processo di apprendimento.  Il capitolo 2 è invece dedicato all’esposizione dei risultati dell’analisi svolta.    Normal 0 14 MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabella normale"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman";} The article offers an analysis of the errors found in a corpus of texts produced by a group of Chinese-speaking university students.  The objective of the analysis is to identify possible interferences from their mother tongue (Mandarin Chinese in the process of acquiring the L2 (Italian, in order to gain a deeper understanding of the main linguistic difficulties encountered by Chinese

  1. L’esperienza poetica nell’Argentina degli anni Sessanta

    Directory of Open Access Journals (Sweden)

    S. Lafuente

    2012-08-01

    Full Text Available ENJuan Gelman, Leónidas Lamborghini, Francisco Urondo, César Ferández Moreno, among the most famous of the poetic generation in Argentina during the Sixties, take up the concept of critical verbal art that the Hispanic-American vanguard had proposed as a priority. They finished the work of their predecessors, especially that of the late Huidobro, who, after Altazor left the more external aspects of the play behind, and of César Vallejo, creating a poetic area where emotion and subjectivity coexist with linguistic experimentation, where the pleasure of construction and the subtleties of linguistic deformations are inexorably tied to sentiment.In obliterating the distance between I and You, their poetry abandons the passage between different textual practices and gives space to an inter-subjectivity that leads the reader to forget his passivity and become active in sensory production.Keywords: avant-garde, Argentine poetry, the Sixties, linguistic experimentationITJuan Gelman, Leónidas Lamborghini, Francisco Urondo, César Ferández Moreno, fra i nomi più noti della generazione poetica argentina degli anni Sessanta, riprendono la concezione di un’arte verbale critica che l’avanguardia ispanoamericana aveva proposto come prioritaria. Completano il lavoro dei suoi predecessori, soprattutto dell’ultimo Huidobro, che dopo Altazor abbandona gli aspetti più esterni del gioco, e di César Vallejo, creando uno spazio poetico dove l’emozione, la soggettività, coesistono con la sperimentazione del linguaggio, dove il piacere della costruzione, delle sottigliezze delle deformazioni linguistiche sono indissolubilmente legate al sentimento.La loro poesia, nell’abolire la distanza fra Io e Tu, lascia aperto il passaggio fra le pratiche testuali differenti e dà spazio a un’intersoggettività che induce il lettore ad abbandonare la sua passività e a diventare attivo nella produzione del senso.Parole chiave: avanguardia, poesia argentina

  2. Training, credentialing, proctoring and medicolegal risks of robotic urological surgery: recommendations of the society of urologic robotic surgeons.

    Science.gov (United States)

    Zorn, Kevin C; Gautam, Gagan; Shalhav, Arieh L; Clayman, Ralph V; Ahlering, Thomas E; Albala, David M; Lee, David I; Sundaram, Chandru P; Matin, Surena F; Castle, Erik P; Winfield, Howard N; Gettman, Matthew T; Lee, Benjamin R; Thomas, Raju; Patel, Vipul R; Leveillee, Raymond J; Wong, Carson; Badlani, Gopal H; Rha, Koon H; Eggener, Scott E; Wiklund, Peter; Mottrie, Alex; Atug, Fatih; Kural, Ali R; Joseph, Jean V

    2009-09-01

    With the exponential growth of robotic urological surgery, particularly with robot assisted radical prostatectomy, guidelines for safe initiation of this technology are a necessity. Currently no standardized credentialing system exists to our knowledge to evaluate surgeon competency and safety with robotic urological surgery performance. Although proctoring is a modality by which such competency can be evaluated, other training tools and guidelines are needed to ensure that the requisite knowledge and technical skills to perform this procedure have been acquired. We evaluated the current status of proctoring and credentialing in other surgical specialties to discuss and recommend its application and implementation specifically for robot assisted radical prostatectomy. We reviewed the literature on safety and medicolegal implications of proctoring and the safe introduction of surgical procedures to develop recommendations for robot assisted radical prostatectomy proctoring and credentialing. Proctoring is an essential mechanism for robot assisted radical prostatectomy institutional credentialing and should be a prerequisite for granting unrestricted privileges on the robot. This should be differentiated from preceptoring, wherein the expert is directly involved in hands-on training. Advanced technology has opened new avenues for long-distance observation through teleproctoring. Although the medicolegal implications of an active surgical intervention by a proctor are not clearly defined, the role as an observer should grant immunity from malpractice liability. The implementation of guidelines and proctoring recommendations is necessary to protect surgeons, proctors, institutions and, above all, the patients who are associated with the institutional introduction of a robot assisted radical prostatectomy program. With no current guidelines we anticipate this article will serve as a catalyst of interorganizational discussion to initiate regulatory oversight of surgeon

  3. [Urology before illustration. From the Urology of the Royal College of Cadiz to that of the "veneranda" gathering].

    Science.gov (United States)

    Romero Tenorio, Manuel; Solano Castro, Domingo; Ledó Cepero, Ma José; Romero de Soto, Reyes; Valencia Vergara, Oscar; García Vázquez, Amalia; Romero de Soto, Dolores; Soto Villalba, Juan; Alvarez Ossorio, José

    2007-10-01

    The study of the urological activity in the Andalusian occident is contained in the printed and handwritten "Observations" of the records of the Royal Society of Medicine of Seville and the Royal College of Surgery of Cadiz. They encompass the period from 1693 to the first third of the 18th century. By the first of October 1701, the "Veneranda" gathering consolidates and Philip V gives the "royal warrant". The "Royal Society of Medicine and Other Sciences of Seville" starts its medical-surgical path. It should be reminded that all the Andalusian surgery and specially the one from Cadiz (through the Royal College of Surgeons) was present in the Royal Society. Ordoñez de la Barrera, Sánchez Bernal, Fray Ambrosio de Guibeville, Juan Lacombe, Pedro Virgili and many others were founders of this extraordinary event. Surgical training and, by extension, urological training had their root and basement in the anatomical amphitheaters (Seville 1731 and Cadiz 1728), which were considered ungodly by the Church. José Celestino Mutis (1750-53) and Pedro Fernandez Castilla (1741) excluded the university from this new movement. There was and intense relationship between Navy surgeons and the Royal Society, being members since its foundation: Guibeville (1719); Sánchez Bernal (1719); Gregorio Arias (1729); Gaspar de Pellicer (1729); Lacombe (1730); Fernández Castilla (1741); Calero (1789). The main protagonist was Luis Montero, real paradigm with projection to the next century, having a neat French influence altogether with Ramos, both of them being Beaumond's alumni (an anatomist of recognized prestige).

  4. Using Paraffin with -10 deg C to 10 deg C Melting Point for Payload Thermal Energy Storage in SpaceX Dragon Trunk

    Science.gov (United States)

    Choi, Michael K.

    2013-01-01

    A concept of using paraffin wax phase change material (PCM) with a melting point between -10 deg C and 10 deg C for payload thermal energy storage in a Space Exploration Technologies (SpaceX) Dragon trunk is presented. It overcomes the problem of limited heater power available to a payload with significant radiators when the Dragon is berthed to the International Space Station (ISS). It stores adequate thermal energy to keep a payload warm without power for 6 hours during the transfer from the Dragon to an ExPRESS logistics carrier (ELC) on the ISS.

  5. Best practices recommendations in the application of immunohistochemistry in urologic pathology: report from the International Society of Urological Pathology consensus conference.

    Science.gov (United States)

    Amin, Mahul B; Epstein, Jonathan I; Ulbright, Thomas M; Humphrey, Peter A; Egevad, Lars; Montironi, Rodolfo; Grignon, David; Trpkov, Kiril; Lopez-Beltran, Antonio; Zhou, Ming; Argani, Pedram; Delahunt, Brett; Berney, Daniel M; Srigley, John R; Tickoo, Satish K; Reuter, Victor E

    2014-08-01

    Members of the International Society of Urological Pathology (ISUP) participated in a half-day consensus conference to discuss guidelines and recommendations regarding best practice approaches to use of immunohistochemistry (IHC) in differential diagnostic situations in urologic pathology, including bladder, prostate, testis and, kidney lesions. Four working groups, selected by the ISUP leadership, identified several high-interest topics based on common or relevant challenging diagnostic situations and proposed best practice recommendations, which were discussed by the membership. The overall summary of the discussions and the consensus opinion forms the basis of a series of articles, one for each organ site. This Special Article summarizes the overall recommendations made by the four working groups. It is anticipated that this ISUP effort will be valuable to the entire practicing community in the appropriate use of IHC in diagnostic urologic pathology.

  6. The role of scarless procedures in urology: A review of literature ...

    African Journals Online (AJOL)

    scarless” surgery has been steadily increasing in the recent urological literature, as a new surgical intervention to access intra-peritoneal organs. NOTES comes with the promise of both scar less and painless postoperative procedures. It utilizes ...

  7. Urology residency and research: round table discussion and plea for innovation.

    Science.gov (United States)

    Montie, James; Faerber, Gary; Schaeffer, Anthony; Steers, William; Liebert, Monica; Stoll, Doris; Macoska, Jill

    2008-05-01

    To evaluate the current and future states of resident research experience in urology residencies in the United States. Round table discussion with leading educators and Urology faculty from a university urology residency. Research exposure has rapidly diminished in urology residencies for a variety of reasons. There are multiple barriers to resident research and only a small number of residencies will be able to provide protected time. Nevertheless, an understanding of research methodology and biostatistics is required to be a successful clinician. Some barriers to resident research can be addressed by better integration of residency and fellowships. Flexibility in the format of resident education may allow introduction of new methods to encourage resident research scholarship. An education program with a research curriculum is needed for all residencies.

  8. Knowledge about urology in the general population of Jeddah, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Ghassan A Barayan

    2011-01-01

    Conclusion : Although significant proportion of our population know little about the field of urology, the overall result is better when compared to North American population. The clarity of Arabic terminology related to the field may explain the difference.

  9. [Urology and National Socialism: the fate of Alexander von Lichtenberg 1880-1949].

    Science.gov (United States)

    Moll, F H; Krischel, M; Rathert, P; Fangerau, H

    2010-09-01

    Alexander von Lichtenberg (1880-1949) was one of the famous members of the German Urological Society (DGU) in pre-war Germany. He introduced excretion urography and a special TURP Instrument. In 1928 he was president of the 8th meeting held in the German capital Berlin. His Handbook of Urology, released by Ferdinand Springer publishing house, was a trendsetter in establishing urology as a specialty in Germany and bringing together the whole wisdom of all aspects of urology. He was the founder of the famous Maximilian Nitze Award of the DGU. As a Jew he-like many others-was forced to leave Nazi Germany after 1933. Even in Hungary, his native country, he again had to resist anti-Semitic hostility. Later on he lived in Mexico. Alexander von Lichtenberg has to be remembered with special focus on the exodus of German Jewish scientists during the Nazi time.

  10. Application of external microwave thermotherapy in urology: Past, present, and future

    NARCIS (Netherlands)

    Gravas, Stavros; Laguna, M. Pilar; de La Rosette, Jean J. M. C. H.

    2003-01-01

    The excellent clinical results of transurethral microwave thermotherapy (TUMT) for the treatment of symptomatic benign prostatic hyperplasia (BPH) gave to TUMT the leading position among the microwave thermotherapy modalities available for the treatment of different urologic conditions. Research in

  11. Feasibility of dexmedetomidine as sole analgesic agent during robotic urological surgery: A pilot study

    Directory of Open Access Journals (Sweden)

    Bright Jebaraj

    2017-01-01

    Conclusion: The study reveals that dexmedetomidine has equal analgesic efficacy as fentanyl for intraoperative use and can be used as the sole analgesic agent in patients undergoing robotic urological surgery.

  12. [Dr. Puigvert and Archivos Españoles de Urología].

    Science.gov (United States)

    Pérez Albacete, Mariano

    2006-04-01

    For the celebration of the first Century of Dr. Antonio Puigvert Gorro's birth we want to know his contribution to and relationship with Archivos Españoles de Urología. We review all articles published by Dr. Puigvert, and additionally all articles with reference to his person and his work; we also review his written works and biography. He was one of the founders of the journal and always maintained a great cooperation until the '70s; he published important works in it, which are analyzed. We also emphasize his contribution to Urology in addition to his dedication to the history of the speciality. Dr. Puigvert is one of the most distinguished figures in the Spanish Urology, with an immense working capacity and written works. In his works published in Archivos he presents the results of his observations and his studies, as well as part of his innovations, ideas, and discoveries, that he later left in his urology books.

  13. Heat-transfer test results for a .0275-scale space shuttle external tank with a 10 deg/40 deg double cone-ogive nose in the NASA/AMES 3.5-foot hypersonic wind tunnel (FH14), volume 2

    Science.gov (United States)

    Carroll, H. R.

    1977-01-01

    A .0275 scale forebody model of the new baseline configuration of the space shuttle external tank vent cap configuration was tested to determine the flow field due to the double cone configuration. The tests were conducted in a 3.5 foot hypersonic wind tunnel at alpha = -5 deg, -4.59 deg, 0 deg, 5 deg, and 10 deg; beta = 0 deg, -3 deg, -5.51 deg, -6 deg, -9 deg, and +6 deg; nominal freestream Reynolds numbers per foot of 1.5 x 1 million, 3.0 x 1 million, and 5.0 x 1 million; and a nominal Mach number of 5. Separation and reattached flow from thermocouple data, shadowgraphs, and oil flows indicate that separation begins about 80% from the tip of the 10 deg cone, then reattaches on the vent cap and produces fully turbulent flow over most of the model forebody. The hardware disturbs the flow over a much larger area than present TPS application has assumed. A correction to the flow disturbance was experimentally suggested from the results of an additional test run.

  14. Evaluation of microscopic hematuria and risk of urologic cancer in female patients.

    Science.gov (United States)

    Lippmann, Quinn K; Slezak, Jeff M; Menefee, Shawn A; Ng, Casey K; Whitcomb, Emily L; Loo, Ronald K

    2017-02-01

    Urologic cancer has a lower prevalence in women compared with men; however, there are no differences in the recommended evaluation for women and men with microscopic hematuria. The purpose of this study was to identify risk factors that are associated with urologic cancer in women with microscopic hematuria and to determine the applicability of a hematuria risk score for women. We conducted a retrospective cohort study within an integrated healthcare system in Southern California. All urinalyses with microscopic hematuria (>3 red blood cells per high-power field) that were performed from 2009-2015 were identified. Women who were referred for urologic evaluation were entered into a prospective database. Clinical and demographic variables that included the presence of gross hematuria in the preceding 6 months were recorded. The cause of the hematuria, benign or malignant, was entered into the database. Cancer rates were compared with the use of chi-square and logistic regression models. Adjusted risk ratios of urologic cancer were estimated with the use of multivariate regression analysis. We also explored the applicability of a previously developed, gender nonspecific, hematuria risk score in this female cohort. A total of 2,705,696 urinalyses were performed in women during the study period, of which 552,119 revealed microscopic hematuria. Of these, 14,539 women were referred for urologic evaluation; clinical data for 3573 women were entered into the database. The overall rate of urologic cancer was 1.3% (47/3573). In women hematuria, the rate of urologic cancer was 5.8% (20/346) compared with a 0.8% (27/3227) in women with no history of gross hematuria (P 60 years old (odds ratio, 3.1; 95% confidence interval, 1.6-5.9), a history of smoking (odds ratio, 3.2; 95% confidence interval, 1.8-5.9), and a history of gross hematuria in the previous 6 months (odds ratio, 6.2; 95% confidence interval, 3.4-11.5) were associated with urologic cancers. A higher microscopic

  15. Urologic Oncology Branch - Training - NCI/AFUD | Center for Cancer Research

    Science.gov (United States)

    Postdoctoral Research Training Program This program is designed to train Ph.D. postdoctoral scientists in the growing field of urologic oncology. This program offers fellows the opportunity to participate in a diverse training experience that includes clinical and laboratory research on several urologic malignancies. The program provides an opportunity for selected individuals to complete a research project under the direction of a Senior Investigator in the Intramural Program of the National Cancer Institute.

  16. Globalization in Urology: A Bibliographical Analysis of Cross-Continent Publication between 2002 and 2012.

    Science.gov (United States)

    Mani, Jens; Juengel, Eva; Bartsch, Georg; Filmann, Natalie; Ackermann, Hanns; Nelson, Karen; Haferkamp, Axel; Engl, Tobias; Blaheta, Roman A

    2015-01-01

    Asian scientists have now increasingly begun to contribute to globalization; yet it is not clear whether publishing in the field of urology is paralleled by elevated cross-continental scientific publishing. An exemplary bibliometric analysis of urologic journals from 3 different continents was conducted between 2002 and 2012. Based on the ISI Web of Knowledge Journal Citation Reports, 2 urologic journals with similar impact factors (IFs) in 2013 were selected from Europe ('British Journal of Urology International', 'World Journal of Urology'), Asia ('International Journal of Urology', 'Asian Journal of Andrology') and North America ('Urologic Oncology-Seminars and Original Investigations', 'Urology'). The home continent of the journal, the workplace continental affiliation of the last author, article type (clinical, experimental or review) as well as the IF were documented. Most authors published their manuscripts in journals from the same continent in which they worked. However, a significant increase in cross-continental publishing was apparent from 2002 to 2012. Asians publishing in North America increased from 17% in 2002 to 35% in 2012. Europeans also increased the number of articles they published in North American journals, while publications from North American authors were shifted towards both European and Asian journals. Experimental and clinical articles showed significant increases in cross-continental publishing, while review publishing showed no significant change. The average IF for authors from all 3 continents increased from 2002 to 2012 (p < 0.001). The largest increase in the IF was found for Asian authors (0.11 per year). Cross-continental publication significantly increased during the period from 2002 to 2012. The impact that the Asian authors have experienced was found to be gradually impacting the North American and European colleagues. © 2015 S. Karger AG, Basel.

  17. Prevalence and management status of urologic diseases in geriatric hospitals in South Korea: A field research

    Directory of Open Access Journals (Sweden)

    Sang Heon Lee

    2017-01-01

    Full Text Available Purpose: We aimed to investigate the current management status of urologic diseases in geriatric hospitals in South Korea. Materials and Methods: Questionnaire surveys and in-depth person-to-person interviews were conducted at 13 hospitals within the Seoul and Incheon areas. Results: The study was carried out from July to December 2014; 75.6% of patients (1,858/2,458 and 77.5% (779/1,031 of medical personnel responded to our survey. All surveys and interviews were performed by urology specialists, fellows, residents, or nurses. The hospitals included in the study had an average of 215.2 beds (range, 110–367, 189.1 patients (range, 90–345, and 40.2 nurses (range, 10–83. The average number of physicians was 6.2 (range, 3–11, but none of these were certified urologists. Only 4 hospitals provided consultation services for urological disorders. In total, 64% of patients had urological disorders, although only 20.7% of patients were receiving medication. Most patients were being treated using urological interventions; diapers (49.7%, indwelling catheters (19.5%, clean intermittent catheters (12.2%, and external collection urinary drainage (7.9%. However, most interventions were inadequately implemented, and only 17% of the patients had been examined by a certified urologist. Urological complications were found in 20.2% of patients, and secondary complications occurred in 18.8%. Excluding redundant cases, the total prevalence of urological complications was 39.0%. Conclusions: Urologic diseases are poorly managed, and no certified urologists work in geriatric hospitals. Therefore, more designated urologists are needed in geriatric hospitals.

  18. Surgical Staff Radiation Protection During Fluoroscopy-Guided Urologic Interventions.

    Science.gov (United States)

    Galonnier, François; Traxer, Olivier; Rosec, Maeva; Terrasa, Jean-Baptiste; Gouezel, Pascal; Celier, David; Bassinet, Céline; Ruffion, Alain; Paparel, Philipe; Fiard, Gaelle; Terrier, Jean-Etienne

    2016-06-01

    Over the past 20 years, the use of fluoroscopy to guide urologic surgical interventions has been constantly growing. Thus, in their daily practice, urologists and other operating room (OR) staff are exposed to X-radiation increasingly frequently. This raises questions as to the risks they encounter and the actions needed to reduce them. Evaluate X-ray dose exposure in the members of the surgical team and determine urologist radioprotection knowledge and practices. A prospective bicenter study was conducted within AFUF (French urology resident association) and in association with The French Nuclear Safety Authority/The Institute for Radiological Protection and Nuclear Safety (ASN/IRSN). Radiation exposure was measured on 12 operators using dosimeters (seven per operator), in staff-occupied locations in the OR using ionization chambers, and on anthropomorphic phantoms. A survey was used to gather information on radiation knowledge and safety practices of the AFUF members. Annual whole-body radiation doses were low (0.1-0.8 millisieverts [mSv], mostly at around 0.3 mSv), and equivalent doses were low for the fingers (0.7-15 mSv, mostly at around 2.5 mSv), and low for the lens of the eye (0.3-2.3 mSv, mostly at around 0.7 mSv). In percutaneous nephrolithotomy, extremity doses were lower when the patient was placed in dorsal decubitus compared with ventral decubitus. Pulsed fluoroscopy reduced radiation dose exposure by a factor of 3 compared with continuous fluoroscopy with no image quality loss. Radiation safety practices were poor: only 15% of urologists wore dosimeters and only 5% had been trained in the handling of X-ray generators. In the present study, radiation exposure for urologists was low, but so was knowledge of radiation safety and optimization practices. This absence of training for radiation safety and reduction, teamed with novel techniques involving long fluoroscopy-guided interventions, could result in unnecessarily high exposure for patients and OR

  19. The urology match as a prisoner's dilemma: a game theory perspective.

    Science.gov (United States)

    Weissbart, Steven J; Hall, Simon J; Fultz, Bonnie R; Stock, Jeffrey A

    2013-10-01

    To investigate the potential inefficiency in allowing urology residency applicants the ability to apply to an unlimited number of programs, and to study whether an application limit would lead toward a more efficient urology match. Eleven-year data from the American Urological Association were assessed to investigate whether an increase in the yearly mean number of submitted applications was associated with an increase in the yearly mean number of interviews attended or yearly match rate. A match model resembling the current match, except for an application limit, was created to assess the financial and time savings of an application limit. There was no statistically significant relationship between the mean number of submitted applications per applicant with the mean number of interviews an applicant attends (P = .545), match rate (P = .383), or match rate when adjusted to account for additional positions becoming available (P = .100). The cost and time savings of a urology residency match that features an application limit in our model are substantial (up to $575,000 for applicants collectively and 1639 minutes per program director). Allowing urology residency applicants the ability to submit an unlimited number of applications is inefficient. A urology residency match program featuring an application limit would be more financially practical for applicants and engender significant time savings for program directors. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Gender Differences in the Urology Residency Match - Does It Make a Difference?

    Science.gov (United States)

    Aisen, Carrie M; Sui, Wilson; Pak, Jamie S; Pagano, Matthew; Cooper, Kimberly L; Badalato, Gina M

    2017-09-21

    To assess the differences between the male and female urology resident applicant pool. Urology is a competitive field with a selective match process. Women have historically been a minority in medicine. While this has equalized, women continue to be underrepresented in urology. All application submitted through the Electronic Residency Application Service (ERAS) to the Columbia University Department of Urology for the 2015 and 2016 match were reviewed. The differences between the cohorts of matched female and male urology applicants were assessed. Two hundred and fifty-six students in 2015 and 259 students in 2016 submitted applications to Columbia and completed rank lists (60% of the national cohort in 2015 and 62% in 2016). We did find that the overall male applicant pool had a slightly lower number of honors (3 vs 2, p=0.02) and higher USMLE step 1 score (238 vs 234, purology sub internships (1.4 (0.9) for men vs 1.18 (0.8) for women, p=0.04). Overall matched male and female applicants appeared to have very similar qualifications. Men had a higher USMLE step 1 score and women had a higher average number of honors. This data supports the finding that contemporary male and female residency candidates who matched in urology had comparable achievements and the criteria for residency selection in both cohorts is similar. Copyright © 2017. Published by Elsevier Inc.

  1. The Publication Ranking Score for pediatric urology: quantifying thought leadership within the subspecialty.

    Science.gov (United States)

    Lloyd, Jessica C; Madden-Fuentes, Ramiro J; Nelson, Caleb P; Kokorowski, Paul J; Wiener, John S; Ross, Sherry S; Kutikov, Alexander; Routh, Jonathan C

    2013-12-01

    Clinical care parameters are frequently assessed by national ranking systems. However, these rankings do little to comment on institutions' academic contributions. The Publication Ranking Score (PRS) was developed to allow for objective comparisons of scientific thought-leadership at various pediatric urology institutions. Faculty lists were compiled for each of the US News & World Report (USNWR) top-50 pediatric urology hospitals. A list of all faculty publications (2006-2011) was then compiled, after adjusting for journal impact factor, and summed to derive a Publication Ranking Score (PRS). PRS rankings were then compared to the USNWR pediatric urology top-50 hospital list. A total of 1811 publications were indexed. PRS rankings resulted in a mean change in rank of 12 positions, compared to USNWR ranks. Of the top-10 USNWR hospitals, only 4 were ranked in the top-10 by the PRS. There was little correlation between the USNWR and PRS ranks for either top-10 (r = 0.42, p = 0.23) or top-50 (r = 0.48, p = 0.0004) hospitals. PRS institutional ranking differs significantly from the USNWR top-50 hospital list in pediatric urology. While not a replacement, we believe the PRS to be a useful adjunct to the USNWR rankings of pediatric urology hospitals. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  2. Institutional Review Board approval and innovation in urology: current practice and safety issues.

    Science.gov (United States)

    Sundaram, Varun; Vemana, Goutham; Bhayani, Sam B

    2014-02-01

    To retrospectively review recent publications describing novel procedures/techniques, and describe the Institutional Review Board (IRB)/ethics approval process and potential ethical dilemmas in their reporting. We searched PubMed for papers about innovative or novel procedures/techniques between 2011 and August 2012. A query of titles/abstracts in the Journal of Urology, Journal of Endourology, European Urology, BJU International, and Urology identified relevant papers. These results were reviewed for human studies that described an innovative technique, procedure, approach, initial series, and/or used new technology. In all, 91 papers met criteria for inclusion; 25 from the Journal of Endourology, 14 from the Journal of Urology, nine from European Urology, 15 from the BJU International and 28 from Urology. IRB/ethics approval was given for an experimental procedure or database in 24% and 22%, respectively. IRB/ethics approval was not mentioned in 52.7% of studies. Published IRB/ethics approvals for innovative techniques are heterogeneous including database, retrospective, and prospective approvals. Given the concept that innovations are likely not in the legal or ethical standard of care, strong consideration should be given to obtaining IRB/ethics approval before the actual procedure, instead of approval to merely report database outcomes. © 2013 The Authors. BJU International © 2013 BJU International.

  3. Training of European urology residents in laparoscopy: results of a pan-European survey.

    Science.gov (United States)

    Furriel, Frederico T G; Laguna, Maria P; Figueiredo, Arnaldo J C; Nunes, Pedro T C; Rassweiler, Jens J

    2013-12-01

    To assess the participation of European urology residents in urological laparoscopy, their training patterns and facilities available in European Urology Departments. A survey, consisting of 23 questions concerning laparoscopic training, was published online as well as distributed on paper, during the Annual European Association of Urology Congress in 2012. Exposure to laparoscopic procedures, acquired laparoscopic experience, training patterns, training facilities and motivation were evaluated. Data was analysed with descriptive statistics. In all, 219 European urology residents answered the survey. Conventional laparoscopy was available in 74% of the respondents' departments, while robotic surgery was available in 17% of the departments. Of the respondents, 27% were first surgeons and 43% were assistants in conventional laparoscopic procedures. Only 23% of the residents rated their laparoscopic experience as at least 'satisfactory'; 32% of the residents did not attend any course or fellowship on laparoscopy. Dry laboratory was the most frequent setting for training (33%), although 42% of the respondents did not have access to any type of laparoscopic laboratory. The motivation to perform laparoscopy was rated as 'high' or 'very high' by 77% of the respondents, and 81% considered a post-residency fellowship in laparoscopy. Urological laparoscopy is available in most European training institutions, with residents playing an active role in the procedure. However, most of them consider their laparoscopic experience to be poor. Moreover, the availability of training facilities and participation in laparoscopy courses and fellowships are low and should be encouraged. © 2013 The Authors. BJU International © 2013 BJU International.

  4. Systematic review of the potential role of cannabinoids as antiproliferative agents for urological cancers.

    Science.gov (United States)

    Gandhi, Shreyas; Vasisth, Gaurav; Kapoor, Anil

    2017-01-01

    The palliative effects of cannabis sativa (marijuana), which include appetite stimulation, attenuation of nausea and emesis, and pain relief, are well known. The active components of cannabis sativa (cannabinoids) and their derivatives have received growing interest due to their diverse pharmacological activities, such as cell growth inhibition and tumour regression. The aim of this review is to look at the current evidence on the antiproliferative effects of cannabinoids in urological malignancies, including renal, prostate, bladder, and testicular cancers. We conducted a systematic review of studies exploring the effect of cannabinoids on tumour activity, including all study types except expert opinions. A formal search was run on Medline database from 1946 to September 2016, along with a hand-search on PubMed for relevant studies. The search yielded a total of 93 studies from Medline and PubMed, of which 23 studies were included in the final analysis. To date, there are various in vitro studies elucidating the potential mechanism of action of cannabinoids for urological cancers, along with population-based studies specifically for testicular malignancies. To date, no clinical trials have been conducted for urological cancer patients. These results demonstrate that the role of endocannabinoids for urological malignancies is an area of active research. Further research is required not only to evaluate the crosstalk between cancer signaling pathways and cannabinoids, but also large randomized clinical studies with urological patients need to be conducted before cannabinoids can be introduced as potential therapeutic options for urological neoplasms.

  5. [Stem cells and regenerative medicine in urology, part 1: General concepts, kidney, testis and urinary incontinence].

    Science.gov (United States)

    Pastor-Navarro, T; Moratalla-Charcos, L M; Bermell-Marco, L; Beamud-Cortés, M; Osca-García, J M; Gil-Salom, M

    2010-06-01

    Progress in stem cell study and tissue engineering reached during the last times proves that this may be one of the most promising research fields in the future. Most urological diseases could profit from the development of disciplines such as regenerative medicine as, up to now, there have been encouraging results in this subject. We performed an electronic research through the Pubmed database, of both original and review publications, with the following search criteria: stem cells urology, kidney stem cells, testis stem cells, urinary sphincter, cell therapy urology, tissue engineering urology y regenerative medicine urology. We reviewed 33 articles published up to January 2010, trying to summarize the most relevant findings within the last years, the clinical applications and the point we have come to this day. Cell therapy and regenerative medicine are showing themselves to be one of the most promising fields within urological basic investigation in the last years. However, there is much work to be done yet, to make the advances reached in basic research be applicable to the clinic.

  6. La risposta della Chiesa Cattolica al problema degli abusi sui minori: una prospettiva sociologica

    OpenAIRE

    Pece, Emanuela

    2012-01-01

    L’oggetto della nostra ricerca riguarda le dinamiche sociologiche in materia di gestione del discredito a seguito dello scandalo degli abusi sessuali nella Chiesa Cattolica dal 2002 al 2010, prendendo in considerazione alcuni degli eventi mediaticamente più significativi che hanno caratterizzato l’intera vicenda. Il punto di partenza della ricerca è il 9 gennaio 2002, quando il quotidiano americano The Boston Globe ha pubblicato un’inchiesta relativa a un caso di abuso nell’arcidiocesi di Bos...

  7. Prostate cancer risk prediction in a urology clinic in Mexico

    Science.gov (United States)

    Liang, Yuanyuan; Messer, Jamie C; Louden, Christopher; Jimenez-Rios, Miguel A; Thompson, Ian M; Camarena-Reynoso, Hector R

    2012-01-01

    Objectives To evaluate factors affecting the risk of prostate cancer (PCa) and high-grade disease (HGPCa, Gleason score ≥7) in a Mexican referral population, with comparison to the Prostate Cancer Prevention Trial Prostate Cancer Risk Calculator (PCPTRC). Methods and Materials From a retrospective study of 826 patients who underwent prostate biopsy between January 2005 and December 2009 at the Instituto Nacional de Cancerología, Mexico, logistic regression was used to assess the effects of age, prostate-specific antigen (PSA), digital rectal exam (DRE), first-degree family history of PCa, and history of a prior prostate biopsy on PCa and HGPCa separately. Internal discrimination, goodness-of-fit and clinical utility of the resulting models were assessed with comparison to the PCPTRC. Results Rates of both PCa (73.2%) and HGPCa (33.3%) were high among referral patients in this Mexican urology clinic. The PCPTRC generally underestimated the risk of PCa but overestimated the risk of HGPCa. Four factors influencing PCa on biopsy were logPSA, DRE, family history and a prior biopsy history (all purological checkups in Mexico imply that men typically first reach specialized clinics with a high cancer risk. This renders diagnostic tools developed on comparatively healthy populations, such as the PCPTRC, of lesser utility. Continued efforts are needed to develop and externally validate new clinical diagnostic tools specific to high-risk referral populations incorporating new biomarkers and more clinical characteristics. PMID:22306115

  8. [Oswald Schwarz: a pioneer in psychosomatic urology and sexual medicine].

    Science.gov (United States)

    Berberich, H J; Schultheiss, D; Kieser, B

    2015-01-01

    Oswald Schwarz, a urologist from Vienna, was a scholar of Anton Ritter von Frisch and Hans Rubritius. As a physician during World War I, he was confronted with numerous bullet wounds to the spinal cord. In 1919, he completed his professorial thesis"Bladder dysfunction as a result of bullet wounds to the spinal cord". Oswald Schwarz was known as a committed surgeon. As an urologist he also treated patients with sexual dysfunction. Besides his practical and scientific urology-related work, he was also interested in psychology and philosophy. He held lectures on both subjects earning himself the nickname, the Urosoph. In the 1920s, Oswald Schwarz belonged to the inner circle of Alfred Adler, the founder of Individual Psychology, and was editor of the first psychosomatic textbook published in German, "Psychological origin and psychotherapy of physical symptoms" (1925). In addition, Schwarz wrote numerous articles and several books on sexual medicine. He also made many valuable contributions to the development of medical anthropology. Altogether, his work includes over 130 publications. Faced with the rise of fascism and National Socialism in Europe, Oswald Schwarz, who was of Jewish origin, emigrated to England in 1934. There he died in 1949. Unfortunately his scientific work has largely been forgotten. The aim of the following article is to remind us of his important contributions to the field.

  9. Extracellular MicroRNAs in Urologic Malignancies: Chances and Challenges

    Directory of Open Access Journals (Sweden)

    Liang Wang

    2013-07-01

    Full Text Available Small noncoding RNAs that are 19-23 nucleotides long, known as microRNAs (miRNAs, are involved in almost all biological mechanisms during carcinogenesis. Recent studies show that miRNAs released from live cells are detectable in body fluids and may be taken up by other cells to confer cell-cell communication. These released miRNAs (here referred to as extracellular miRNAs are often protected by RNA-binding proteins or embedded inside circulating microvesicles. Due to their relative stability, extracellular miRNAs are believed to be promising candidates as biomarkers for diagnosis and prognosis of disease, or even as therapeutic agents for targeted treatment. In this review, we first describe biogenesis and characteristics of these miRNAs. We then summarize recent publications involving extracellular miRNA profiling studies in three representative urologic cancers, including: prostate cancer, bladder cancer, and renal cell carcinoma. We focus on the diagnostic, prognostic, and therapeutic potential of these miRNAs in biological fluids, such as serum, plasma, and urine. Finally, we discuss advantages and challenges of these miRNAs in clinical applications.

  10. Single-setting laparoscopic approach to synchronous urologic tumors.

    Science.gov (United States)

    Papalia, Rocco; Simone, Giuseppe; Guaglianone, Salvatore; Forastiere, Ester; Gallucci, Michele

    2010-12-01

    To evaluate the feasibility and safety of two or three concomitant laparoscopic procedures in the same patient in one anesthesia session. Data were reviewed for 32 patients for whom two or three concomitant laparoscopic surgeries at our institution were considered. Preoperative details, port position, surgical time, blood loss, complications, hospital stay, and postoperative recovery were analyzed. Thirty-two patients underwent two concomitant laparoscopic procedures and one patient three procedures. Surgical time was increased by 6 minutes because of the repositioning time of the patients. There were no complications during all procedures, and hospital stay was not increased, being limited only by the first procedure. Planned laparoscopic surgery for two or three urologic malignancies is feasible in one anesthesia session, thereby reducing cost and overall hospital stay for the patient without any increased risk of perioperative morbidity. The decision to continue with the second or the third procedures depends on the successful conclusion of the former procedures in a reasonable time and without any complications.

  11. Research prioritization of men’s health and urologic diseases

    Directory of Open Access Journals (Sweden)

    Tyler Okland

    Full Text Available ABSTRACT Objectives We sought to determine whether disease representation in the Cochrane Database of Systematic Reviews (CDSR reflects disease burden, measured by the Global Burden of Disease (GBD Study as disability-adjusted life-years (DALYs. Materials and Methods Two investigators performed independent assessment of ten men’s health and urologic diseases (MHUDs in CDSR for systematic review and protocol representation, which were compared with percentage of total 2010 DALYs for the ten conditions. Data were analyzed for correlation using Spearman rank analysis. Results Nine of ten MHUDs were represented by at least one CDSR review. There was a poor and statistically insignificant positive correlation between CDSR representation and disease burden (rho = 0.42, p = 0.23. CDSR representation was aligned with disease burden for three conditions, greater than disease burden for one condition, and less than disease burden for six conditions. Conclusions These results yield high-quality estimates to inform future research prioritization for MHUDs. While prioritization processes are complex and multi-faceted, disease burden should be strongly considered. Awareness of research priority setting has the potential to minimize research disparities on a global scale.

  12. [Optical spectroscopy: a new approach to assess urological tumors].

    Science.gov (United States)

    Bensalah, K; Fleureau, J; Rolland, D; Rioux-Leclercq, N; Senhadji, L; Lavastre, O; Guillé, F; Patard, J-J; de Crevoisier, R

    2010-07-01

    Optical spectroscopy refers to a group of novel technologies that uses interaction of light with tissues to analyze their structure and chemical composition. The objective of this article is to describe these technologies and detail their potential for assessing urological tumors. It has been shown that optical spectroscopy can accurately analyse multiple solid tumors. Several publications specifically aimed at assessing prostate cancers, renal carcinomas and urothelial tumors. There are three types of spectroscopy that all use light focussed on a tissue and thereafter collect a specific reflected optical signal. Optical spectroscopy can differentiate benign (adenoma or inflammation) and malignant (adenocarcinoma) prostatic tissues. It can also distinguish normal bladder tissue from inflammatory or cancerous cells. Regarding renal tumors, spectroscopy can identify normal and tumoral tissue and differentiate benign and malignant tumors. Its diagnostic accuracy is about 85%. However, reported studies only concentrate on in vitro or ex vivo specimen and the numbers of patients are quite small. Optical spectroscopy can be envisioned as an "optical biopsy" tool. Potential applications in the clinical field are promising. Larger studies on in vivo specimen need to be undertaken to confirm phase I preliminary reports. Copyright 2010 Elsevier Masson SAS. All rights reserved.

  13. EAU guidelines on robotic and single-site surgery in urology.

    Science.gov (United States)

    Merseburger, Axel S; Herrmann, Thomas R W; Shariat, Shahrokh F; Kyriazis, Iason; Nagele, Udo; Traxer, Olivier; Liatsikos, Evangelos N

    2013-08-01

    This is a short version of the European Association of Urology (EAU) guidelines on robotic and single-site surgery in urology, as created in 2013 by the EAU Guidelines Office Panel on Urological Technologies. To evaluate current evidence regarding robotic and single-site surgery in urology and to provide clinical recommendations. A comprehensive online systematic search of the literature according to Cochrane recommendations was performed in July 2012, identifying data from 1990 to 2012 regarding robotic and single-site surgery in urology. There is a lack of high-quality data on both robotic and single-site surgery for most upper and lower urinary tract operations. Mature evidence including midterm follow-up data exists only for robot-assisted radical prostatectomy. In the absence of high-quality data, the guidelines panel's recommendations were based mostly on the review of low-level evidence and expert opinions. Robot-assisted urologic surgery is an emerging and safe technology for most urologic operations. Further documentation including long-term oncologic and functional outcomes is deemed necessary before definite conclusions can be drawn regarding the superiority or not of robotic assistance compared with the conventional laparoscopic and open approaches. Laparoendoscopic single-site surgery is a novel laparoscopic technique providing a potentially superior cosmetic outcome over conventional laparoscopy. Nevertheless, further advantages offered by this technology are still under discussion and not yet proven. Due to the technically demanding character of the single-site approach, only experienced laparoscopic surgeons should attempt this technique in clinical settings. This work represents the shortened version of the 2013 European Association of Urology guidelines on robotic and single-site surgery. The authors systematically evaluated published evidence in these fields and concluded that robotic assisted surgery is possible and safe for most urologic

  14. [Outpatient pediatric urology in France: A still under developed practice. Results of a survey of the French Section of pediatric Urology (SFUP)].

    Science.gov (United States)

    Rod, J; Marret, J-B; Ravasse, P

    2015-05-01

    Outpatient surgery is a very well adapted practice to the pediatric population. Our goal was to evaluate its actual development in the field of the pediatric urology. A questionnaire was addressed to all the French pediatric surgery centers in which at least one surgeon was member of the French Section of Pediatric Urology. The questionnaire concerned the organization and the outpatient urology procedures performed during the years 2011 and 2012. Thirty of the 34 approached centers returned the questionnaire. The total number of patients concerned in this study was of 33,166. The practices were very variable among centers: the inferior limit of age for anesthesia ranged from 2 to 12 months and type of surgery was also heterogeneous. Foreskin surgery, orchiopexy for undescended testis, inguinal hernia, and endoscopic treatment of vesico-ureteral reflux were the only procedures performed for more than 60% of cases as outpatient surgery. Outpatient surgery is not well developed in hypospadias repair. Only five centers raised 60% of ambulatory procedures for distal cases. No serious complication related to the outpatient approach was reported. This survey demonstrated very heterogeneous practices among French pediatric urologic centers. According to the French guidelines about outpatient pediatric surgery, this type of care could be more developed if anesthesiologists and surgeons accepted to evolve in their practice. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. getDEG: A Versatile Matlab Tool for Identifying Differentially Expressed Genes from High-Throughput Biomedical Data

    Directory of Open Access Journals (Sweden)

    Hua Tan

    2017-10-01

    Full Text Available The identification of differentially expressed genes (DEGs is an important initial step for characterizing critical regulators and associated signaling profiles under specific conditions. Yet, a sophisticated computational tool to detect DEGs in a fully automatic manner is still lacking. Here we describe getDEG, a versatile Matlab program to fill this gap by offering efficient solutions of the most needed functions. Particularly, getDEG adopts user-designated statistical test and ranking method to prioritize probes/genes assayed. Furthermore, getDEG allows preliminary filtering by the machine detection p-value, and collapsing multiple probes to their associated gene. Taken together, getDEG is a powerful and automatic tool which satisfies basic and advanced needs in searching for most relevant candidates from microarray assays or other high-throughput screens. The toolgetDEG and test examples are freely available online at https://sites.google.com/site/differentiallyexpressedgene.

  16. The Timed Up and Go Test as a measure of frailty in urologic practice

    Science.gov (United States)

    Pangilinan, Jayce; Quanstrom, Kathryn; Bridge, Mark; Walter, Louise C.; Finlayson, Emily; Suskind, Anne M.

    2017-01-01

    Objectives To evaluate the prevalence of frailty, a known predictor of poor outcomes, among patients presenting to an academic non-oncologic urology practice and to examine whether frailty differs among patients who did and did not undergo urologic surgery. Methods The Timed up and Go Test (TUGT), a parsimonious measure of frailty, was administered to patients ages ≥ 65. The TUGT, demographic data, urologic diagnoses and procedural history were abstracted from the medical record into a prospective database. TUGT times were categorized as nonfrail (≤10 sec), prefrail (11–14 sec) and frail (≥15 sec). These times were evaluated across age and urologic diagnoses and compared between patients who did and did not undergo urologic surgery using chi-square and t-tests. Results The TUGT was recorded for 78.9% of patient visits from December 2015 to May 2016. For 1089 patients, average age was 73.3 ± 6.3 years; average TUGT time was 11.6 ± 6.0 sec; 30.0% were categorized as prefrail and 15.2% as frail. TUGT times increased with age, with 56.9% of patients age 86 and over categorized as frail. Times varied across diagnoses (highest average TUGT was 14.3 ± 11.9 sec for patients with urinary tract infections), however no difference existed between patients who did and did not undergo surgery (p = 0.94). Conclusions Among our population, prefrailty and frailty were common, TUGT times increased with age and varied by urologic diagnosis, but did not differ between patients who did and did not undergo urologic surgery, presenting an opportunity to consider frailty in preoperative surgical decision making. PMID:28477941

  17. A learning package for medical students in a busy urology department: design, implementation, and evaluation.

    Science.gov (United States)

    Owen, Lysa E; Byrne, Derek J; Ker, Jean S

    2008-11-01

    The need for innovation in the delivery of quality teaching and learning for undergraduates in urology is driven by a number of factors. An increasing proportion of care is delivered in ambulatory settings, hospital inpatients are increasingly unwell, and the National Health Service staff must find a balance in their dual roles as healthcare providers and clinical teachers. We describe the design, implementation, and evaluation of an innovative learning package for undergraduate medical students in urology. This consisted of a simulated urology outpatient clinic to prepare students for learning in the outpatient environment and an on-line self- and peer-assessed learning exercise to provide students with the necessary clinical knowledge of the core problems in urology and to encourage reflection. Action research principles were used to design, deliver, and evaluate a model for teaching and learning in the outpatient setting. Fourth-year medical students at the start of a 1-week clinical teaching block were given the opportunity to participate in a simulated urology outpatient clinic. On-line support material was designed around 2 core clinical problems in urology. The evaluations were gathered using an anonymous on-line questionnaire and a pre- and postcourse test of knowledge for a sample group. Of the students who responded, 100% found the on-line material helpful for learning about the core clinical problems. The results demonstrated a 12% improvement in scores in a knowledge test at 1 week and 18% at 1 month after the teaching block compared with the control group from the previous academic year for which the mean improvement was 7% at 1 week and 8% at 1 month after the teaching program. The evaluation results demonstrated a positive effect on learning without compromise to the service provided to patients. This could be developed as a model for teaching and learning urology or other specialties.

  18. Urology technical and non-technical skills development: the emerging role of simulation.

    Science.gov (United States)

    Rashid, Prem; Gianduzzo, Troy R J

    2016-04-01

    To review the emerging role of technical and non-technical simulation in urological education and training. A review was conducted to examine the current role of simulation in urology training. A PUBMED search of the terms 'urology training', 'urology simulation' and 'urology education' revealed 11,504 titles. Three hundred and fifty-seven abstracts were identified as English language, peer reviewed papers pertaining to the role of simulation in urology and related topics. Key papers were used to explore themes. Some cross-referenced papers were also included. There is an ongoing need to ensure that training time is efficiently utilised while ensuring that optimal technical and non-technical skills are achieved. Changing working conditions and the need to minimise patient harm by inadvertent errors must be taken into account. Simulation models for specific technical aspects have been the mainstay of graduated step-wise low and high fidelity training. Whole scenario environments as well as non-technical aspects can be slowly incorporated into the curriculum. Doing so should also help define what have been challenging competencies to teach and evaluate. Dedicated time, resources and trainer up-skilling are important. Concurrent studies are needed to help evaluate the effectiveness of introducing step-wise simulation for technical and non-technical competencies. Simulation based learning remains the best avenue of progressing surgical education. Technical and non-technical simulation could be used in the selection process. There are good economic, logistic and safety reasons to pursue the process of ongoing development of simulation co-curricula. While the role of simulation is assured, its progress will depend on a structured program that takes advantage of what can be delivered via this medium. Overall, simulation can be developed further for urological training programs to encompass technical and non-technical skill development at all stages, including

  19. [Risk of bias assessment of clinical trials published in iberoamerican urological journals].

    Science.gov (United States)

    García-Perdomo, Herney Andres; Díaz-Hung, Andrés Manuel; Mejía, Luz Marina

    2015-09-01

    To assess the risk of bias of clinical trials published in iberoamerican indexed journals from January 1, 2008 to December 31, 2012. We performed a descriptive study based on the clinical trials published from January 1st 2008 to December 31st 2012 in the iberoamerican urological journals. We assessed the risk of bias by the Cochrane tool. We used descriptive statistics in Stata 13 and Revman 5.2 to create the risk of bias graphs within and across studies. We identified 41 clinical trials: 21 trials in the International Brazilian Journal of Urology, seven trials in Actas Urológicas Españolas, six trials in Archivos Españoles de Urología, two trials in the Boletin Mexicano de Urología, four trials in Revista Mexicana de Urología and one trial in Revista Urología Colombiana. Most of these trials had unclear risk for the generation of the randomization (selection bias), the allocation concealment (selection bias) and the blinding (performance and detection). There was low risk of bias for incomplete results data (Attrition bias) and selective notification (notification bias). High risk of bias was found in other possible sources of bias, mainly because of low sample size. Based on the Cochrane risk of bias tool assessment, most of the published trials do not accomplish an adequate description of the methods. We should also be aware that most of the trials lack an adequate sample size calculation that limits the power of these trials. We recommend better description of the methods for randomization, and increasing the sample size to improve the quality of the trials published in urologic iberoamerican journals.

  20. The Drosophila Postsynaptic DEG/ENaC Channel ppk29 Contributes to Excitatory Neurotransmission.

    Science.gov (United States)

    Hill, Alexis; Zheng, Xingguo; Li, Xiling; McKinney, Ross; Dickman, Dion; Ben-Shahar, Yehuda

    2017-03-22

    The protein family of degenerin/epithelial sodium channels (DEG/ENaCs) is composed of diverse animal-specific, non-voltage-gated ion channels that play important roles in regulating cationic gradients across epithelial barriers. Some family members are also enriched in neural tissues in both vertebrates and invertebrates. However, the specific neurophysiological functions of most DEG/ENaC-encoding genes remain poorly understood. The fruit fly Drosophila melanogaster is an excellent model for deciphering the functions of DEG/ENaC genes because its genome encodes an exceptionally large number of DEG/ENaC subunits termed pickpocket (ppk) 1-31 Here we demonstrate that ppk29 contributes specifically to the postsynaptic modulation of excitatory synaptic transmission at the larval neuromuscular junction. Electrophysiological data indicate that the function of ppk29 in muscle is necessary for normal postsynaptic responsivity to neurotransmitter release and for normal coordinated larval movement. The ppk29 mutation does not affect gross synaptic morphology and ultrastructure, which indicates that the observed phenotypes are likely due to defects in glutamate receptor function. Together, our data indicate that DEG/ENaC ion channels play a fundamental role in the postsynaptic regulation of excitatory neurotransmission.SIGNIFICANCE STATEMENT Members of the degenerin/epithelial sodium channel (DEG/ENaC) family are broadly expressed in epithelial and neuronal tissues. To date, the neurophysiological functions of most family members remain unknown. Here, by using the power of Drosophila genetics in combination with electrophysiological and behavioral approaches, we demonstrate that the DEG/ENaC-encoding gene pickpocket 29 contributes to baseline neurotransmission, possibly via the modulation of postsynaptic glutamate receptor functionality. Copyright © 2017 the authors 0270-6474/17/373171-10$15.00/0.

  1. Evaluation of Applied Laparoscopic Urology Course Using Validated Checklist

    Science.gov (United States)

    Tunc, Lutfi; Gurbuz, Cenk; Gozen, Ali Serdar; Tuncel, Altug; Saracoglu, Firat; Istanbulluoglu, Okan; Ozgok, Aysegul; Ozgok, Yasar

    2013-01-01

    Background and Objectives: The objectives of this study were to investigate the effectiveness of the applied laparoscopic urology course using a validated checklist and to determine any differences in laparoscopic skills achieved by the participants at the end of the course period based on whether they began their training in a dry or wet laboratory. Methods: To facilitate the mastering of challenging laparoscopic skills by urologists, a unique 3-day mini-training program was established at the Gulhane Military Academy of Medicine, Surgical Research Center, Ankara, Turkey. Only 30 trainees were accepted in each course, and they were divided into 3 subgroups. The primary outcome of the study was the changes in the performance and task accomplishment duration of the trainees at the beginning compared with the end of the course. The secondary outcome was any differences in the basic skills of the trainees based on whether they started their training in the dry or wet laboratory. Results: The overall laparoscopic skills, which were evaluated by use of a standardized laparoscopic suturing task score, significantly improved (18.8 to 26.0, P < .001), and the time needed for task accomplishment decreased throughout the course (9.5 minutes to 5.25 minutes, P = .002). With respect to the course design, laparoscopic skills scores and the times needed for task accomplishment showed no statistically significant changes at the end of the course despite the fact that the trainees had started their training at different stages. Conclusion: The applied short-term laparoscopy course was shown to be an effective format particularly for achieving laparoscopic skills in which suturing and knotting are essential. This is mainly achieved through close cooperation in dry and wet laboratories. PMID:23925025

  2. Subpubic Cartilaginous Pseudocyst: Orthopedic Feature with Urological Consequences

    Directory of Open Access Journals (Sweden)

    Fawzy Farag

    2014-01-01

    Full Text Available Introduction. Masses arising from structures adjacent to the female urethra can cause obstructive urinary symptoms. Subpubic cartilaginous pseudocyst is a rare degenerative lesion of pubic symphysis that may cause these symptoms. Materials and Methods. A 61-year- and 57-year-old women presented with symptoms of difficult micturition and dyspareunia. Physical examination revealed a painless smooth, rounded, firm, and cystic mass, at the anterior vaginal wall of about 4 cm width. The mass caused inward deviation of the external urethral meatus. Cystoscopy and MRI were done. Results. Cystoscopy of case 1 (61 y demonstrated anterior external urethral compression with normal urethral mucosa. Cystoscopy was not possible in case 2 (57 y because the urethra could not be entered under local anesthesia. MRI showed almost the same findings in both cases: midline, rounded, and cystic mass ~3×3×4 cm, anterosuperior to the urethra, and posteroinferior to the pubic symphysis, with normal features of the urinary bladder. Open surgical excision of theses lesions was performed in both patients. Histopathologic assessment of the specimen obtained from both patients showed degenerated hyaline with areas of fibrinous and mucoid degeneration, a picture suggestive of cartilaginous subpubic pseudocyst. After 11-month and 4-month followup of patients numbers 1 and 2, respectively, there is no evidence of local recurrence of the lesion, either clinically or radiologically and both patients void empty. Conclusions. Subpubic cartilaginous pseudocysts are rare benign lesions with only 13 cases were reported in the literature. Patients present with a spectrum of gynecological and/or urological manifestations. Sizable lesions severely compressing the urethra need surgical excision to restore the voiding function.

  3. TIP hypospadias repair: A pediatric urology indicator operation.

    Science.gov (United States)

    Snodgrass, Warren; Bush, Nicol

    2016-02-01

    We review development and evolution of TIP hypospadias repair, including technical changes made to improve its results. We also discuss general risk factors for hypospadias surgical complications. We describe use of a database with prospective data entry to first identify our most common complications and their frequency, and then to monitor results of technical modifications made to reduce their occurrence. Multiple logistic regression of various factors recorded in the database was done to identify those predicting increased risk for urethroplasty complications. Fistula and glans dehiscence are the two most common complications we encountered after TIP repair. Changes in urethral plate tubularization and barrier layers covering the neourethra resulted in a significant reduction in fistulas after proximal TIP. Changes in glansplasty sutures and use of preoperative testosterone to increase glans size did not reduce likelihood for dehiscence, whereas increasing the extent of glans wings dissection did. Logistic regression analysis confirmed proximal meatal location and reoperation predicted increased complications, but also identified glans width ≤ 14 mm as an independent risk factor for hypospadias urethroplasty complications. Systematic, prospective data collection facilitated identification of complications and their risk factors, and provided a means to assess results of modifications made to address them. Limiting the algorithm used for hypospadias repair increases expertise in those techniques used. Reported low surgical volumes for proximal hypospadias repair suggest subspecialization of these cases be carried out so that designated surgeons can achieve sufficient volume to analyze their results and make improvements. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  4. Evaluation of potential distractors in the urology operating room.

    Science.gov (United States)

    Lee, Jason Y; Lantz, Andrea G; McDougall, Elspeth M; Landman, Jaime; Gettman, Matthew; Sweet, Robert; Sundaram, Chandru P; Zorn, Kevin C

    2013-09-01

    Surgical outcomes depend on patient and disease-related factors, as well as the technical skill of the surgeon. Various distractions in the operating room (OR) environment have been shown to negatively impact a surgeon's performance. A survey was conducted with the objective to evaluate and characterize distractions during urologic surgery. An Internet-based survey was distributed to 2057 international urologists via email between April and October 2011; questions focused on a variety of disruptive factors postulated to have a negative impact on surgical performance. Of the 523 (25%) respondents, 58% practiced in North America, 42% were from an academic institution, and 68% had completed a clinical fellowship. In an average year, 83% reported having operated at least once while sleep deprived, 84% when significantly ill, 55% with a musculoskeletal injury, and 65% under significant social stress. Up to 38% reported that on at least one occasion, such "internal distractions" had significantly affected surgical performance and 14% perceived that at least one surgical complication was caused mainly by an internal distraction. Less than 50% had ever cancelled surgery because of an internal distraction. Music was routinely played in the OR by 57% of respondents, >67% reported answering pages and discussing consults while operating, and 25% reported "commonly" working with scrub nurses/techs that were unfamiliar with the procedure and/or instruments. Only 44% had consistent individual(s) assisting, and 27% reported that the scrub nurse/tech would "commonly" scrub out during a critical portion of the procedure. Overall, 14.5% reported that at least one complication had occurred mainly because of such "external" or "interactive" distractions. Urologists face various distractions in the OR that can negatively impact surgical performance, potentially compromising patient outcomes and safety. Further studies are needed to elucidate the true impact of such distractions and to

  5. ALGORITHM FOR MANAGEMENT OF HYPERTENSIVE PATIENTS UNDERWENT UROLOGY INTERVENTIONS

    Directory of Open Access Journals (Sweden)

    S. S. Davydova

    2015-09-01

    Full Text Available Aim. To study the efficacy of cardiovascular non-invasive complex assessment and pre-operative preparation in hypertensive patients needed in surgical treatment of urology dis- eases.Material and methods. Males (n=883, aged 40 to 80 years were included into the study. The main group consisted of patients that underwent laparotomic nephrectomy (LTN group; n=96 and patients who underwent laparoscopic nephrectomy (LSN group; n=53. Dynamics of ambulatory blood pressure monitoring (ABPM data was analyzed in these groups in the immediate postoperative period. The efficacy of a package of non-invasive methods for cardiovascular system assessment was studied. ABPM was performed after nephrectomy (2-nd and 10-th days after surgery in patients with complaints of vertigo episodes or intense general weakness to correct treatment.Results. In LTN group hypotension episodes or blood pressure (BP elevations were observed in 20 (20.8% and 22 (22.9% patients, respectively, on the 2-nd day after the operation. These complications required antihypertensive treatment correction. Patients with hypotension episodes were significantly older than patients with BP elevation and had significantly lower levels of 24-hour systolic BP, night diastolic BP and minimal night systolic BP. Re-adjustment of antihypertensive treatment on the 10-th postoperative day was required to 2 (10% patients with hypotension episodes and to 1 (4.5% patient with BP elevation. Correction of antihypertensive therapy was required to all patients in LSN group on the day 2, and to 32 (60.4% patients on the 10-th day after the operation. Reduction in the incidence of complications (from 1.2% in 2009 to 0.3% in 2011, p<0.001 was observed during the application of cardiovascular non-invasive complex assessment and preoperative preparation in hypertensive patients.Conclusion. The elaborated management algorithm for patients with concomitant hypertension is recommended to reduce the cardiovascular

  6. I problemi del dopo Legge Ossicini e la formazione degli psicanalisti

    Directory of Open Access Journals (Sweden)

    Maria Grazia Giacomazzi

    2015-12-01

    Full Text Available Una singola legge può mettere alla prova l'intero sistema legislativo, è un fattore che ha a che fare con lo stile, che orienta una società verso una direzione, che sagoma le relazioni, mette alla prova i rapporti, mette in crisi le coscienze. Occorre dunque poter sempre riconoscere l'iniquità della legge dal momento che la vita degli esseri umani dipende dall'esito che ne scaturisce tra il rispetto della legge e il desiderio di ciascuno. Con l'entrata in vigore della legge 56/89 che istituiva l'Ordine degli psicologi e la figura professionale degli psicoterapeuti la gran parte degli psicanalisti italiani ha deciso di fare domanda per esercitare la psicoterapia, domanda cui non erano obbligati dal momento che la legge in questione non nominava la psicanalisi. Vi era compresa nel disegno di legge in un primo tempo, ma successivamente, nella stesura definitiva del testo, la parola "psicanalisi" era stata tolta. Le differenti soluzioni adottate finora e di cui si parla in questo breve testo continuano a fare problema attorno ad un punto: la psicanalisi è una professione? Per trovare una soluzione a questo problema si è costituito il Coordinamento degli psicanalisti italiani, Coopi, che vuole continuare pensare la professione dello psicanalista nel rispetto dei criteri analitici incentrando la propria riflessione sugli scopi teorici ma anche immediatamente politici della psicanalisi.

  7. Composition and Control of a Deg/ENaC Channel during Presynaptic Homeostatic Plasticity

    Directory of Open Access Journals (Sweden)

    Brian O. Orr

    2017-08-01

    Full Text Available The homeostatic control of presynaptic neurotransmitter release stabilizes information transfer at synaptic connections in the nervous system of organisms ranging from insect to human. Presynaptic homeostatic signaling centers upon the regulated membrane insertion of an amiloride-sensitive degenerin/epithelial sodium (Deg/ENaC channel. Elucidating the subunit composition of this channel is an essential step toward defining the underlying mechanisms of presynaptic homeostatic plasticity (PHP. Here, we demonstrate that the ppk1 gene encodes an essential subunit of this Deg/ENaC channel, functioning in motoneurons for the rapid induction and maintenance of PHP. We provide genetic and biochemical evidence that PPK1 functions together with PPK11 and PPK16 as a presynaptic, hetero-trimeric Deg/ENaC channel. Finally, we highlight tight control of Deg/ENaC channel expression and activity, showing increased PPK1 protein expression during PHP and evidence for signaling mechanisms that fine tune the level of Deg/ENaC activity during PHP.

  8. Quantitative cine-left ventriculography - Superiority of 45 .deg. RAO view to straight AB view -

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Tae Hwan; Han, Man Chung [Seoul Natinal University College of Medicine, Seoul (Korea, Republic of)

    1981-12-15

    The volumetry by cineangiocardiography is known to have the most diagnostic and prognostic value in the evaluation of various valvular heart diseases and ischemic heart diseases. Although many authors favor the area-length method for the volumetry of left ventricle, 45 .deg. RAO projection seems to be more simple, inexpensive and accurate technique, considering the positional relationship of cardiac valves and obliquity of the long axis of left ventricle within the chest cage. Authors present the anatomical, geometrical and radiological basis for the superiority of 45 .deg. RAO protection by analyzing 20 normal heart specimen and 115 cineangiocardiograms of valvular heart diseases, and the results as follows: 1. Blood flow and motility of the mitral and aortic valves can be more clearly demonstrated by 45 .deg. RAO projection than by AP view. 2. The long diameter of left ventricular silhouette made 45 .deg. RAO projection reflects 90% or more of real diameter. 3. In RAO 45 .deg. position, patient's left nipple is optimal and convenient level for the ruler offering accurate magnification coefficient of left ventricle. 4. Ejection fraction after the extrasystole is exaggerated regardless of the left ventricular function, so it is desirable to exclude the 2 or 3 beats after extrasystole.

  9. The innovative therapeutic application of botulinum toxin type A in urology patients

    Directory of Open Access Journals (Sweden)

    Chrysoula Belai

    2016-06-01

    Full Text Available In the history of medical science the use of botulinum toxin was impressive. In the early 18th century it was defined as the neurotoxin implicated in the deadly disease botulism. Today, despite the toxic action finds application in the treatment of various diseases in a wide range of Medicine. Its use in urology was revolutionary in the treatment of neurogenic bladder, refractory idiopathic detrusor overactivity and other painful syndromes. The purpose of this review was to describe the treatment option of intravesical injection of botulinum toxin, in diseases of the urinary tract. The review showed that after many test applications under the experimental studies, the botulinum toxin type A has already established itself as the new treatment of choice after failure of conservative drug dealing in patients with neuro-urological symptoms of lower urinary tract. Cases of application of botulinum toxin in Urology are related to overactive bladder, neurogenic or idiopathic etiology, as bladder pain syndrome and chronic pelvic pain syndrome. According to the guidelines of the European Union directives Urology, the intravesical botulinum toxin injections are the most effective, minimally invasive treatment which results in reducing neurogenic hyperactivity of detrusor. In conclusion, this is a safe, easy and effective method that can be applied by health professionals, helping improve patients’ quality of life with neuro-urological diseases.

  10. Expert Involvement Predicts mHealth App Downloads: Multivariate Regression Analysis of Urology Apps.

    Science.gov (United States)

    Pereira-Azevedo, Nuno; Osório, Luís; Cavadas, Vitor; Fraga, Avelino; Carrasquinho, Eduardo; Cardoso de Oliveira, Eduardo; Castelo-Branco, Miguel; Roobol, Monique J

    2016-07-15

    Urological mobile medical (mHealth) apps are gaining popularity with both clinicians and patients. mHealth is a rapidly evolving and heterogeneous field, with some urology apps being downloaded over 10,000 times and others not at all. The factors that contribute to medical app downloads have yet to be identified, including the hypothetical influence of expert involvement in app development. The objective of our study was to identify predictors of the number of urology app downloads. We reviewed urology apps available in the Google Play Store and collected publicly available data. Multivariate ordinal logistic regression evaluated the effect of publicly available app variables on the number of apps being downloaded. Of 129 urology apps eligible for study, only 2 (1.6%) had >10,000 downloads, with half having ≤100 downloads and 4 (3.1%) having none at all. Apps developed with expert urologist involvement (P=.003), optional in-app purchases (P=.01), higher user rating (PApp cost was inversely related to the number of downloads (Pdevelopers' websites, but not other platforms, were publicly available for analysis, and the level and nature of expert involvement was not documented. The explicit participation of urologists in app development is likely to enhance its chances to have a higher number of downloads. This finding should help in the design of better apps and further promote urologist involvement in mHealth. Official certification processes are required to ensure app quality and user safety.

  11. Gender Trends of Urology Manuscript Authors in the United States: A 35-Year Progression

    Science.gov (United States)

    Weiss, Dana A.; Kovshilovskaya, Bogdana; Breyer, Benjamin N.

    2013-01-01

    Purpose The presence of women in urology has gradually increased in the last 35 years with an accelerated rate in the last decade. We evaluated manuscript authorship trends by gender. Manuscript authorship is a metric that has been used as a marker of academic productivity. We hypothesized that the number of first and last author publications by women has increased proportionately to the number of women in the field during the last 35 years. Materials and Methods We performed a bibliometric study to examine authorship gender in The Journal of Urology® and Urology®. We reviewed all original articles published from American institutions in 1974, 1979, 1984, 1989, 1994, 1999, 2004 and 2009. Results Of the 8,313 articles reviewed 5,461 were from American institutions, including 97.5% for which we determined author gender. There were 767 articles with female authors, including 440 first and 327 last authors. First and last female authorship increased from 2.7% of all authors in 1979 to 26.5% in 2009 (test for trend p urology, which increased from 0.24% in 1975 to 6.2% in 2008. Conclusions Based on authorship gender analysis women urologists produce manuscripts at a rate that exceeds their number in the field. Findings show that women in urology are productive, active members of the academic community. PMID:22099995

  12. [More than just "stones" : On the history of urology in Regensburg].

    Science.gov (United States)

    Otto, Wolfgang

    2016-07-01

    In recent years the regional aspects of medical history in the field of urology have been more intensively studied. There is already an interesting study on the history of urology in Rhineland. This article examines the checkered medical history aspects concerning urology in provincial areas of Germany, exemplified by the Bavarian town of Regensburg. The article combines the history of the over 1800-year-old town of Regensburg, one of the oldest German communities, with selected aspects of medical history and follows the route of "stones" from antiquity to the present day. The article explains what Regensburg, Galen of Pergamon and his professional colleagues from antiquity have in common, why monastery medicine was so successful here, how syphilis patients were treated in imperial cities (Reichsstädte), why one of the greatest "stone cutters" of the era met with an accident in the perpetual Reichstag town of Regensburg and how a main department of urology was finally founded after a delay but ultimately with tempo, which in 2003 led to the establishment of the most recent chair for urology in Germany.

  13. Paediatric urologic pathologies at the national teaching hospital in Cotonou: A etiological and therapeutic aspects

    Directory of Open Access Journals (Sweden)

    Augustin Karl Agossou-Voyeme

    2013-01-01

    Full Text Available Background: Urological pathologies of children are dominated by congenital malformations of the kidneys and urinary tract. Their management is often surgical. The objective of this survey was to study etiological and therapeutic aspects of urological presentations in children. Patients and Methods: Data for aetiology, treatment, and results in children hospitalized at the Paediatric Surgery service of National Teaching Hospital (CNHU in Cotonou were retrospectively analyzed from January 1999 to December 2008. Results: A total of 214 patients with complete data were evaluated. Urological pathologies represented 4.8% of the hospitalizations in paediatric surgery, with an incidence of 21 cases per year. The mean age was 4.9 ± 3.2 years (age 1 week to 14 years. The male to female ratio was 14:14. Cryptorchidism, hydrocele, nephroblastoma, the posterior urethral valves, ureteropelvic junction obstructions, post-circumcision haemorrhage and hypospadias were the most frequent pathologies. Congenital urological malformations represented 81.3%, followed neoplastic pathologies (7.9%, traumatic pathologies (6.1% and others (4.7%. The disorders of male genitalia were more frequent and constituted 68.2% of the cases. The anomalies of the urinary tract were 30.8% and intersex disorders were 0.9%. The average age of the children urological pathologies at the time of consultation was 8.85 ± 4.6 years. The treatment was often surgical with a mortality of 2.8%.

  14. Pan-urologic cancer genomic subtypes that transcend tissue of origin.

    Science.gov (United States)

    Chen, Fengju; Zhang, Yiqun; Bossé, Dominick; Lalani, Aly-Khan A; Hakimi, A Ari; Hsieh, James J; Choueiri, Toni K; Gibbons, Don L; Ittmann, Michael; Creighton, Chad J

    2017-08-04

    Urologic cancers include cancers of the bladder, kidney, prostate, and testes, with common molecular features spanning different types. Here, we show that 1954 urologic cancers can be classified into nine major genomic subtypes, on the basis of multidimensional and comprehensive molecular characterization (including DNA methylation and copy number, and RNA and protein expression). Tissue dominant effects are first removed computationally in order to define these subtypes, which reveal common processes-reflecting in part tumor microenvironmental influences-driving cellular behavior across tumor lineages. Six of the subtypes feature a mixture of represented cancer types as defined by tissue or cell of origin. Differences in patient survival and in the manifestation of specific pathways-including hypoxia, metabolism, NRF2-ARE, Hippo, and immune checkpoint-can further distinguish the subtypes. Immune checkpoint markers and molecular signatures of macrophages and T cell infiltrates are relatively high within distinct subsets of each cancer type studied. The pan-urologic cancer genomic subtypes would facilitate information sharing involving therapeutic implications between tissue-oriented domains.Urological cancers have disparate tissues and cells of origin but share many molecular features. Here, the authors use multidimensional and comprehensive molecular characterization to classify urological cancers into nine major genomic subtypes, highlighting potential therapeutic targets.

  15. Robot-assisted urologic surgery in 2010 - Advancements and future outlook

    Directory of Open Access Journals (Sweden)

    Paurush Babbar

    2011-01-01

    Full Text Available Robotic surgery is a cutting edge and minimally invasive procedure, which has generated a great deal of excitement in the urologic community. While there has been much advancement in this emerging technology, it is safe to say that robotic urologic surgery holds tremendous potential for progress in the near future. Hence, it is paramount that urologists stay up-to-date regarding new developments in the realm of robotics with respect to novel applications, limitations and opportunities for incorporation into their practice. Robot-assisted surgery provides an enhanced 3D view, increased magnification of the surgical field, better manual dexterity, relatively bloodless field, elimination of surgeon′s tremor, reduction in a surgeon′s fatigue and mitigation of scattered light. All these factors translate into greater precision of surgical dissection, which is imperative in providing better intraoperative and postoperative outcomes. Pioneering work assessing the feasibility of robotic surgery in urology began in the early 2000′s with robot-assisted radical prostatectomy and has since expanded to procedures such as robot-assisted radical cystectomy, robot-assisted partial nephrectomy, robot-assisted nephroureterectomy and robot-assisted pyeloplasty. A MEDLINE search was used to identify recent articles (within the last two years and publications of specific importance, which highlighted the recent developments and future direction of robotics. This review will use the aforementioned urologic surgeries as vehicles to evaluate the current status and future role of robotics in the advancement of the field of urology.

  16. A snapshot of the adult spina bifida patient – high incidence of urologic procedures

    Science.gov (United States)

    Liu, Joceline S.; Greiman, Alyssa; Casey, Jessica T.; Mukherjee, Shubhra

    2016-01-01

    Introduction To describe the urologic outcomes of contemporary adult spina bifida patients managed in a multidisciplinary clinic. Material and methods A retrospective chart review of patients seen in our adult spina bifida clinic from January 2004 to November 2011 was performed to identify urologic management, urologic surgeries, and co-morbidities. Results 225 patients were identified (57.8% female, 42.2% male). Current median age was 30 years (IQR 27, 36) with a median age at first visit of 25 years (IQR 22, 30). The majority (70.7%) utilized clean intermittent catheterization, and 111 patients (49.3%) were prescribed anticholinergic medications. 65.8% had urodynamics performed at least once, and 56% obtained appropriate upper tract imaging at least every other year while under our care. 101 patients (44.9%) underwent at least one urologic surgical procedure during their lifetime, with a total of 191 procedures being performed, of which stone procedures (n = 51, 26.7%) were the most common. Other common procedures included continence procedures (n = 35, 18.3%) and augmentation cystoplasty (n = 29, 15.2%). Only 3.6% had a documented diagnosis of chronic kidney disease and 0.9% with end-stage renal disease. Conclusions Most adult spina bifida patient continue on anticholinergic medications and clean intermittent catheterization. A large percentage of patients required urologic procedures in adulthood. Patients should be encouraged to utilize conservative and effective bladder management strategies to reduce their risk of renal compromise. PMID:27123330

  17. Current Status of Robot-Assisted Laparoscopic Surgery in Pediatric Urology

    Science.gov (United States)

    Song, Sang Hoon

    2014-01-01

    Laparoscopic procedures for urological diseases in children have been proven to be safe and effective. However, the availability of laparoscopic procedures is still partly limited to experienced, high-volume centers because the procedures are technically demanding. The da Vinci robot system is being used for an increasing variety of reconstructive procedures because of the advantages of this approach, such as motion scaling, greater optical magnification, stereoscopic vision, increased instrument tip dexterity, and tremor filtration. Particularly in pediatric urologic surgery, where the operational field is limited owing to the small abdominal cavity of children, robotic surgical technology has its own strengths. Currently, robots are used to perform most surgeries in children that can be performed laparoscopically. In this review, we aimed to provide a comprehensive overview of the current role of robot-assisted laparoscopic surgery in Pediatric Urology by analyzing the published data in this field. A growing body of evidence supports the view that robotic technology is technically feasible and safe in pediatric urological surgery. Robotic technology provides additional benefits for performing reconstructive urologic surgery, such as in pyeloplasty, ureteral reimplantation, and enterocystoplasty procedures. The main limitations to robotic surgery are its high purchase and maintenance costs and that the cost-effectiveness of this technology remains to be validated. PMID:25132942

  18. Gender Differences in Compensation, Job Satisfaction and Other Practice Patterns in Urology.

    Science.gov (United States)

    Spencer, E Sophie; Deal, Allison M; Pruthi, Nicholas R; Gonzalez, Chris M; Kirby, E Will; Langston, Joshua; McKenna, Patrick H; McKibben, Maxim J; Nielsen, Matthew E; Raynor, Mathew C; Wallen, Eric M; Woods, Michael E; Pruthi, Raj S; Smith, Angela B

    2016-02-01

    The proportion of women in urology has increased from less than 0.5% in 1981 to 10% today. Furthermore, 33% of students matching in urology are now female. In this analysis we characterize the female workforce in urology compared to that of men with regard to income, workload and job satisfaction. We collaborated with the American Urological Association to survey its domestic membership of practicing urologists regarding socioeconomic, workforce and quality of life issues. A total of 6,511 survey invitations were sent via e-mail. The survey consisted of 26 questions and took approximately 13 minutes to complete. Linear regression models were used to evaluate bivariable and multivariable associations with job satisfaction and compensation. A total of 848 responses (660 or 90% male, 73 or 10% female) were collected for a total response rate of 13%. On bivariable analysis female urologists were younger (p salaries among female urologists were $76,321 less than those of men. Gender was not a predictor of job satisfaction. Female urologists are significantly less compensated compared to male urologists after adjusting for several factors likely contributing to compensation. There is no difference in job satisfaction between male and female urologists. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  19. Ureteroscopy in a community hospital compared to published data of SWL between 1997 and 2003 and the guidelines of the American Urological Association/European Association of Urology and the guidelines of the German Association of Urology

    OpenAIRE

    Benken, Nicola

    2010-01-01

    Aim of this retrospective study was to compare the results of a primary ureteroscopy (URS) in patients with flank pain and ureteral calculi of a community hospital and extracorporeal shock wave lithotripsy (SWL). 535 patients between 1997 and 2003 have been evaluated and matched to published results of SWL of these era and the AUA/ EAU (2007) guidelines and the guidelines of the German Association of Urology (2009). The overall stone free rate after 3 month has been slightly better in the SWL...

  20. Giovanni Degli Alessandri: i primi anni del direttorato agli Uffizi fra nuovi e vecchi ruoli

    Directory of Open Access Journals (Sweden)

    Chiara Pasquinelli

    2011-11-01

    Full Text Available La figura di Giovanni Degli Alessandri (1765-1830, presidente dell’Accademia di Belle Arti di Firenze e direttore degli Uffizi tra gli anni napoleonici e la Restaurazione di Ferdinando III d’Asburgo-Lorena, è quella di un personaggio chiave nella politica artistica fiorentina, e toscana più in generale. Nel saggio si esaminano i primi anni del suo direttorato alla Galleria, i rapporti con Antonio Canova, il suo ruolo all’interno dell’entourage di Elisa Baciocchi Bonaparte, oltre a considerare alcuni spunti legati al rinnovamento degli Uffizi, nonché la delicata vicenda del passaggio in città di Dominique-Vivant Denon, direttore del Louvre. L’obbiettivo è quello di introdurre elementi di approfondimento relativamente a una figura molto nota ma poco studiata.

  1. Nobel Prize nominees and the rise of urology in Europe around 1900.

    Science.gov (United States)

    Hansson, Nils; Krischel, Matthis; Halling, Thorsten; Moll, Friedrich; Fangerau, Heiner

    2017-08-01

    Recent historical research has reconstructed the roads leading to the Nobel Prize for the trained urologists Werner Forssmann (1904-1979) in 1956 and Charles Huggins (1901-1997) in 1966. However, the story of urology and the Nobel Prize does not start and end with the laureates. Taking James Israel (1848-1926), Félix Guyon (1831-1920), and Peter J Freyer (1852-1921) as examples, this paper shows that pioneers in urology were in fact runners-up for the award much earlier. The study is based on an analysis of original files in the Nobel Prize archive in Stockholm, scientific publications of the early twentieth century, and secondary literature. We argue that Israel's, Guyon's, and Freyer's candidacies reflect not only scientific trends and controversies in urology at the turn of twentieth century, but that the development of the specialty itself was reflected in nominations of physicians working on problems of the genito-urinary system.

  2. Community-Partnered Collaboration to Build an Integrated Palliative Care Clinic: The View From Urology.

    Science.gov (United States)

    Bergman, Jonathan; Ballon-Landa, Eric; Lorenz, Karl A; Saucedo, Josemanuel; Saigal, Christopher S; Bennett, Carol J; Litwin, Mark S

    2016-03-01

    We partnered with patients, families, and palliative care clinicians to develop an integrated urology-palliative care clinic for patients with metastatic cancer. We assessed clinician satisfaction with a multidisciplinary palliative care clinic model. We conducted semi-structured interviews with 18 clinicians who practice in our integrated clinic. We analyzed transcripts using a multistage, cutting-and-sorting technique in an inductive approach based on grounded theory analysis. Finally, we administered a validated physician job satisfaction survey. Clinicians found that referring a patient to palliative care in the urology clinic was feasible and appropriate. Patients were receptive to supportive care, and clinicians perceived that quality of care improved following the intervention. An integrated, patient-centered model for individuals with advanced urologic malignancies is feasible and well received by practitioners. © The Author(s) 2014.

  3. Urological disease and tobacco. A review for raising the awareness of urologists.

    Science.gov (United States)

    Méndez-Rubio, S; Salinas-Casado, J; Esteban-Fuertes, M; Méndez-Cea, B; Sanz-de-Burgoa, V; Cozar-Olmo, J M

    2016-09-01

    Smoking is the leading cause of preventable death in our community. Its relationship with urological disease is well documented. To present an updated review on the relationship between urological disease and tobacco consumption and the importance of involving urologists in smoking prevention. We conducted a review of current literature, primarily by searching PubMed and using as the main base the report on the consequences of smoking on health performed by the Surgeon General. Urologists play an essential role in informing patients of the relationship between smoking and urological disease. It is the duty of every urologist to play a more active role in educating patients and promoting smoking cessation. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Detection and Isolation of Circulating Tumor Cells in Urologic Cancers: A Review

    Directory of Open Access Journals (Sweden)

    Robert D. Loberg

    2004-07-01

    Full Text Available The American Cancer Society has estimated that in 2003, there will be approximately 239,600 new cases of urologic cancer diagnosed and 54,600 urologic cancer-related deaths in the United States. To date, the majority of research and therapy design have focused on the microenvironment of the primary tumor site, as well as the microenvironment of the metastatic or secondary (target tumor site. Little attention has been placed on the interactions of the circulating tumor cells and the microenvironment of the circulation (i.e., the third microenvironment. The purpose of this review is to present the methods for the detection and isolation of circulating tumor cells and to discuss the importance of circulating tumor cells in the biology and treatment of urologic cancers.

  5. [Pre-emptive ketoprofen for postoperative pain relief after urologic surgery].

    Science.gov (United States)

    Rutyna, Rafał; Popowicz, Magdalena; Wojewoda, Paweł; Nestorowicz, Andrzej; Białek, Waldemar

    2011-01-01

    Effective multimodal postoperative analgesia is one of determinants of patient satisfaction after successful surgery. Following the recommendations of non-steroidal antiinflammatory agents (NSAIDs) for pre-emptive analgesia, we assessed the efficacy of ketoprofen administered before urological surgery. Fifty-two ASA I and II adult patients, scheduled for elective urologic procedures under general anaesthesia, were enrolled in this prospective, double blind study. They were randomized to receive intravenously either 100 mg ketoprofen or placebo (0.9% saline), one hour before the procedure, and at 8, 24, 36 and 48 h after. Pethidine was given for rescue analgesia. VAS was used for pain scoring. Pain scores were similar in both groups and identified as severe (VAS >4) during the first 48 h after surgery. There was no difference in the number of patients requiring rescue pethidine analgesia, mostly required during the first 12 postoperative hours. Pre-emptive analgesia with intravenous ketoprofen was ineffective in patients undergoing urological surgery.

  6. A Review of Transplantation Practice of the Urologic Organs: Is It Only Achievable for the Kidney?

    Science.gov (United States)

    Donati-Bourne, Jack; Roberts, Harry W; Rajjoub, Yaseen; Coleman, Robert A

    2015-01-01

    Transplantation is a viable treatment option for failure of most major organs. Within urology, transplantation of the kidney and ureter are well documented; however, evidence supporting transplantation of other urologic organs is limited. Failure of these organs carries significant morbidity, and transplantation may have a role in management. This article reviews the knowledge, research, and literature surrounding transplantation of each of the urologic organs. Transplantation of the penis, testicle, urethra, vas deferens, and bladder is discussed. Transplantation attempts have been made individually with each of these organs. Penile transplantation has only been performed once in a human. Testicular transplantation research was intertwined with unethical lucrative pursuits. Interest in urethra, bladder, and vas deferens transplantation has decreased as a result of successful surgical reconstructive techniques. Despite years of effort, transplantations of the penis, testicle, urethra, vas deferens, and bladder are not established in current practice. Recent research has shifted toward techniques of reconstruction, tissue engineering, and regenerative medicine.

  7. Advanced Practice Nursing in Pediatric Urology: experience report in the Federal District

    Directory of Open Access Journals (Sweden)

    Bruna Marcela Lima de Souza

    Full Text Available ABSTRACT Objective: To describe the creation and implementation of the extension program Advanced Practice Nursing in Pediatric Urology, developed in the outpatient clinic of a teaching hospital in the Federal District. Method: This is an experience report regarding the implementation of an outpatient service aimed at children and adolescents with symptoms of bladder and bowel dysfunction. Results: Because it is an extension program linked to the university, it follows a different model of care, valuing empowerment, informed and shared decision making, which results in a stronger bond between patients, family and the Pediatric Urology nursing team. It has also become a privileged space for the production and use of scientific knowledge, associated with the principles of evidence-based practice. Conclusion: This project shows a different performance of the nurse-specialist-professor-researcher in Pediatric Urology Nursing, and it has become a reference in the Federal District, mainly for undergraduate and graduate nursing students.

  8. Urological complications after radical hysterectomy: Incidence rates and predisposing factors

    Directory of Open Access Journals (Sweden)

    Likić-Lađević Ivana

    2007-01-01

    Full Text Available Bacground/Aim. Radical hysterectomy is a surgical approach for stage Ib and IIa of cervical cancer. The incidence of intraoperative injuries of the bladder during radical hysterectomy ranges from 0.4-3.7%. The ureter can be crushed, caught in sutures, transsected, obstructed by angulation, or ischemic by the stippling or periureteric fascia. Vesicovaginal and ureterovaginal fistuls are reported to develop in 0.9-2% of patients after radical abdominal hysterectomy. Fistulas usually become manifested or visible at speculum examination within 14 days following the surgery. The aim of this study was to establish the incidence and predisposing factor of urological complications after radical hysterectomy. Methods. The study included a total of 536 patients with invasive stage Ib to IIb cancer of the cervix uteri who had underwent radical hysterectomy. The special elements considered were: the patient’s age; the International Federation of Ginecology and Obstetrics (FIGO stage after pathohistology; duration of operation; the result of preoperative laboratory tests for diabetes, anemia, hypoproteinemia, or disorders of liver or kidney function; ASA status; postoperative surgical infection. Results. The average age of the patients with complications was 48.68 years. All patients with intraoperative ureteric and bladder injuries had statisticaly significant higher stage of disease and operation lasted more than in others without injury. We noticed 1.3% ureteral injuries and 1.49% bladder injuries, more than 50% of the patients with a previously mentioned injuries were operated on more than 3 hours. We found 2.61% vesicovaginal and 2.43% ureterovaginal fistuls. A total of 50% of the patients with bladder injury and vesicovaginal fistuls and 70% of the patients with ureterovaginal fistuls had diabetes mellitus. Postoperative infection of surgical site is a very important factor for the development of fistule. Half of the patients with vesicovaginal

  9. Ex vivo applications of multiphoton microscopy in urology

    Science.gov (United States)

    Jain, Manu; Mukherjee, Sushmita

    2016-03-01

    Background: Routine urological surgery frequently requires rapid on-site histopathological tissue evaluation either during biopsy or intra-operative procedure. However, resected tissue needs to undergo processing, which is not only time consuming but may also create artifacts hindering real-time tissue assessment. Likewise, pathologist often relies on several ancillary methods, in addition to H&E to arrive at a definitive diagnosis. Although, helpful these techniques are tedious and time consuming and often show overlapping results. Therefore, there is a need for an imaging tool that can rapidly assess tissue in real-time at cellular level. Multiphoton microscopy (MPM) is one such technique that can generate histology-quality images from fresh and fixed tissue solely based on their intrinsic autofluorescence emission, without the need for tissue processing or staining. Design: Fresh tissue sections (neoplastic and non-neoplastic) from biopsy and surgical specimens of bladder and kidney were obtained. Unstained deparaffinized slides from biopsy of medical kidney disease and oncocytic renal neoplasms were also obtained. MPM images were acquired using with an Olympus FluoView FV1000MPE system. After imaging, fresh tissues were submitted for routine histopathology. Results: Based on the architectural and cellular details of the tissue, MPM could characterize normal components of bladder and kidney. Neoplastic tissue could be differentiated from non-neoplastic tissue and could be further classified as per histopathological convention. Some of the tumors had unique MPM signatures not otherwise seen on H&E sections. Various subtypes of glomerular lesions were identified as well as renal oncocytic neoplasms were differentiated on unstained deparaffinized slides. Conclusions: We envision MPM to become an integral part of regular diagnostic workflow for rapid assessment of tissue. MPM can be used to evaluate the adequacy of biopsies and triage tissues for ancillary studies

  10. Reclutamento e formazione dei poliziotti: il caso degli ufficiali della gendarmeria francese

    Directory of Open Access Journals (Sweden)

    François Dieu

    2007-04-01

    Full Text Available Partendo dal caso degli ufficiali della gendarmeria francese, questo articolo illustra il modo in cui il reclutamento e la formazione possono contribuire, informalmente, alla ripartizione del potere nelle organizzazioni di polizia. Tramite la diversità delle vie di reclutamento si costituisce, di fatto, un vero e proprio sistema di "caste", con una stratificazione degli ufficiali in tre livelli gerarchici, che produce, al di là dei principi meritocratici, delle ineguaglianze manifeste nella ripartizione del potere nell'organizzazione della gendarmeria.

  11. Degradation of PsbO by the deg protease HhoA is thioredoxin dependent

    OpenAIRE

    Roberts, Irma N; Xuan Tam Lam; Helder de Miranda; Thomas Kieselbach; Christiane Funk

    2012-01-01

    The widely distributed members of the Deg/HtrA protease family play an important role in the proteolysis of misfolded and damaged proteins. Here we show that the Deg protease rHhoA is able to degrade PsbO, the extrinsic protein of the Photosystem II (PSII) oxygen-evolving complex in Synechocystis sp. PCC 6803 and in spinach. PsbO is known to be stable in its oxidized form, but after reduction by thioredoxin it became a substrate for recombinant HhoA (rHhoA). rHhoA cleaved reduced eukaryotic (...

  12. 360  deg full-parallax light-field display using panoramic camera.

    Science.gov (United States)

    Su, Chen; Zhou, Xinxin; Li, Haifeng; Yang, Qing; Wang, Zhechao; Liu, Xu

    2016-06-10

    One of the common approaches to achieving vertical parallax for the horizontal-parallax-only light-field display is to introduce the viewer-tracking method. A panoramic camera is assembled in a 360 deg scanning light-field display system for the full-parallax demand in this study, wherein the image generation algorithm is improved to be sensitive to multiple viewer positions, and the tracking and rendering are processed in real time. The horizontal-parallax-only light-field display using a panoramic camera is determined to be able to achieve smooth and consecutive full-parallax performance for multiple viewers in a 360 deg range.

  13. AC-magnetotransport of a 2DEG in the quantum Hall regime

    Energy Technology Data Exchange (ETDEWEB)

    Hernández, C. [Departamento de Física, Universidad de los Andes, A.A. 4976, Bogotá D.C. (Colombia); Chaubet, C. [Laboratoire Charles Coulomb L2C, Université Montpellier II, Pl. E: Bataillon, 34095 Montpellier Cedex 5 (France)

    2014-05-15

    In this paper we present an ac-magneto-transport study of a two-dimensional electron gas (2DEG) in the quantum Hall effect (QHE) regime, for frequencies in the range [100Hz, 1MHz]. We present a new approach to understand admittance measurements based in the Landauer-Buttiker formalism for QHE edge channels and taking into account the capacitance and the topology of the cables connected to the contacts used in the measurements. Our model predicts an universal behavior with the a-dimensional parameter RCω where R is the 2 wires resistance of the 2DEG, C the capacitance cables and the angular frequency, in agreement with experiments.

  14. A review of the available urology skills training curricula and their validation.

    Science.gov (United States)

    Shepherd, William; Arora, Karan Singh; Abboudi, Hamid; Shamim Khan, Mohammed; Dasgupta, Prokar; Ahmed, Kamran

    2014-01-01

    The transforming field of urological surgery continues to demand development of novel training devices and curricula for its trainees. Contemporary trainees have to balance workplace demands while overcoming the cognitive barriers of acquiring skills in rapidly multiplying and advancing surgical techniques. This article provides a brief review of the process involved in developing a surgical curriculum and the current status of real and simulation-based curricula in the 4 subgroups of urological surgical practice: open, laparoscopic, endoscopic, and robotic. An informal literature review was conducted to provide a snapshot into the variety of simulation training tools available for technical and nontechnical urological surgical skills within all subgroups of urological surgery using the following keywords: "urology, surgery, training, curriculum, validation, non-technical skills, technical skills, LESS, robotic, laparoscopy, animal models." Validated training tools explored in research were tabulated and summarized. A total of 20 studies exploring validated training tools were identified. Huge variation was noticed in the types of validity sought by researchers and suboptimal incorporation of these tools into curricula was noted across the subgroups of urological surgery. The following key recommendations emerge from the review: adoption of simulation-based curricula in training; better integration of dedicated training time in simulated environments within a trainee's working hours; better incentivization for educators and assessors to improvise, research, and deliver teaching using the technologies available; and continued emphasis on developing nontechnical skills in tandem with technical operative skills. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

  15. Financial and educational costs of the residency interview process for urology applicants.

    Science.gov (United States)

    Kerfoot, B Price; Asher, Kevin P; McCullough, David L

    2008-06-01

    To investigate the financial and educational costs of the urology residency interview process, we performed a survey of the applicants to the 2006 urology match. All applicants registered for the 2006 urology match were invited to participate. In January 2006 prior to the match, an anonymous online survey containing 8 questions on the financial and educational costs of the interview process was distributed via email. Survey response rate was 61% (287/468). The median educational debt of the applicants was $125,000 (IQR 65,000 to 160,000). Respondents reported having a median 12 interviews (IQR 8 to 15) with urology residencies and spending a median 20 days (IQR 14 to 30) on the interview trail. The total cost of the interview process was a median $4000 (IQR 2000 to 5200) with a median expense per interview of $330 (IQR 211 to 455). Applicants reported that travel expenses accounted for a median 60% of overall interview expenses, whereas the remainder of the expense was accounted for by lodging (25%), food (10%) and clothing (5%). The money to cover these interview-related expenses was obtained primarily by loans. Forty-six percent of the applicants reported that skipping medical school clerkships and classes for urology interviews was "not at all detrimental" to their medical education, whereas 1% reported that it was "greatly detrimental." The financial cost of the interview process for urology applicants is substantial, although the educational cost appears to be limited. Efforts to reduce the financial impact of the interview process should be initiated at both a regional and national level.

  16. Urethrography interpretation skills of urology and radiology residents at tertiary care medical centers.

    Science.gov (United States)

    Eswara, Jairam R; Song, Joseph B; Chang, Andrew J; Rosenstein, Daniel I; Gonzalez, Christopher M; Vetter, Joel M; Brandes, Steven B

    2014-06-01

    To assess the ability of urology and radiology residents to interpret retrograde urethrograms (RUGs) and voiding cystourethrograms (VCUGs). A standardized examination of 10 combination RUGs and VCUGs of the male urethra was administered to urology and radiology residents from all levels of training at Washington University, Stanford University, and Northwestern University. Residents were asked to evaluate stricture location(s) and length, if present. Sixty residents participated, consisting of 26 from Washington University, 15 from Stanford University, and 19 from Northwestern University. Average years of training for urology and radiology were 3.6 and 2.8 years, respectively (P=.01). Normal RUGs and VCUGs were recognized by 18 of 31 radiologists (58%) and 19 of 29 urologists (65.5%; P=.5). Anterior strictures were correctly identified in 145 of 403 (36%) and 165 of 377 (43.8%) responses by radiologists and urologists, respectively (P=.03). Posterior strictures were correctly identified in 20 of 62 (32.3%) and 10 of 58 (17.2%) responses by radiologists and urologists, respectively (P=.09). When both groups of residents were combined, anterior strictures were identified correctly more often than posterior strictures (39.7% vs 25%; Purology group (P=.30). In the presence of multiple strictures, accuracy declined to 7.26% (9 of 124) for the radiology group and 9.48% (11 of 116) for the urology group (P=.5), with a combined accuracy of 8.33% (20 of 240). Radiology and urology residents in the United States have poor skills at interpreting urethrography, especially when multiple strictures or posterior strictures are present. A formal educational program for RUG and VCUG interpretation should be designed and implemented into the radiology and urology resident curriculum. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Omissions in Urology Residency Training Regarding Sexual Dysfunction Subsequent to Prostate Cancer Treatment: Identifying a Need.

    Science.gov (United States)

    Krouwel, Esmée M; Grondhuis Palacios, Lorena A; Putter, Hein; Pelger, Rob C M; Kloens, Gert Jan; Elzevier, Henk W

    2016-04-01

    To assess urology residents' current knowledge, practice, previous training, barriers, and training needs regarding prostate cancer treatment-related sexual dysfunction. A cross-sectional questionnaire study inventoried the practice patterns and training need of urology residents attending a national training course in June 2015. Of 101 urology residents throughout the Netherlands, 87 attended the training (response rate 100%). Median age was 32 years (range 28-38); 55.2% were woman. Regardless of the residency level, most trainees had never received education about sexual dysfunction (58.6%), reported a limited level of knowledge (48.3%), and indicated an evident need for training (69.4%). The majority did not feel competent to advise prostate cancer patients regarding the treatment of sexual dysfunction (55.2%). Almost all participants inquired about preoperative erectile dysfunction (89.7%), and always informed about treatment-related sexual dysfunction (88.5%). At follow-up, 63.9% of the residents routinely addressed sexual complaints again. More than half of the participants indicated that urology residency training does not provide sufficient education on sexual dysfunction (54.8%).Time constraint (67.1%) and lack of training (35.3%) were the most frequently mentioned barriers. Current urology residency does not pay sufficient attention to sexual communication skills and sexual dysfunction. The residents require more knowledge about and more practical training in sexual counseling. Findings support efforts to enhance the education of urology residents regarding prostate cancer treatment-related sexual dysfunction. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Rates and Risk Factors for Opioid Dependence and Overdose after Urological Surgery.

    Science.gov (United States)

    Shah, Arpeet S; Blackwell, Robert H; Kuo, Paul C; Gupta, Gopal N

    2017-11-01

    Effective pain management is a critical component of the perioperative process with opioids representing a mainstay of therapy. The opioid epidemic is a growing concern in the United States. The goal of this study was to quantify the risk of opioid dependence or overdose among patients undergoing urological surgery and to identify risk factors of opioid dependence or overdose. We retrospectively reviewed data on urological surgery from 2007 to 2011. Data sources included the HCUP (Healthcare Cost and Utilization Project) inpatient, ambulatory surgery and emergency department data sets. Outcomes of postoperative opioid dependence and overdose were identified by previously validated ICD-9 codes. Multivariable logistic regression adjusted for surgical procedure was performed to identify predictors of opioid dependence or overdose following urological surgery. Overall 675,527 patients underwent urological surgery, of whom 0.09% were diagnosed with opioid dependence or overdose. Patients in whom opioid dependence or overdose developed were younger (median age 51 vs 62 years), carried nonprivate insurance (69.6% vs 66%), underwent an inpatient procedure (81.0% vs 42.4%) and had a longer length of stay (median 3 vs 0 days) and a history of depression (14.4% vs 3.4%) or chronic obstructive pulmonary disease (20.3% vs 8.9%, all p opioid dependence or overdose. Postoperative opioid dependence or overdose affects 1 of 1,111 urological surgery patients. Risk factors for opioid dependence or overdose included younger age, inpatient surgery and increasing hospitalization duration, baseline depression, tobacco use and chronic obstructive pulmonary disease as well as insurance provider, including Medicaid, Medicare (age less than 65 years) and noninsured status. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  19. From Leonardo to da Vinci: the history of robot-assisted surgery in urology.

    Science.gov (United States)

    Yates, David R; Vaessen, Christophe; Roupret, Morgan

    2011-12-01

    What's known on the subject? and What does the study add? Numerous urological procedures can now be performed with robotic assistance. Though not definitely proven to be superior to conventional laparoscopy or traditional open surgery in the setting of a randomised trial, in experienced centres robot-assisted surgery allows for excellent surgical outcomes and is a valuable tool to augment modern surgical practice. Our review highlights the depth of history that underpins the robotic surgical platform we utilise today, whilst also detailing the current place of robot-assisted surgery in urology in 2011. The evolution of robots in general and as platforms to augment surgical practice is an intriguing story that spans cultures, continents and centuries. A timeline from Yan Shi (1023-957 bc), Archytas of Tarentum (400 bc), Aristotle (322 bc), Heron of Alexandria (10-70 ad), Leonardo da Vinci (1495), the Industrial Revolution (1790), 'telepresence' (1950) and to the da Vinci(®) Surgical System (1999), shows the incredible depth of history and development that underpins the modern surgical robot we use to treat our patients. Robot-assisted surgery is now well-established in Urology and although not currently regarded as a 'gold standard' approach for any urological procedure, it is being increasingly used for index operations of the prostate, kidney and bladder. We perceive that robotic evolution will continue infinitely, securing the place of robots in the history of Urological surgery. Herein, we detail the history of robots in general, in surgery and in Urology, highlighting the current place of robot-assisted surgery in radical prostatectomy, partial nephrectomy, pyeloplasty and radical cystectomy. © 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

  20. Ireland's contribution to urology and nephrology research in the new millennium: a bibliometric analysis.

    Science.gov (United States)

    O'Connor, E M; Nason, G J; O'Brien, M F

    2017-05-01

    Bibliometrics is the statistical analysis of written publications. Bibliometric analyses have been performed across a range of biomedical disciplines. The aim of this study was to provide a comprehensive qualitative and quantitative analysis of Irish urology and nephrology research and to analyse how this compares internationally. We performed a retrospective bibliometric analysis of the top 20 ranking journals in the field of "Urology and Nephrology" based on their 5 years impact factor, as obtained from the ISI Journal Citation Report database over the 15-year study period, 2000-2015. Utilising the Pubmed database, a search phrase was constructed using country of affiliation, year of publication and journal title. The abstracts of the Irish publications identified were analysed for their institution of origin, article theme and content. A total of 67,740 article abstracts were analysed over the 15 years study period. As anticipated, the USA accounted for the largest number of publications by a country [28,206 (41.64 % of all articles)]. Ireland contributed 347 articles in total (0.51 % of all articles); however, ranking according to population per million was 13th worldwide. Ireland's contribution to urology and nephrology research was highest in the BJUI-British Journal of Urology International [76 articles (21.90 % of Irish total)]. We believe this study to be the largest bibliometric analysis in the field of urology and nephrology internationally. This study provides a novel overview of the current Irish urology- and nephrology-related research, and examines how our results compare within the international community.

  1. Evaluation of urologic morbidity after radiotherapy for cervical carcinoma by urodynamic examinations and patient voiding schemes: a prospective study

    DEFF Research Database (Denmark)

    Lajer, Henrik; Thranov, Ingrid R; Bagi, Per

    2002-01-01

    To assess urologic morbidity in a 5-year period by urodynamic examinations and patient voiding schemes after radiotherapy and brachytherapy for cervical carcinoma.......To assess urologic morbidity in a 5-year period by urodynamic examinations and patient voiding schemes after radiotherapy and brachytherapy for cervical carcinoma....

  2. Multiple authorship and article type in journals of urology across the Atlantic: trends over the past six decades.

    Science.gov (United States)

    Hammad, Fayez T; Shaban, Sami; Abu-Zidan, Fikri

    2012-01-01

    The aim of this research was to study the trends in authorship and type of article in European and North American journals of urology over the past 6 decades. Using a self-developed Visual Basic program, the number of authors per article and the type of article in four European journals (BJU International, Current Opinion in Urology, European Urology and Urologia Internationalis) and four North American journals (Journal of Urology, Urologic Clinics of North America, Urology and World Journal of Urology) were extracted from the PubMed website from January 1946 to October 2010, and the number of authors per article in each year was calculated in all the journals. The average number of authors per article has increased and the percentage of single-author articles has decreased in both European and American journals. An increase in the number of authors per article was observed mainly in original articles and case reports. Since the early 1980s, there has also been a decreasing percentage of published case reports and a general increase in the percentage of letters to the editor and editorials. The multiple-authorship trends observed in both European and North American urology journals were similar and appeared to be mainly due to changes in original articles and case reports. Copyright © 2012 S. Karger AG, Basel.

  3. Adherence to European Association of Urology Guidelines on Prophylactic Antibiotics: An Important Step in Antimicrobial Stewardship.

    Science.gov (United States)

    Cai, Tommaso; Verze, Paolo; Brugnolli, Anna; Tiscione, Daniele; Luciani, Lorenzo Giuseppe; Eccher, Cristina; Lanzafame, Paolo; Malossini, Gianni; Wagenlehner, Florian M E; Mirone, Vincenzo; Bjerklund Johansen, Truls E; Pickard, Robert; Bartoletti, Riccardo

    2016-02-01

    The evolution of resistant pathogens is a worldwide health crisis and adherence to European Association of Urology (EAU) guidelines on antibiotic prophylaxis may be an important way to improve antibiotic stewardship and reduce patient harm and costs. To evaluate the prevalence of antibiotic-resistant bacterial strains and health care costs during a period of adherence to EAU guidelines in a tertiary referral urologic institution. A protocol for adherence to EAU guidelines for antibiotic prophylaxis for all urologic procedures was introduced in January 2011. Data for 3529 urologic procedures performed between January 2011 and December 2013 after protocol introduction were compared with data for 2619 procedures performed between January 2008 and December 2010 before protocol implementation. The prevalence of bacterial resistance and health care costs were compared between the two periods. The outcome measures were the proportion of resistant uropathogens and costs related to antibiotic consumption and symptomatic postoperative infection. We used χ2 and Fisher's exact tests to test the significance of differences. The proportion of patients with symptomatic postoperative infection did not differ (180/3529 [5.1%] vs. 117/2619 [4.5%]; p=0.27). A total of 342 isolates from all patients with symptomatic postoperative infections were analysed. The rate of resistance of Escherichia coli to piperacillin/tazobactam (9.1% vs. 5.4%; p=0.03), gentamicin (18.3% vs. 11.2%; p=0.02), and ciprofloxacin (32.3% vs. 19.1%; p=0.03) decreased significantly after protocol introduction. The defined daily dose (DDD) use of ciprofloxacin fell from 4.2 to 0.2 DDD per 100 patient-days after implementation (pguidelines on antibiotic prophylaxis reduced antibiotic usage without increasing post-operative infection rate and lowered the prevalence of resistant uropathogens. We analysed the impact of adherence to European Association of Urology guidelines on antibiotic prophylaxis for all surgical

  4. Serious renal and urological complications in fast-track primary total hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Bjerregaard, Lars S; Jørgensen, Christoffer C; Kehlet, Henrik

    2016-01-01

    BACKGROUND: Overall medical complications have been reduced after fast-track total hip (THA) and knee arthroplasty (TKA), but data on specific renal and urological (RU) complications are limited. METHODS: To describe the incidence and consequences of serious RU complications resulting in length...... postoperatively. Seven complications . (0.08 %) were urological, mainly haematuria after bladder catheterisation, whereas 5 (0.06 were urosepsis/pyelonephritis. CONCLUSION: The overall incidence of serious RU complications after fast-track THA and TKA was 0.61 %. AKI occurred in 0.49% and was most often due...

  5. Training, Research, and Working Conditions for Urology Residents in Germany: A Contemporary Survey.

    Science.gov (United States)

    Borgmann, Hendrik; Arnold, Hannah K; Meyer, Christian P; Bründl, Johannes; König, Justus; Nestler, Tim; Ruf, Christian; Struck, Julian; Salem, Johannes

    2016-12-16

    Excellent uniform training of urology residents is crucial to secure both high-quality patient care and the future of our specialty. Residency training has come under scrutiny following the demands of subspecialized care, economical aspects, and working hour regulations. To comprehensively assess the surgical training, research opportunities, and working conditions among urology residents in Germany. We sent a 29-item online survey via email to 721 members of the German Society of Residents in Urology. Descriptive analyses were conducted to describe the surveys' four domains: (1) baseline characteristics, (2) surgical training (cumulative completed case volume for all minor-, medium-, and major-complexity surgeries), (3) research opportunities, and (4) working conditions. Four hundred and seventy-two residents completed the online survey (response rate 65%). Surgical training: the median number of cumulative completed cases for postgraduate yr (PGY)-5 residents was 113 (interquartile range: 76-178). Minor surgeries comprised 57% of all surgeries and were performed by residents in all PGYs. Medium-complexity surgeries comprised 39% of all surgeries and were mostly performed by residents in PGYs 2-5. Major surgeries comprised 4% of all surgeries and were occasionally performed by residents in PGYs 3-5. Research opportunities: some 44% have attained a medical thesis (Dr. med.), and 39% are currently pursuing research. Working conditions: psychosocial work-related stress was high and for 82% of residents their effort exceeded their rewards. Some 44% were satisfied, 32% were undecided, and 24% were dissatisfied with their current working situation. Limitations include self-reported survey answers and a lack of validated assessment tools. Surgical exposure among German urology residents is low and comprises minor and medium-complex surgeries. Psychosocial work-related stress is high for the vast majority of residents indicating the need for structural improvements in

  6. Advances in laparoscopic urologic surgery techniques [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Haidar M. Abdul-Muhsin

    2016-04-01

    Full Text Available The last two decades witnessed the inception and exponential implementation of key technological advancements in laparoscopic urology. While some of these technologies thrived and became part of daily practice, others are still hindered by major challenges. This review was conducted through a comprehensive literature search in order to highlight some of the most promising technologies in laparoscopic visualization, augmented reality, and insufflation. Additionally, this review will provide an update regarding the current status of single-site and natural orifice surgery in urology.

  7. Training potential in minimally invasive surgery in a tertiary care, paediatric urology centre.

    Science.gov (United States)

    Schroeder, R P J; Chrzan, R J; Klijn, A J; Kuijper, C F; Dik, P; de Jong, T P V M

    2015-10-01

    Minimally invasive surgery (MIS) is being utilized more frequently as a surgical technique in general surgery and in paediatric urology. It is associated with a steep learning curve. Currently, the centre does not offer a MIS training programme. It is hypothesized that the number of MIS procedures performed in the low-volume specialty of paediatric urology will offer insufficient training potential for surgeons. To assess the MIS training potential of a highly specialized, tertiary care, paediatric urology training centre that has been accredited by the Joint Committee of Paediatric Urology (JCPU). The clinical activity of the department was retrospectively reviewed by extracting the annual number of admissions, outpatient consultations and operative procedures. The operations were divided into open procedures and MIS. Major ablative procedures (nephrectomy) and reconstructive procedures (pyeloplasty) were analysed with reference to the patients' ages. The centre policy is not to perform major MIS in children who are under 2 years old or who weigh less than 12 kg. Every year, this institution provides approximately 4300 out-patient consultations, 600 admissions, and 1300 procedures under general anaesthesia for children with urological problems. In 2012, 35 patients underwent major intricate MIS: 16 pyeloplasties, eight nephrectomies and 11 operations for incontinence (seven Burch, and four bladder neck procedures). In children ≥2 years of age, 16/21 of the pyeloplasties and 8/12 of the nephrectomies were performed laparoscopically. The remaining MIS procedures included 25 orchidopexies and one intravesical ureteral reimplantation. There is no consensus on how to assess laparoscopic training. It would be valuable to reach a consensus on a standardized laparoscopic training programme in paediatric urology. Often training potential is based on operation numbers only. In paediatric urology no minimum requirement has been specified. The number of procedures quoted

  8. Role of Geriatric Oncologists in Optimizing Care of Urological Oncology Patients.

    Science.gov (United States)

    Droz, Jean-Pierre; Boyle, Helen; Albrand, Gilles; Mottet, Nicolas; Puts, Martine

    2017-11-08

    Urological cancers are common. Since the median age of diagnosis is 60-70 yr, many patients require geriatric as well as urological evaluation if treatment is to be tailored to individual health status including comorbidities and frailty. To review the most important features of geriatric assessment and its expected benefits. We also consider ways in which collaboration between urologists and geriatricians and geriatric teams can benefit patient well-being. Members of a multidisciplinary International Society of Geriatric Oncology task force reviewed articles published in 2010-2017 using search terms relevant to urological cancers, the elderly, and geriatric evaluation. The final manuscript reflects their expert consensus. Elderly patients should be managed according to their individual health status and not according to age. As a first step, screening for cognitive impairment is mandatory to establish patient competence in making decisions. Initial evaluation of health status should use a validated screening tool, the G8 screening tool being generally preferred. Abnormal scores on the G8 should lead to a geriatric assessment that evaluates comorbid conditions and functional, nutritional, mental, and medicosocial status. When patients are frail or disabled or have severe comorbidities, comprehensive geriatric assessment is required. Diagnosis of health status impairment shows the need for geriatric interventions. This overall approach is realistic in the setting of a department of urological oncology and given the involvement of a multidisciplinary team including trained nurses and other professionals and collaboration with geriatricians. Mutual education and support of all those involved in managing elderly urological cancer patients is the key to effective care. Advances in geriatric evaluation and cancer treatment are contributing to more appropriate management of elderly patients with urological cancers. Better understanding of the role of all participants and

  9. Infrequent Reservoir‐Related Complications of Urologic Prosthetics: A Case Series and Literature Review

    Directory of Open Access Journals (Sweden)

    Tao Cui, MD

    2015-12-01

    Conclusion: Complications involving urologic prosthesis reservoirs, although rare, can have serious implications for patients. A high index of suspicion and familiarity with treatment options is required in order to allow timely diagnosis and appropriate treatment. Patients with prior major abdominal surgeries seem to be more prone to intestinal complications of reservoirs and warrant special concern. Cui T, Terlecki R, and Mirzazadeh M. Infrequent reservoir‐related complications of urologic prosthetics: A case series and literature review. Sex Med 2015;3:334–338.

  10. Patterns of Performance of Oncologic Surgery by North American Pediatric Urologists: A Report from the Pediatric Urologic Oncology Working Group of the Society for Pediatric Urology.

    Science.gov (United States)

    Cost, Nicholas G; Ross, Jonathan H; Ferrer, Fernando A; Lorenzo, Armando J; Shnorhavorian, Margarett; Routh, Jonathan C; Kieran, Kathleen; Ritchey, Michael L

    2017-05-01

    Objective data on patterns of oncology practice among pediatric urologists are lacking. We reviewed surgical case logs submitted to the American Board of Urology by those self-reporting as pediatric urologists. We hypothesized that logs would reveal a low oncology volume (fewer than 5 cases) and identify orchiectomy as the most common oncology cases, and that less than 25% of logs would show nephrectomy for renal tumor. Case logs submitted for American Board of Urology certification, recertification or pediatric subspecialty certification were reviewed and standardized to represent 12-month practice. Data were collected on pediatric oncologic surgeries as noted by procedure codes linked with oncologic diagnosis codes for patients up to age 30 years. We identified 281 case logs meeting study criteria. A total of 364 oncology cases were logged and 131 logs (46.6%) listed at least 1 oncology case, while 150 (53.4%) contained no oncology cases. The 75th, 90th and 95th percentiles of oncology volume were represented by reporting 2, 3 and 4 cases, respectively. A total of 13 logs (4.6%) accounted for more than a third of all oncology cases (35.9%). The most frequent oncology case logged was orchiectomy, which was documented in 83 logs (29.5%). On Poisson regression surgeon variables associated with higher oncology volume included male gender (IRR 2.8, 95% CI 2.1-3.9), 2010 log year (IRR 2.4, 95% CI 1.3-4.4), 2015 log year (IRR 3.7, 95% CI 2.1-6.4) and nonpediatric subspecialty certification log (IRR 1.6, 95% CI 1.2-2.3). Few pediatric urologists perform a high volume of oncologic surgeries based on surgical case logs submitted to the American Board of Urology. A small cohort of pediatric urologists logged the majority of such cases. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  11. Renal oncocytoma: experience of Clinical Urology A, Urology Department, CHU Ibn Sina, Rabat, Morocco and literature review.

    Science.gov (United States)

    Benatiya, Marwane Andaloussi; Rais, Ghizlane; Tahri, Mounir; Barki, Ali; El sayegh, Hachem; Iken, Ali; Nouini, Yassine; Lachkar, Azzouz; Benslimane, Lounis; Errihani, Hassan; Faik, Mohammed

    2012-01-01

    Renal oncocytoma is a rare and benign renal tumor. Only few cases have been reported in Moroccan populations. In the present study, we report our experiences in the diagnosis, management and follow-up of this disease. We report on six cases of renal oncocytoma indentified between 1990 and 2008 in the urology department of "CHU Ibn Sina" in Rabat. These six cases are listed among 130 kidney tumors reported during the study period. We assess the clinical, radiological and therapeutic features of the patients and we review literature. Six cases of renal oncocytoma, representing 4.6% of all primitive kidney tumors treated in our institution during the study period. The mean age was 53 ±9.7 years (range 34 to 61 years). One patient was asymptomatic at presentation, five patients (83%) had flank pain and two (33%) had macroscopic hematuria. The tumor was right sided in 4 cases (66%) and left sided in 2 cases (33%). All patients underwent CT scan which showed, in three cases, a centrally located stellate area of low attenuation. The clinical suspicion of oncocytoma was made preoperatively in only 3 patients by imaging studies, but the suspicion of renal cell carcinoma persist and all patients were treated with radical nephrectomy. Definitive diagnosis was made in all cases postoperatively. All the tumors were well circumscribed but unencapsulated. The mean tumor size was 8,75±2,04 cm. Four patients were classified at stage pT2 and two at stage p T1. Most of the pathological features in our patients were typical of this entity. Predominant cell type was a typical oncocytoma with general low mitotic activity. No extension to peri-nephric fat tissue or lymphovascular invasion was observed. After a mean follow-up of 36 months (range 26-62 months), there was neither recurrence nor death from oncocytoma. Accordingly, the disease-specific survival was 100%. Renal oncocytoma has a benign clinical course with excellent long-term outcomes. In our series, it happened mostly in

  12. Current status and future perspectives in laparoendoscopic single-site and natural orifice transluminal endoscopic urological surgery.

    Science.gov (United States)

    Autorino, Riccardo; Stein, Robert J; Lima, Estevão; Damiano, Rocco; Khanna, Rakesh; Haber, Georges-Pascal; White, Michael A; Kaouk, Jihad H

    2010-05-01

    Objective of this study is to provide an evidence-based analysis of the current status and future perspectives of scarless urological surgery. A PubMed search has been performed for all relevant urological literature regarding natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS). In addition, experience with LESS and NOTES at our own institution has been considered. All clinical and investigative reports for LESS and NOTES procedures in the urological literature have been considered. A wide variety of clinical procedures in urology have been successfully completed by using LESS techniques. Thus far, experience with NOTES has largely been investigational, although early clinical reports are emerging. Further development of instrumentation and platforms is necessary for both techniques to become more widely adopted throughout the urological community.

  13. The air oxidation behavior of lanthanum ion implanted zirconium at 500 deg. C

    CERN Document Server

    Peng, D Q; Chen, X W; Zhou, Q G

    2003-01-01

    The beneficial effect of lanthanum ion implantation on the oxidation behavior of zirconium at 500 deg. C has been studied. Zirconium specimens were implanted by lanthanum ions using a MEVVA source at energy of 40 keV with a fluence range from 1x10 sup 1 sup 6 to 1x10 sup 1 sup 7 ions/cm sup 2 at maximum temperature of 130 deg. C, The weight gain curves were measured after being oxidized in air at 500 deg. C for 100 min, which showed that a significant improvement was achieved in the oxidation behavior of zirconium ion implanted with lanthanum compared with that of the as-received zirconium. The valence of the oxides in the scale was analyzed by X-ray photoemission spectroscopy; and then the depth distributions of the elements in the surface of the samples were obtained by Auger electron spectroscopy. Glancing angle X-ray diffraction at 0.3 deg. incident angles was employed to examine the modification of its phase transformation because of the lanthanum ion implantation in the oxide films. It was obviously fou...

  14. Exploring a possible origin of a 14 deg y-normal spin tilt at RHIC polarimeter

    Energy Technology Data Exchange (ETDEWEB)

    Meot, F. [Brookhaven National Lab. (BNL), Upton, NY (United States); Huang, H. [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2015-06-15

    A possible origin of a 14 deg y-normal spin n0 tilt at the polarimeter is in snake angle defects. This possible cause is investigated by scanning the snake axis angle µ, and the spin rotation angle at the snake, φ, in the vicinity of their nominal values.

  15. Interaction of the components in the systems Ce-Ag-Si at 500 deg. C and Eu-Ag-Si at 400 deg. C

    Energy Technology Data Exchange (ETDEWEB)

    Belan, B. [Ivan Franko National University of Lviv, Kyryla i Mefodiya St. 6, UA-79005 Lviv (Ukraine)]. E-mail: belan@mail.lviv.ua; Bodak, O. [Ivan Franko National University of Lviv, Kyryla i Mefodiya St. 6, UA-79005 Lviv (Ukraine); Gladyshevskii, R. [Ivan Franko National University of Lviv, Kyryla i Mefodiya St. 6, UA-79005 Lviv (Ukraine); Soroka, I. [Ivan Franko National University of Lviv, Kyryla i Mefodiya St. 6, UA-79005 Lviv (Ukraine); Kuzhel, B. [Ivan Franko National University of Lviv, Kyryla i Mefodiya St. 6, UA-79005 Lviv (Ukraine); Protsyk, O. [Lviv Academy of Arts, Kubiyovych St. 38, UA-79000 Lviv (Ukraine); Stets, I. [Ivan Franko National University of Lviv, Kyryla i Mefodiya St. 6, UA-79005 Lviv (Ukraine)

    2005-06-21

    Isothermal sections of the phase diagrams of the systems Ce-Ag-Si and Eu-Ag-Si were built at 500 and 400 deg. C, respectively. Three intermetallic compounds were found in the former system, two in the latter and their crystal structures and homogeneity regions were determined. The effective valence of europium in the CeAl{sub 2}Ga{sub 2}-type phase EuAg{sub 2}Si{sub 2} was found to be 2+ over the whole homogeneity range, based on L{sub III}-absorption spectroscopy. The temperature dependence of the electrical resistivity, thermoelectric power and magnetic susceptibility of this phase was also studied.

  16. High-fidelity simulation-based team training in urology: evaluation of technical and nontechnical skills of urology residents during laparoscopic partial nephrectomy.

    Science.gov (United States)

    Abdelshehid, Corollos S; Quach, Stephen; Nelson, Corey; Graversen, Joseph; Lusch, Achim; Zarraga, Jerome; Alipanah, Reza; Landman, Jaime; McDougall, Elspeth M

    2013-01-01

    The use of low-risk simulation training for resident education is rapidly expanding as teaching centers integrate simulation-based team training (SBTT) sessions into their education curriculum. SBTT is a valuable tool in technical and communication skills training and assessment for residents. We created a unique SBTT scenario for urology residents involving a laparoscopic partial nephrectomy procedure. Urology residents were randomly paired with a certified registered nurse anesthetists or an anesthesia resident. The scenario incorporated a laparoscopic right partial nephrectomy utilizing a unique polyvinyl alcohol kidney model with an embedded 3cm lower pole exophytic tumor and the high-fidelity SimMan3G mannequin. The Urology residents were instructed to pay particular attention to the patient's identifying information provided at the beginning of the case. Two scripted events occurred, the patient had an anaphylactic reaction to a drug and, after tumor specimen was sent for a frozen section, the confederate pathologist called into the operating room (OR) twice, first with the wrong patient name and subsequently with the wrong specimen. After the scenario was complete, technical performance and nontechnical performance were evaluated and assessed. A debriefing session followed the scenario to discuss and assess technical performance and interdisciplinary nontechnical communication between the team. All Urology residents (n = 9) rated the SBTT scenario as a useful tool in developing communication skills among the OR team and 88% rated the model as useful for technical skills training. Despite cuing to note patient identification, only 3 of 9 (33%) participants identified that the wrong patient information was presented when the confederate "pathologist" called in to report pathology results. All urology residents rated SBTT sessions as useful for the development of communication skills between different team members and making residents aware of unlikely but

  17. DegQ regulates the production of fengycins and biofilm formation of the biocontrol agent Bacillus subtilis NCD-2.

    Science.gov (United States)

    Wang, Peipei; Guo, Qinggang; Ma, Yinan; Li, Shezeng; Lu, Xiuyun; Zhang, Xiaoyun; Ma, Ping

    2015-09-01

    Bacillus subtilis NCD-2 is an excellent biocontrol agent for tomato gray mold and cotton soil-borne diseases. The fengycin lipopeptides serve as a major role in its biocontrol ability. A previous study revealed that insertion of degQ with the mini-Tn10 transposon decreased the antifungal activity of strain NCD-2 against the growth of Botrytis cinerea. To clarify the regulation of degQ on the production of fengycin, we deleted degQ by in-frame mutagenesis. Compared with the wild-type strain NCD-2, the degQ-null mutant had decreased extracellular protease and cellulase activities as well as antifungal ability against the growth of B. cinerea in vitro. The lipopeptides from the degQ-null mutant also had significantly decreased antifungal activity against B. cinerea in vitro and in vivo. This result was confirmed by the decreased fengycin production in the degQ-null mutant that was detected by fast protein liquid chromatography analysis. Quantitative reverse transcription PCR further demonstrated that degQ positively regulated the expression of the fengycin synthetase gene. In addition, the degQ-null mutant also had a flatter colony phenotype and significantly decreased biofilm formation ability relative to the wild-type strain. All of those characteristics from degQ-null mutant could be restored to the strain NCD-2 wild-type level by complementation of intact degQ in the mutant. Therefore, DegQ may be an important regulator of fengycin production and biofilm formation in B. subtilis NCD-2. Copyright © 2015 Elsevier GmbH. All rights reserved.

  18. Infections by carbapenemase-producing enterobacteriaceae in a department of urology. A new challenge.

    Science.gov (United States)

    Justo-Quintas, J; Medina-Polo, J; Gil-Moradillo, J; Jaén-Herreros, F; Lara-Isla, A; Tejido-Sánchez, Á

    2017-11-17

    To analyse infections by carbapenemase-producing enterobacteriaceae (CPE) and describe the characteristics and potential risk factors associated with patients of a department of urology. Observational and retrospective study. The inclusion criterion was hospitalisation in our department of Urology between August 2013 and December 2016. We analysed those patients who were positive for CPE in at least 1 culture. We reviewed their baseline characteristics, risk factors and variables such as the presence of previous urinary tract infections, subsequent readmissions, the microorganism, type of CPE, treatment, origin (hospital or community) and mortality. Of the 5,657 patients who met the inclusion criterion, a CPE was isolated in 12 cases. CPE infections represented 3.6% of all healthcare-associated infections and 9.7% of those caused by enterobacteria. The analysed factors associated with CPE infection in our series were the presence of urinary catheters (100%), undergoing surgery (58.3%), previous ICU admission (8.3%) and immunosuppression (16.6%). In terms of mortality, 8.3% of the patients who presented CPE infection died during hospitalisation. Approximately 10% of enterobacteria present a carbapenemase-resistance pattern in urological patients in our setting. Carrying a urinary catheter and/or undergoing surgery are risk factors associated with the development of these infections in urological patients in our setting. CPE infections increase morbidity and mortality. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Urologic day-care surgery: scope and problems in a developing ...

    African Journals Online (AJOL)

    Objective: Due to the numerous economic and social benefits associated with the practice of day-care surgery, it is gaining widespread acceptance worldwide and across all specialties. We therefore determined the spectrum of procedures and the difficulties faced during implementation of day-care urologic surgery in a ...

  20. Training and general and financial conditions of European residents in urology: an international survey.

    Science.gov (United States)

    Ballario, Riccardo; Rubilotta, Emanuele

    2004-10-01

    To assess the training and the general and financial conditions of European residents in urology. Between February and April 2004 a questionnaire was sent by e-mail to 351 residents in urology in 30 different European countries. The questionnaire was divided into four different sections concerning general and financial conditions, clinical and surgical practice, research activities and participation in scientific meetings. One hundred and one trainees from 30 European countries completed the questionnaire and returned it, a response rate of 28.8%. The results of greatest interest were that 30% of the trainees feel there are too many residents in their departments, 34% have a compulsory annual assessment and 83.2% have a final qualifying examination. The majority of trainees say their experience in minor surgery is at least fair, while 33% and 36% have poor or non-existent experience in major surgery and endourology respectively. Furthermore, half of the respondents do not have the support of a tutor in their clinical practice. The European Association of Urology (EAU) guidelines are frequently used and their implementation in clinical practice is advocated by 96% of the respondents. The vast majority of the respondents are planning to become Fellows of the European Board of Urology (FEBU) and members of the EAU. This survey shows that, even if the general characteristics of different training programmes seem to be similar, the products of these systems present various discrepancies in terms of surgical and clinical practice.

  1. Psychosocial difficulties in children referred to pediatric urology: a closer look.

    Science.gov (United States)

    Wolfe-Christensen, Cortney; Veenstra, Amy L; Kovacevic, Larisa; Elder, Jack S; Lakshmanan, Yegappan

    2012-10-01

    To assess rates of psychosocial difficulties in children seen in a pediatric urology clinic to determine whether all patients should be screened for psychosocial problems, and to use standardized measures to determine whether the severity of voiding dysfunction and/or enuresis in children is related to their degree of psychosocial difficulties. A retrospective chart review was conducted to collect the Pediatric Symptom Checklist from all children referred to an outpatient urology clinic over a 6-month period. In addition, scores from the child's Dysfunctional Voiding Scoring System were collected for patients referred for voiding dysfunction and/or enuresis. Caregivers of 600 children completed the Pediatric Symptom Checklist as part of their child's outpatient clinic paperwork. Overall, 15.2% of the patients met the clinical cut-off for significant psychosocial difficulties. However, children with voiding dysfunction and/or enuresis were at increased risk for these problems, with the severity of their psychosocial difficulties being related to the severity of their urologic condition. It is unnecessary to screen all pediatric urology patients, although those referred for voiding dysfunction and/or enuresis should be screened for psychosocial difficulties. Children at greatest risk for psychosocial problems were those who were male, had a high body mass index, had nocturnal enuresis, had an elevated Dysfunctional Voiding Scoring System score, and/or reported frequent episodes of wetting or soaking their underwear when they wet. Importantly, children appear to be most concerned with "wetness." Copyright © 2012 Elsevier Inc. All rights reserved.

  2. [Predictable access to the fellowship of urology in France till 2016: an update of the AFUF].

    Science.gov (United States)

    Celhay, O; Brichart, N; Audenet, F; Capon, G; Dariane, C; Fiard, G; Lebdai, S; Madec, F-X; Maurin, C; Sanson, S; Rizk, J; Tanchoux, C; Thibault, F; Terrasa, J-B; Murez, T; Terrier, J-É

    2014-09-01

    To evaluate the predictable accessibility to the fellowship of urology for residents expecting to accomplish their residentship from November 2013 to November 2016. Between September and November 2013, the representants of the residents ongoing for the residentship of urology in each region of France were reached to participate to the study. A questionnaire was given in aim at reporting all the local residents expecting to accomplish their residentship between November 2013 and 2016, and the number and the expected availability of fellow and specialist assistant posts in the region during the same period. In November 2013, our study listed 334 junior urologists (197 residents, 81 fellows, 56 assistants). Fifty-five residents were ending their internship by November 2013, whereas 67, 50, 77 residents were expecting to accomplish their residentship from November 2014 to 2016 respectively. The predictable accessibility to the fellowship of urology was 96.4%, 82.1%, 90.0%, 74.0% respectively for the residents accomplishing their residentship from November 2013 to November 2016. The predictable deficit of fellow and assistant posts were -2, -12, -5, -20 posts from November 2013 to November 2016 respectively. The predictable number of fellow and assistant post in Urology remains insufficiently available for the 2013-2016 period. By reason of the unstable number of residents accomplishing their residentship from 2014 to 2016, the fellowship accessibility was measured at 82.1%, 90.0%, 74.0% from 2014 to 2016 respectively. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. 77 FR 36951 - Gastroenterology-Urology Devices; Reclassification of Implanted Blood Access Devices

    Science.gov (United States)

    2012-06-20

    ... Implanted Blood Access Devices AGENCY: Food and Drug Administration, HHS. ACTION: Proposed rule. SUMMARY: The Food and Drug Administration (FDA) is proposing to reclassify the implanted blood access device...-Urology Devices Panel recommended that both implanted and nonimplanted blood access devices be classified...

  4. Epididymitis in Patients with Anorectal Malformations: A Cause for Urologic Concern

    Directory of Open Access Journals (Sweden)

    Brian A. VanderBrink

    2014-10-01

    Full Text Available Introduction Epididymitis in patients with anorectal malformation (ARM represents a unique problem because unlike the general population, an underlying urinary tract problem is frequently identified. We review our experience with epididymitis in ARM population with an emphasis on examining urologic outcomes. Materials and Methods We performed a retrospective review of male patients with ARM cared for from 1980 to 2010. Clinical and pathologic variables recorded included age at presentation, recurrence, associated urologic anomalies, incidence of ureteral fusion with mesonephric ductal structures, glomerular filtration rate and urodynamic parameters. Results Twenty-six patients were identified with documented episodes of epididymitis. Renal injury was noted in five patients (19%, all of whom were diagnosed with neurogenic bladder (NGB several years after anorectoplasty. NGB was found in ten patients (38% in our series. Ectopic insertion of ureter into a mesonephric ductal structure was discovered in five patients (19%. Twelve patients (46% had recurrent episodes of epididymitis, with seven of these patients (58% being diagnosed with NGB. Two patients in the pubertal group presented with a history of epididymitis and complained of ejaculatory pain. Conclusion Epididymitis in a patient with ARM warrants a comprehensive urologic investigation, particularly in recurrent episodes. Attempts at surgical intervention (e.g. vasectomy should be avoided until functional assessment of the urinary tract has occurred. Failure to recognize this association may lead to potentially avoidable complications and morbidity. Long term urological follow up of these patients is warranted to identify at risk patients and minimize renal deterioration

  5. Epididymitis in patients with anorectal malformations: a cause for urologic concern.

    Science.gov (United States)

    VanderBrink, Brian A; Sivan, Bezalel; Levitt, Marc A; Peña, Alberto; Sheldon, Curtis A; Alam, Shumyle

    2014-01-01

    Epididymitis in patients with anorectal malformation (ARM) represents a unique problem because unlike the general population, an underlying urinary tract problem is frequently identified. We review our experience with epididymitis in ARM population with an emphasis on examining urologic outcomes. We performed a retrospective review of male patients with ARM cared for from 1980 to 2010. Clinical and pathologic variables recorded included age at presentation, recurrence, associated urologic anomalies, incidence of ureteral fusion with mesonephric ductal structures, glomerular filtration rate and urodynamic parameters. Twenty-six patients were identified with documented episodes of epididymitis. Renal injury was noted in five patients (19%), all of whom were diagnosed with neurogenic bladder (NGB) several years after anorectoplasty. NGB was found in ten patients (38%) in our series. Ectopic insertion of ureter into a mesonephric ductal structure was discovered in five patients (19%). Twelve patients (46%) had recurrent episodes of epididymitis, with seven of these patients (58%) being diagnosed with NGB. Two patients in the pubertal group presented with a history of epididymitis and complained of ejaculatory pain. Epididymitis in a patient with ARM warrants a comprehensive urologic investigation, particularly in recurrent episodes. Attempts at surgical intervention (e.g. vasectomy) should be avoided until functional assessment of the urinary tract has occurred. Failure to recognize this association may lead to potentially avoidable complications and morbidity. Long term urological follow up of these patients is warranted to identify at risk patients and minimize renal deterioration.

  6. A System Approach to Navy Medical Education and Training. Appendix 35. Competency Curriculum for Urology Assistant.

    Science.gov (United States)

    1974-08-31

    30 12. Loopograms, 1Nephrostograms, Etc. ......... 31 13. Excretory Urography . . . . . .. .. .. .. .... 32 V. Urologic Radiology Performed in...MODULE 13: EXCRETORY UROGRAPHY TASKS a. Determine from patient history or requisition radiologic procedure to be performed b. Determine and obtain...hypertensive study PERFORMANCE OBJECTIVE (Stimulus) When assigned a patient for excretory urography (Behavior) The URA will obtain/assemble the

  7. Qualitative Twitter analysis of participants, tweet strategies, and tweet content at a major urologic conference

    Science.gov (United States)

    Borgmann, Hendrik; Woelm, Jan-Henning; Merseburger, Axel; Nestler, Tim; Salem, Johannes; Brandt, Maximilian P.; Haferkamp, Axel; Loeb, Stacy

    2016-01-01

    Introduction: The microblogging social media platform Twitter is increasingly being adopted in the urologic field. We aimed to analyze participants, tweet strategies, and tweet content of the Twitter discussion at a urologic conference. Methods: A comprehensive analysis of the Twitter activity at the European Association of Urology Congress 2013 (#eau2013) was performed, including characteristics of user profiles, engagement and popularity measurements, characteristics and timing of tweets, and content analysis. Results: Of 218 Twitter contributors, doctors (45%) were the most frequent, ahead of associations (15%), companies (10%), and journals (3%). However, journals had the highest tweet/participant rate (22 tweets/participant), profile activity (median: 1177, total tweets, 1805 followers, 979 following), and profile popularity (follower/following ratio: 2.1; retweet rank percentile: 96%). Links in a profile were associated with higher engagement (presearch (21%), and urotechnology (12%). Limitations include the analysis of a single conference analysis, assessment of global profile and not domain-specific activity, and the rapid evolution in Twitter-using habits. Conclusion: Results of this single conference qualitative analysis are promising for an enrichment of the scientific discussions at urologic conferences through the use of Twitter. PMID:26977205

  8. Denosumab: a new option in the treatment of bone metastases from urological cancers

    Directory of Open Access Journals (Sweden)

    Yonese J

    2012-09-01

    Full Text Available Takeshi Yuasa, Shinya Yamamoto, Shinji Urakami, Iwao Fukui, Junji YoneseDepartment of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, JapanAbstract: Bone metastases often create serious clinical problems: they lead to poor performance status due to pathologic fractures, spinal cord compression and intractable pain, commonly referred to as skeletal-related events. The receptor activator of nuclear factor-κB (RANK, the RANK ligand (RANKL, and osteoprotegerin, a decoy receptor for RANK, regulate osteoclastogenesis and may play a key role in bone metastasis. Denosumab (XGEVA; Amgen, Thousand Oaks, CA, a fully human monoclonal antibody that binds to and neutralizes RANKL, inhibits osteoclast function, prevents generalized bone resorption and local bone destruction, and has become a therapeutic option for preventing or delaying first on-study skeletal-related events in various malignancies. In the context of urological cancer, three main Phase III clinical studies have been published in prostate cancer. This article provides a brief overview of the characteristics of bone metastasis in urological cancers, reviews the mechanisms of bone metastasis, including the RANK/RANKL/osteoprotegerin axis, the current standard of care, zoledronic acid, and describes the efficacy of the novel bone-targeted agent denosumab in bone metastasis. Denosumab is emerging as a key therapeutic option in the treatment of bone metastases from urological cancers.Keywords: bone metastasis, denosumab, prostate cancer, renal cell cancer, urothelial cancer, zoledronic acid

  9. Urologic complications following obstetrics and gynecologicai surgery: Our experience in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Dilip Kumar Pal

    2016-01-01

    Conclusion: Although obstetrical causes are still important in developing countries, gynecological procedures especially laparoscopic surgeries are on the rise. In these procedures the suspicion of urological injuries should be kept in mind and intra-operative detection and early repair should be attempted. Delayed diagnosis and improper treatment leads to severe complications.

  10. Female Sexual Abuse Evaluation in the Urological Practice : Results of a Dutch Survey

    NARCIS (Netherlands)

    Beck, Jack; Bekker, Milou; Van Driel, Mels; Putter, Hein; Pelger, Rob; Nijeholt, A. A. B. Lycklama A.; Elzevier, Henk Willem

    Introduction. There is a strong association between urological complaints and a history of sexual abuse, especially in females. It is not known whether urologists integrate these facts in their daily practice. Aim. To evaluate whether Dutch urologists address the issues of sexual abuse in their

  11. Current status of clinical trials assessing oncolytic virus therapy for urological cancers.

    Science.gov (United States)

    Taguchi, Satoru; Fukuhara, Hiroshi; Homma, Yukio; Todo, Tomoki

    2017-05-01

    Oncolytic virus therapy has recently been recognized as a promising new option for cancer treatment. Oncolytic viruses replicate selectively in cancer cells, thus killing them without harming normal cells. Notably, T-VEC (talimogene laherparepvec, formerly called OncoVEX(GM)(-)(CSF) ), an oncolytic herpes simplex virus type 1, was approved by the US Food and Drug Administration for the treatment of inoperable melanoma in October 2015, and was subsequently approved in Europe and Australia in 2016. The efficacies of many types of oncolytic viruses against urological cancers have been investigated in preclinical studies during the past decade, and some have already been tested in clinical trials. For example, a phase I trial of the third-generation oncolytic Herpes simplex virus type 1, G47Δ, in patients with prostate cancer was completed in 2016. We summarize the current status of clinical trials of oncolytic virus therapy in patients with the three major urological cancers: prostate, bladder and renal cell cancers. In addition to Herpes simplex virus type 1, adenoviruses, reoviruses, vaccinia virus, Sendai virus and Newcastle disease virus have also been used as parental viruses in these trials. We believe that oncolytic virus therapy is likely to become an important and major treatment option for urological cancers in the near future. © 2017 The Japanese Urological Association.

  12. Urological care for children with spina bifida : Individual, tailored and without antibiotic prophylaxis

    NARCIS (Netherlands)

    Zegers, S.H.J.

    2017-01-01

    In our SPIN UTI study, we have focused on the urological problems, urinary tract infections and Quality of Life in spina bifida children. For eighteen months, we have analyzed the diagnosing, treatment and prevention of urinary tract infections in 176 children with spina bifida from Utrecht and

  13. A bibliometric evaluation of publications in urological journals among European Union countries between 2000-2005.

    Science.gov (United States)

    Oelrich, Beibei; Peters, Robert; Jung, Klaus

    2007-10-01

    To perform a bibliometric evaluation of publications from European Union (EU) countries in the international urological journals between 2000-2005 according to their national origin and in relation to international context. Articles except reviews, editorials, letters, and reports published during 2000-2005 in 19 international urological journals were screened using Web of Science database. The total number of publications and the cumulative impact factor were determined for the first 15 EU member states (EU15), the USA, and the world. These data were related for every country to the population size and the socio-economic indicators gross domestic product, gross domestic expenditure on research and experimental development, and expenditure on health care. A total of 19.709 articles were published of which 6.878 (34.9%) came from the EU15 countries and 7.927 (40.2%) from the USA. About 15% of all papers from the EU15 countries were in collaboration with USA researchers. In the EU, the number of publications and the cumulative impact factor were dominated by United Kingdom, Germany, and Italy with about 52% of all papers and 50% of the cumulative impact factor. If adjusted for demographic and socio-economic factors the smaller countries Austria, Denmark, Finland, the Netherlands, and Sweden (alphabetical order) revealed a distinctly higher publication rate. This study based on bibliometric analyses in urological journals demonstrated a feasible solution to validate and compare the contribution of the various EU countries towards the urological research.

  14. Training potential in minimally invasive surgery in a tertiary care, paediatric urology centre

    NARCIS (Netherlands)

    Schroeder, R. P. J.; Chrzan, R. J.; Klijn, A. J.; Kuijper, C. F.; Dik, P.; de Jong, T. P. V. M.

    2015-01-01

    Background Minimally invasive surgery (MIS) is being utilized more frequently as a surgical technique in general surgery and in paediatric urology. It is associated with a steep learning curve. Currently, the centre does not offer a MIS training programme. It is hypothesized that the number of MIS

  15. Training potential in minimally invasive surgery in a tertiary care, paediatric urology centre

    NARCIS (Netherlands)

    Schroeder, R. P. J.; Chrzan, R. J.; Klijn, A. J.; Kuijper, C. F.; Dik, P.; de Jong, T. P. V. M.

    2015-01-01

    Minimally invasive surgery (MIS) is being utilized more frequently as a surgical technique in general surgery and in paediatric urology. It is associated with a steep learning curve. Currently, the centre does not offer a MIS training programme. It is hypothesized that the number of MIS procedures

  16. [Integrate the surgical hand disinfection as a quality indicator in an operating room of urology].

    Science.gov (United States)

    Francois, M; Girard, R; Mauranne, C C; Ruffion, A; Terrier, J E

    2017-12-01

    The surgical hand disinfection by friction (SDF) helps to reduce the risk of surgical site infections. For this purpose and in order to promote good compliance to quality care, the urology service of Centre Hospitalier Lyon Sud achieved a continuous internal audit to improve the quality of the SDF. An internal audit executed by the medical students of urology was established in 2013. The study population was all operators, instrumentalists and operating aids of urology operating room (OR). Each student realized 5-10 random observations, of all types of professionals. The criteria measured by the audit were criteria for friction. The evolution of indicators was positive. Particularly, the increasing duration of the first and second friction was statistically significant during follow-up (P=0.001). The total duration of friction shows a similar trend for all professionals. The surgical hand disinfection by friction in the urology OR of the Centre Hospitalier Lyon Sud has gradually improved over the iterative audits. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  17. Secondary data analysis of large data sets in urology: successes and errors to avoid.

    Science.gov (United States)

    Schlomer, Bruce J; Copp, Hillary L

    2014-03-01

    Secondary data analysis is the use of data collected for research by someone other than the investigator. In the last several years there has been a dramatic increase in the number of these studies being published in urological journals and presented at urological meetings, especially involving secondary data analysis of large administrative data sets. Along with this expansion, skepticism for secondary data analysis studies has increased for many urologists. In this narrative review we discuss the types of large data sets that are commonly used for secondary data analysis in urology, and discuss the advantages and disadvantages of secondary data analysis. A literature search was performed to identify urological secondary data analysis studies published since 2008 using commonly used large data sets, and examples of high quality studies published in high impact journals are given. We outline an approach for performing a successful hypothesis or goal driven secondary data analysis study and highlight common errors to avoid. More than 350 secondary data analysis studies using large data sets have been published on urological topics since 2008 with likely many more studies presented at meetings but never published. Nonhypothesis or goal driven studies have likely constituted some of these studies and have probably contributed to the increased skepticism of this type of research. However, many high quality, hypothesis driven studies addressing research questions that would have been difficult to conduct with other methods have been performed in the last few years. Secondary data analysis is a powerful tool that can address questions which could not be adequately studied by another method. Knowledge of the limitations of secondary data analysis and of the data sets used is critical for a successful study. There are also important errors to avoid when planning and performing a secondary data analysis study. Investigators and the urological community need to strive to use

  18. The landscape of systematic reviews in urology (1998 to 2015): an assessment of methodological quality.

    Science.gov (United States)

    Han, Julia L; Gandhi, Shreyas; Bockoven, Crystal G; Narayan, Vikram M; Dahm, Philipp

    2017-04-01

    To assess the quality of published systematic reviews in the urology literature (an extension of our previously reported work), as high-quality systematic reviews play a paramount role in informing evidence-based clinical practice. Our focus was on systematic reviews in the urology literature that incorporated questions of prevention and therapy. To identify such reviews published during a 36-month period (2013-2015), we systematically searched PubMed and hand-searched the table of contents of four major urology journals. Two reviewers independently assessed the methodological quality of those reviews, using the 11-point 'Assessment of Multiple Systematic Reviews' (AMSTAR) instrument. We performed protocol-driven analyses of the data from our present study's 36-month period alone, as well as in aggregate with the data from our previously reported work's study periods (2009-2012 and 1998-2008). In our literature search of the 36-month period (2013-2015), we initially identified 490 possibly relevant reviews, of which 125 met our inclusion criteria. The most common topic of reviews for the 2013-2015 period was oncology (51.2%; n = 64), followed by voiding dysfunction (21.6%; n = 27). The mean [standard deviation (SD)] AMSTAR score in the 2013-2015 period (n = 125) was 4.8 (2.4); 2009-2012 (n = 113), 5.4 (2.3); and 1998-2008 (n = 57), 4.8 (2.0) (P = 0.127). In the 2013-2015 period, the mean (SD) AMSTAR score for the BJU International (n = 25) was 5.6 (2.9); for The Journal of Urology (n = 20), 5.1 (2.6); for European Urology (n = 60), 4.5 (2.2); and for Urology (n = 20), 4.4 (2.2) (P = 0.106). The number of systematic reviews published in the urology literature has exponentially increased, year by year, but their methodological quality has stagnated. To enhance the validity and impact of systematic reviews, all authors and editors must apply established methodological standards. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley

  19. Bladder management methods and urological complications in spinal cord injury patients

    Directory of Open Access Journals (Sweden)

    Roop Singh

    2011-01-01

    Full Text Available Background: The optimal bladder management method should preserve renal function and minimize the risk of urinary tract complications. The present study is conducted to assess the overall incidence of urinary tract infections (UTI and other urological complications in spinal cord injury patients (SCI, and to compare the incidence of these complications with different bladder management subgroups. Materials and Methods: 545 patients (386 males and 159 females of traumatic spinal cord injury with the mean age of 35.4±16.2 years (range, 18 - 73 years were included in the study. The data regarding demography, bladder type, method of bladder management, and urological complications, were recorded. Bladder management methods included indwelling catheterization in 224 cases, clean intermittent catheterization (CIC in 180 cases, condom drainage in 45 cases, suprapubic cystostomy in 24 cases, reflex voiding in 32 cases, and normal voiding in 40 cases. We assessed the incidence of UTI and bacteriuria as the number of episodes per hundred person-days, and other urological complications as percentages. Results: The overall incidence of bacteriuria was 1.70 / hundred person-days. The overall incidenceof urinary tract infection was 0.64 / hundered person-days. The incidence of UTI per 100 person-days was 2.68 for indwelling catheterization, 0.34 for CIC, 0.34 for condom drainage, 0.56 for suprapubic cystostomy, 0.34 for reflex voiding, and 0.32 for normal voiding. Other urological complications recorded were urethral stricture (n=66, 12.1%, urethritis (n=78, 14.3%, periurethral abscess (n=45, 8.2%, epididymorchitis (n=44, 8.07%, urethral false passage (n=22, 4.03%, urethral fistula (n=11, 2%, lithiasis (n=23, 4.2%, hematuria (n=44, 8.07%, stress incontinence (n=60, 11%, and pyelonephritis (n=6, 1.1%. Clean intermittent catheterization was associated with lower incidence of urological complications, in comparison to indwelling catheterization. Conclusions

  20. Urological and sexual outcome in patients with Hirschsprung disease: A systematic review.

    Science.gov (United States)

    Versteegh, Hendt P; Johal, Navroop S; de Blaauw, Ivo; Stanton, Michael P

    2016-12-01

    There is a paucity of recent evidence regarding long-term urological and sexual outcomes following surgery for Hirschsprung disease (HD). We aimed to undertake a systematic review of all HD literature to define these outcomes. A systematic literature search was conducted on studies from 1966 to 2014. Relevant articles were assessed for urological/sexual operative complications and functional sequelae. Studies were analysed in qualitative (Rangel score) and quantitative syntheses. Initially 257 reports were assessed, with 24 studies were eligible for inclusion (1972-2014). Mean study quality was 16.5 ± SD 4.8 (range 6-23), indicating overall fair/poor quality. Ten studies (1021 patients) reported operative complications, with ureteric/urethral/vaginal injury occurring in seven (0.7%) patients. In three studies, the primary outcome was urological functional assessment. From 17 studies, 52/2546 patients (2.0%) had reported urinary incontinence. In infants, absent spontaneous erections post-operatively was reported in 3/203 patients (1.5%, 5 studies); of these 3, parents did not note spontaneous erections pre-operatively either. In older patients, erectile dysfunction occurred in 6/498 (1.2%) males. Other sexual outcomes were reported in 10 studies, with 5/10 studies (416 patients) reporting no erectile dysfunction. In the other studies reports ranged from non-specified sexual dysfunction in one study to diverse sexual related problems in nine (7.8%) of their patients in another. Urological/sexual outcomes are rarely reported after HD surgery (24 studies over 42 years). Study quality is usually poor and a large proportion of the studies are more than 30 years old. In the majority of series it is unclear whether urological and sexual function impairments were not present or if they were not assessed. Prospective reporting of urological/sexual outcome is required, in particular in the era of new surgical techniques/approaches to HD. Copyright © 2016 Journal of

  1. Multidrug-resistant NDM-1 Klebsiella outbreak and infection control in endoscopic urology.

    Science.gov (United States)

    Koo, Vincent S W; O'Neill, Patricia; Elves, Andrew

    2012-12-01

    What's known on the subject? and What does the study add? Since the first case of multidrug-resistant New Delhi metallo-β-lactamase (NDM-1) Klebsiella and Escherichia coli UTI in January 2008, there have been more reports of cases worldwide. Urology is a specialty uniquely vulnerable to these organisms because the NDM-1 carriers tend to be the common UTI-causing organisms. Further, the nature of the procedures involved in endoscopy in the urinary tract confers the potential for direct exposure and transmission of the organisms that commonly cause UTI. Although decontamination by sterilization of urological endoscopes and surgical instruments is well established in the operating theatre suite, there were no national standardized guidelines for infection control measures with respect to the video camera head in endoscopic urology in the UK. This paper reports the first UK outbreak of NDM-1 Klebsiella UTI, for which the common source of infection was rapidly traced to the endoscopic camera head in the urology theatre, where single-use sterile disposable plastic camera sheaths were not routinely used and the camera head was regularly cleaned with detergent wipes. We found that infection control practices vary across UK urology units. In the context of infection control, we highlight a need for standardized practice in the use of camera sheaths and in the decontamination process for endoscopic video camera heads. Either sterilization or use of single-use sterile disposable plastic camera sheaths with regular cleaning of the camera head using approved disinfectant for all endoscopy work is recommended. • To report the first UK outbreak of NDM-1 Klebsiella, for which the common source of infection was rapidly traced to the endoscopic camera head in the urology theatre, where camera sheathing was not routinely used and the camera head was regularly cleaned with detergent wipes. • To survey the use of camera sheath and infection control practices in endoscopy in

  2. Experimental study of the iron - smectite system in the presence of a solution at 80 at 300 deg; Etude experimentale du systeme fer-smectite en presence de solution a 80 deg et 300 deg

    Energy Technology Data Exchange (ETDEWEB)

    Guillaume, D

    2002-04-01

    One of the concepts proposed for the storage of nuclear wastes consists in the use of several confining barriers placed between the waste and the biosphere. Vitrified wastes are placed in steel containers surrounded by compacted smectite (engineered barrier). The whole is placed in the geological deep site (geological barrier, granite or argilite). The prediction of the evolution of the performances of the engineered barrier (low permeability, high swelling and sorption capacities) necessitates the study of the long-term stability of its mineral constituents under the conditions of the repository. The aim is to determine the nature and the chemistry of potential newly-formed phases resulting from the temperature increase due to disintegration reactions of the wastes, the presence of fluids coming from the geological barrier, and from the liberation of iron due to the degradation of the containers. Natural systems (in particular geothermal systems and sedimentary basins) give information concerning the possible evolutions of clay minerals. However, the potential availability of metallic iron makes a particular case of the nuclear waste storage. The aim of this experimental study is to put to evidence the chemical and mineralogical transformations of the iron-clay system at 80 deg C and 300 deg C, in the presence of a solution, so as to predict the possible transformations of a bentonite placed in the deep storage conditions of radioactive wastes. Several sets of experiments were carried out to study the reactivity of the MX80 bentonite in the presence of a solution ([CI]=3.10{sup -2} molal, Na/Ca=5,5 and liquid/rock ratio of 10) in absence or in presence of iron (magnetite + hematite or iron + magnetite) at 80 deg C or 300 deg C, and over periods ranging from 1 day to 9 months. Run products were submitted to multi-technique and multi-scale characterisation: X-ray diffraction, scanning electron microscopy, transmission electron microscopy (HR imaging, EDS and EELS

  3. Survey on lower urinary tract symptoms and sleep disorders in patients treated at urology departments

    Directory of Open Access Journals (Sweden)

    Shimizu N

    2013-01-01

    Full Text Available Nobutaka Shimizu,1 Yasuharu Nagai,1 Yutaka Yamamoto,1 Takafumi Minami,1 Taiji Hayashi,1 Hidenori Tsuji,1 Masahiro Nozawa,1 Kazuhiro Yoshimura,1 Tokumi Ishii,1 Hirotsugu Uemura,1 Takashi Oki,2 Koichi Sugimoto,2 Kazuhiro Nose,2 Tsukasa Nishioka21Department of Urology, Kinki University Faculty of Medicine, Osaka, Japan; 2Department of Urology, Sakai Hospital, Kinki University Faculty of Medicine, Osaka, JapanObjectives: This study examined the association between sleep disorders and lower urinary tract symptoms in patients who had visited urology departments.Methods: This was an independent cross-sectional, observational study. Outpatients who had visited the urology departments at the Kinki University School of Medicine or the Sakai Hospital, Kinki University School of Medicine, between August 2011 and January 2012 were assessed using the Athens Insomnia Scale and the International Prostate Symptom Score.Results: In total, 1174 patients (mean age, 65.7 ± 13.7 years, with 895 men (67.1 ± 13.2 years old and 279 women (61.4 ± 14.6 years old, were included in the study. Approximately half of these patients were suspected of having a sleep disorder. With regard to the International Prostate Symptom Score subscores, a significant increase in the risk for suspected sleep disorders was observed among patients with a post-micturition symptom (the feeling of incomplete emptying subscore of ≥1 (a 2.3-fold increase, a storage symptom (daytime frequency + urgency + nocturia subscore of ≥5 (a 2.7-fold increase, a voiding symptom (intermittency + slow stream + hesitancy subscore of ≥2 (a 2.6-fold increase, and a nocturia subscore of ≥2 (a 1.9-fold increase.Conclusion: The results demonstrated that the risk factors for sleep disorders could also include voiding, post-micturition, and storage symptoms, in addition to nocturia.Keywords: lower urinary tract symptoms, sleep disturbance, urological disease

  4. Survey of Applicant Experience and Cost in the Urology Match: Opportunities for Reform.

    Science.gov (United States)

    Nikonow, Tara N; Lyon, Timothy D; Jackman, Stephen V; Averch, Timothy D

    2015-10-01

    The urology match is highly competitive but there is a paucity of published data regarding the costs and barriers that applicants face. We gathered data on contributors to cost in the 2014 urology residency match. A survey was sent to all applicants offered an interview at each of 18 participating institutions. Information on demographics, interview related costs, access to financial aid, frequency of away rotations and second look invitations was collected. A total of 173 respondents spent a median of $7,000 on the urology match. Applicants attended a mean of 14 interviews with an average per interview cost of $500. Overall 95% of respondents did at least 1 away rotation and 79% reported being asked to return for a second look interview at least once. Of the respondents 66% did not receive any financial aid for interviews and only 28% believed their financial aid departments provided adequate financial planning. Of those surveyed 20% indicated that their financial situation limited the number of interviews they attended. We estimate that $3,122,000 was spent by applicants on the 2014 urology match. One in 5 applicants reported limiting the number of interviews they attended due to financial concerns. Adequate financial planning resources were not widely available. Nearly all applicants went on an away rotation and encouragement to return for second look interviews was common. These factors may contribute to financial and regional bias in the match process, and are potential targets for reform. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. A review of inpatient urology consultations in an Irish tertiary referral centre.

    Science.gov (United States)

    Sullivan, J F; Forde, J C; Creagh, T A; Donovan, M G; Eng, M P; Hickey, D P; Mohan, P; Power, R E; Smyth, G P; Little, D M

    2013-12-01

    Our institution is a 680-bed tertiary referral centre with broad medical and surgical subspecialty services. We retrospectively audited the pattern of inpatient consultations from all specialities within our institution to the urology department over a 1-year period. All consultations to the urology service were identified from our computerised inpatient consultation system from July 2010 to June 2011. Follow up data on investigations, interventions and subsequent outpatient appointments were also identified by review of individual patient discharge letters. Seven hundred and twenty five inpatient consultations were received over the period. The male to female ratio was 7:3. Mean age of patients was 66 (15-96) years. Seventy three percent of referrals were from medical sub-specialities, most commonly nephrology (17%), gastroenterology (11%) and respiratory medicine (9%). The remainder were from general surgery (16%) and other surgical sub specialities (11%). Interns (66%) and senior house officers (SHO) (28%) communicated the majority of consults. Male lower urinary tract/benign prostate related issues resulted in 25% of all consultations. Less than half of consults (47%) resulted in interventions initiated by urology, most commonly of which were catheter insertions (48%) and endoscopic procedures (35%). Only 43% of consultations were followed up in the outpatients setting. Inpatient consultations constitute a significant workload for urology services. The majority of these referrals did not require any urological intervention and could have been seen routinely in the outpatient setting. Providing structured referral guidelines and achieving better communication with referring teams may help to optimise this service. Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  6. Activity, content, contributors, and influencers of the twitter discussion on urologic oncology.

    Science.gov (United States)

    Borgmann, Hendrik; Loeb, Stacy; Salem, Johannes; Thomas, Christian; Haferkamp, Axel; Murphy, Declan G; Tsaur, Igor

    2016-09-01

    To analyse the activity, content, contributors, and influencers of the Twitter discussion on urologic oncology. We performed a comprehensive quantitative and qualitative Twitter analysis for the hashtags #prostatecancer, #bladdercancer, #kidneycancer, and #testicularcancer. Symplur was used to analyse activity over different time periods and the top influencers of the Twitter discussion. Tweet Archivist and Twitonomy analysis tools were used to assess characteristics of content and contributors. Twitter discussion on urologic oncology in 2014 contained 100,987 tweets created by 39,326 participants. Mean monthly tweet activity was 6,603±2,183 for #prostatecancer, 866±923 for #testicularcancer, 457±477 for #bladdercancer and 401±504 for #kidneycancer. Twitter activity increased by 41% in 2013 and by 122% in 2014. The content analysis detected awareness, cancer, and risk as frequently mentioned words in urologic oncology tweets. Prevalently used related hashtags were the general hashtag #cancer, awareness hashtags, and the respective cancer/urology tag ontology hashtags. Contributors originated from 41 countries on 6 continents and had a mean of 5,864±4,747 followers. They tweeted from platforms on exclusively mobile devices (39%) more frequently than from desktop devices (29%). Health care organizations accounted for 58% of the top influencers in all cancers. The largest proportion of physicians were among the #prostatecancer and #kidneycancer (each 9%) influencers and individual contributors were most frequent in the discussion on #kidneycancer (57%) and #testicularcancer (50%). There is a significant and growing activity in the Twitter discussion on urologic oncology, particularly on #prostatecancer. The Twitter discussion is global, social, and mobile, and merits attention of stakeholders in health care as a promising communication tool. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Effect of Music on Outpatient Urological Procedures: A Systematic Review and Meta-Analysis from ESUT.

    Science.gov (United States)

    Kyriakides, Rena; Jones, Patrick; Geraghty, Robert; Skolarikos, Andreas; Liatsikos, Evangellos; Traxer, Olivier; Pietropaolo, Amelia; Somani, Bhaskar K

    2017-12-07

    Music is a practical, inexpensive and harmless analgesic and anxiolytic. An increasing number of original studies have been performed to investigate its potential application in urology. Our aim was to identify the effect of music on outpatient based urological procedures. We systematically reviewed the effect of using music during all reported outpatient urology procedures, including transrectal ultrasound guided prostate biopsy, shock wave lithotripsy, urodynamic studies, percutaneous nephrostomy tube placement and cystoscopy. Data were included on all randomized trials from 1980 to 2017 and no language restrictions were applied. Included in analysis were 16 randomized studies in which 972 of 1,950 patients (49.8%) were exposed to music during an outpatient procedure. The procedures included transrectal ultrasound guided prostate biopsy in 4 studies in a total of 286 patients, shock wave lithotripsy in 6 studies in a total of 1023, cystoscopy in 3 studies in a total of 331, urodynamics in 2 studies in a total of 210 and percutaneous nephrostomy in 1 study in a total of 100. All studies incorporated a visual analog score to measure pain. Anxiety was measured by STAI (State-Trait anxiety Inventory) in 13 studies and by a visual analog scale in 2. While 14 of the 16 studies showed a reduction in self-reported pain, a reduction in anxiety was seen in 14. When using music, overall procedural satisfaction was better in 9 studies and patient willingness to repeat the procedure was also higher in 7. Our meta-analysis revealed a significant reduction in visual analog scale and STAI findings across all studies (p <0.001). Our systematic review demonstrated a beneficial effect of music on urological outpatient procedures. Music seemed to decrease anxiety and pain. It might serve as a useful adjunct to increase procedural satisfaction and patient willingness to undergo the procedure again. Copyright © 2018 American Urological Association Education and Research, Inc

  8. New Media for Educating Urology Residents: An Interview Study in Canada and Germany.

    Science.gov (United States)

    Salem, Johannes; Borgmann, Hendrik; MacNeily, Andrew; Boehm, Katharina; Schmid, Marianne; Groeben, Christer; Baunacke, Martin; Huber, Johannes

    To investigate the usage and perceived usefulness of new media for educating urology residents in Canada and Germany. We designed an 11-item online survey to assess the use and perceived usefulness of new media for education. We performed a comparative analysis. The survey was distributed via e-mail to 143 Canadian and 721 German urology residents. The survey included 58 urology residents from Canada and 170 from Germany. A total of 58 residents from Canada (41% response rate) and 170 from Germany (24% response rate) responded to this survey. Residents spent 45% of their education time on new media. The Internet was used by 91% (n = 208) of the residents for professional education purposes, with a median time of 270 minutes (interquartile range [IQR]: 114-540) per month. Apps were used by 54% (n = 118) of the residents, with a median time of 101 minutes (IQR: 45-293) per month. A total of 23% (n = 47) of the residents used social media (SoMe) for education, with a median time of 90 minutes (IQR: 53-80) per month. In all, 100% (n = 228) rated the Internet, 76% (n = 173) apps, and 43% (n = 97) SoMe as being useful for professional education purposes. A total of 90% (n = 205) watched medical videos for education, and 89% (n = 203) of these videos were on surgical procedures. Canadian urology residents used more new media sources for professional education than did the Germans (58% vs. 41%, p source for personal education in urology is the Internet. Future studies and technological developments should investigate and improve new media tools to optimize education during residency. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. The current state of diversity and multicultural training in urology residency programs.

    Science.gov (United States)

    Vemulakonda, Vijaya M; Sorensen, Mathew D; Joyner, Byron D

    2008-08-01

    The American population continues to increase in ethnic diversity. However, the medical work force has lagged behind these population trends. We evaluated the extent of diversity and perceived barriers to multicultural training in American urology programs. A 25-question nonvalidated diversity questionnaire was distributed electronically to 112 American urology residency program directors. A total of 62 program directors (55%) responded, representing all American Urological Association geographic regions nationwide. Of the respondents 92% were male and 90% were older than 40 years. During their residency 44% of respondents reported no female co-residents and 51% reported no co-residents of color. As faculty, 40% of respondents reported no female colleagues and 49% reported no colleagues of color. Of the respondents 75% identified no formal process to recruit faculty of color. With regard to current residency training 36% of respondents reported 1 or fewer female residents, 66% reported at least 1 black resident and 42% reported at least 1 Hispanic resident in their program. Of the respondents 75% stated that multicultural training is important for residents and 46% reported no barriers to multicultural training. However, 75% of program directors reported no formal multicultural program training. Most urology program directors trained with few minority or female co-residents. This paucity of diversity has continued with current faculty members. Residents are increasingly diverse but few urology residency programs have a formal curriculum or mentors to address diversity issues. Therefore, current residency training may not encourage diversity at academic centers or adequately prepare residents to serve an increasingly diverse patient population.

  10. Nationwide Trends and Variations in Urological Surgical Interventions and Renal Outcome in Patients with Spina Bifida.

    Science.gov (United States)

    Wang, Hsin-Hsiao S; Lloyd, Jessica C; Wiener, John S; Routh, Jonathan C

    2016-04-01

    Bladder dysfunction in patients with spina bifida can lead to significant morbidity due to renal insufficiency. Indications for surgery vary among institutions and the impact is unclear. We examined trends and variations in urological interventions and chronic renal insufficiency in patients with spina bifida. We reviewed NIS (Nationwide Inpatient Sample) for all patients with spina bifida treated from 1998 to 2011. We used ICD-9-CM codes to identify urological surgery and chronic renal insufficiency. We calculated the Spearman correlation coefficients between rates of spina bifida related bladder surgeries and rates of chronic renal insufficiency outcomes by state. Linear regression models were fitted to investigate the associations between rates of spina bifida related surgery and chronic renal insufficiency across treatment years. We identified 427,616 spina bifida hospital admissions. Mean patient age was 26 years and 56% of patients were female. Of the admissions 35,249 (8%) were for chronic renal insufficiency and 11,078 (3%) were for surgery. During the study period chronic renal insufficiency rates doubled from 6% to 12% and surgery rates decreased from 2.0% to 1.8%. There was a moderately weak inverse association between surgery and chronic renal insufficiency rates with time (r = -0.3, p = 0.06) and by state (r = -0.3, p = 0.04). On multivariate analysis higher rates of surgery were associated with the state in which the patient was treated (p spina bifida related surgery (p = 0.67). We observed a temporal and geographic trend toward decreasing urological surgery and increasing chronic renal insufficiency rates in spina bifida and a wide variation in urological surgical rates among states. Further study is needed to determine the factors behind these trends and variations in spina bifida management. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  11. The urology work force in Ontario for the 21st century: feast or famine?

    Science.gov (United States)

    Pace, K T; Provan, J L; Jewett, M A

    1999-06-01

    To address the issues of work-force planning and modelling in the 21st century for the specialty of urology in the Province of Ontario. Data (from 1991 to 1995) regarding urology physician resources were gathered from Health Canada, the Royal College of Physicians and Surgeons of Canada, the Ontario Physician Human Resources Data Centre, the Canadian Post-M.D. Education Registry, the System for Health Area Resource Planning (SHARP) database, the Canadian Institute for Health Information and the National Physician Database. Specifically, the age and gender breakdown of currently active Ontario urologists, measures of urologist clinical activity (from Ontario Hospital Insurance Plan billings and questionnaires), inputs into and exits from the active urologist population were gathered, and estimates of future needs for urologist services, based on current population and demographic models, were made. A model to predict the balance between future needs for urology services and future supply of urologists was then created and validated against data drawn from the SHARP database. The model revealed that there will be a significant shortage of urologists in Ontario in the immediate and long-term future; by the year 2010 there will be a shortfall of 101 urologists in Ontario, or 51% of the total needed. Enlarging the urology training programs in Ontario would help to minimize the estimated shortfall. Systematic modelling of physician work-force needs for the future is necessary for the optimal allocation of health care resources. The methodology of the urology work-force model is generalizable to physician work-force planning for other specialty groups on a provincial or national basis.

  12. Outpatient urologic surgery office conducted by nursing staff. A process integrated in a total quality strategy.

    Science.gov (United States)

    Lujan, Marcos; Gamarra, Manuela; Mora, Jose Ramon; Lopez, Maria Carmen; Pascual, Carlos; Martin, Carlos; Diz, Manuel Ramon; Chiva, Vicente

    2013-11-01

    To create an innovative process to care for urological outpatient surgery patients in an outpatient clinic basis conducted by nursing staff. Our centre covers a population of 153,266 inhabitants. A differentiated process for urological outpatient surgery patients has been implemented, conducted by nursing staff trained for the attendance of urologic patients ("phimosis","short penile frenulum",and "vasectomy request" sent from Primary Care units). Planning and implementation phases have been carried out. In the control phase, a questionnaire was given after surgical procedures with 9 different items, in order to assess different issues of the process. A total of 224 patients were attended during the study period, and 175 valid questionnaires were collected (78.1%). The procedures performed were circumcision (11.7%), frenuloplasty (14.6%), and vasectomy (73.7%), with a median patient age of 36 years. Satisfaction level was high for all items of the questionnaire, with 98.2% of patients" very satisfied" or "rather satisfied" when asked for the overall quality of attention of the whole process. The lowest scores were obtained in items that assessed delay from the appointment to attendance date (5.1% of patients "little satisfaction or not satisfied"), and the perception of information supplied (2.3% "little satisfaction or not satisfied"). A lower satisfaction score was observed (in the delay from appointment to attendance) in younger patients (p=0.001) and in patients who underwent circumcision (p=0.004). No complaints with regard to this process were collected. No incorrect indications for interventions were observed. The attendance of urological outpatient surgery patients can be safely and effectively performed by nursing staff trained for the care of urologic patients, without observing a decrease of the level of user satisfaction. Focusing on a process strategy allows the identification of areas for improvement and makes possible total quality management.

  13. Xenogenic extracellular matrices as potential biomaterials for interposition grafting in urological surgery.

    Science.gov (United States)

    Davis, N F; McGuire, B B; Callanan, A; Flood, H D; McGloughlin, T M

    2010-12-01

    The field of tissue engineering focuses on developing strategies for reconstructing injured, diseased, and congenitally absent tissues and organs. During the last decade urologists have benefited from remodeling and regenerative properties of bioscaffolds derived from xenogenic extracellular matrices. We comprehensively reviewed the current literature on structural and functional characteristics of xenogenic extracellular matrix grafting since it was first described in urological surgery. We also reviewed the clinical limitations, and assessed the potential for safe and effective urological application of extracellular matrix grafting in place of autogenous tissue. We performed literature searches for English language publications using the PubMed® and MEDLINE® databases. Keywords included "xenogenic," "extracellular matrix" and "genitourinary tract applications." A total of 112 articles were scrutinized, of which 50 were suitable for review based on clinical relevance and importance of content. Since the mid 1990s xenogenic extracellular matrices have been used to successfully treat a number of pathological conditions that affect the upper and lower genitourinary tract. They are typically prepared from porcine organs such as small intestine and bladder. These organs are harvested and subjected to decellularization and sterilization techniques before surgical implantation. Bioinductive growth factors that are retained during the preparation process induce constructive tissue remodeling as the extracellular matrix is simultaneously degraded and excreted. However, recent documented concerns over durability, decreased mechanical strength and residual porcine DNA after preparation techniques have temporarily hampered the potential of extracellular matrices as a reliable replacement for genitourinary tract structures. Extracellular matrices are a useful alternative for successfully treating a number of urological conditions that affect the genitourinary tract. However

  14. The Role of SwrA, DegU and PD3 in fla/che Expression in B. subtilis

    Science.gov (United States)

    Mordini, Serena; Osera, Cecilia; Marini, Simone; Scavone, Francesco; Bellazzi, Riccardo; Galizzi, Alessandro; Calvio, Cinzia

    2013-01-01

    In B. subtilis swarming and robust swimming motility require the positive trigger of SwrA on fla/che operon expression. Despite having an essential and specific activity, how SwrA executes this task has remained elusive thus far. We demonstrate here that SwrA acts at the main σA-dependent fla/che promoter PA(fla/che) through DegU. Electrophoretic mobility shift assays (EMSA) reveal that SwrA forms a complex with the phosphorylated form of DegU (DegU~P) at PA(fla/che) while it is unable to do so with either unphosphorylated DegU or the DegU32(Hy) mutant protein. Motility assays show that a highly phosphorylated DegU is not detrimental for flagellar motility provided that SwrA is present; however, DegU~P represses PA(fla/che) in the absence of SwrA. Overall, our data support a model in which DegU~P is a dual regulator, acting either as a repressor when alone or as a positive regulator of PA(fla/che) when combined with SwrA. Finally, we demonstrate that the σD-dependent PD3(fla/che) promoter plays an important role in motility, representing a contingent feedback loop necessary to maintain basal motility when swrA is switched to the non-functional swrA- status. PMID:24386445

  15. Reevaluation of usefulness of excretory urography in the diagnosis of urological diseases. Comparison with ultrasonography and computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Takasaki, Noboru; Kawasaki, Toshihiro; Hirai, Kei; Okada, Shigeki; Miyazaki, Shigeru

    1988-12-01

    Excretory urography (IVP) has been used as a screening test for urological diseases for the past several decades. The useflness of IVP, however, might be lessened or at least changed, since the recent development of technology has produced new diagnostic devices such as ultrasonography (US) and computed tomography (CT). Therefore, IVP was compared with US and CT in regard to their diagnostic value in urological disorders. The subjects chosen for this investigation were 397 inpatients who underwent IVP in the Department of Urology of Osaka Medical School Hospital between 1982 and 1986, and 35 outpatients referred to the Department of Urology of Saiseikai Ibaraki Hospital from other clinics in 1986 and 1987, because US had shown abnormal findings suspicious of a urological problem. Although IVP was less useful than US or CT in the basic diagnosis of retroperitoneal or renal mass or injury of the kidney, it was more useful in the diagnosis of urinary calculi and diseases of the ureter. Excretory urography also provides valuable information in the follow-up of patients after surgical treatment for urological diseases. In conclusion, IVP still remains one of the most useful examinations in current clinical urology despite the fact that new diagnostic devices, including US and CT, are now widely employed.

  16. Pourbaix diagrams for the system copper-chlorine at 5-100 deg C

    Energy Technology Data Exchange (ETDEWEB)

    Beverskog, B. [Studsvik Material AB, Nykoeping (Sweden); Puigdomenech, I. [Studsvik Eco and Safety AB, Nykoeping (Sweden)

    1998-04-01

    Pourbaix diagrams for the copper-chlorine system in the temperature interval 5-100 deg C have been revised. Predominance diagrams for dissolved copper containing species have also been calculated. Two different total concentrations of each dissolved element, 10{sup -4} and 10{sup -6} molal for copper and 0.2 and 1.5 molal for chlorine have been used in the calculations. Chloride is the predominating chlorine species in aqueous solutions. Presence of chloride increases the corrosion regions of copper at the expense of the immunity and passivity regions in the Pourbaix diagrams. CuCl{sub 2} {center_dot} 3Cu(OH){sub 2} is the only copper-chloride solid phase that forms at the concentrations of chlorine studied. However, its stability area decreases with increasing temperature. The ion CuCl{sub 2}{sup -} predominates at all temperatures at [Cl(aq)]{sub tot}=0.2 molal and this reduces the immunity and passivity areas. A corrosion region exists between the immunity and passivity regions at 100 deg C at [Cu(aq)]{sub tot}=10{sup -6} and [Cl(aq)]{sub tot}=0.2 molal. At the chlorine concentration of 1.5 molal the corrosion region exists in the whole temperature range investigated. The ion CuCl{sub 3}{sup 2-} predominates at 5-25 and 100 deg C, while CuCl{sub 2}{sup -} predominates at 50-80 deg C at [Cl(aq)]{sub tot=}1-5 molal. A copper concentration of 10{sup -4} molal reduces the corrosion areas due to expansion of the immunity and passivity areas. However, a corrosion region still exists between the immunity and passivity regions at all investigated temperatures at pH{sub {Tau}}<9.5 and 1.5 molal chloride concentration. According to our calculations the copper canisters in the deep nuclear waste repository should not corrode at the copper concentration of 10{sup -6} molal and the chloride concentration of 0.2 molal. However, at 80-100 deg C the equilibrium potentials postulated for the Swedish nuclear repository are dangerously close to a corrosion situation. According to

  17. Book review, Igiene e Tecnologie degli Alimenti di Origine Animale Giampaolo Colavita (a cura di

    Directory of Open Access Journals (Sweden)

    Manuel Graziani

    2008-09-01

    Full Text Available Igiene e Tecnologie degli Alimenti di Origine Animale si avvale del contributo di 33 autori, tutti soci dell’Associazione Italiana Veterinari Igienisti (AIVI, che garantiscono l’appropriata trattazione di una materia estremamente vasta e dinamica. Il manuale nasce da un’iniziativa finalizzata alla realizzazione di un testo che rifletta e possa soddisfare le esigenze didattiche degli insegnamenti di un’ampia serie di materie universitarie: Igiene e Tecnologie degli Alimenti di Origine Animale della Facoltà di Medicina Veterinaria, di Agraria, nei corsi di Scienze e Tecnologie Alimentari, di Scienze e Tecnologie delle Produzioni Animali, nel corso di laurea in Tecniche della Prevenzione nell’ambiente e nei Luoghi di Lavoro, nonché in altri corsi di studio dove si insegnano le discipline relative all’igiene e alla sicurezza degli alimenti.Sono stati trattati gran parte degli alimenti di origine animale, i prodotti a base di carne, il latte e i prodotti derivati, i prodotti della pesca freschi e trasformati, i prodotti dell’alveare, le uova e gli ovoprodotti. Di particolare interesse appare il capitolo riguardante la diagnostica analitica degli alimenti, considerato che le moderne metodologie analitiche risultano fondamentali per affrontare le tematiche legate all’igiene e alla sicurezza alimentare.Il volume ha una finalità prevalentemente didattica ma è comunque rivolto a tutti coloro che operano nel campo dell’Igiene e delle Tecnologie Alimentari. Infatti, visti gli argomenti trattati come le tossinfezioni e le intossicazioni alimentari, la conservazione, il confezionamento e l’etichettatura dei prodotti alimentari, anche i professionisti del settore possono trarre dal testo elementi utili per la loro attività. Per esempio argomenti quali l’analisi del rischio, le attività di audit ed i sistemi di accreditamento e di certificazione sono particolarmente utili per chi opera nelle Aziende Sanitarie Locali e negli Istituti

  18. Creep crack growth in a reactor pressure vessel steel at 360 deg C

    Energy Technology Data Exchange (ETDEWEB)

    Rui Wu; Seitisleam, F.; Sandstroem, R. [Swedish Institute for Metals Research, Stockholm (Sweden)

    1998-12-31

    Plain creep (PC) and creep crack growth (CCG) tests at 360 deg C and post metallography were carried out on a low alloy reactor pressure vessel steel (ASTM A508 class 2) with different microstructures. Lives for the CCG tests were shorter than those for the PC tests and this is more pronounced for simulated heat affected zone microstructure than for the parent metal at longer lives. For the CCG tests, after initiation, the cracks grew constantly and intergranularly before they accelerated to approach rupture. The creep crack growth rate is well described by C*. The relations between reference stress, failure time and steady crack growth rate are presented for the CCG tests. It is demonstrated that the failure stress due to CCG is considerably lower than the yield stress at 360 deg C. Consequently, the CCG will control the static strength of a reactor vessel. (orig.) 17 refs.

  19. Observation of Polar Mesosphere Summer Echoes using the Northernmost MST Radar at Eureka (80 deg N)

    Science.gov (United States)

    Swarnalingam, N.; Hocking, W.; Janches, D.; Drummond, J.

    2017-01-01

    We investigate long-term Polar Mesosphere Summer Echoes (PMSEs) observations conducted by the northern most geographically located MST radar at Eureka (80 deg N, 86 deg W). While PMSEs are a well recognized summer phenomenon in the polar regions, previous calibrated studies at Resolute Bay and Eureka using 51.5 MHz and33 MHz radars respectively, showed that PMSE backscatter signal strengths are relatively weak in the polar cap sites, compared to the auroral zone sites (Swarnalingam et al., 2009b; Singer et al., 2010). Complications arise with PMSEs in which the echo strength is controlled by the electrons, which are, in turn, influenced by heavily charged ice particles as well as the variability in the D-region plasma. In recent years, PMSE experiments were conducted inside the polar cap utilizing a 51 MHz radar located at Eureka. In this paper, we investigate calibrated observations, conducted during 2009-2015. Seasonal and diurnal variations of the backscatter signal strengths are discussed and compared to previously published results from the ALOMAR radar, which is a radar of similar design located in the auroral zone at Andenes, Norway (69 deg N, 16 deg E). At Eureka, while PMSEs are present with a daily occurrence rate which is comparable to the rate observed at the auroral zone site for at least two seasons, they show a great level of inter-annual variability. The occurrence rate for the strong echoes tends to be low. Furthermore, comparison of the absolute backscatter signal strengths at these two sites clearly indicates that the PMSE backscatter signal strength at Eureka is weak. Although this difference could be caused by several factors, we investigate the intensity of the neutral air turbulence at Eureka from the measurements of the Doppler spectrum of the PMSE backscatter signals. We found that the level of the turbulence intensity at Eureka is weak relative to previously reported results from three high latitude sites.

  20. A Superconducting 180{\\deg} Hybrid Ring Coupler for circuit Quantum Electrodynamics

    OpenAIRE

    Hoffmann, E; Deppe, F.; Niemczyk, T.; Wirth, T.; Menzel, E. P.; Wild, G.; Huebl, H.; Mariantoni, M.; Weißl, T.; Lukashenko, A.; Zhuravel, A. P.; Ustinov, A. V.; Marx, A.; Gross, R.

    2010-01-01

    Superconducting circuit quantum electrodynamics experiments with propagating microwaves require devices acting as beam splitters. Using niobium thin films on silicon and sapphire substrates, we fabricated superconducting 180{\\deg} microstrip hybrid ring couplers, acting as beam splitters with center frequencies of about 6GHz. For the magnitude of the coupling and isolation we find -3.5+/-0.5dB and at least -15dB, respectively, in a bandwidth of 2GHz. We also investigate the effect of reflecti...

  1. submitter Technical Note: Using DEG-CPCs at upper tropospheric temperatures

    CERN Document Server

    Wimmer, D; Nieminen, T; Duplissy, J; Ehrhart, S; Almeida, J; Rondo, L; Franchin, A; Kreissl, F; Bianchi, F; Manninen, H E; Kulmala, M; Curtius, J; Petäjä, T

    2015-01-01

    Over the last few years, several condensation particle counters (CPCs) capable of measuring in the sub-3 nm size range have been developed. Here we study the performance of CPCs based on diethylene glycol (DEG) at different temperatures during Cosmics Leaving OUtdoor Droplets (CLOUD) measurements at CERN. The data shown here are the first set of verification measurements for sub-3 nm CPCs under upper tropospheric temperatures using atmospherically relevant aerosol particles. To put the results in perspective we calibrated the DEG-CPC at room temperature, resulting in a cut-off diameter of 1.4 nm. All diameters refer to mobility equivalent diameters in this paper. At upper tropospheric temperatures ranging from 246.15 K to 207.15 K, we found cut-off sizes relative to a particle size magnifier in the range of 2.5 to 2.8 nm. Due to low number concentration after size classification, the cut-off diameters have a high uncertainty (±0.3 nm) associated with them. Operating two laminar flow DEG-CPCs with different c...

  2. Sensory functions for degenerin/epithelial sodium channels (DEG/ENaC).

    Science.gov (United States)

    Ben-Shahar, Yehuda

    2011-01-01

    All animals use a sophisticated array of receptor proteins to sense their external and internal environments. Major advances have been made in recent years in understanding the molecular and genetic bases for sensory transduction in diverse modalities, indicating that both metabotropic and ionotropic pathways are important in sensory functions. Here, I review the historical background and recent advances in understanding the roles of a relatively newly discovered family of receptors, the degenerin/epithelial sodium channels (DEG/ENaC). These animal-specific cation channels show a remarkable sequence and functional diversity in different species and seem to exert their functions in diverse sensory modalities. Functions for DEG/ENaC channels have been implicated in mechanosensation as well as chemosensory transduction pathways. In spite of overall sequence diversity, all family members share a unique protein topology that includes just two transmembrane domains and an unusually large and highly structured extracellular domain, that seem to be essential for both their mechanical and chemical sensory functions. This review will discuss many of the recent discoveries and controversies associated with sensory function of DEG/ENaC channels in both vertebrate and invertebrate model systems, covering the role of family members in taste, mechanosensation, and pain. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Sexy DEG/ENaC channels involved in gustatory detection of fruit fly pheromones.

    Science.gov (United States)

    Pikielny, Claudio W

    2012-11-06

    Hydrocarbon pheromones on the cuticle of Drosophila melanogaster modulate the complex courtship behavior of males. Recently, three members of the degenerin/epithelial Na+ channel (DEG/ENaC) family of sodium channel subunits, Ppk25, Ppk23, and Ppk29 (also known as Nope), have been shown to function in gustatory perception of courtship-modulating contact pheromones. All three proteins are required for the activation of male courtship by female pheromones. Specific interactions between two of them have been demonstrated in cultured cells, suggesting that, in a subset of cells where they are coexpressed, these three subunits function within a common heterotrimeric DEG/ENaC channel. Such a DEG/ENaC channel may be gated by pheromones, either directly or indirectly, or alternatively may control the excitability of pheromone-sensing cells. In addition, these studies identify taste neurons that respond specifically to courtship-modulating pheromones and mediate their effects on male behavior. Two types of pheromone-sensing taste neurons, F and M cells, have been defined on the basis of their specific response to either female or male pheromones. These reports set the stage for the dissection of the molecular and cellular mechanisms that mediate gustatory detection of contact pheromones.

  4. Evaluation and establishment of a ward-based geriatric liaison service for older urological surgical patients: Proactive care of Older People undergoing Surgery (POPS)-Urology.

    Science.gov (United States)

    Braude, Philip; Goodman, Anna; Elias, Tania; Babic-Illman, Gordana; Challacombe, Ben; Harari, Danielle; Dhesi, Jugdeep K

    2017-07-01

    To assess the impact of introducing and embedding a structured geriatric liaison service, Proactive care of Older People undergoing Surgery (POPS)-Urology, using comprehensive geriatric assessment methodology, on an inpatient urology ward. A phased quality improvement project was undertaken using stepwise interventions. Phase 1 was a before-and-after study with initiation of a daily board round, weekly multidisciplinary meeting, and targeted geriatrician-led ward rounds for elective and emergency urology patients aged ≥65 years admitted over two 1-month periods. Outcomes were recorded from medical records and discharge documentation, including length of inpatient stay, medical and surgical complications, and 30-day readmission and mortality rates. Phase 2 was a quality improvement project involving Plan-Do-Study-Act cycles and qualitative staff surveys in order to create a Geriatric Surgical Checklist (GSCL) to standardize the intervention in Phase 1, improve equity of care by extending it to all ages, improve team-working and streamline handovers for multidisciplinary staff. Phase 1 included 112 patients in the control month and 130 in the intervention month. The length of inpatient stay was reduced by 19% (mean 4.9 vs 4.0 days; P = 0.01), total postoperative complications were lower (risk ratio 0.24 [95% confidence interval 0.10, 0.54]; P = 0.001). A non-significant trend was seen towards fewer cancellations of surgery (10 vs 5%; P = 0.12) and 30-day readmissions (8 vs 3%; P = 0.07). In Phase 2, the GSCL was created and incrementally improved. Questionnaires repeated at intervals showed that the GSCL helped staff to understand their role better in multidisciplinary meetings, improved their confidence to raise issues, reduced duplication of handovers and standardized identification of geriatric issues. Equity of care was improved by providing the intervention to patients of all ages, despite which the time taken for the daily board round did not lengthen. This

  5. Introducing the Twitter Impact Factor: An Objective Measure of Urology's Academic Impact on Twitter.

    Science.gov (United States)

    Cardona-Grau, Diana; Sorokin, Igor; Leinwand, Gabriel; Welliver, Charles

    2016-10-01

    Social media use in academia and urology is rising. Specifically, individual journals now have Twitter accounts (Twitter Inc, San Francisco, CA, USA) and regularly tweet academic content. To present and evaluate the Twitter impact factor (TIF), a novel means of measuring a journal's academic influence in the realm of social media. Journal Citation Reports (JCR; Thomson Reuters, New York, NY, USA) for 2014 was queried for urologic academic journals. English-language journals with active Twitter accounts since 2013 were included. The total number of followers, tweets, and retweets over a 2-yr period were collected. Each journal's TIF was calculated based on the number of retweets per original relevant tweet. Comparisons between the TIF and the journal impact factor (JIF) as well as the Klout score were made using the Pearson correlation. Of 33 journals listed in the JCR for 2014, 7 (21%) had a Twitter presence as of 2013. The number of JCR-listed journals with a Twitter handle increased by 29% in 2014. There was an increase in the mean number of relevant tweets per journal during the study period and a 130% increase in the number of retweets over 1 yr. European Urology (1.80) and BJU International (1.46) had the highest TIFs. The journals with the highest number of Twitter followers were European Urology (5807) and the Journal of Urology (4402). The journals with the highest numbers of relevant tweets were European Urology (1159) and BJU International (1090). There was a positive but statistically insignificant association between the TIF and the JIF (r=0.64, p=0.12). There was a strongly positive linear correlation between the TIF and the Klout score (r=0.84, p=0.0086). With the increasing use of social media by individuals and academic journals, the TIF can be a useful tool to measure the academic reach and impact of a journal on Twitter. Social media is an increasing part of the way in which practitioners and academicians communicate. The TIF can be used to

  6. Haemonchus contortus acetylcholine receptors of the DEG-3 subfamily and their role in sensitivity to monepantel.

    Directory of Open Access Journals (Sweden)

    Lucien Rufener

    2009-04-01

    Full Text Available Gastro-intestinal nematodes in ruminants, especially Haemonchus contortus, are a global threat to sheep and cattle farming. The emergence of drug resistance, and even multi-drug resistance to the currently available classes of broad spectrum anthelmintics, further stresses the need for new drugs active against gastro-intestinal nematodes. A novel chemical class of synthetic anthelmintics, the Amino-Acetonitrile Derivatives (AADs, was recently discovered and the drug candidate AAD-1566 (monepantel was chosen for further development. Studies with Caenorhabditis elegans suggested that the AADs act via nicotinic acetylcholine receptors (nAChR of the nematode-specific DEG-3 subfamily. Here we identify nAChR genes of the DEG-3 subfamily from H. contortus and investigate their role in AAD sensitivity. Using a novel in vitro selection procedure, mutant H. contortus populations of reduced sensitivity to AAD-1566 were obtained. Sequencing of full-length nAChR coding sequences from AAD-susceptible H. contortus and their AAD-1566-mutant progeny revealed 2 genes to be affected. In the gene monepantel-1 (Hco-mptl-1, formerly named Hc-acr-23H, a panel of mutations was observed exclusively in the AAD-mutant nematodes, including deletions at intron-exon boundaries that result in mis-spliced transcripts and premature stop codons. In the gene Hco-des-2H, the same 135 bp insertion in the 5' UTR created additional, out of frame start codons in 2 independent H. contortus AAD-mutants. Furthermore, the AAD mutants exhibited altered expression levels of the DEG-3 subfamily nAChR genes Hco-mptl-1, Hco-des-2H and Hco-deg-3H as quantified by real-time PCR. These results indicate that Hco-MPTL-1 and other nAChR subunits of the DEG-3 subfamily constitute a target for AAD action against H. contortus and that loss-of-function mutations in the corresponding genes may reduce the sensitivity to AADs.

  7. The Canadian Urology Fair: a model for minimizing the financial and academic costs of the residency selection process

    Science.gov (United States)

    Grober, Ethan D.; Matsumoto, Edward D.; Jewett, Michael A.S.; Chin, Joseph L.

    2003-01-01

    Introduction In 1994, the Canadian urology residency training programs designed the “Canadian Urology Fair” — a single-site (Toronto, Ont.), 1-day fair to conduct the personal interview portion of the residency selection process. The objective of the current study was to evaluate the success of the Urology Fair in achieving its original goals of decreasing the financial burden and minimizing time away from medical training for applicants and faculty. Methods Both candidates and Canadian urology training programs were surveyed regarding the financial and academic costs (days absent) of attending the 2001 Urology Fair. Data from the 2001 Canadian Resident Matching Service (CaRMS) was used to compare the financial and academic costs of attending personal interviews incurred by candidates declaring urology as their first-choice discipline to candidates interviewing with other surgical specialties throughout Canada. Results Financial costs incurred by candidates to attend the Urology Fair (mean Can$367) were significantly lower than candidates' estimated costs of attending on-site interviews at the individual programs (mean Can$2065). The financial costs of attending personal interviews by CaRMS applicants declaring urology as their first-choice discipline (mean Can$2002) were significantly lower than the costs incurred by applicants interviewing with other surgical disciplines (meanCan$2744). Financial costs to urology programs attending the fair (mean Can$1931) were not significantly greater than the programs' estimated costs of conducting on-site interviews at their respective program locations (mean Can$1825). Days absent from medical school to attend interviews were significantly lower among CaRMS applicants declaring urology as their first-choice discipline (3 d) compared with applicants who interviewed with other surgical specialties (9.1 d). Conclusion The Canadian Urology Fair represents an innovative and efficient method for residency programs to conduct

  8. Is sperm banking of interest to patients with nongerm cell urological cancer before potentially fertility damaging treatments?

    Science.gov (United States)

    Salonia, Andrea; Gallina, Andrea; Matloob, Rayan; Rocchini, Lorenzo; Saccà, Antonino; Abdollah, Firas; Colombo, Renzo; Suardi, Nazareno; Briganti, Alberto; Guazzoni, Giorgio; Rigatti, Patrizio; Montorsi, Francesco

    2009-09-01

    We assessed the opinions of patients with nongerm cell urological cancer on sperm banking before undergoing surgical or nonsurgical therapy that could potentially endanger subsequent fertility. Between April 2007 and July 2008, 753 patients visited a urological office and were invited to complete a brief self-administered questionnaire to assess opinions on sperm banking before undergoing any eventual therapy potentially dangerous for male fertility. Logistic regression models tested the association between predictors (age, educational level, relationship status, previous fatherhood and benign disorder vs nongerm cell urological cancer) and patient wishes for sperm banking. Median patient age was 65 years (mean 61.6, range 18 to 76). Overall 522 patients (69.3%) had nongerm cell urological cancer and only 242 (32.1%) were in favor of pretreatment sperm banking. On univariate analysis age (OR 0.961, p banking, whereas having cancer and educational status were not significantly correlated. Multivariate analysis indicated that aging (OR 0.966, p = 0.001) and previous fatherhood (OR 0.587, p = 0.029) maintained inverse associations. Having urological cancer was positively (OR 1.494, p = 0.045) associated with the wish for sperm banking. In urological patients there is a low rate of willingness to bank sperm before any potential fertility damaging therapeutic approach. Having nongerm cell urological cancer is an independent predictor that is positively associated with the wish to bank sperm. It is vitally important to provide comprehensive information about pretreatment sperm banking to young adults with nongerm cell urological cancer.

  9. Comparative Study of Scientific Publications in Urology and Nephrology Journals Originating from USA, China and Japan (2001–2010)

    OpenAIRE

    Li, Juan; Gao, Xian Hua; Bian, Qi; Guo, Zhi Yong; Mei, Xiao Bin; Yu, Guang; Wu, Hao; Lai, Xue Li; Chen, Wei

    2012-01-01

    Background In the past decade, scientific research has developed rapidly in China, but the growth seems to vary widely between different disciplines. In this study, we aimed to compare the quantity and quality of publications in urology and nephrology journals from USA, China and Japan. Methods Journals listed in the “Urology and Nephrology” category of Science Citation Index Expanded subject categories were included. Scientific papers in these journals written by researchers from USA, Japan ...

  10. European Association of Urology (@Uroweb) recommendations on the appropriate use of social media.

    Science.gov (United States)

    Rouprêt, Morgan; Morgan, Todd M; Bostrom, Peter J; Cooperberg, Matthew R; Kutikov, Alexander; Linton, Kate D; Palou, Joan; Martínez-Piñeiro, Luis; van der Poel, Henk; Wijburg, Carl; Winterbottom, Andrew; Woo, Henry H; Wirth, Manfred P; Catto, James W F

    2014-10-01

    Social media use is becoming common in medical practice. Although primarily used in this context to connect physicians, social media allows users share information, to create an online profile, to learn and keep knowledge up to date, to facilitate virtual attendance at medical conferences, and to measure impact within a field. However, shared content should be considered permanent and beyond the control of its author, and typical boundaries, such as the patient-physician interaction, become blurred, putting both parties at risk. The European Association of Urology brought together a committee of stakeholders to create guidance on the good practice and standards of use of social media. These encompass guidance about defining an online profile; managing accounts; protecting the reputations of yourself and your organization; protecting patient confidentiality; and creating honest, responsible content that reflects your standing as a physician and your membership within this profession. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  11. Port-Site Metastasis after Laparoscopic Surgery for Urological Malignancy: Forgotten or Missed

    Directory of Open Access Journals (Sweden)

    N. Kadi

    2012-01-01

    Full Text Available Purpose. Port-site metastasis has been a concern with the common use of laparoscopy in urologic oncology. We conducted this study to provide a review of port-site metastases reported after the laparoscopy in managing urologic malignancies, possible contributing factors and preventative measures. Materials and Methods. An electronic search of MEDLINE using the combined MESH key words “port-site metastasis” and “Urology”. Results. 51 articles addressing port-site metastasis after laparoscopic surgery for urolo¬gical malignancy were identified. Conclusion. Port-site metastasis after laparoscopic surgery for urolo¬gical malignancy is rare. The incidence is comparable to the rate for surgical wound metastases.

  12. Applications of neuromodulation of the lower urinary tract in female urology

    Directory of Open Access Journals (Sweden)

    Firouz Daneshgari

    2006-06-01

    Full Text Available Neuromodulation is becoming part of clinical armamentarium for treatment of a variety of lower urinary tract conditions in female urology. Its increased usage stems from need of patients who have exhausted all other therapeutic options for their complex and poorly understood lower urinary tract disorders. Currently neuromodulation may consist of the use of sacral nerve stimulation (SNS and injectable therapies. Herein, we will discuss the background and development of SNS, its current indications, methods of patient selection and will review the results of the recent published literature on SNS. In addition, we will discuss some of the newer developments in SNS such as Bion device and the future direction in integration of SNS in female urology.

  13. Association of BMI and pediatric urologic postoperative events: Results from pediatric NSQIP.

    Science.gov (United States)

    Kurtz, Michael P; McNamara, Erin R; Schaeffer, Anthony J; Logvinenko, Tanya; Nelson, Caleb P

    2015-08-01

    Elevated body mass index (BMI) is a well-known risk factor for perioperative complications in adults, but has not been investigated in children undergoing urologic procedures. Given the low rate of complications associated with urologic surgery, a large sample is required for their characterization, but BMI is frequently not available in administrative databases. Here we report results from the first nationally based, prospectively assembled cohort analyzed with respect to the association of BMI with 30-day postoperative events for pediatric urologic procedures. To determine the association of elevated BMI with overall 30-day postoperative events and wound complications in a large national sample of children undergoing urologic procedures. We queried the 2012 Pediatric National Surgical Quality Improvement Program database (NSQIP), defining obesity as a BMI above the 95th percentile and overweight above the 85th percentile, per CDC definitions. We used BMI percentile as a referent group. Complications were collected within 30 days of the procedure. Comorbidity was classified on a linear scale using a validated pediatric-specific comorbidity score, and procedures were classified as genital, abdominal without bowel involvement, or abdominal with bowel involvement. Univariate and multivariate logistic models were used to test significance of associations. 2871 patients aged 2-18 years were analyzed. Of these, 420 (14.6%) were overweight and 440 (15.3%) were obese. A summary of 30-day events and complications is shown in the structured abstract table. On multivariate analysis adjusting for age, gender, class of procedure, and comorbidity, BMI remained a significant risk factor for 30-day events when comparing BMI ≥85th percentile to BMI percentile (OR 1.36, 95% CI 1.03-1.8, p = 0.035). An exploratory subgroup analysis examining the rate of wound complications demonstrated an odds ratio of 2.36 (95% CI 1.28-4.35, p = 0.006) for BMI >85th percentile on multivariate

  14. Image-guided urologic surgery: intraoperative optical imaging and tissue interrogation (Conference Presentation)

    Science.gov (United States)

    Liao, Joseph C.

    2017-02-01

    Emerging optical imaging technologies can be integrated in the operating room environment during minimally invasive and open urologic surgery, including oncologic surgery of the bladder, prostate, and kidney. These technologies include macroscopic fluorescence imaging that provides contrast enhancement between normal and diseased tissue and microscopic imaging that provides tissue characterization. Optical imaging technologies that have reached the clinical arena in urologic surgery are reviewed, including photodynamic diagnosis, near infrared fluorescence imaging, optical coherence tomography, and confocal laser endomicroscopy. Molecular imaging represents an exciting future arena in conjugating cancer-specific contrast agents to fluorophores to improve the specificity of disease detection. Ongoing efforts are underway to translate optimal targeting agents and imaging modalities, with the goal to improve cancer-specific and functional outcomes.

  15. Comprehensive Approach to Port Placement Templates for Robot-Assisted Laparoscopic Urologic Surgeries.

    Science.gov (United States)

    Pathak, Ram A; Patel, Manish; Hemal, Ashok K

    2017-11-10

    Port placement for robot-assisted laparoscopic urologic surgery can be critical to effective completion of the minimally invasive procedure. An ideal port template would allow unhampered access to all critical structures during surgery, easy access for the bedside assistant, and minimization of arm collision with the fewest ports necessary to minimize cosmetic impact. We present a comprehensive plan for the placement of ports across different procedures for a variety of upper tract (radical/partial nephrectomy, retroperitoneal radical/partial nephrectomy, and pyeloplasty), lower tract (prostatectomy, and cystectomy), combined upper/lower tract (nephroureterectomy, retroperitoneal lymph node dissection), and female pelvic surgeries. Optimal exploitation of these tips across the different procedures for different generations of robots will help in effective execution of robotic urologic surgery.

  16. Urological surgery in epidermolysis bullosa: tactical planning for surgery and anesthesia

    Directory of Open Access Journals (Sweden)

    Lisieux Eyer de Jesus

    2014-10-01

    Full Text Available Epidermolysis bullosa (EB is characterized by extreme fragility of the skin and mucosae. Anesthetic and surgical techniques have to be adapted to those children and routine practice may not be adequate. Urological problems are relatively common, but surgical techniques adapted to those children have not been well debated and only low evidence is available to this moment. Herein we discuss the specifics of anesthetic and surgical techniques chosen to treat a six year old EB male presenting with symptomatic phimosis.

  17. Gender Differences in Academic Productivity and Academic Career Choice Among Urology Residents

    Science.gov (United States)

    Yang, Glen; Villalta, Jacqueline D.; Weiss, Dana A.; Carroll, Peter R.; Breyer, Benjamin N.

    2012-01-01

    Purpose Gender disparities have long existed in medicine but they have not been well examined in urology. We analyzed a large cohort of graduating urology residents to investigate gender disparities in academic productivity, as measured by peer reviewed publications and academic career choice. Materials and Methods We assembled a list of urology residents who graduated from 2002 through 2008 who were affiliated with the top 50 urology hospitals, as ranked by 2009 U.S. News & World Report. PubMed® was queried to determine the publication output of each resident during the last 3 years of residency. We used an Internet search to determine the fellowship training, career choice and academic rank of each subject. Gender effects on each factor were evaluated. Results A total of 459 male (84.5%) and 84 female (15.5%) residents were included in analysis. During residency women produced fewer total publications (average 3.0 vs 4.8, p = 0.01) and fewer as first author (average 1.8 vs 2.5, p = 0.03) than men. A higher proportion of women than men underwent fellowship training (54.8% vs 48.5%, p =0.29) and ultimately chose an academic career (40.5% vs 33.3%, p = 0.20), although these differences were not statistically significant. Of residents who chose an academic career a higher proportion of men than women (24.7% vs 2.9%, p = 0.01) obtained associate vs assistant professor rank. Conclusions Women produced fewer peer reviewed publications than men during residency but they were equally likely to undergo fellowship training and choose an academic career. During the study period a higher proportion of men achieved associate professor rank. PMID:22902027

  18. Urological injuries during obstetric and gynaecological procedures: a retrospective analysis over a period of eleven years

    OpenAIRE

    Rashmi S. Desai; Sunil Kumar K.

    2016-01-01

    Background: To determine frequency and nature of urological injuries in obstetric and gynaecological procedures and their consequences and mode of management in a tertiary care hospital SDM Medical college and hospital, Dharwad, India. Methods: A retrospective study of all obstetric and gynaecological surgeries over a period of 11 years from January 2004 to December 2014 was carried out at Department of Obstetrics and Gynaecology, SDM Medical College and Hospital, Dharwad, India. Cases wit...

  19. Fibrinogen Release and Deposition on Urinary Catheters Placed during Urological Procedures.

    Science.gov (United States)

    Flores-Mireles, Ana L; Walker, Jennifer N; Bauman, Tyler M; Potretzke, Aaron M; Schreiber, Henry L; Park, Alyssa M; Pinkner, Jerome S; Caparon, Michael G; Hultgren, Scott J; Desai, Alana

    2016-08-01

    Catheter associated urinary tract infections account for approximately 40% of all hospital acquired infections worldwide with more than 1 million cases diagnosed annually. Recent data from a catheter associated urinary tract infection animal model has shown that inflammation induced by catheterization releases host fibrinogen, which accumulates on the catheter. Further, Enterococcus faecalis catheter colonization was found to depend on EbpA (endocarditis and biofilm-associated pilus), a fibrinogen binding adhesin. We evaluated this mechanism in a human model. Urinary catheters were collected from patients hospitalized for surgical or nonsurgical urological procedures. Catheters were subjected to immunofluorescence analyses by incubation with antifibrinogen antibody and then staining for fluorescence. Fluorescence intensity was compared to that of standard catheters. Catheters were incubated with strains of Enterococcus faecalis, Staphylococcus aureus or Candida to assess binding of those strains to fibrinogen laden catheters. After various surgical and urological procedures, 50 catheters were collected. In vivo dwell time ranged from 1 hour to 59 days. All catheters had fibrinogen deposition. Accumulation depended on dwell time but not on surgical procedure or catheter material. Catheters were probed ex vivo with E. faecalis, S. aureus and Candida albicans, which bound to catheters only in regions where fibrinogen was deposited. Taken together, these data show that urinary catheters act as a binding surface for the accumulation of fibrinogen. Fibrinogen is released due to inflammation resulting from a urological procedure or catheter placement, creating a niche that can be exploited by uropathogens to cause catheter associated urinary tract infections. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  20. Selective imaging modalities after first pyelonephritis failed to identify significant urological anomalies, despite normal antenatal ultrasounds

    DEFF Research Database (Denmark)

    Mola, Gylli; Wenger, Therese Ramstad; Salomonsson, Petra

    2017-01-01

    in 95 patients. Dilated vesicoureteral reflux (VUR) was the predominant finding (n = 29), including nine who initially had surgery. Using imaging guidelines from the American Academy of Pediatrics would have missed 11 urological patients, including two with initial surgery, and avoided 339...... identified all patients initially treated with surgery and avoided 65 scintigraphies. CONCLUSION: Dilated VUR was the dominant anomaly in a cohort with first time pyelonephritis and normal antenatal ultrasound. The optimal imaging strategy after pyelonephritis must be identified....

  1. An Analysis of Gender Diversity in Urology in the UK and Ireland

    LENUS (Irish Health Repository)

    E M O’Connor, E M

    2017-11-01

    Traditionally, surgery and certain surgical sub-specialities in particular have been predominantly male orientated. In recent years, there has been an increased proportion of female medical graduates which will ultimately have an effect on speciality choices. The aim of this study was to assess the gender diversity among urologists in the UK and Ireland. The total number and gender breakdown of consultant urologists and trainees in the UK and Ireland was obtained from the British Association of Urological Surgeons (BAUS) and the Irish Society of Urology (ISU) membership offices. The total number and gender breakdown of medical school entrants and graduates in 2015 was obtained from the six medical schools in the Republic of Ireland. There are a total of 1,012 consultant urologists in the UK and Ireland. In the UK, 141 (14.6%) are female compared to four (8.2%) in Ireland, p= 0.531. There was a significant increase in the number of females between consultant urologists and trainees in both the UK (p=0.0001) and Ireland (p=0.015). In recent years, there has been a significant change in the percentage of female trainees in the UK and Ireland (22.8% (n=75) in 2011 vs 31.7% (n=93) in 2014, p=0.019. Between the six medical schools in Ireland, there were significantly more female entrants (n=726, 56.5%) than female graduates (n=521, 51.2%) in 2015, p=0.013.There has been a significant shift in gender diversity in urology in the UK and Ireland. Efforts to increase diversity should be pursued to attract further trainees to urology.

  2. Pain management in urology training: A national survey of senior residents.

    Science.gov (United States)

    Pace, Jonathan; Jaeger, Melanie; Nickel, J Curtis; Siemens, D Robert

    2013-01-01

    We explore the attitudes and experience of urology residents toward acute and chronic pain management during their training. A convenience sample of Canadian Urology chief residents were invited to complete an anonymous questionnaire involving both open and closed-ended questions using a 5-point Likert scale. Descriptive and quantitative statistics were used to analyze the attitudes toward pain management, including their experience and training issues. The response rate was 97%. Most residents agreed or strongly agreed that more formal training in acute pain (77% agreement, mean 4.03 ± 0.98 SD) and chronic pain (68%, 3.97 ± 0.95) management would be valuable in urology residency with only 1 respondent disagreeing that training should be mandatory. There was a significant difference of training experience in chronic versus acute pain management, with only 13% agreement (2.99 ± 0.67) that their training in chronic pain was adequate. Most residents agreed (74%, 3.84 ± 1.00) that most of their training in pain management came from their senior residents or fellows. Many of the residents (65%, 3.61 ± 0.84) felt that they could manage their patients' acute pain issues independently, even in the absence of an acute pain service, although apparent knowledge of opioids was poor. The results of this survey suggest that urology residents attain their knowledge of pain management experientially with what may be insufficient formal training, particularly in chronic pain. These observations are limited by the relatively small number of respondents and by the nature of a cross-sectional, self-reported survey; however, they would appear to underscore a need to redouble efforts in residency education.

  3. Delivery of a urology online course using Moodle versus didactic lectures methods.

    Science.gov (United States)

    Reis, Leonardo Oliveira; Ikari, Osamu; Taha-Neto, Khaled A; Gugliotta, Antonio; Denardi, Fernandes

    2015-02-01

    To subjectively and objectively compare an accessible interactive electronic library using Moodle with lectures for urology teaching of medical students. Forty consecutive fourth-year medical students and one urology teacher were exposed to two teaching methods (4 weeks each) in the form of problem-based learning: - lectures and - student-centered group discussion based on Moodle (modular object-oriented dynamic learning environment) full time online delivered (24/7) with video surgeries, electronic urology cases and additional basic principles of the disease process. All 40 students completed the study. While 30% were moderately dissatisfied with their current knowledge base, online learning course delivery using Moodle was considered superior to the lectures by 86% of the students. The study found the following observations: (1) the increment in learning grades ranged from 7.0 to 9.7 for students in the online Moodle course compared to 4.0-9.6 to didactic lectures; (2) the self-reported student involvement in the online course was characterized as large by over 60%; (3) the teacher-student interaction was described as very frequent (50%) and moderately frequent (50%); and (4) more inquiries and requisitions by students as well as peer assisting were observed from the students using the Moodle platform. The Moodle platform is feasible and effective, enthusing medical students to learn, improving immersion in the urology clinical rotation and encouraging the spontaneous peer assisted learning. Future studies should expand objective evaluations of knowledge acquisition and retention. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Are patients at nutritional risk more prone to complications after major urological surgery?

    Science.gov (United States)

    Cerantola, Yannick; Valerio, Massimo; Hubner, Martin; Iglesias, Katia; Vaucher, Laurent; Jichlinski, Patrice

    2013-12-01

    The nutritional risk score is a recommended screening tool for malnutrition. While a nutritional risk score of 3 or greater predicts adverse outcomes after digestive surgery, to our knowledge its predictive value for morbidity after urological interventions is unknown. We determined whether urological patients at nutritional risk are at higher risk for complications after major surgery than patients not at nutritional risk. We performed a prospective observational study in consecutive patients undergoing major surgery. A priori sample calculation resulted in a study cohort of 220 patients. Interim analysis was planned after 110 patients. The nutritional risk score was assessed preoperatively by a specialized study nurse. Nutritional care was standardized in all patients. Postoperative complications were defined previously using the standardized Dindo-Clavien classification. The primary end point was 30-day morbidity. Univariate and multivariate analysis was performed to identify predictors of complications. The study was discontinued due to significant results after interim analysis. A total of 125 patients were included in analysis from June 2011 to June 2012 and 15 were excluded because of incomplete data. Of 51 patients at nutritional risk 38 (74%) presented with at least 1 complication compared to 28 of 59 controls (47%). Patients at nutritional risk were at threefold risk for complications on univariate and multivariate analysis (OR 3.3, 95% CI 1.3-8.0). Cystectomy was the only other predictor of morbidity (OR 10, 95% CI 2-48). Patients at nutritional risk are more prone to complications after major urological procedures. Whether this increased morbidity can be reversed by perioperative nutritional support should be studied. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. [Urology and National Socialism. Paul Rosenstein 1875-1964, the disrupted biography of a Jewish urologist].

    Science.gov (United States)

    Moll, F H; Krischel, M; Rathert, P; Fangerau, H

    2011-09-01

    The biography of Paul Rosenstein (1875-1964) serves as an example of the fate of a Jewish scientist at the beginning of the twentieth century in an area of conflict between the development of urology as a specialty at greater urban hospitals, professional achievements as a surgeon and scientist, drastic breaks during Nazi era and escape from Nazi terror via New York to Brazil.

  6. Xenogenic extracellular matrices as potential biomaterials for interposition grafting in urological surgery.

    LENUS (Irish Health Repository)

    Davis, N F

    2012-01-31

    PURPOSE: The field of tissue engineering focuses on developing strategies for reconstructing injured, diseased, and congenitally absent tissues and organs. During the last decade urologists have benefited from remodeling and regenerative properties of bioscaffolds derived from xenogenic extracellular matrices. We comprehensively reviewed the current literature on structural and functional characteristics of xenogenic extracellular matrix grafting since it was first described in urological surgery. We also reviewed the clinical limitations, and assessed the potential for safe and effective urological application of extracellular matrix grafting in place of autogenous tissue. MATERIALS AND METHODS: We performed literature searches for English language publications using the PubMed(R) and MEDLINE(R) databases. Keywords included "xenogenic," "extracellular matrix" and "genitourinary tract applications." A total of 112 articles were scrutinized, of which 50 were suitable for review based on clinical relevance and importance of content. RESULTS: Since the mid 1990s xenogenic extracellular matrices have been used to successfully treat a number of pathological conditions that affect the upper and lower genitourinary tract. They are typically prepared from porcine organs such as small intestine and bladder. These organs are harvested and subjected to decellularization and sterilization techniques before surgical implantation. Bioinductive growth factors that are retained during the preparation process induce constructive tissue remodeling as the extracellular matrix is simultaneously degraded and excreted. However, recent documented concerns over durability, decreased mechanical strength and residual porcine DNA after preparation techniques have temporarily hampered the potential of extracellular matrices as a reliable replacement for genitourinary tract structures. CONCLUSIONS: Extracellular matrices are a useful alternative for successfully treating a number of urological

  7. Current Status of Robot-Assisted Laparoscopic Surgery in Pediatric Urology

    OpenAIRE

    Song, Sang Hoon; Kim, Kun Suk

    2014-01-01

    Laparoscopic procedures for urological diseases in children have been proven to be safe and effective. However, the availability of laparoscopic procedures is still partly limited to experienced, high-volume centers because the procedures are technically demanding. The da Vinci robot system is being used for an increasing variety of reconstructive procedures because of the advantages of this approach, such as motion scaling, greater optical magnification, stereoscopic vision, increased instru...

  8. Abstracts presented at the European Society for Pediatric Urology (ESPU) meetings (2003-2010): characteristics and outcome.

    Science.gov (United States)

    Castagnetti, Marco; Subramaniam, Ramnath; El-Ghoneimi, Alaa

    2014-04-01

    To determine the characteristics and outcome of abstracts presented to the meetings of the European Society for Pediatric Urology (ESPU). Abstract books from 2003 to 2010 were reviewed and subsequent publication of presented abstracts determined by MEDLINE/PubMed search. Of 1194 abstracts, 50-78% per year originated from 15 to 20 European countries and 50-22% from 8 to 13 non-European countries; 233 (19%) were basic science and 961 (81%) clinical. Clinical abstracts included 135 (14%) multicenter/prospective/randomized trials. These figures did not change significantly over time. A total of 564 (47%) abstracts were subsequently published, 65% within 1 year of the meeting, mostly in the Journal of Urology (33%) and the Journal of Pediatric Urology (21%). Multicenter/prospective/randomized trials studies (OR 2.03; 95% CI 1.37-2.96) and abstracts originating from outside Europe (OR 1.61; 95% CI 1.26-2.05) were significantly more likely to be subsequently published in full. The ESPU meetings are a true occasion for international exchange of scientific endeavors. Almost half of the abstracts are subsequently published. The Journal of Urology and the Journal of Pediatric Urology are consistently the two major target journals for publication. Non-European countries, irrespective of whether English-speaking or not, seem significantly more likely to publish their abstracts. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  9. The European Association of Urology (EAU) guidelines methodology: a critical evaluation.

    Science.gov (United States)

    Aus, Gunnar; Chapple, Christopher; Hanûs, Tomas; Irani, Jacques; Lobel, Bernard; Loch, Tillmann; Mitropoulos, Dionysios; Parsons, Keith; Plass, Karin; Schmid, Hans-Peter

    2009-11-01

    Guidelines can be produced and written in numerous ways. The aim of the present article is to describe and evaluate the method currently used to produce the European Association of Urology (EAU) guidelines. The methodology is described in detail, compared to other urologic guidelines by members of the EAU Guidelines Office Board. The new methodology is evaluated by the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. The currently used methodology is adapted to the aims and objectives as established by the EAU for their guidelines; wide coverage (essentially all fields of urology) and useful to urologists all over Europe. The frequent updates are easily accessible in a printed and electronic format. The AGREE instrument supports these strong points, but also identifies potentially weak points, such as no patient involvement, no formal validation of the guidelines texts prior to publication, and lack of discussion of organisational barriers and cost implications. The currently used methodology for the production of EAU guidelines fulfils the association's main objectives related to their guidelines, but the texts will benefit from the inclusion of country-specific cost and organisational data. For the practising clinician, these guidelines will help to take science into clinical practice.

  10. Pediatric urology and the internet--does an uncommon topic decrease content quality?

    Science.gov (United States)

    Routh, Jonathan C; Gong, Edward M; Nelson, Caleb P

    2009-10-01

    The Internet has become a widely used resource for patients and families to obtain medical information but the quality of information available is highly variable. We sought to determine if Web pages addressing common and uncommon pediatric urology topics differ in terms of quality or characteristics. We performed an Internet search using 5 common conditions (vesicoureteral reflux, hypospadias, prenatal hydronephrosis, cryptorchidism, enuresis) and 5 uncommon conditions (exstrophy, prune belly, posterior urethral valves, Wilms tumor, ureterocele). We recorded total hits, presence of sponsored links, page owner and author type, last update, content quality, readability, accreditation and advertising. Content quality was graded on a 5-point scale for accuracy and completeness of natural history, diagnosis and treatment. We evaluated 100 sites on 10 topics. Common topics had more hits (980,000 vs 194,000) and were more likely to have sponsored advertisements (40% vs 0%) than uncommon topics. No difference was seen between topics in time from last update, owner/author type, financial disclosure, accreditation or advertising. Median quality grade was 4.0. Common topics had higher quality grades for disease natural history and diagnosis. Reading grade level was high and was similar between the groups. Web sites devoted to common pediatric urology topics have higher quality information for disease diagnosis and natural history. Otherwise, the quality of pediatric urology information on the Internet is high for common and uncommon topics. A high reading level is required to use these resources.

  11. Developments in urologic oncology 'OncoForum': The best of 2014.

    Science.gov (United States)

    Gómez-Veiga, F; Alcaraz-Asensio, A; Burgos-Revilla, J; Cózar-Olmo, J

    2015-06-01

    To review the latest evidence on the oncologic urology of prostate, renal and bladder tumors, analyzing their impact on daily clinical practice and the future medium to long-term regimens. We review the abstracts on prostate, renal and bladder cancer presented at the 2014 congresses (European Association of Urology, American Urological Association, American Society of Clinical Oncology and American Society for Radiation Oncology) that received the best evaluations by the OncoForum committee. The committee considered the following messages important: cytoreductive nephrectomy followed by treatment with a tyrosine-kinase inhibitor can significantly increase the overall survival of patients with metastatic renal cancer; for advanced bladder cancer, early adjuvant chemotherapy after cystectomy is preferable because it significantly increases progression-free survival; and several studies have shown that multiparametric magnetic resonance imaging and fusion imaging improve the diagnosis of prostate cancer and provide greater possibilities for placing patients in the appropriate risk group in order to offer them the best treatment possible. The results of the PREVAIL study have demonstrated the efficacy of enzalutamide on the overall survival of men with castration-resistant prostate cancer and metastases, with no prior chemotherapy. The study also demonstrated the drug's favorable safety profile. Progress is continuing in renal and bladder cancer, improving the approach and clinical results with current therapeutic options. There is constant progress in castration-resistant prostate cancer; in 2014, prechemotherapy treatments were consolidated. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Social Media in Urology: opportunities, applications, appropriate use and new horizons

    Science.gov (United States)

    Socarrás, Moises Rodríguez; Blanco, Leonardo Tortolero

    2016-01-01

    Introduction Social Media (SoMe) includes a broad spectrum of public use platforms like Twitter, YouTube or Facebook that have changed the way humans interact and communicate. Considering the high usage rates for various SoMe platforms among urologists, we aimed to perform a review regarding opportunities, applications, appropriate use and new horizons of SoMe in urology. Material and methods Literature review. Results We are currently experiencing an explosion in the use of SoMe in healthcare and urology due to the clear offer of advantages in communication, information sharing, enhanced experience of meetings and conferences, as well as, for networking. However, SoMe is an open environment and recommendations should be implemented on the appropriate use in order to respect ethical considerations and not break the harmony of the doctor-patient relationship. SoMe activity has become an important part of our participation in scientific meetings. Conclusions SoMe represents a vibrant area of opportunities for the communication of knowledge in health care and so their potential applications today are unquestionable; however, its development in the urological community is still in its infancy. At present the benefits include communication between associations, urologists, residents, other health care professionals and patients. Further efforts are focusing on standardizing the language used through SoMe and finding out how we can objectively quantify the impact of the information published in SoMe. PMID:27729998

  13. Education in sexual medicine - a nationwide study among German urologists/andrologists and urology residents.

    Science.gov (United States)

    Schloegl, I; Köhn, F M; Dinkel, A; Schulwitz, H; Gschwend, J E; Bosinski, H A G; Herkommer, K

    2017-03-01

    Although sexual-related problems are very prevalent, inadequate training for physicians has been reported. The aim was to investigate the educational situation in sexual medicine, including sexual dysfunctions, gender dysphoria and paraphilia, among German physicians in urology and andrology. Additional, barriers when addressing sexual health issues and confidence in taking care of patients with sexual-related problems were evaluated. A questionnaire was sent to 5955 urologists, urology residents and andrologists throughout Germany. The results of this study emphasise the need for continuing education and training in sexual medicine including sexual dysfunctions (83.9%), gender dysphoria (58.2%) and paraphilia (56.6%). Physicians, especially when working in urology, need basic skills in order to feel confident (89.0% in taking care of patients with sexual dysfunctions, 25.8% with gender dysphoria and 22.9% with paraphilia) and be able to reduce several barriers when addressing sexual health issues. The main reported barriers were lack of time (61.0%), inadequate financial compensation (42.5%), lack of necessity (29.9%) and the assumption of patients feeling uncomfortable (20.9%). It is within the competence of urologists and andrologists to correctly assess the situation and to refer patients to multidisciplinary support, such as psychologists, psychosomatics or couple therapists. © 2016 Blackwell Verlag GmbH.

  14. Urology Resident Publication Output and Its Relationship to Future Academic Achievement

    Science.gov (United States)

    Yang, Glen; Zaid, Uwais B.; Erickson, Bradley A.; Blaschko, Sarah D.; Carroll, Peter R.; Breyer, Benjamin N.

    2013-01-01

    Purpose Scholarly research is considered by many to be an important component of residency training but little is known about the quantity and types of publications produced by urology residents. To our knowledge whether publication efforts during residency predict future academic publication performance is also unknown. We evaluated resident productivity, as measured by peer reviewed publication output, and determined its relation to future publication output as junior faculty. Materials and Methods We assembled a list of graduating residents from 2002 to 2004 who were affiliated with the top 50 urology hospitals, as ranked in 2009 by U.S. News & World Report. PubMed® was queried to determine the publication total in the last 3 years of residency of each individual and during years 2 to 4 after residency graduation. Resident publication output was stratified by research time and fellowship training. The relationship between resident productivity and future achievement was assessed. Results We assessed the publication output of 251 urologists from a total of 34 training programs affiliated with the top 50 urology hospitals. Subjects published a mean total of 3.5 and a mean of 2.0 first author papers during training. Greater research time during residency was associated with increased productivity during and after residency. Publication during training correlated with publication during the early academic career. Conclusions Publication output correlated with increasing dedicated research time and was associated with the pursuit of fellowship training and an academic career. Publication during residency predicted future academic achievement. PMID:21168863

  15. Soft-tissue applications of the holmium:YAG laser in urology

    Science.gov (United States)

    Denstedt, John D.; Razvi, Hassan A.; Chun, Samuel S.; Sales, Jack L.

    1995-05-01

    The ideal surgical laser for the treatment of soft tissue pathology should possess both ablative and hemostatic abilities. As well, for use in urologic conditions the laser must also be suitable for endoscopic use. The Holmium:YAG laser possesses these qualities and in preliminary clinical use has demonstrated a variety of potential urologic applications. In this study we review our initial experience with the Holmium:YAG laser over a 18 month period. A total of 51 patients underwent 53 procedures for a variety of soft tissue conditions including: bladder tumor ablation (25), incision of ureteral stricture (15), incision of urethral stricture (6), treatment of ureteropelvic junction obstruction (3), incision of bladder neck contracture (2), and ablation of a ureteral tumor (2). Satisfactory hemostasis was achieved in all cases. Procedures were considered successful (no further intervention being required to treat the condition) in 81% of the cases. Two patients with dense bladder neck contractures required electroincision under the same anesthetic for completion of the procedure. A single complication, that of urinary extravasation following incision of a urethral stricture resolved with conservative management. In summary, the Holmium:YAG laser has demonstrated safety and proficiency in the treatment of a variety of urologic soft tissue conditions.

  16. Social Media in Urology: opportunities, applications, appropriate use and new horizons.

    Science.gov (United States)

    Rivas, Juan Gómez; Socarrás, Moises Rodríguez; Blanco, Leonardo Tortolero

    2016-01-01

    Social Media (SoMe) includes a broad spectrum of public use platforms like Twitter, YouTube or Facebook that have changed the way humans interact and communicate. Considering the high usage rates for various SoMe platforms among urologists, we aimed to perform a review regarding opportunities, applications, appropriate use and new horizons of SoMe in urology. Literature review. We are currently experiencing an explosion in the use of SoMe in healthcare and urology due to the clear offer of advantages in communication, information sharing, enhanced experience of meetings and conferences, as well as, for networking. However, SoMe is an open environment and recommendations should be implemented on the appropriate use in order to respect ethical considerations and not break the harmony of the doctor-patient relationship. SoMe activity has become an important part of our participation in scientific meetings. SoMe represents a vibrant area of opportunities for the communication of knowledge in health care and so their potential applications today are unquestionable; however, its development in the urological community is still in its infancy. At present the benefits include communication between associations, urologists, residents, other health care professionals and patients. Further efforts are focusing on standardizing the language used through SoMe and finding out how we can objectively quantify the impact of the information published in SoMe.

  17. Lymph scrotum: an unusual urological presentation of lymphatic filariasis. A case series study.

    Science.gov (United States)

    Aguiar-Santos, Ana Maria; Leal-Cruz, Marcela; Netto, Maria José; Carrera, Arturo; Lima, Guilherme; Rocha, Abraham

    2009-01-01

    Lymphatic filariasis (LF) causes a wide range of clinical signs and symptoms, including urogenital manifestations. Transmission control and disability/morbidity management/control are the two pillars of the overall elimination strategy for LF. Lymph scrotum is an unusual urological clinical presentation of LF with important medical, psychological, social and economic repercussions. A retrospective case series study was conducted on outpatients attended at the National Reference Service for Filariasis, in an endemic area for filariasis (Recife, Brazil), between 2000 and 2007. Over this period, 6,361 patients were attended and seven cases with lymph scrotum were identified. Mean patient age was 45 years (range, 26 to 64 years). Mean disease duration was 8.5 years (range, two to 15 years). All patients had evidence of filarial infection from at least one laboratory test (parasitological, antigen investigation or 'filarial dance sign' on ultrasound). Six patients presented histories of urological surgery. The authors highlight the importance of the association between filarial infection and the inadequate surgical and clinical management of hydrocele in an endemic area, as risk factors for lymph scrotum. Thus, filarial infection should be routinely investigated in all individuals presenting urological morbidity within endemic areas, in order to identify likely links in the transmission chain.

  18. Computer-assisted surgery: virtual- and augmented-reality displays for navigation during urological interventions.

    Science.gov (United States)

    van Oosterom, Matthias N; van der Poel, Henk G; Navab, Nassir; van de Velde, Cornelis J H; van Leeuwen, Fijs W B

    2017-12-22

    To provide an overview of the developments made for virtual- and augmented-reality navigation procedures in urological interventions/surgery. Navigation efforts have demonstrated potential in the field of urology by supporting guidance for various disorders. The navigation approaches differ between the individual indications, but seem interchangeable to a certain extent. An increasing number of pre- and intra-operative imaging modalities has been used to create detailed surgical roadmaps, namely: (cone-beam) computed tomography, MRI, ultrasound, and single-photon emission computed tomography. Registration of these surgical roadmaps with the real-life surgical view has occurred in different forms (e.g. electromagnetic, mechanical, vision, or near-infrared optical-based), whereby the combination of approaches was suggested to provide superior outcome. Soft-tissue deformations demand the use of confirmatory interventional (imaging) modalities. This has resulted in the introduction of new intraoperative modalities such as drop-in US, transurethral US, (drop-in) gamma probes and fluorescence cameras. These noninvasive modalities provide an alternative to invasive technologies that expose the patients to X-ray doses. Whereas some reports have indicated navigation setups provide equal or better results than conventional approaches, most trials have been performed in relatively small patient groups and clear follow-up data are missing. The reported computer-assisted surgery research concepts provide a glimpse in to the future application of navigation technologies in the field of urology.

  19. Therapy insight: prophylaxis, monitoring and treatment of perioperative myocardial ischemia with emphasis on urological surgery.

    Science.gov (United States)

    Winkler, Mathias H; Mayer, Eric K; Hrouda, David; Doyle, Patrick

    2007-06-01

    Unrecognized or silent perioperative myocardial ischemia is common in patients who undergo high-risk surgery, including cystectomy, and could predict cardiac morbidity and mortality in postoperative patients. This disorder is not merely a marker of extensive coronary disease but has a close association with perioperative myocardial infarction (PMI). In a review of published data, including meta-analyses, in the context of high-risk urological surgery, up to 50% of PMIs were found to go unrecognized if only clinical signs and symptoms are considered. Prevention and treatment of these previously unrecognized cardiac events might significantly reduce long-term morbidity and mortality. The emergence of reliable markers of PMI, such as increased levels of troponin I, could help in the detection of events that would have otherwise remained unnoticed. In this Review we examine the effect of these developments in the context of high-risk urological surgery. Changes to preoperative assessment, perioperative management, and prophylaxis of PMI are critically assessed. We performed a prospective audit using postoperative troponin I levels to assess the rate of silent perioperative myocardial ischemia and infarction. An increasingly proactive attitude towards perioperative monitoring for myocardial ischemia and infarction has evolved, and postoperative serial screening with troponin I might be beneficial in high-risk patients undergoing major urological surgery.

  20. Thrombospondin-1 in Urological Cancer: Pathological Role, Clinical Significance, and Therapeutic Prospects

    Directory of Open Access Journals (Sweden)

    Yasuyoshi Miyata

    2013-06-01

    Full Text Available Angiogenesis is an important process for tumor growth and progression of various solid tumors including urological cancers. Thrombospondins (TSPs, especially TSP-1, are representative “anti”-angiogenic molecules and many studies have clarified their pathological role and clinical significance in vivo and in vitro. In fact, TSP-1 expression is associated with clinicopathological features and prognosis in many types of cancers. However, TSP-1 is a multi-functional protein and its biological activities vary according to the specific tumor environments. Consequently, there is no general agreement on its cancer-related function in urological cancers, and detailed information regarding regulative mechanisms is essential for a better understanding of its therapeutic effects and prognostic values. Various “suppressor genes” and “oncogenes” are known to be regulators and TSP-1-related factors under physiological and pathological conditions. In addition, various types of fragments derived from TSP-1 exist in a given tissue microenvironment and TSP-1 derived-peptides have specific activities. However, a detailed pathological function in human cancer tissues is not still understood. This review will focus on the pathological roles and clinical significance of TSP-1 in urological cancers, including prostate cancer, renal cell carcinoma, and urothelial cancer. In addition, special attention is paid to TSP-1-derived peptide and TSP-1-based therapy for malignancies.