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Sample records for delayed urological involvement

  1. The effect of steroids for the treatment of delayed urological involvement arising from radiation therapy; A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kawano, Shinichi; Tasaki, Yoshihisa; Fukunaga, Yoshikazu (Oita National Hospital (Japan))

    1992-07-01

    A 55-year-old woman visited our hospital with the chief complaint of high fever. She had received whole pelvic radiation therapy following radical hysterectomy 22 years earlier. Excretory urography revealed bilateral severe hydrone phrosis. Urological examinations were carried out. Urethral stricture and marked small bladder were found. This case was diagnosed as delayed urological involvement arising from radiation therapy complicated with neurogenic bladder. Prednisolone at a total dose of 1,060 mg was administered over 51 days under indwelling catheters to the urethra and to both ureters. The function of the urinary bladder has been maintained at an improved level over a period of 2 months following the removal of the ureteral and urethral catheters. (author).

  2. 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

  3. 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.

  4. 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.

  5. 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

  6. [Urological diseases most frequently involved in medical professional liability claims].

    Science.gov (United States)

    Vargas-Blasco, César; Gómez-Durán, Esperanza L; Arimany-Manso, Josep; Pera-Bajo, Francisco

    2014-03-01

    Clinical safety and medical professional liability are international major concerns, especially in surgical specialties such as urology. This article analyzes the claims filed at the Council of Medical Colleges of Catalonia between 1990 and 2012, exploring urology procedures. The review of the 173 cases identified in the database highlighted the importance of surgical procedures (74%). Higher frequencies related to scrotal-testicular pathology (34%), especially testicular torsion (7.5%) and vasectomy (19.6%), and prostate pathology (26 %), more specifically the surgical treatment of benign prostatic hyperplasia (17.9%). Although urology is not among the specialties with the higher frequency of claims, there are special areas of litigation in which it is advisable to implement improvements in clinical safety. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  7. Review of the pathophysiological aspects involved in urological disease associated with metabolic syndrome.

    Science.gov (United States)

    Sáenz Medina, J; Carballido Rodríguez, J

    2016-06-01

    Metabolic syndrome is a constellation of disorders that includes insulin resistance, central obesity, arterial hypertension and hyperlipidaemia. These disorders can have implications for the genitourinary apparatus. To conduct a review on the pathophysiological aspects that explain the relationship between metabolic syndrome and sexual dysfunction, lower urinary tract syndrome, prostate cancer and stone disease. We performed a qualitative, narrative literature review through a literature search on PubMed of articles published between 1997 and 2015, using the terms pathophysiology, metabolic syndrome, endothelial dysfunction, lipotoxicity, mitochondrial dysfunction, kidney stones, hypogonadism, erectile dysfunction, lower urinary tract syndrome and prostate cancer. Metabolic syndrome constitutes an established complex of symptoms, defined as the presence of insulin resistance, central obesity, hypertension and hyperlipidaemia. Endothelial dysfunction secondary to lipotoxicity generates an inflammatory state, which involves renal cell metabolism, vascularisation of the pelvis and androgen production. These facts explain the relationship between metabolic syndrome, nephrolithiasis, lower urinary tract syndrome, hypogonadism and erectile dysfunction in men. Strategies such as proper diet, regular exercise, insulin treatment, testosterone-replacement therapy, therapy with antioxidants and free-radical inhibitors and urological treatments classically used for lower urinary tract syndrome have shown promising results in this syndrome. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Urological Cancers

    African Journals Online (AJOL)

    Results. A total of 8829 cancers were diagnosed over the 15 year study period, 749 (8.4%) were Urological malignancies. 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 cancer of the bladder (21.1%) and cancer of ...

  9. Involvement of HLA class I molecules in the immune escape of urologic tumors.

    Science.gov (United States)

    Carretero, R; Gil-Julio, H; Vázquez-Alonso, F; Garrido, F; Castiñeiras, J; Cózar, J M

    2014-04-01

    To analyze the influence of different alterations in human leukocyte antigen class I molecules (HLA I) in renal cell carcinoma, as well as in bladder and prostate cancer. We also study the correlation between HLA I expression and the progression of the disease and the response after immunotherapy protocols. It has been shown, experimentally, that the immune system can recognize and kill neoplastic cells. By analyzing the expression of HLA I molecules on the surface of cancer cells, we were able to study the tumor escape mechanisms against the immune system. Alteration or irreversible damage in HLA I molecules is used by the neoplastic cells to escape the immune system. The function of these molecules is to recognize endogenous peptides and present them to T cells of the immune system. There is a clear relationship between HLA I reversible alterations and success of therapy. Irreversible lesions also imply a lack of response to treatment. The immune system activation can reverse HLA I molecules expression in tumors with reversible lesions, whereas tumors with irreversible ones do not respond to such activation. Determine the type of altered HLA I molecules in tumors is of paramount importance when choosing the type of treatment to keep looking for therapeutic success. Those tumors with reversible lesions can be treated with traditional immunotherapy; however, tumour with irreversible alterations should follow alternative protocols, such as the use of viral vectors carrying the HLA genes to achieve damaged re-expression of the protein. From studies in urologic tumors, we can conclude that the HLA I molecules play a key role in these tumors escape to the immune system. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  10. Delayed In-Custody Death Involving Excited Delirium.

    Science.gov (United States)

    Kennedy, Daniel B; Savard, Dennis M

    2018-01-01

    This case study presents a 37-year-old male who was experiencing excited delirium (ExD) and died in a county jail 4 days after being taken into custody. The male died in a jail observation cell without having been restrained and was not under the influence of a drug stimulant. The subject had a documented psychiatric history of bipolar disorder and schizophrenia and was known to consume marijuana, cocaine, and methamphetamines. This case illustrates the pernicious effects of ExD and how its lethality can be delayed when many cases involve drug use and use of force where subjects die shortly thereafter. Implications of ExD for correctional agencies and efforts of responding to it in correctional and law enforcement contexts are discussed.

  11. Delayed onset muscle soreness: Involvement of neurotrophic factors.

    Science.gov (United States)

    Mizumura, Kazue; Taguchi, Toru

    2016-01-01

    Delayed-onset muscle soreness (DOMS) is quite a common consequence of unaccustomed strenuous exercise, especially exercise containing eccentric contraction (lengthening contraction, LC). Its typical sign is mechanical hyperalgesia (tenderness and movement related pain). Its cause has been commonly believed to be micro-damage of the muscle and subsequent inflammation. Here we present a brief historical overview of the damage-inflammation theory followed by a discussion of our new findings. Different from previous observations, we have observed mechanical hyperalgesia in rats 1-3 days after LC without any apparent microscopic damage of the muscle or signs of inflammation. With our model we have found that two pathways are involved in inducing mechanical hyperalgesia after LC: activation of the B2 bradykinin receptor-nerve growth factor (NGF) pathway and activation of the COX-2-glial cell line-derived neurotrophic factor (GDNF) pathway. These neurotrophic factors were produced by muscle fibers and/or satellite cells. This means that muscle fiber damage is not essential, although it is sufficient, for induction of DOMS, instead, NGF and GDNF produced by muscle fibers/satellite cells play crucial roles in DOMS.

  12. 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 ...

  13. Managing delayed projects. Cernavoda NPP - Romania. Importance of NGO involvement

    International Nuclear Information System (INIS)

    Rotaru, I.

    2003-01-01

    In Romania there is a diversity of civil societies with respect to the attitude towards nuclear power. Among the dedicated societies supporting nuclear power development there are: the Romanian Atomic Forum (Ratomet), affiliated to the European Atomic Forum; the Romanian Nuclear Power Association (Arden), affiliated to the European Nuclear Society; the Romanian Radioprotection Society (SR Rp), affiliated to the Radiation Protection Association. The main dedicated activities of above mentioned Non-governmental Organizations (Ng) are: establishing contacts and organizing meeting with Romanian political decision making factors, mass media representatives, institutional entities, civil society ect.; orienting and co-coordinating activities of Romanian companies involved in production and services for nuclear energy; serving as contact point for relevant international communication and business relation; creating internal working groups for certain theme or sub-domain and suggested solution for a particular issue, including experts even from outside of the association; performing lobby activities ect

  14. The Effect of Resident Involvement on Surgical Outcomes for Common Urologic Procedures: A Case Study of Uni- and Bilateral Hydrocele Repair.

    Science.gov (United States)

    Löppenberg, Björn; Cheng, Philip J; Speed, Jacqueline M; Cole, Alexander P; Vetterlein, Malte W; Kibel, Adam S; Noldus, Joachim; Trinh, Quoc-Dien; Meyer, Christian P

    2016-08-01

    Previous studies have investigated the effect of resident involvement (RI) on surgical complications in minimally invasive and complex surgical cases. This study evaluates the effect of surgical education on outcomes in a simple general urologic procedure, unilateral and bilateral hydrocele repair, in a large prospectively collected multi-institutional database. Relying on the American College of Surgeons National Surgical Quality Improvement Program Participant User files (2005-2013), we extracted patients who underwent unilateral or bilateral hydrocele repair using Current Procedural Terminology codes 55040, 55041, and 55060. Cases with missing information on RI were excluded. Descriptive and logistic regression analyses were performed to assess the impact of RI on perioperative outcomes. A prolonged operative time (pOT) was defined as operative time >75th percentile. Overall, 1378 cases were available for final analyses. The overall complication, readmission, and reoperation rates were 2.3% (32/1378), 0.5% (7/1378), and 1.4% (19/1378), respectively. A pOT was more frequently observed in bilateral procedures (35.2% vs 21.3%, P hydrocele repairs leads to higher odds of pOT, it does not affect patient safety, as evidenced by similar complication rates. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. A Longitudinal Examination of Father Involvement with Children with Developmental Delays: Does Timing of Diagnosis Matter?

    Science.gov (United States)

    Dyer, W. Justin; McBride, Brent A.; Jeans, Laurie M.

    2009-01-01

    With a representative sample of U.S. children born in 2001, growth curve modeling was used to investigate the association between father-child involvement and the developmental status of the child. Three groups of children, which varied by timing of developmental delay diagnosis, were compared for father involvement trajectories. These groups of…

  16. [Antibiotic treatments in urology].

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    Chaussade, H; Sunder, S; Bernard, L; Coloby, P; Guy, L; Karsenty, G; Bastide, C; Bruyère, F

    2013-11-01

    To define prescription modalities for the use of antibiotics in urology. A bibliographic research was performed using the MEDLINE database concerning all the antibiotics usable in urology. Treatments were classified by families; modes of action, indications in urology and adverse events have been detailed. Administrative files for commercial use have been consulted and associated with literature analysis. About 8 classes of antibiotics are usable in urology in a routine use. How they work, indications in urology and adverse events are discussed. Knowing that bacterial resistance to quinilones is increasing dramatically, it seems imperative to control the use of 8 classes of antibiotics. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  17. Involvement of Sodium Nitroprusside (SNP in the Mechanism That Delays Stem Bending of Different Gerbera Cultivars

    Directory of Open Access Journals (Sweden)

    Aung H. Naing

    2017-11-01

    Full Text Available Longevity of cut flowers of many gerbera cultivars (Gerbera jamesonii is typically short because of stem bending; hence, stem bending that occurs during the early vase life period is a major problem in gerbera. Here, we investigated the effects of sodium nitroprusside (SNP on the delay of stem bending in the gerbera cultivars, Alliance, Rosalin, and Bintang, by examining relative fresh weight, bacterial density in the vase solution, transcriptional analysis of a lignin biosynthesis gene, antioxidant activity, and xylem blockage. All three gerbera cultivars responded to SNP by delaying stem bending, compared to the controls; however, the responses were dose- and cultivar-dependent. Among the treatments, SNP at 20 mg L-1 was the best to delay stem bending in Alliance, while dosages of 10 and 5 mg L-1 were the best for Rosalin and Bintang, respectively. However, stem bending in Alliance and Rosalin was faster than in Bintang, indicating a discrepancy influenced by genotype. According to our analysis of the role of SNP in the delay of stem bending, the results revealed that SNP treatment inhibited bacterial growth and xylem blockage, enhanced expression levels of a lignin biosynthesis gene, and maintained antioxidant activities. Therefore, it is suggested that the cause of stem bending is associated with the above-mentioned parameters and SNP is involved in the mechanism that delays stem bending in the different gerbera cultivars.

  18. 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.

  19. Minors' behavioral responses to parental involvement laws: delaying abortion until age 18.

    Science.gov (United States)

    Colman, Silvie; Joyce, Ted

    2009-06-01

    Prior research on the effect of laws mandating parental involvement in minors' abortions has failed to examine an important behavioral response to such laws: Older teenagers may delay an abortion until age 18; for some, this may mean terminating a pregnancy after the first trimester. Statewide data were obtained on abortions in Texas in 1997-2003. Analysis of relative rate ratios with narrowly defined comparison groups was used to evaluate the association between Texas's parental notification law and the occurrence of second-trimester abortions among minors who have responded to the law by delaying abortion until age 18. In the four years after the law went into effect, the proportion of abortions obtained at age 18 increased by six percentage points among minors who conceived at age 17 years and eight months, and by 13 points among those who did so at 17 years and nine months. As a result, the second-trimester abortion rate of these groups combined increased by 21%; by contrast, there was no evidence of an increase in this rate among younger minors, for whom delaying the abortion until age 18 was not feasible. Some minors postpone abortion until the second or even third trimester of pregnancy to circumvent parental notification requirements. Given the greater costs of and medical risks associated with late-term abortions, policymakers should not ignore this behavior.

  20. 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.

  1. Duration reproduction with sensory feedback delay: Differential involvement of perception and action time

    Directory of Open Access Journals (Sweden)

    Stephanie eGanzenmüller

    2012-10-01

    Full Text Available Previous research has shown that voluntary action can attract subsequent, delayed feedback events towards the action, and adaptation to the sensorimotor delay can even reverse motor-sensory temporal-order judgments. However, whether and how sensorimotor delay affects duration reproduction is still unclear. To investigate this, we injected an onset- or offset-delay to the sensory feedback signal from a duration reproduction task. We compared duration reproductions within (visual, auditory modality and across audiovisual modalities with feedback signal onset- and offset-delay manipulations. We found that the reproduced duration was lengthened in both visual and auditory feedback signal onset-delay conditions. The lengthening effect was evident immediately, on the first trial with the onset delay. However, when the onset of the feedback signal was prior to the action, the lengthening effect was diminished. In contrast, a shortening effect was found with feedback signal offset-delay, though the effect was weaker and manifested only in the auditory offset-delay condition. These findings indicate that participants tend to mix the onset of action and the feedback signal more when the feedback is delayed, and they heavily rely on motor-stop signals for the duration reproduction. Furthermore, auditory duration was overestimated compared to visual duration in crossmodal feedback conditions, and the overestimation of auditory duration (or the underestimation of visual duration was independent of the delay manipulation.

  2. 31 CFR 538.506 - 30-day delayed effective date for pre-November 4, 1997 trade contracts involving Sudan.

    Science.gov (United States)

    2010-07-01

    ...-November 4, 1997 trade contracts involving Sudan. 538.506 Section 538.506 Money and Finance: Treasury....506 30-day delayed effective date for pre-November 4, 1997 trade contracts involving Sudan. (a) Pre... of Sudanese origin or owned or controlled by the Government of Sudan, importations under the pre...

  3. Oxidant-induced cell-cycle delay in Saccharomyces cerevisiae: the involvement of the SWI6 transcription factor.

    Science.gov (United States)

    Fong, Chii Shyang; Temple, Mark D; Alic, Nazif; Chiu, Joyce; Durchdewald, Moritz; Thorpe, Geoffrey W; Higgins, Vincent J; Dawes, Ian W

    2008-05-01

    Cells treated with low doses of linoleic acid hydroperoxide (LoaOOH) exhibit a cell-cycle delay that may provide a mechanism to overcome oxidative stress. Strains sensitive to LoaOOH from the genome-wide deletion collection were screened to identify deletants in which the cell-cycle delay phenotype was reduced. Forty-seven deletants were identified that were unable to mount the normal delay response, implicating the product of the deleted gene in the oxidant-mediated cell-cycle delay of the wild-type. Of these genes, SWI6 was of particular interest due to its role in cell-cycle progression through Start. The swi6 deletant strain was delayed on entry into the cell cycle in the absence of an oxidant, and oxidant addition caused no further delay. Transforming the swi6 deletant with SWI6 on a plasmid restored the G1 arrest in response to LoaOOH, indicating that Swi6p is involved in oxidant sensing leading to cell division delay. Micro-array studies identified genes whose expression in response to LoaOOH depended on SWI6. The screening identified 77 genes that were upregulated in the wild-type strain and concurrently downregulated in the swi6 deletant treated with LoaOOH. These data show that functions such as heat shock response, and glucose transport are involved in the response.

  4. Current status of urological training in Europe.

    Science.gov (United States)

    Carrion, Diego M; Gómez Rivas, Juan; Esperto, Francesco; Patruno, Giulio; Vasquez, Juan L

    2018-01-01

    Modern urological training has changed drastically in the past years, due to the global surgical training trends, advances in technology, subspecialization of the field and, working hour regulations for doctors. The lack of a standardized curriculum across Europe, puts in evidence the great difference in the requirements in every country, from the start of the residency, to obtaining the accreditation. We sought to identify problems related to medical, scientific and surgical activity during urological training, and summarize data obtained from surveys realized during the European Urology Residents Education Programme (EUREP) in 2013, and from countries such as Germany, Italy and Spain. Data from surveys reveals an evident lack of surgical confidence across all participants for major procedures, a general non-compliance with the working hour regulations, and a worrisome risk for burnout and negative consequences in resident's personal lives. Possible solutions are discussed, involving an early preference for a particular practice, and a standardized simulation-based training. The European Association of Urology (EAU) and the European School of Urology (ESU) offer a wide range of working groups, educational and scientific activities for improving the acquisition of competencies (surgical and scientific) of residents and urologists at any point of their career. We describe a brief description of the most important EAU and ESU opportunities.

  5. Identification and Characterization of Soluble Factors Involved in Delayed Effects of Low Dose Radiation. Final report

    International Nuclear Information System (INIS)

    Baulch, Janet

    2013-01-01

    This is a 'glue grant' that was part of a DOE Low Dose project entitled 'Identification and Characterization of Soluble Factors Involved in Delayed Effects of Low Dose Radiation'. This collaborative program has involved Drs. David L. Springer from Pacific Northwest National Laboratory (PNNL), John H. Miller from Washington State University, Tri-cities (WSU) and William F. Morgan then from the University of Maryland, Baltimore (UMB). In July 2008, Dr. Morgan moved to PNNL and Dr. Janet E. Baulch became PI for this project at University of Maryland. In November of 2008, a one year extension with no new funds was requested to complete the proteomic analyses. The project stemmed from studies in the Morgan laboratory demonstrating that genomically unstable cells secret a soluble factor or factors into the culture medium, that cause cytogenetic aberrations and apoptosis in normal parental GM10115 cells. The purpose of this project was to identify the death inducing effect (DIE) factor or factors, estimate their relative abundance, identify the cell signaling pathways involved and finally recapitulate DIE in normal cells by exogenous manipulation of putative DIE factors in culture medium. As reported in detail in the previous progress report, analysis of culture medium from the parental cell line, and stable and unstable clones demonstrated inconsistent proteomic profiles as relate to candidate DIE factors. While the proposed proteomic analyses did not provide information that would allow DIE factors to be identified, the analyses provided another important set of observations. Proteomic analysis suggested that proteins associated with the cellular response to oxidative stress and mitochondrial function were elevated in the medium from unstable clones in a manner consistent with mitochondrial dysfunction. These findings correlate with previous studies of these clones that demonstrated functional differences between the mitochondria of stable and unstable clones. These

  6. Identification and Characterization of Soluble Factors Involved in Delayed Effects of Low Dose Radiation. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Baulch, Janet

    2013-09-11

    This is a 'glue grant' that was part of a DOE Low Dose project entitled 'Identification and Characterization of Soluble Factors Involved in Delayed Effects of Low Dose Radiation'. This collaborative program has involved Drs. David L. Springer from Pacific Northwest National Laboratory (PNNL), John H. Miller from Washington State University, Tri-cities (WSU) and William F. Morgan then from the University of Maryland, Baltimore (UMB). In July 2008, Dr. Morgan moved to PNNL and Dr. Janet E. Baulch became PI for this project at University of Maryland. In November of 2008, a one year extension with no new funds was requested to complete the proteomic analyses. The project stemmed from studies in the Morgan laboratory demonstrating that genomically unstable cells secret a soluble factor or factors into the culture medium, that cause cytogenetic aberrations and apoptosis in normal parental GM10115 cells. The purpose of this project was to identify the death inducing effect (DIE) factor or factors, estimate their relative abundance, identify the cell signaling pathways involved and finally recapitulate DIE in normal cells by exogenous manipulation of putative DIE factors in culture medium. As reported in detail in the previous progress report, analysis of culture medium from the parental cell line, and stable and unstable clones demonstrated inconsistent proteomic profiles as relate to candidate DIE factors. While the proposed proteomic analyses did not provide information that would allow DIE factors to be identified, the analyses provided another important set of observations. Proteomic analysis suggested that proteins associated with the cellular response to oxidative stress and mitochondrial function were elevated in the medium from unstable clones in a manner consistent with mitochondrial dysfunction. These findings correlate with previous studies of these clones that demonstrated functional differences between the mitochondria of stable and

  7. 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

  8. STRUCTURE UROLOGICAL OUTPATIENT RECEPTION

    Directory of Open Access Journals (Sweden)

    E. V. Kulchavenya

    2013-01-01

    Full Text Available This article analyzes the structure of the example receiving outpatient urological Cabinet city polyclinic №26 Novosibirsk. Revealed a clear predominance of inflammatory diseases of the genitourinary system, benign prostatic hyperplasia and urolithiasis. This group of diseases should be given due attention in the medical examination of the population. 

  9. Are cognitive "insomnia" processes involved in the development and maintenance of delayed sleep wake phase disorder?

    Science.gov (United States)

    Richardson, Cele E; Gradisar, Michael; Barbero, Sebastian C

    2016-04-01

    Although individuals with delayed sleep wake phase disorder (DSWPD) and chronic insomnia disorder (CID) share many of the same phenomenological experiences, theories relating to the development and maintenance of these disorders are distinct in focus. Unlike CID, theory relating to DSWPD is primarily physiologically based and assumes almost no cognitive pathway. However, recent research findings suggest that individuals with DSWPD also display many of the sleep-disordered cognitive processes that were previously assumed to be unique to the insomnia experience. As such, this review aims to summarise current research findings to address the question "Could cognitive processes be involved in the development and maintenance of DSWPD?" In particular, the presence of cognitive and physiological pre-sleep arousal, sleep-related attentional bias, distorted perception of sleep and daytime functioning, dysfunctional beliefs and safety behaviours will be investigated. As this emerging area of research requires a stronger evidence base, we highlight suggestions for future investigation and provide preliminary practice points for clinicians assessing and treating "insomnia" in patients with DSWPD. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Wound healing in urology.

    Science.gov (United States)

    Ninan, Neethu; Thomas, Sabu; Grohens, Yves

    2015-03-01

    Wound healing is a dynamic and complex phenomenon of replacing devitalized tissues in the body. Urethral healing takes place in four phases namely inflammation, proliferation, maturation and remodelling, similar to dermal healing. However, the duration of each phase of wound healing in urology is extended for a longer period when compared to that of dermatology. An ideal wound dressing material removes exudate, creates a moist environment, offers protection from foreign substances and promotes tissue regeneration. A single wound dressing material shall not be sufficient to treat all kinds of wounds as each wound is distinct. This review includes the recent attempts to explore the hidden potential of growth factors, stem cells, siRNA, miRNA and drugs for promoting wound healing in urology. The review also discusses the different technologies used in hospitals to treat wounds in urology, which make use of innovative biomaterials synthesised in regenerative medicines like hydrogels, hydrocolloids, foams, films etc., incorporated with growth factors, drug molecules or nanoparticles. These include surgical zippers, laser tissue welding, negative pressure wound therapy, and hyperbaric oxygen treatment. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. 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.

  12. EAU standardised medical terminology for urologic imaging: a taxonomic approach.

    Science.gov (United States)

    Loch, Tillmann; Carey, Brendan; Walz, Jochen; Fulgham, Pat Fox

    2015-05-01

    The terminology and abbreviations used in urologic imaging have generally been adopted on an ad hoc basis by different speciality groups; however, there is a need for shared nomenclature to facilitate clinical communication and collaborative research. This work reviews the current nomenclature for urologic imaging used in clinical practice and proposes a taxonomy and terminology for urologic imaging studies. A list of terms used in urologic imaging were compiled from guidelines published by the European Association of Urology and the American Urological Association and from the American College of Radiology Appropriateness Criteria. Terms searched were grouped into broad categories based on technology, and imaging terms were further stratified based on the anatomic extent, contrast or phases, technique or modifiers, and combinations or fusions. Terms that had a high degree of utilisation were classified as accepted. We propose a new taxonomy to define a more useful and acceptable nomenclature model acceptable to all health professionals involved in urology. The major advantage of a taxonomic approach to the classification of urologic imaging studies is that it provides a flexible framework for classifying the modifications of current imaging modalities and allows the incorporation of new imaging modalities. The adoption of this hierarchical classification model ranging from the most general to the most detailed descriptions should facilitate hierarchical searches of the medical literature using both general and specific terms. This work is limited in its scope, as it is not currently all-inclusive. This will hopefully be addressed by future modification as others embrace the concept and work towards uniformity in nomenclature. This paper provides a noncomprehensive list of the most widely used terms across different specialties. This list can be used as the basis for further discussion, development, and enhancement. In this paper we describe a classification system

  13. Beta-delayed fission probabilities of transfermium nuclei, involved in the r-process

    International Nuclear Information System (INIS)

    Panov, I; Lutostansky, Yu; Thielemann, F-K

    2016-01-01

    For the nucleosynthesis of heavy and superheavy nuclei fission becomes very important when the r-process runs in a very high neutron density environment. In part, fission is responsible for the formation of heavy nuclei due to the inclusion of fission products as new seed nuclei (fission cycling). More than that, beta-delayed fission, along with spontaneous fission, is responsible in the late stages of the r-process for the suppression of superheavy element yields.For beta-delayed fission probability calculations a model description of the beta-strength- functions is required. Extended theoretical predictions for astro-physical applications were provided long ago, and new predictions also for superheavy nuclei with uptodate nuclear input are needed. For the further extension of data to heavier transactinides the models of strength- functions should be modified, taking into account more complicated level schemes. In our present calculations the strength-function model is based on the quasi-particle approximation of Finite Fermi Systems Theory.The probabilities of beta-delayed fission and beta-delayed neutron emission are calculated for some transfermium neutron-rich nuclei, and the influence of beta-delayed fission upon superheavy element formation is discussed. (paper)

  14. 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 ...

  15. Archives: African Journal of Urology

    African Journals Online (AJOL)

    Items 1 - 50 of 66 ... 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 66 Items, 1 2 ...

  16. 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

  17. 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.

  18. 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

  19. Psychological Stress Delays Periodontitis Healing in Rats: The Involvement of Basic Fibroblast Growth Factor

    Directory of Open Access Journals (Sweden)

    Ya-Juan Zhao

    2012-01-01

    Full Text Available Objective. To evaluate the effects of psychological stress on periodontitis healing in rats and the contribution of basic fibroblast growth factor (bFGF expression to the healing process. Methods. Ninety-six rats were randomly distributed into control group, periodontitis group, and periodontitis plus stress group. Then, the rats were sacrificed at baseline and week(s 1, 2, and 4. The periodontitis healing condition was assessed, and the expression of interleukin-1β (IL-1β, tumor necrosis factor-α (TNF-α, and bFGF were tested by immunohistochemistry. Results. The stressed rats showed reduced body weight gain, behavioral changes, and increased serum corticosterone and ACTH levels (. The surface of inflammatory infiltrate, alveolar bone loss, attachment loss, and expression of IL-1β and TNF-α in the stress group were higher than those in the periodontitis group at weeks 2 and 4 (. Rats with experimental periodontitis showed decreased bFGF expression (, and the recovery of bFGF expression in the stress group was slower than that in the periodontitis group (. Negative correlations between inflammatory cytokines and bFGF were detected. Conclusion. Psychological stress could delay periodontitis healing in rats, which may be partly mediated by downregulation of the expression of bFGF in the periodontal ligament.

  20. Father Involvement and Maternal Depressive Symptoms in Families of Children with Disabilities or Delays

    Science.gov (United States)

    Laxman, Daniel J.; McBride, Brent A.; Jeans, Laurie M.; Dyer, William J.; Santos, Rosa M.; Kern, Justin L.; Sugimura, Niwako; Curtiss, Sarah L.; Weglarz-Ward, Jenna M.

    2015-01-01

    This study examined the longitudinal association between fathers' early involvement in routine caregiving, literacy, play, and responsive caregiving activities at 9 months and maternal depressive symptoms at 4 years. Data for 3,550 children and their biological parents were drawn from the Early Childhood Longitudinal Study-Birth Cohort data set.…

  1. African Journal of Urology: Continuing progress

    African Journals Online (AJOL)

    I. Khalaf Editor

    ees.elsevier.com/afju · www.sciencedirect.com. Editorial. African Journal of Urology: Continuing progress. The African Journal of Urology was first published in 1995 as the official journal of the PAUSA, through Springer Veralg Paris as three.

  2. Urological complications in pediatric renal transplantation.

    NARCIS (Netherlands)

    Nuininga, J.E.; Feitz, W.F.J.; Dael, K.C. van; Gier, R.P.E. de; Cornelissen, E.A.M.

    2001-01-01

    OBJECTIVE: In this study, we evaluated the urological complications and their consequences after renal transplantation in children. MATERIALS AND METHODS: A retrospective study was performed concerning urological complications after kidney transplantation in children at the University Medical Center

  3. Urological complications in pediatric renal transplantation

    NARCIS (Netherlands)

    Nuininga, JE; Feitz, WFJ; van Dael, KCML; de Gier, RPE

    Objective: In this study, we evaluated the urological complications and their consequences after renal transplantation in children. Materials and Methods: A retrospective study was performed concerning urological complications after kidney transplantation in children at the University Medical Center

  4. 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

  5. Tissue engineering in urology: where are we going?

    Science.gov (United States)

    Metwalli, Adam R; Colvert, James R; Kropp, Bradley P

    2003-04-01

    Tissue engineering in urology is a broad term used to describe the development of alternative tissue sources for diseased or dysfunctional native urologic tissue. This article reviews the recently published techniques involving synthetic and natural biodegradable matrices alone, known as "unseeded" scaffolds, and the latest data on "seeded" scaffolds, which are impregnated with cultured cells from urologic organs. Recent discoveries in reporter gene labeling of urologic tissue are discussed as a new method to identify and track the fates of these transplanted cells in vivo. This article also investigates how these bioengineering techniques are applied to synthetic and natural scaffolds, such as polyglycolic acid and porcine small intestine submucosa, to increase bladder capacity, repair urethral strictures, and replace corporal plaques in Peyronie's disease. Furthermore, recently published reports that these materials have been seeded with chondrocytes to create corporal rods for penile prostheses and stents for ureteral and urethral stricture disease are discussed. With these latest developments as a foundation, the future directions of tissue engineering in urology are presented.

  6. African Journal of Urology: Submissions

    African Journals Online (AJOL)

    Author Guidelines. The African Journal of Urology welcomes original papers, case reports and letters to the editor from any country of the world, particularly from Africa. Review articles are usually commissioned, but the Editorial Board are happy to discuss potential articles with authors who would like to contribute.

  7. 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.

  8. Urological diagnosis using clinical PACS

    Science.gov (United States)

    Mills, Stephen F.; Spetz, Kevin S.; Dwyer, Samuel J., III

    1995-05-01

    Urological diagnosis using fluoroscopy images has traditionally been performed using radiographic films. Images are generally acquired in conjunction with the application of a contrast agent, processed to create analog films, and inspected to ensure satisfactory image quality prior to being provided to a radiologist for reading. In the case of errors the entire process must be repeated. In addition, the radiologist must then often go to a particular reading room, possibly in a remote part of the healthcare facility, to read the images. The integration of digital fluoroscopy modalities with clinical PACS has the potential to significantly improve the urological diagnosis process by providing high-speed access to images at a variety of locations within a healthcare facility without costly film processing. The PACS additionally provides a cost-effective and reliable means of long-term storage and allows several medical users to simultaneously view the same images at different locations. The installation of a digital data interface between the existing clinically operational PACS at the University of Virginia Health Sciences Center and a digital urology fluoroscope is described. Preliminary user interviews that have been conducted to determine the clinical effectiveness of PACS workstations for urological diagnosis are discussed. The specific suitability of the workstation medium is discussed, as are overall advantages and disadvantages of the hardcopy and softcopy media in terms of efficiency, timeliness and cost. Throughput metrics and some specific parameters of gray-scale viewing stations and the expected system impacts resulting from the integration of a urology fluoroscope with PACS are also discussed.

  9. Onco forum in urology

    International Nuclear Information System (INIS)

    Richaud, P.; Hennequin, Ch.

    2009-01-01

    Objective: To present to the radiation oncologist the main advances in prostate cancer in the last year Methodology. - A review of the main congress in uro-oncology (ASCO, ASTRO, AUA, EAU) and international literature Results. - The increase in the incidence of prostate cancer without increasing in mortality must be a signal for oncologist to propose active surveillance to the patients without bad prognostic factors. Use of bio-markers could probably facilitate the selection of patients needing treatment. After prostatectomy, adjuvant radiotherapy could decrease the biochemical relapse rate but also the risk of distant metastasis, particularly for pT3 R1 patients ; but the optimal time to deliver this post-operative radiotherapy is discussed : immediately after surgery or delayed in case of PSA relapse (≥ 0,2 ng/ml). For locally advanced disease, combination of radiotherapy and long-term androgen deprivation improved survival over hormonal treatment alone. But duration of androgen deprivation must be adapted to the co-morbidities of the patient because of the risk of metabolic syndrome. The value of dose escalation in association with hormonal treatment must be defined. Conclusion. - Important advances in prostate cancer management have been made during the last months, but inclusion of patients into on-going prospective studies is still important to continue to improve the therapeutic results. (authors)

  10. Update on Urological Management of Spina Bifida from Prenatal Diagnosis to Adulthood.

    Science.gov (United States)

    Snow-Lisy, Devon C; Yerkes, Elizabeth B; Cheng, Earl Y

    2015-08-01

    We review the current literature regarding urological management of spina bifida from prenatal diagnosis to adulthood. We searched MEDLINE(®), EMBASE(®) and PubMed(®) for English articles published through December 2014 using search terms "spina bifida," "spinal dysraphism" and "bladder." Based on review of titles and abstracts, 437 of 1,869 articles were identified as addressing topics related to open spina bifida in pediatric patients, or long-term or quality of life outcomes in adults with spina bifida. We summarize this literature to inform clinical guidelines and create a framework for disease management. The birth prevalence of spina bifida in the United States has recently plateaued at approximately 30 per 100,000. With improved management more individuals are surviving to adulthood, with an economic impact of $319,000 during the lifetime of an individual with spina bifida. Recent advances in prenatal surgery have demonstrated that prenatal closure of spina bifida is possible. To assess safety and efficacy, the National Institutes of Health sponsored Management of Myelomeningocele Study was undertaken, in which subjects were randomized to prenatal or postnatal closure. Until the urological results of this trial are published, the impact of prenatal intervention on future bladder function remains unclear. Controversy continues regarding the optimal use and timing of urodynamic studies, and the indications for initiation of clean intermittent catheterization and anticholinergics in infants and children. Many favor expectant management, while others argue for a more proactive approach. Based on the current literature, both approaches appear to protect the child from renal injury, although delayed intervention may increase rates of bladder augmentation. The current literature regarding this topic is difficult to interpret and compare due to heterogeneity of patient populations, variable outcome measures and lack of reporting of quality of life outcomes

  11. Obesity and urologic complications after renal transplantation

    Directory of Open Access Journals (Sweden)

    Ashkan Heshmatzadeh Behzadi

    2014-01-01

    Full Text Available Although obesity has been associated with improved survival on dialysis, its short-and long-term effects on renal transplantation outcomes remain unclear. Herein, we evaluate the short-term and intermediate long-term effects of obesity on first-time renal transplant patients. A retrospective analysis was performed on 180 consecutive renal transplant recipients from living unrelated donors during 2006-2008 in a major transplantation center in Tehran, Iran. Among these, 34 (18% patients were found to be obese (body mass index ≥30 kg/m 2 . Obese patients were more likely to develop post-transplant renal artery stenosis (RAS (17.6% vs. 2.8%, P <0.001, hematoma (47.9% vs. 17.6, P = 0.009, surgical wound complications (64.7% vs. 9.6%, P <0.001 and renal vein thrombosis (2% vs. 0%, P <0.001. However, the incidence of delayed graft function, lymphocele, urologic complications of ureterovesical junction stenosis or urinary leakage, surgical complications of excessive bleeding or renal artery thrombosis and duration of hospitalization were similar between the two groups. The two-year patient and graft survival were also statistically not different. Renal transplantation in obese recipients is associated with a higher incidence of post-transplant RAS, hematoma, surgical wound complications and renal vein thrombosis, but similar two-year patient and graft survival.

  12. UROLOGY

    African Journals Online (AJOL)

    of kidney cancer of 1.2 per 100 000 people per year, which equates to 40.8 cases per year or more than 200 cases over the. 5-year period. Tumour Characteristics. The tumour characteristics for the patients with RCC are described in Table 1. Organ confined disease (T1-T2, N0, M0) was present in. 30 patients (73.2%).

  13. UROLOGY

    African Journals Online (AJOL)

    According to recent data from the South. African National Cancer Registry,2 the incidence of prostate cancer in SA in 2007 was 29.4 per 100 000. More recent data for 2012 has placed this incidence as high as 67.9 per. 100 000.1. There was limited data on the presentation of prostate cancer in African countries.

  14. 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

    is performed by an inexperienced physician; and the feasibility of simulation training. Round 3 involved elimination and reranking of procedures according to priority. Results: The response rates for the three Delphi rounds were 70%, 55% and 67%, respectively. The 34 procedures identified in Round 1 were......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...... to identify technical procedures in urology that should be included in a simulation-based curriculum for residency training. Materials and methods: A national needs assessment was performed using the Delphi method involving 56 experts with significant roles in the education of urologists. Round 1 identified...

  15. "A tree must be bent while it is young": teaching urological surgical techniques to schoolchildren.

    Science.gov (United States)

    Buntrock, Stefan

    2012-01-01

    Playing video games in childhood may help achieve advanced laparoscopic skills later in life. The virtual operating room will soon become a reality, as "doctor games 2.0" will doubtlessly begin to incorporate virtual laparoscopic techniques. To teach surgical skills to schoolchildren in order to attract them to urology as a professional choice later in life. As part of EAU Urology Week 2010, 108 school children aged 15-19 attended a seminar with lectures and simulators (laparoscopy, TUR, cystoscopy, and suture sets) at the 62nd Congress of the German Society of Urology in Düsseldorf. A Pub-Med and Google Scholar search was also performed in order to review the beneficial effects of early virtual surgical training. MeSh terms used were "video games," "children," and "surgical skills." Searches were performed without restriction for a certain period of time. In terms of publicity for urology, EAU Urology Week, and the German Society of Urology, the event was immensely successful. Regarding the literature search, four relevant publications were found involving children. An additional three articles evaluated the usefulness of video gaming in medical students and residents. Making use of virtual reality to attract and educate a new generation of urologists is an important step in designing the future of urology.

  16. Radioisotopes for diagnosis in urology

    International Nuclear Information System (INIS)

    Galvan, G.

    1980-01-01

    A lecture, held on the occasion of the meeting, organized by the Austrian Company for Urology and the Bavarian Union of Urologists. Kidney diagnosis with means of nuclear medicine technology, scintigraphy of skeleton and candula suprarenalis as well as radioimmunological hormone determination are characterized by a non-invasive, valuable extension of the convential nephrourological diagnosis under a relatively low rate of radioactive emission. In the field of kidney diagnosis the specification of the function of each kidney by means of renography, sequence-scintigraphy and clearance must be regarded as an important factor, especially for the measurement of the degree of kidney damages. Therefore, it is also of a great pre-operative value in context with the determination of the functional capacity of a kidney, the control of prae-, -intra - and postrenal diseases, urological emergencies and the period after kidney-transplantations. The Tc-perfusion can be used for the diagnosis of kidney arterio-stenosis. In the field of skeleton scintigraphy with Tc-marked phosphates a very sensitive method for the discovery of metastasis is available. It can be applied as a screeningstest to the determination of the stage and to the control of the progress concerning the prostata carcinoma. The candula suprarenalis scintigraphy guarantees the differentiation of hormon producing tumors of the adrenalin gland in context with the determination of ACTH, cortisol, aldosteron, estrogens and testosteron. (F.R.)

  17. UROLOGIC ROBOTS AND FUTURE DIRECTIONS

    Science.gov (United States)

    Mozer, Pierre; Troccaz, Jocelyne; Stoianovici, Dan

    2009-01-01

    Purpose of review Robot-assisted laparoscopic surgery in urology has gained immense popularity with the Da Vinci system but a lot of research teams are working on new robots. The purpose of this paper is to review current urologic robots and present future developments directions. Recent findings Future systems are expected to advance in two directions: improvements of remote manipulation robots and developments of image-guided robots. Summary 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 based on medical transcutaneous imaging, in a less invasive way, at lower costs. It is expected that improvements for remote system could be augmented reality, haptic feed back, size reduction and development of new tools for NOTES surgery. The paradigm of image-guided robots is close to a 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. PMID:19057227

  18. 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...

  19. Diagnostic and treatment manual of urological cancer

    International Nuclear Information System (INIS)

    Paz y Mino, Milton; Tafur, Fausto; Cornejo, Francisco; Gaibor, Jose; Bueno, Cesar; Basantes, Amparito

    2004-01-01

    This book compiles different opinions about researches, diagnosis, methods, procedures and treatment of urological cancer, which will be useful for physicians and specialists of this illness. This manual is well structured in eight chapters with references, illustrations, figures and tables about neoplasms of kidney, urinary tract, urogenital system. This document is a bibliographic revision about ecuadorian experience in urological cancer

  20. Basic science research in urology training

    Directory of Open Access Journals (Sweden)

    D Eberli

    2009-01-01

    In this article we will analyse the current status of basic research in urology training and discuss the importance of and obstacles to successful addition of research into the medical training curricula. Further, we will highlight different opportunities for trainees to obtain significant research exposure in urology.

  1. [The current urological training program in Spain. Urology National Specialty Commission.

    Science.gov (United States)

    Cortiñas-González, José Ramón; Pesquera-Ortega, Laura

    2018-01-01

    44/2003 Law involved the creation of the National Council of Specialties in Health Sciences and the National Commissions of the Specialties in Health Sciences. Analysis of the main laws implicated in Specialized Training and the role of the National Specialty Commission. 44/2003 Law regulates the training of health professionals and establishes the procedure for the training programs creation by the National Specialty Commission and its later approval and publication in the BOE. Access to specialized training will be carried out with the annual and national MIR exam. The Health Ministry establishes the criteria for educational centers accreditation, and the National Specialty Commission issues a favorable or unfavorable report as advisor about new accreditation requests. 183/2008 RD develops the tutor figure, the formative evaluation through the Resident's Book and how will be like the external rotations. to understand the Urology's specialty training system we must know the laws that regulate it, being the most important the 44/2003 Law. The National Specialty Commission is an advisory party of the Ministry, whose main function is to elaborate the Urology training program and to establish the evaluation criteria of the specialists in formation.

  2. 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.

  3. Distribution of isodose curves in urological surgical procedures

    International Nuclear Information System (INIS)

    Lanfredi, M.P.; Dias, J.H.; Ravazio, R.C.; Anés, M.; Bacelar, A.; Lykawka, R.

    2017-01-01

    During urological surgical procedures with fluoroscopy, the doses of the care team may be significant. However, the knowledge of the occupational exposure of these professionals is still very incipient in the national surgical centers. The objective of the study is to determine the isodose curves of the urological surgical procedures, in order to estimate the exposure of the personnel involved. The equipment used was a Arco-C BV Philips Bracelet. Patients with thicknesses of 20 and 28 cm were simulated using acrylic plates. The dose rates were measured with RaySafe i2 Unfors dosimeters positioned in a 50 x 50 cm mesh at three different heights of the floor: 95, 125 and 165 centimeters respectively corresponding to the gonadal, thoracic and crystalline regions of a typical adult . The isodose curves applied to the distribution of the surgical team suggest that the exposures are in the following descending order of intensity: primary physician, auxiliary physician, scrub nurse, anesthetist and nurse

  4. 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.

  5. 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...

  6. Vesical calculus: a urological complication of intrauterine ...

    African Journals Online (AJOL)

    African Journal of Urology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 12, No 1 (2006) >. Log in or Register to get access to full text downloads.

  7. 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.

  8. Robotics in urology: past, present, and future.

    Science.gov (United States)

    Thiel, David D; Winfield, Howard N

    2008-04-01

    The modern-day urologist is continually armed with new instruments and technology aimed at decreasing the overall invasiveness of urologic procedures. Robotic technology is aimed at improving clinical outcomes by correcting human technical inadequacies such as hand tremors and imprecise suturing. The first reported use of robotics to assist with surgery was in 1985, and the first use of robotics in urology was published in 1989. The currently utilized master-slave system (da Vinci Robotic Platform), Intuitive Surgical, Sunnyvale, CA) has popularized robotic surgery for use in numerous urologic conditions including prostate cancer, bladder cancer, renal cancer, uretero-pelvic junction obstruction, and pelvic prolapse. New developments in robotic technology may revolutionize many other aspects of urology including percutaneous renal access and rounding on patients after surgery. This review provides a brief overview of the history of robotics in urology, a description of the da Vinci surgical system and its current utilization as well as limitations, and a review of evolving robotic technology in the field of urology.

  9. 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.

  10. Robotic surgery in pediatric urology.

    Science.gov (United States)

    Howe, Adam; Kozel, Zachary; Palmer, Lane

    2017-01-01

    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.

  11. [Computerized image analysis applied to urology research].

    Science.gov (United States)

    Urrutia Avisrror, M

    1994-05-01

    Diagnosis with the aid of imaging techniques in urology had developed dramatically over the last few years as a result of using state-of-the-art technology that has added digital angiology to the last generation apparatus for ultrasound. Computerized axial tomography and nuclear magnetic resonance allow very high rates of diagnostic possibilities that only a decade ago were not extended to routine use. Each of these examination procedures has its own limits of sensitivity and specificity which vary as a function of the pathoanatomical characteristics depending on the condition to be explored, although none reaches yet absolute values. With ultrasound, CAT and NMR, identification of the various diseases rely on the analysis of densities although with a significant degree of the examiner's subjectivity in the diagnostic judgement. The logic evolution of these techniques is to eliminate such subjective component and translate the features which characterize each disease in quantifiable parameters, a challenge made feasible by computerized analysis. Thanks to technological advances in the field of microcomputers and the decreased cost of the equipment, currently it is possible for any clinical investigator with average resources to use the most sophisticated imaging analysis techniques for the post-processing of the images obtained, opening in the scope of practical investigation a pathway that just a few years ago was exclusive to only certain organizations due to the high cost involved.

  12. Involvement of microbial mats in early fossilization by decay delay and formation of impressions and replicas of vertebrates and invertebrates.

    Science.gov (United States)

    Iniesto, Miguel; Buscalioni, Ángela D; Carmen Guerrero, M; Benzerara, Karim; Moreira, David; López-Archilla, Ana I

    2016-05-10

    Microbial mats have been hypothesized to improve the persistence and the preservation of organic remains during fossilization processes. We test this hypothesis with long-term experiments (up to 5.5 years) using invertebrate and vertebrate corpses. Once placed on mats, the microbial community coats the corpses and forms a three-dimensional sarcophagus composed of microbial cells and exopolymeric substances (EPS). This coverage provides a template for i) moulding superficial features, resulting in negative impressions, and ii) generating replicas. The impressions of fly setulae, fish scales and frog skin verrucae are shaped mainly by small cells in an EPS matrix. Microbes also replicate delicate structures such as the three successive layers that compose a fish eye. The sarcophagus protects the body integrity, allowing the persistence of inner organs such as the ovaries and digestive apparatus in flies, the swim bladder and muscles in fish, and the bone marrow in frog legs. This study brings strong experimental evidence to the idea that mats favour metazoan fossilization by moulding, replicating and delaying decay. Rapid burial has classically been invoked as a mechanism to explain exceptional preservation. However, mats may play a similar role during early fossilization as they can preserve complex features for a long time.

  13. Involvement of microbial mats in early fossilization by decay delay and formation of impressions and replicas of vertebrates and invertebrates

    Science.gov (United States)

    Iniesto, Miguel; Buscalioni, Ángela D.; Carmen Guerrero, M.; Benzerara, Karim; Moreira, David; López-Archilla, Ana I.

    2016-01-01

    Microbial mats have been hypothesized to improve the persistence and the preservation of organic remains during fossilization processes. We test this hypothesis with long-term experiments (up to 5.5 years) using invertebrate and vertebrate corpses. Once placed on mats, the microbial community coats the corpses and forms a three-dimensional sarcophagus composed of microbial cells and exopolymeric substances (EPS). This coverage provides a template for i) moulding superficial features, resulting in negative impressions, and ii) generating replicas. The impressions of fly setulae, fish scales and frog skin verrucae are shaped mainly by small cells in an EPS matrix. Microbes also replicate delicate structures such as the three successive layers that compose a fish eye. The sarcophagus protects the body integrity, allowing the persistence of inner organs such as the ovaries and digestive apparatus in flies, the swim bladder and muscles in fish, and the bone marrow in frog legs. This study brings strong experimental evidence to the idea that mats favour metazoan fossilization by moulding, replicating and delaying decay. Rapid burial has classically been invoked as a mechanism to explain exceptional preservation. However, mats may play a similar role during early fossilization as they can preserve complex features for a long time. PMID:27162204

  14. The rapid calculation of frequency responses for linear systems involving time-delayed terms (Fortran program FRP Mk 2)

    International Nuclear Information System (INIS)

    Sumner, H.M.

    1967-07-01

    A program entitled FRP Mk 1, for computing the frequency response of a linear system, with transport delays, has been developed previously. The present report considers the minimisation of time and storage requirements. In particular, if the system is described by a set of first order differential and algebraic equations, some variables, specified by the programmer may be eliminated by the computer. The method is incorporated in the KDF 9/EGDON code FRP Mk 2, and includes special non-numeric, compiler subroutines for input of the equations and other data in a simple form orientated towards the analyst. The input scheme used for the equations is compatible with that used for the pole-zero, or transfer function program, ZIP so that the same card-deck may be used for data entry in both codes. The code FRP Mk 2 was designed to be used for the analysis of nuclear reactor power systems, but is equally applicable to most forms of process plant, especially chemical plant. (author)

  15. "A case report of Pott’s disease with unusual involvement of two separate levels of spine and delayed progressive Kyphosis "

    Directory of Open Access Journals (Sweden)

    Rahimi Movaghar V

    2001-05-01

    Full Text Available In Pott’s disease (tuberculous spondylitis, involvement of two separate levels of spine is rare. Attention to stability of spine prevents delayed progressive kyphosis. A 12-year-old girl presented with neck pain, tenderness and swelling Imaging showed Cl—C2 and T9-T10 and destruction. Mild spastic paraparesis was noticed. Preoperative diagnosis was metastasis. T9, T10 and T11 laminectomy and cervical operations were done in 2 sessions. Both pathologic examinations confirmed tuberculosis. Although antituberculous medications and casting were performed, kyhosis progressed and neurologic deficit restrated. Reportation was done for spinal cord decompression and stabilzation. Tuberculosis could involve multiple spinal levels. Laminectomy is not suggested in children. Bone fusion and serial observations are important.

  16. 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

  17. The evolution of lasers in urology.

    Science.gov (United States)

    Zarrabi, Amir; Gross, Andreas J

    2011-04-01

    The world's first laser was developed by Theodore Maiman in 1960. Over the course of the past five decades, this technology has evolved into a highly specialized entity, also finding a niche market in the field of urology. Lasers obtained from various lasing mediums producing amplified light of different wavelengths have been tested for urological applications. Today, these lasers are most commonly used in the surgical management of benign prostatic hyperplasia and as intracorporeal lithotripters. Other uses include ablation of various urologic tumors and incising strictures of the upper- and lower urinary tract. A continuous process of evolution of this technology is taking place, resulting in surgical lasers becoming ever safer, more effective, and more affordable.

  18. 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

  19. "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.

  20. The history and anatomy of urologic lymphadenectomy.

    Science.gov (United States)

    Lewinshtein, Daniel J; Porter, Christopher R

    2011-11-01

    The history of urologic lymphadenectomy is rich and diverse. Our current understanding of its use and benefits is a product of the hard work of numerous physicians and scientists from many nations. Standard dissection templates for the various urologic malignancies are based on a complete understanding of the anatomy of the lymphatic system, which has developed immensely since Hippocrates first described the white blood of the lymphatic system while performing an axillary dissection. It is hoped that the next 100 years will bring even greater comprehension of its value and utility. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Iatrogenic urological triggers of autonomic dysreflexia

    DEFF Research Database (Denmark)

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

    2015-01-01

    dyssynergia. Without anesthesia, the majority of individuals develop AD during cystoscopy, transurethral litholapaxy and ESWL. The effectiveness of different anesthesia methods relies on blocking the nociceptive signals from the lower urinary tract (LUT) below the level of the neurological lesion. Other...... iatrogenic urological triggers were commonly associated with bladder filling. CONCLUSION: The LUT triggers of episodes of AD are often associated with iatrogenic urological procedures. AD was more prevalent in cervical SCI than in thoracic SCI. To detect this potential life-threatening complication following...

  2. 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.

  3. 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.

  4. An improvement project within urological care.

    Science.gov (United States)

    Khatami, Annelie; Rosengren, Kristina

    2015-01-01

    The purpose of this paper is to describe staff experiences in an on-going improvement project regarding patients with ureteral stones. A qualitative descriptive study based on eight group interviews and 48 narratives, was performed. Data were analysed using qualitative content analysis. Trustworthiness was ensured by using a well-documented improvement process method during six months. The results formed three categories: an absent comprehensive view; complexity; and vulnerability within the organisation. A holistic perspective regarding urological care at the micro-, meso- and macro-levels is needed to improve planning and caring processes. This study includes one team (six members, different health professionals) within the same urology department. Results show that staff need information, such as guidelines and support throughout the improvement work to deliver high-quality care. Moreover, there is a need for evidence-based guidelines at national level to support improvement work. Healthcare staff need to pay attention to all team member needs to improve urological care. Organisational and managerial aspect are needed to support clear and common goals regarding healthcare improvement work. Urological improvement projects, generally, are lacking, which is why this study is important to improve nephrolithiasis patient care.

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

    African Journals Online (AJOL)

    women.[1,2] The way this inevitable status is perceived differs in many settings and it is usually influenced by sociocultural factors, quality of information at their disposal as well as economic ... proximate determinants of sexual activity and urological morbidities of menopausal women. ..... orgasm in middle‑aged woman.

  6. 3D Printing and Its Urologic Applications.

    Science.gov (United States)

    Soliman, Youssef; Feibus, Allison H; Baum, Neil

    2015-01-01

    3D printing is the development of 3D objects via an additive process in which successive layers of material are applied under computer control. This article discusses 3D printing, with an emphasis on its historical context and its potential use in the field of urology.

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

    African Journals Online (AJOL)

    Background: Menopause represents the end of women reproductive career and it is at this time they begin to manifest morbidities such as urinary incontinence. Aim: To document proximate determinants of sexual activity and urological morbidities of menopausal women. Subjects and Methods: This was a community survey ...

  8. 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 ...

  9. PAEDIATRIC UROLOGICAL TRAUMA AT NNEWI, SOUTH ...

    African Journals Online (AJOL)

    The patient group included neonates up to children aged 15 years. Apart from the biodata, the cause of the trauma, the organ(s) injured, the treatment given and its outcome were critically analyzed. Results: In the two years under review, 257 cases of paediatric trauma were managed. Out of these, urological trauma was ...

  10. 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.

  11. The American Urological Association Symptom Index for Benign Prostatic Hyperplasia.

    Science.gov (United States)

    Barry, Michael J; Fowler, Floyd J; O'leary, Michael P; Bruskewitz, Reginald C; Holtgrewe, H Logan; Mebust, Winston K; Cockett, Abraham T K

    2017-02-01

    A symptom index for benign prostatic hyperplasia (BPH) was developed and validated by a multidisciplinary measurement committee of the American Urological Association (AUA). Validation studies were conducted involving a total of 210 BPH patients and 108 control subjects. The final AUA symptom index includes 7 questions covering frequency, nocturia, weak urinary stream, hesitancy, intermittence, incomplete emptying and urgency. On revalidation, the index was internally consistent (Cronbach's α = 0.86) and the score generated had excellent test-retest reliability (r = 0.92). Scores were highly correlated with subjects' global ratings of the magnitude of their urinary problem (r = 0.65 to 0.72) and powerfully discriminated between BPH and control subjects (receiver operating characteristic area 0.85). Finally, the index was sensitive to change, with preoperative scores decreasing from a mean of 17.6 to 7.1 by 4 weeks after prostatectomy (p index is clinically sensible, reliable, valid and responsive. It is practical for use in practice and for inclusion in research protocols. Copyright © 1992 American Urological Association, Inc. Published by Elsevier Inc. All rights reserved.

  12. Computer tomography for TNM based radiation planning of urological tumours

    International Nuclear Information System (INIS)

    Ammon, J.; Karstens, J.H.; Ruebben, H.; Technische Hochschule Aachen

    1978-01-01

    From the extensive statistics concerning treatment results of urological tumours which are available from central tumour registers, a first draft of a treatment plan has been worked out, which is based on tumour spread. Since the extent of tumour invasion is documented by the TNM system of the UICC, one is justified in speaking of TNM orientated treatment planning. For planning it is necessary to consider not only tumour type and depth of infiltration of local tissues, but also the lymph node anatomy, whether the nodes are involved or not. Computer tomography assists significantly in the performance of such TNM orientated treatment planning, particularly in determining the extent of the volume to be irradiated. It must be stressed that computer tomography does not replace the use of simulators, but that it is a valuable addition. In our view, computer tomography has also an undoubted value in treatment planning of urological tumours where palliation only is the aim. It provides the possibility of checking the effect of the chosen treatment by a non-invasive diagnostic method. (orig.) [de

  13. Training in urological robotic surgery. Future perspectives.

    Science.gov (United States)

    El Sherbiny, Ahmed; Eissa, Ahmed; Ghaith, Ahmed; Morini, Elena; Marzotta, Lucilla; Sighinolfi, Maria Chiara; Micali, Salvatore; Bianchi, Giampaolo; Rocco, Bernardo

    2018-01-01

    As robotics are becoming more integrated into the medical field, robotic training is becoming more crucial in order to overcome the lack of experienced robotic surgeons. However, there are several obstacles facing the development of robotic training programs like the high cost of training and the increased operative time during the initial period of the learning curve, which, in turn increase the operative cost. Robotic-assisted laparoscopic prostatectomy is the most commonly performed robotic surgery. Moreover, robotic surgery is becoming more popular among urologic oncologists and pediatric urologists. The need for a standardized and validated robotic training curriculum was growing along with the increased number of urologic centers and institutes adopting the robotic technology. Robotic training includes proctorship, mentorship or fellowship, telementoring, simulators and video training. In this chapter, we are going to discuss the different training methods, how to evaluate robotic skills, the available robotic training curriculum, and the future perspectives.

  14. Post-transplant urological and vascular complications

    Directory of Open Access Journals (Sweden)

    Safa Javid

    2009-01-01

    Full Text Available To determine the prevalence of urological and vascular complications in renal trans-plant recipients (RTx at Tabriz Renal Transplant Center, we studied 55 recipients of renal allo-grafts (25 male and 29 female patients with a mean age of 38.3 ± 13.4 years from October 2005 to November 2006. The surgical complications in our study included hematomas: 20.4%, renal artery stenosis: 20.4%, calculi: 7.4%, hydronephrosis or ureteral stricture: 5.6%, urinary leakage: 5.6%, lymphoceles: 1.9%, and renal vein thrombosis: 1.9%. We conclude that the most common urologic complications in our center were ureteric strictures and urine leaks, and the most common vascular complication was renal artery stenosis.

  15. Inhibition of phosphatidylinositol 3-kinase promotes tumor cell resistance to chemotherapeutic agents via a mechanism involving delay in cell cycle progression

    International Nuclear Information System (INIS)

    McDonald, Gail T.; Sullivan, Richard; Pare, Genevieve C.; Graham, Charles H.

    2010-01-01

    Approaches to overcome chemoresistance in cancer cells have involved targeting specific signaling pathways such as the phosphatidylinositol 3-kinase (PI3K) pathway, a stress response pathway known to be involved in the regulation of cell survival, apoptosis and growth. The present study determined the effect of PI3K inhibition on the clonogenic survival of human cancer cells following exposure to various chemotherapeutic agents. Treatment with the PI3K inhibitors LY294002 or Compound 15e resulted in increased survival of MDA-MB-231 breast carcinoma cells after exposure to doxorubicin, etoposide, 5-fluorouracil, and vincristine. Increased survival following PI3K inhibition was also observed in DU-145 prostate, HCT-116 colon and A-549 lung carcinoma cell lines exposed to doxorubicin. Increased cell survival mediated by LY294002 was correlated with a decrease in cell proliferation, which was linked to an increase in the proportion of cells in the G 1 phase of the cell cycle. Inhibition of PI3K signaling also resulted in higher levels of the cyclin-dependent kinase inhibitors p21 Waf1/Cip1 and p27 Kip1 ; and knockdown of p27 kip1 with siRNA attenuated resistance to doxorubicin in cells treated with LY294002. Incubation in the presence of LY294002 after exposure to doxorubicin resulted in decreased cell survival. These findings provide evidence that PI3K inhibition leads to chemoresistance in human cancer cells by causing a delay in cell cycle; however, the timing of PI3K inhibition (either before or after exposure to anti-cancer agents) may be a critical determinant of chemosensitivity.

  16. 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.

  17. The role of lasers in modern urology

    OpenAIRE

    Do?owy, ?ukasz; Krajewski, Wojciech; Dembowski, Janusz; Zdrojowy, Romuald; Ko?odziej, 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. Resul...

  18. Phytotherapy: emerging therapeutic option in urologic disease

    OpenAIRE

    Kim, Sae Woong

    2012-01-01

    Phytotherapy belongs to the area of complementary and alternative medicine (CAM) and the definition of phytotherapy is the use of plants or plant extracts for medicinal uses. Interest in phytotherapy is growing in both Asian and western countries for its use in the prevention and management of disease, improvement of general health and anti-aging. And also, there are several studies about the efficacy of phytotherapy in urologic diseases like benign prostatic hyperplasia (BPH), erectile dysfu...

  19. Unsuspected urological anomalies in asymptomatic cryptorchid boys

    Energy Technology Data Exchange (ETDEWEB)

    Pappis, C.H.; Argianas, S.A.; Bousgas, D.; Athanasiades, E.

    1988-01-01

    In a period of 6 years 144 asymptomatic boys with cryptorchidism, of mean age 7 +- SD 3.5 years, underwent orchiopexy. None of these boys referred to a history of a known urological anomaly, urinary tract infection haematuria, palpable mass in the renal region, bladder extrophy, epispadias, hypospadias or anorectal malformation. On the third day after orchiopexy an intravenous pyelography was done in every boy following testicular protection against irradiation. Ultrasonic investigation was not available at that time. There were minor urological abnormalities in 36 (25%) boys and major ones in 8 (5.5%) boys. A major anomaly is defined as one resulting in significant loss of renal substance (one case of single kidney and three cases of unilateral renal hypoplasia), or requiring surgical correction for conservation of the renal substance (one case of ureterocele, two cases of pelviureteric stenosis and one case of vesicoureteric stenosis with ipsilateral hydronephrosis). The unsuspected major urological abnormalities are usually ipsilateral to the more undescended testis. They may be associated with a hernia and are more frequent in bilateral cryptorchidism. In conclusion we encourage the routine use of IVP, or ultrasonic investigation or dynamic renal scanning (99/sup mTc/-DTPA), if it is possible, in all patients undergoing orchiopexy for the detection of an unsuspected major renal anomaly.

  20. Introducing new technology safely into urological practice.

    Science.gov (United States)

    Van Bruwaene, Siska; Namdarian, Benjamin; Challacombe, Ben; Eddy, Ben; Billiet, Ignace

    2018-04-01

    Surgical innovation is necessary to ensure continued improvement in patient care. However, several challenges unique to the surgical craft are encountered during the development and validation of such new technology. This article highlights some of these challenges and gives an overview of existing solutions. A Pubmed review was performed about the "introduction of new technology" to identify challenges. Cross-referencing was used to explore the possible solutions per challenge. Several characteristics of the surgical craft itself limit our ability to establish randomised controlled trials and hence provide clear categorical evidence. Existing certification bodies for new technology often use unstructured regulations and allow fast-track bypassing systems. Consequently the IDEAL framework (innovation, development, exploration, assessment, long-term follow-up) proposes an objective scientific approach whilst defining stakeholder responsibilities. The selection of which new modality to implement is heavily influenced by third parties unrelated to the best patient outcomes and thus professional organisations can aid in this decision-making. Appropriate training of surgeons and their teams until proficiency is achieved is essential prior to credentialling. Finally long-term surveillance of outcomes in the form of registries is an increasing responsibility of the urological community to maintain our role in directing the adoption or rejection of these innovations. Urological innovation is a dynamic and challenging process. Increasing efforts are identified within the urological community to render the process more reliable and transparent.

  1. Phytotherapy: emerging therapeutic option in urologic disease

    Science.gov (United States)

    2012-01-01

    Phytotherapy belongs to the area of complementary and alternative medicine (CAM) and the definition of phytotherapy is the use of plants or plant extracts for medicinal uses. Interest in phytotherapy is growing in both Asian and western countries for its use in the prevention and management of disease, improvement of general health and anti-aging. And also, there are several studies about the efficacy of phytotherapy in urologic diseases like benign prostatic hyperplasia (BPH), erectile dysfunction (ED), late-onset hypogonadism (LOH) and infertility in males. Phytotherapy for BPH including saw palmetto, pygeum, and nettles, is under vigorous research for the therapeutic effect. No solid evidence showing better effective treatment modality for ED than placebo has been found yet for phytotherapy. Recently, a potent NO donor, L-arginine is under research with promising results. Phytotherapy is used by a number of patients with urological disease, and urologists need to have accurate knowledge about phytotherapy as well as keep a cautious approach. The possible effects and side effects should be defined and related to urologic patients by urologists. PMID:26816707

  2. Experience of a Tertiary-Level Urology Center in the Clinical Urological Events of Rare and Very Rare Incidence. I. Surgical Never Events: 1. Urological Wrong-Surgery Catastrophes and Disabling Complications.

    Science.gov (United States)

    Gadelkareem, Rabea A

    2018-02-01

    Surgical never events are preventable harmful non-intentional human errors. Urology is a common surgical specialty for their occurrence. A retrospective search of our center's data was done during the period 2006-2016 for surgical never events. Each included case was studied for the primary diagnosis, procedure, and subspecialty, never event type and timing, needed extra-interventions, urologist/procedure proportioning, outcomes, and possible underlying causes of the event. Of more than 55,000 different urological interventions, 61 patients were involved in never events. Wrong procedures represented 75% of the never events, and endourology and urolithiasis subspecialties were more often involved. The main detectable underlying factor was the disproportion between the levels of the procedure class and the qualification of the urologist (41%). Thirty-four cases had extra-procedures. The short-term harm effect represented the final outcome in 42% of all events. Death, permanent organ loss, and long-term harm represented 20, 15, and 23%, respectively. Urological surgical never events are rare, but their final outcomes could be catastrophic, even leading to death.

  3. 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.

  4. Interstitial Cystitis: Characterization and Management of an Enigmatic Urologic Syndrome

    Science.gov (United States)

    Nickel, J. Curtis

    2002-01-01

    The enigmatic urologic condition known as interstitial cystitis has an estimated prevalence of 0.01% to 0.50% of the female population. Its etiology is unknown but may involve microbiologic, immunologic, mucosal, neurogenic, and/or other, as yet undefined, agents. There is no gold standard for the diagnosis of interstitial cystitis; rather, it is a diagnosis of exclusion. It is impossible to provide a purely evidence-based treatment strategy, but review of available evidence suggests that conservative supportive therapy (including diet modification); oral treatment with pentosan polysulfate, amitriptyline, hydroxyzine, or cimetidine; and intravesical treatments with heparinoids, dimethyl sulfoxide, alkalized lidocaine, or bacille Calmette-Guérin may be effective in some patients. PMID:16985667

  5. Publication of Original Research in Urologic Journals ? A Neglected Orphan?

    OpenAIRE

    Mani, Jens; Makarevi?, Jasmina; Juengel, Eva; Ackermann, Hanns; Nelson, Karen; Haferkamp, Axel; Blaheta, Roman A.

    2012-01-01

    The pathophysiologic mechanisms behind urologic disease are increasingly being elucidated. The object of this investigation was to evaluate the publication policies of urologic journals during a period of progressively better understanding and management of urologic disease. Based on the ISI Web of Knowledge Journal Citation Reports and the PubMed database, the number and percentage of original experimental, original clinical, review or commentarial articles published between 2002–2010 in six...

  6. 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.

  7. Urology training in the developing world: The trainees’ perspective in Kurdistan, Iraq

    Science.gov (United States)

    Friad, Goran; Sabah, Kawa; Ameen, Ismaeel Hama

    2013-01-01

    Objective To analyse the advanced systems of urology residency in the developed world, to compare them to a system in the developing world, and thereby identify the shortcomings and make recommendations to improve residency programmes for urology in the Kurdistan Region of Iraq. Methods A survey was conducted amongst the urology Residents (55) in the three governorates of the Kurdistan Region of Iraq, to assess the accessibility of the training programme, the types of the residency programmes, skills acquisition, the use of modern technology for teaching and assessment, the environment of the settings of practice, and the status of research in their training. Results An overwhelming majority (88%) of trainees reported difficulty in securing a training position. A high proportion (43%) felt disappointed at the beginning of their training. There is no unified curriculum of training, and more than two-thirds of the respondents reported a lack of a proper evidence-based medical education. There is no formal subspecialty training programme. Of the respondents, 65% referred to the difficulties in the environment for training, and that there was a low level of research involvement (12%). Conclusions Urology training is not easily accessible, there is no unified programme of residency, there are limited facilities, and a minimal assessment of practical skills. The environment for practice needs enormous improvements and a strong foundation for research should be created. PMID:26019913

  8. Urology training in the developing world: The trainees' perspective in Kurdistan, Iraq.

    Science.gov (United States)

    Friad, Goran; Sabah, Kawa; Ameen, Ismaeel Hama

    2014-03-01

    To analyse the advanced systems of urology residency in the developed world, to compare them to a system in the developing world, and thereby identify the shortcomings and make recommendations to improve residency programmes for urology in the Kurdistan Region of Iraq. A survey was conducted amongst the urology Residents (55) in the three governorates of the Kurdistan Region of Iraq, to assess the accessibility of the training programme, the types of the residency programmes, skills acquisition, the use of modern technology for teaching and assessment, the environment of the settings of practice, and the status of research in their training. An overwhelming majority (88%) of trainees reported difficulty in securing a training position. A high proportion (43%) felt disappointed at the beginning of their training. There is no unified curriculum of training, and more than two-thirds of the respondents reported a lack of a proper evidence-based medical education. There is no formal subspecialty training programme. Of the respondents, 65% referred to the difficulties in the environment for training, and that there was a low level of research involvement (12%). Urology training is not easily accessible, there is no unified programme of residency, there are limited facilities, and a minimal assessment of practical skills. The environment for practice needs enormous improvements and a strong foundation for research should be created.

  9. [Genitourinary tuberculosis in the urologic works of Professor Rafael Mollá Rodrigo].

    Science.gov (United States)

    Cánovas Ivorra, Jose Antonio; Tramoyeres Galván, Alfredo; Sánchez Ballester, Francisco; de la Torre Abril, Luis; Ordoño Domínguez, Felipe; Navalón Verdejo, Pedro; Ramada Benlloch, Francisco; López Alcina, Emilio; Pérez Albacete, Mariano; Zaragoza Orts, Julio

    2005-04-01

    Professor Rafael Molla Rodrigo is considered by some the author who contributed with his scientific work and solid technique to consolidate Urology as a speciality in Valencia. Such importance is also perceived in a national level, as demonstrated by the fact that he belonged to the first board of the Spanish Association of Urology and contributed to its foundation in the two-year period 1910--1911, from his position of head of the department of Surgical Therapy and Operations at the Central University. Genitourinary tuberculosis is one of the most outstanding chapters of his extensive works. We reviewed all his works, selecting all original articles about genitourinary tuberculosis. Original articles have been obtained from the journals Revista de Higiene y Tuberculosis, La Medicina Valenciana, Revista Valenciana de Ciencias Médicas y Policínica, and from his two most important books, Clinical Lessons In Urology and Clinical Lessons in Urology and Genitourinary Surgery. Throughout his work he analyzes features of relevance about this disease, such as diagnosis, about which he emphasizes the clinical and bacteriological difficulties, and treatment, which was only feasible by precocious nephrectomy. He dedicates a great part of his work to the study of this pathology and defends a precocious diagnosis in order to perform the only treatment that had demonstrated efficacy. He also exposes the symptoms and variety of clinical presentations, as well as diagnosis through separate kidney catheterization with the aim to determine unilateral involvement.

  10. [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.

  11. Female genital mutilation: a urology focus.

    Science.gov (United States)

    Clarke, Elinor

    2016-10-13

    Female genital mutilation (FGM) is a collective term for the deliberate alteration, removal and cutting of the female genitalia. It has no known health benefits and can have negative physical and psychological consequences. The number of women and girls in the UK that are affected by FGM is unknown. Recent NHS data suggested that FGM has been evident (declared or observed) in women who have accessed health care; however, there are gaps in knowledge and a limited evidence base on the health consequences of FGM. This article explores the urological complications experienced by women who have undergone this practice, and the effects this can have on their health and wellbeing.

  12. [From paediatric urological care to adult urology. Assessment of a transition consultation for adolescents].

    Science.gov (United States)

    Even, L; Mouttalib, S; Moscovici, J; Soulie, M; Rischmann, P; Game, X; Galinier, P; Bouali, O

    2017-10-01

    To provide an adequate lifelong urological care in the complex period of adolescence, a transition consultation conducted by a paediatric surgeon and an urologist was developed in our institution. As a real rite of passage, it allows the follow-up and the adapted care of urological conditions, sometimes complex, and permits the transition between childhood and the world of grown-ups. We reported our experience at the Children Hospital of our institution (paediatric surgery and urology departments). During a 6 months period (January-July 2015), forty-five young adults with a mean age of 17.8±3.6 years were seen in transition consultation. Eight patients had neurogenic voiding disorders (4 spina bifida, 1 multiple sclerosis, 1 mitochondrial encephalopathy, 1 metachromic leucodystrophy, 1 paraplegia), 9 patients had idiopathic voiding disorders, 1 patient had a non obstructive malformative uropathy; and 30 patients had surgery during infancy and childhood: hypospadias in 17 young men and malformative uropathy in 13 patients. This consultation occurred within 4.6±4.5 years after the last consultation with paediatric surgeon. For 6 patients, the transition consultation was the first for the urological problem. After this consultation, 8 patients stayed in paediatric surgery and 37 patients were referred to adult urologist. Among those 8 patients: 2 patients had cognitive and psychiatric disorders; 4 patients refused to be transferred to adult unit; 2 patients wanted to come back at transition consultation. Among the 37 patients transferred in adult urological care: 6 patients had urological surgery, and one patient was referred to a sexology consultation. The remaining 30 patients have initiated long-term monitoring. All reconvened patients came back at the follow-up visit (at least 12 months follow-up). A 16-year-old patient (spina bifida with polymalformative syndrome) developed a depressive syndrome at the end of the consultation, in the motive of an awareness of

  13. Place of radiation therapy for the treatment of gynecologic and urologic tumors in 1994

    International Nuclear Information System (INIS)

    Maulard-Durdux, C.; Housset, M.

    1995-01-01

    External-beam radiation therapy and brachytherapy are currently used both as curative and as palliative therapy in patients with gynecologic and urologic tumors. Ionizing radiation plays a key role in the locoregional control of uterine and prostatic tumors, in particular in combination with surgery. External-beam radiation therapy in combination with concomitant radiosensitizing chemotherapy may allow conservation of the bladder in patients with infiltrating vesical tumors classically treated by cystectomy. It has beneficial effects on some of the most incapacitating complications of these cancers: its hemostatic effect is valuable in patients with vaginal bleeding or hematuria and it relieves the pain due to bone metastases, which are particularly common in prostatic cancer. Furthermore, use of high energy accelerators, development of better imaging techniques, and advances in dosimetry have substantially reduced the rate of delayed radiation-induced complications. Thus, external-beam radiation therapy and brachytherapy are important tools for the treatment of gynecologic and urologic tumors. A discussion is provided of the role of radiation therapy in the four most common types of gynecologic and urologic cancer: cancers of the prostate, bladder, uterine cervix, and uterine corpus. (authors). 52 refs., 2 tabs

  14. 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

  15. 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

  16. 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

  17. 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.

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

    African Journals Online (AJOL)

    Objective: To establish the epidemiology of outpatient urology patients and their service needs as seen in a tertiary centre in the Western region of Kenya. Design: Hospital based observational, descriptive, prospective, cross sectional study. Setting: The Urology Outpatient clinic of Moi Teaching and Referral Hospital ...

  19. Paediatric urologic pathologies at the national teaching hospital in ...

    African Journals Online (AJOL)

    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, ...

  20. 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 ...

  1. [The William P. Didusch Center for Urologic History of the American Urological Association: new exciting approaches in presenting urologic history, not only in the USA - a personal guided tour].

    Science.gov (United States)

    Engel, R M

    2011-04-01

    The Didusch Center for Urologic History encompasses a rich and varied collection of drawings, photographs, and instruments of historical importance to urology, many displayed in the urological exhibits during the American Urological Association (AUA) conventions. The Center also houses a library devoted to urological and early medical texts and the AUA archives and is the institution of research in all fields of urologic history in the USA. The museum collection features most of Didusch's original drawings, as well as an impressive instrument collection acquired primarily through donations by urologists. The original William P. Didusch Museum (now known as the William P. Didusch Center for Urologic History) was originally housed in the AUA's Baltimore City headquarters building. Upon the association's move to Linthicum, MD in 2003, the museum has evolved into the William P. Didusch Center for Urologic History and taken on new tasks and responsibilities that include the topic of research in urologic history.

  2. A Novel Microdeletion in 1(p34.2p34.3), Involving the "SLC2A1" ("GLUT1") Gene, and Severe Delayed Development

    Science.gov (United States)

    Vermeer, Sascha; Koolen, David A; Visser, Gepke; Brackel, Hein J. L.; van der Burgt, Ineke; de Leeuw, Nicole; Willemsen, Michel A. A. P.; Sistermans, Erik A.; Pfundt, Rolph; de Vries, Bert B. A.

    2007-01-01

    A "de novo" 4.1-megabase microdeletion of chromosome 1p34.2p34.3 has been identified by array-based comparative genomic hybridization in a young male with severely delayed development, microcephaly, pronounced hypotonia, and facial dysmorphism. The deleted region encompasses 48 genes, among them the glucose transporter 1 ("SLC2A1" or "GLUT1")…

  3. Edward Loughborough Keyes: an early twentieth century leader in urology.

    Science.gov (United States)

    Stahl, Peter J; Vaughan, E D; Belt, Edward S; Bloom, David A

    2006-11-01

    Edward Loughborough Keyes was a renowned urologist, decorated war hero, prolific writer and beloved professor. Having served as president of the American Association of Genitourinary Surgeons, the American Urological Association, the International Urological Society and the Clinical Urological Association, Keyes in large part steered the course of urology during the early twentieth century. We reviewed letters, original publications and historical records pertaining to Doctor Keyes found in the New York Hospital archives, the American Urological Association historical record, the medical literature and the popular press. Edward Loughborough Keyes, Jr. received his M.D. from Columbia in 1895, and went on to hold academic positions in urology at Georgetown, the New York Polyclinic Medical School, St. Vincent's Hospital, Memorial Hospital, New York University and at the Cornell University Medical College, where he spent most of his career. He authored the premier urology textbook of his day, Urology, and published prolifically on a myriad of urological conditions. Doctor Keyes served in World War I as consultant in urology to General John J. Pershing, commander of the American Expeditionary Force. During the war he and Hugh Hampton Young led modern history's first public campaign against sexually transmitted disease, and in America he was one of the leaders of the American social hygiene movement from which contemporary sexual education evolved. He spoke Spanish and French fluently, wrote poetry and prose prolifically, and was beloved for his good humor. He died at the age of 75 in New York. Edward Loughborough Keyes is remembered as one of the great urologists of the early twentieth century.

  4. [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.

  5. [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.

  6. Urological aspects of HIV and AIDS.

    Science.gov (United States)

    Heyns, Chris F; Smit, Shaun G; van der Merwe, André; Zarrabi, Amir D

    2013-12-01

    The use of highly active antiretroviral therapy (HAART) in HIV-infected people has led to a dramatic decrease in the incidence of opportunistic infections and virus-related malignancies such as non-Hodgkin lymphoma and Kaposi sarcoma, but not cervical or anal cancer. Advanced-stage cervical cancer is associated with a high incidence of urological complications such as hydronephrosis, renal failure, and vesicovaginal fistula. Adult male circumcison can significantly reduce the risk of male HIV acquisition. Although HAART does not completely eradicate HIV, compliance with medication increases life expectancy. HIV infection or treatment can result in renal failure, which can be managed with dialysis and transplantation (as for HIV-negative patients). Although treatment for erectile dysfunction--including phosphodiesterase 5 inhibitors, intracavernosal injection therapy, and penile prosthesis--can increase the risk of HIV transmission, treatment decisions for men with erectile dysfunction should not be determined by HIV status. The challenges faced when administering chemotherapy to HIV-infected patients with cancer include late presentation, immunodeficiency, drug interactions, and adverse effects associated with compounded medications. Nonetheless, HIV-infected patients should receive the same cancer treatment as HIV-negative patients. The urologist is increasingly likely to encounter HIV-positive patients who present with the same urological problems as the general population, because HAART confers a prolonged life expectancy. Performing surgery in an HIV-infected individual raises safety issues for both the patient (if severely immunocompromised) and the surgeon, but the risk of HIV transmission from patients on fully suppressive HAART is small.

  7. 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.

  8. 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.

  9. The current role of simulation in urological training.

    Science.gov (United States)

    Preece, Ryan

    2015-01-01

    Simulation is becoming an increasingly popular educational tool in numerous surgical specialities, including urology. This article reviews the current role of urological simulators; discussing their need, availability, incorporation and current limitations. A literature review of the electronic databases Medline, Embase and Google Scholar was performed. For increasingly limited urological training programs, simulation can act as a valuable adjunct to clinical training. Evidence suggests that simulation enables the trainee to bypass the early, error-prone part of the surgical learning curve. It should be incorporated into proficiency-based curricula, with junior trainees initially beginning with low fidelity simulators to grasp basic surgical skills before moving onto full-procedural simulation as they progress through their training. A wide variety of simulators of differing fidelity are currently available, teaching both technical (eg. cystoscopy) and non-technical (eg. communication) urological surgical skills. Whist numerous studies have assessed the face, content and construct validity of various urological simulators, further work needs to be undertaken to determine whether the skills learnt actually improve trainee performance in the operating room. Then, educators will be able to make informed decisions about whether these resource demanding (financially and in terms of demands on faculty) simulators are a worthwhile educational tool. Although further investigation is required, urological simulators appear to have a considerable role for developing both technical and non-technical urological skills in an increasingly restricted educational environment in modern urogynecology.

  10. [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.

  11. 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

  12. The Global Prevalence of Infections in Urology Study: A Long-Term, Worldwide Surveillance Study on Urological Infections

    Directory of Open Access Journals (Sweden)

    Florian Wagenlehner

    2016-01-01

    Full Text Available The Global Prevalence of Infections in Urology (GPIU study is a worldwide-performed point prevalence study intended to create surveillance data on antibiotic resistance, type of urogenital infections, risk factors and data on antibiotic consumption, specifically in patients at urological departments with healthcare-associated urogenital infections (HAUTI. Investigators registered data through a web-based application (http://gpiu.esiu.org/. Data collection includes the practice and characteristics of the hospital and urology ward. On a certain day in November, each year, all urological patients present in the urological department at 8:00 a.m. are screened for HAUTI encompassing their full hospital course from admission to discharge. Apart from the GPIU main study, several side studies are taking place, dealing with transurethral resection of the prostate, prostate biopsy, as well as urosepsis. The GPIU study has been annually performed since 2003. Eight-hundred fifty-six urology units from 70 countries have participated so far, including 27,542 patients. A proxy for antibiotic consumption is reflected by the application rates used for antibiotic prophylaxis for urological interventions. Resistance rates of most uropathogens against antibiotics were high, especially with a note of multidrug resistance. The severity of HAUTI is also increasing, 25% being urosepsis in recent years.

  13. Delayed Puberty

    DEFF Research Database (Denmark)

    Kolby, Nanna; Busch, Alexander Siegfried; Juul, Anders

    2017-01-01

    Delayed puberty can be a source of great concern and anxiety, although it usually is caused by a self-limiting variant of the normal physiological timing named constitutional delay of growth and puberty (CDGP). Delayed puberty can, however, also be the first presentation of a permanent condition ...... mineral density) and psychological (e.g., low self-esteem) and underline the importance of careful clinical assessment of the patients....

  14. 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

  15. bFGF-Regulating MAPKs Are Involved in High Glucose-Mediated ROS Production and Delay of Vascular Endothelial Cell Migration.

    Directory of Open Access Journals (Sweden)

    Zhong Xin Zhu

    Full Text Available High blood sugar is a symptom of diabetes mellitus (DM. Vascular endothelial cells (VECs directly contact the blood and are damaged when blood sugar levels are high. However, the molecular mechanism underlying this process remains elusive. To analyze the effects of DM on migration, we simulated DM by applying high glucose (HG to the human VEC. HG delayed cell migration and induced phosphorylation of MAPKs (JNK and ERK. By contrast, in presence of bFGF, cell migration was promoted and MAPK phosphorylation levels were reduced. Furthermore, treatment with JNK and ERK inhibitors rescued HG-mediated delay of cell migration. Molecular and cell biological studies demonstrated that HG increased ROS production, whereas treatment with bFGF or JNK/ERK inhibitors blocked HG-induced ROS accumulation. Addition of MnTMPyP, a ROS scavenger, reduced HG-induced ROS production and accelerated cell migration, suggesting that the influence of HG on bFGF-MAPK signaling causes accumulation of ROS, which in turn regulate cell migration. This is the first study to elucidate the molecular mechanism of HG-mediated VEC migration; these findings could facilitate the development of novel therapies for DM.

  16. Optimizing urology group partnerships: collaboration strategies and compensation best practices.

    Science.gov (United States)

    Jacoby, Dana L; Maller, Bruce S; Peltier, Lisa R

    2014-10-01

    Market forces in health care have created substantial regulatory, legislative, and reimbursement changes that have had a significant impact on urology group practices. To maintain viability, many urology groups have merged into larger integrated entities. Although group operations vary considerably, the majority of groups have struggled with the development of a strong culture, effective decision-making, and consensus-building around shared resources, income, and expense. Creating a sustainable business model requires urology group leaders to allocate appropriate time and resources to address these issues in a proactive manner. This article outlines collaboration strategies for creating an effective culture, governance, and leadership, and provides practical suggestions for optimizing the performance of the urology group practice.

  17. First urology simulation boot camp in the United Kingdom

    African Journals Online (AJOL)

    C.S. Biyani

    ;. Urology;. Medical education;. Technical skills;. Non-technical skills;. Surgical education. Abstract ... with subjective and objective clinical performance evaluations over ... the required foundation in the practice of hospital medicine, the next.

  18. Applications of three-dimensional printing technology in urological practice.

    Science.gov (United States)

    Youssef, Ramy F; Spradling, Kyle; Yoon, Renai; Dolan, Benjamin; Chamberlin, Joshua; Okhunov, Zhamshid; Clayman, Ralph; Landman, Jaime

    2015-11-01

    A rapid expansion in the medical applications of three-dimensional (3D)-printing technology has been seen in recent years. This technology is capable of manufacturing low-cost and customisable surgical devices, 3D models for use in preoperative planning and surgical education, and fabricated biomaterials. While several studies have suggested 3D printers may be a useful and cost-effective tool in urological practice, few studies are available that clearly demonstrate the clinical benefit of 3D-printed materials. Nevertheless, 3D-printing technology continues to advance rapidly and promises to play an increasingly larger role in the field of urology. Herein, we review the current urological applications of 3D printing and discuss the potential impact of 3D-printing technology on the future of urological practice. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

  19. 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.

  20. '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...

  1. '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...... 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...

  2. Trends in the training of female urology residents in Canada.

    Science.gov (United States)

    Anderson, Katherine; Tennankore, Karthik; Cox, Ashley

    2017-12-22

    There is limited research on why females do or do not choose a career in urology. Considering the increasing proportion of female medical students, we assessed for trends in female applicants to urology programs in Canada and their post-residency career choices. Data from the Canadian Residency Matching Service (CaRMS) was used (1998-2015). Trends in the proportions of females applying and matching to surgical subspecialties, and applying and matching to urology were computed. Surveys were sent to urology program directors to assess female residents' chosen career paths over the last decade. A significant increasing trend in the proportion of females applying to urology as their first choice program was found (0.19 in 1998-99 to 0.27 in 2012-15; p=0.04). An increasing trend in the proportion of females successfully matching to urology was found, although it was not statistically significant (0.13 in 1998-99 to 0.24 in 2012-15; p=0.07). This was in keeping with the trends found for surgical programs overall. Female graduates choose a variety of career paths with urogynecology being the most common fellowship (26%). The last two decades has seen an increase in the proportion of female students applying to urology in Canada. Female urology graduates pursue a variety of career paths. It remains imperative that both female and male medical students have early exposure and education about our subspecialty to ensure we continue to recruit the most talented candidates.

  3. Urology Group Compensation and Ancillary Service Models in an Era of Value-based Care.

    Science.gov (United States)

    Shore, Neal D; Jacoby, Dana

    2016-01-01

    Changes involving the health care economic landscape have affected physicians' workflow, productivity, compensation structures, and culture. Ongoing Federal legislation regarding regulatory documentation and imminent payment-changing methodologies have encouraged physician consolidation into larger practices, creating affiliations with hospitals, multidisciplinary medical specialties, and integrated delivery networks. As subspecialization and evolution of care models have accelerated, independent medical groups have broadened ancillary service lines by investing in enterprises that compete with hospital-based (academic and nonacademic) entities, as well as non-physician- owned multispecialty enterprises, for both outpatient and inpatient services. The looming and dramatic shift from volume- to value-based health care compensation will assuredly affect urology group compensation arrangements and productivity formulae. For groups that can implement change rapidly, efficiently, and harmoniously, there will be opportunities to achieve the Triple Aim goals of the Patient Protection and Affordable Care Act, while maintaining a successful medical-financial practice. In summary, implementing new payment algorithms alongside comprehensive care coordination will assist urology groups in addressing the health economic cost and quality challenges that have been historically encountered with fee-for-service systems. Urology group leadership and stakeholders will need to adjust internal processes, methods of care coordination, cultural dependency, and organizational structures in order to create better systems of care and management. In response, ancillary services and patient throughput will need to evolve in order to adequately align quality measurement and reporting systems across provider footprints and patient populations.

  4. [Fatigue syndrome: Stress, Burnout and depression in Urology.

    Science.gov (United States)

    Rodríguez-Socarrás, Moisés; Vasquez, Juan Luis; Uvin, Pieter; Skjold-Kingo, Pernille; Gómez Rivas, Juan

    2018-01-01

    To determine the factors related to stress, Burnout and depression in urology, as well as consequences in residents and urologists, in addition to the possible applicable strategies to diminish and treat them. Depression, stress and Burnout syndrome has become a problem in urology specialty. These topics have gained interest in international congresses and urological associations. Efforts are being made to find related factors as well as possible strategies and applicable support programs. Burnout frequency is higher among health professionals than general population, 40-76% in students and residents, its incidence has skyrocketed in recent years, in addition Urology is one of the specialties with highest incidence and severity. Its increase has been related to work overload, documentation, administrative/bureaucratic workload, hostile work environment; its consequences include poor work performance, medical errors, depression, substance abuse, disruption in family and couple relationships and suicidal ideation. Strategies for prevention including resilience training, lifestyle balance, teamwork, and support programs. Stress, burnout and depression are problems in urology, early detection, promoting individual techniques in resilience, lifestyle and teamwork are fundamental now and for the future of the specialty. Developing and implementing support programs should be seriously considered by health systems and urological associations.

  5. 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 importance on gender-confirming surgical training than did their male colleagues (91% vs 70%, P important. Most residents (77%) stated transgender-related surgical training should be offered in fellowships. 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.

  6. Learning curve of robotic assisted pyeloplasty for pediatric urology fellows.

    Science.gov (United States)

    Tasian, Gregory E; Wiebe, Douglas J; Casale, Pasquale

    2013-10-01

    Little is known about the learning curve of robotic surgery for surgeons in training. We hypothesized that pediatric urology fellows could attain proficiency in robotic pyeloplasty, defined as operative time equivalent to that of an experienced robotic surgeon, within the 2-year time frame of fellowship. From 2006 to 2010 we performed a prospective cohort study of pediatric robotic pyeloplasty done by 4 pediatric urology fellows and 1 pediatric urology attending surgeon. We recorded operative times and surgical outcomes of the total of 20 consecutive robotic pyeloplasties performed by the 4 pediatric urology fellows (80 cases) and a random sample of 20 performed by the attending surgeon. Multivariate linear regression was used to determine the change in operative time for each case done by fellows and estimate the number of cases needed for fellows to achieve the median operative time of the attending pediatric urologist. Fellow operative time decreased at a constant average rate of 3.7 minutes per case (95% CI 3.0-4.3). Fellows were projected to achieve the median operative time of the attending surgeon after 37 cases. No operative complications or failed pyeloplasties occurred. The operative time for robotic pyeloplasty performed by fellows consistently decreased with cumulative surgical experience. These data can be used to help establish benchmarks of robotic pyeloplasty for pediatric urology, assuming appropriate exposure to robotics and adequate case volume. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  7. 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.

  8. 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.

  9. Evidence for the involvement of peripheral β-adrenoceptors in delayed liquid gastric emptying induced by dipyrone, 4-aminoantipyrine, and antipyrine in rats

    Energy Technology Data Exchange (ETDEWEB)

    Vinagre, A.M. [Núcleo de Medicina e Cirurgia Experimental, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP (Brazil); Collares, E.F. [Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP (Brazil); Núcleo de Medicina e Cirurgia Experimental, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP (Brazil)

    2013-09-27

    Dipyrone (Dp), 4-aminoantipyrine (AA), and antipyrine (At) delay liquid gastric emptying (GE) in rats. We evaluated adrenergic participation in this phenomenon in a study in male Wistar rats (250-300 g) pretreated subcutaneously with guanethidine (GUA), 100 mg·kg{sup −1}·day{sup −1}, or vehicle (V) for 2 days before experimental treatments. Other groups of animals were pretreated intravenously (iv) 15 min before treatment with V, prazosin (PRA; 1 mg/kg), yohimbine (YOH; 3 mg/kg), or propranolol (PRO; 4 mg/kg), or with intracerebroventricular (icv) administration of 25 µg PRO or V. The groups were treated iv with saline or with 240 µmol/kg Dp, AA, or At. GE was determined 10 min later by measuring the percentage of gastric retention (%GR) of saline labeled with phenol red 10 min after gavage. %GR (mean±SE, n=8) indicated that GUA abolished the effect of Dp (GUA vs V=31.7±1.6 vs 47.1±2.3%) and of At (33.2±2.3 vs 54.7±3.6%) on GE and significantly reduced the effect of AA (48.1±3.2 vs 67.2±3.1%). PRA and YOH did not modify the effect of the drugs. %GR (mean±SE, n=8) indicated that iv, but not icv, PRO abolished the effect of Dp (PRO vs V=29.1±1.7 vs 46.9±2.7%) and At (30.5±1.7 vs 49±3.2%) and significantly reduced the effect of AA (48.4±2.6 vs 59.5±3.1%). These data suggest activation of peripheral β-adrenoceptors in the delayed GE induced by phenylpyrazolone derivatives.

  10. PENILE ENHANCEMENT PROCEDURES: UROLOGICAL AND ETHICOLEGAL ISSUES

    Directory of Open Access Journals (Sweden)

    Marco Vella

    2012-04-01

    Full Text Available Phalloplasty procedures for most men requiring penile augmentation surgery are cosmetic procedures; generally the patients have a normal-sized and fully functional penis but they think that their penis is too small. There are not well defined indications for penile enhancement surgery and, except for the treatment of “micropenis”, there are not established guidelines and the outcome measures for success are still unclear. All penile enhancement techniques often do not reach the expected result and the grade of patient’s satisfaction is frequently poor. Phalloplasty procedures for psychological dysmorfism are not approved by any scientific society and the majority of these procedures are performed in private settings. The ethical and medicolegal problems resulting from a penis enhancement can be various and numerous, but few of them are reported in literature. After phalloplasty an attribution of professional responsibility and request of reimbursement is not rare. In this contribution the authors summarize a panorama of several urological and medico-legal aspects related to phalloplasty procedures.

  11. Angiotensin-converting enzyme inhibitors delay the occurrence of renal involvement and are associated with a decreased risk of disease activity in patients with systemic lupus erythematosus--results from LUMINA (LIX): a multiethnic US cohort.

    Science.gov (United States)

    Durán-Barragán, S; McGwin, G; Vilá, L M; Reveille, J D; Alarcón, G S

    2008-07-01

    To examine if angiotensin-converting enzyme (ACE) inhibitor use delays the occurrence of renal involvement and decreases the risk of disease activity in SLE patients. SLE patients (Hispanics, African Americans and Caucasians) from the lupus in minorities: nature vs nurture (LUMINA) cohort were studied. Renal involvement was defined as ACR criterion and/or biopsy-proven lupus nephritis. Time-to-renal involvement was examined by univariable and multivariable Cox proportional hazards regression analyses. Disease activity was examined with a case-crossover design and a conditional logistic regression model; in the case intervals, a decrease in the SLAM-R score >or=4 points occurred but not in the control intervals. Eighty of 378 patients (21%) were ACE inhibitor users; 298 (79%) were not. The probability of renal involvement free-survival at 10 yrs was 88.1% for users and 75.4% for non-users (P = 0.0099, log rank test). Users developed persistent proteinuria and/or biopsy-proven lupus nephritis (7.1%) less frequently than non-users (22.9%), P = 0.016. By multivariable Cox proportional hazards regression analyses, ACE inhibitors use [hazard ratio (HR) 0.27; 95% CI 0.09, 0.78] was associated with a longer time-to-renal involvement occurrence whereas African American ethnicity (HR 3.31; 95% CI 1.44, 7.61) was with a shorter time. ACE inhibitor use (54/288 case and 254/1148 control intervals) was also associated with a decreased risk of disease activity (HR 0.56; 95% CI 0.34, 0.94). ACE inhibitor use delays the development of renal involvement and associates with a decreased risk of disease activity in SLE; corroboration of these findings in other lupus cohorts is desirable before practice recommendations are formulated.

  12. Infrequent Reservoir-Related Complications of Urologic Prosthetics: A Case Series and Literature Review.

    Science.gov (United States)

    Cui, Tao; Terlecki, Ryan; Mirzazadeh, Majid

    2015-12-01

    Complications related to inflatable penile prosthesis (IPP) and artificial urinary sphincter (AUS) reservoirs are rare, potentially life threatening, and poorly described in the literature. As more devices are implanted, the incidence of reservoir-related complications may increase, and it will be important to recognize the relevant signs and symptoms. We present a case series of reservoir-related complications presenting to our institution for treatment. We also reviewed all accounts of reservoir-related complications within the urologic literature. Three cases of reservoir-related complications are presented. Case 1 involves erosion of an intact AUS reservoir into the cecum of a patient with a history of myelomeningocele and bladder augmentation. Case 2 involves an IPP reservoir causing vascular compression, resulting in open exploration and repositioning of the reservoir. Case 3 involves intraperitoneal migration of a retained IPP reservoir to a subhepatic area, which was then removed laparoscopically. Literature review yielded descriptions of eight cases of intestinal complications, five cases of vascular complications, but zero reports of migration to a subhepatic area. Other notable complications include 20 reported cases of reservoir erosion into the bladder and inguinal herniation of the reservoir. 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.

  13. Progesterone attenuates hemorrhagic transformation after delayed tPA treatment in an experimental model of stroke in rats: involvement of the VEGF-MMP pathway.

    Science.gov (United States)

    Won, Soonmi; Lee, Jin Hwan; Wali, Bushra; Stein, Donald G; Sayeed, Iqbal

    2014-01-01

    Tissue plasminogen activator (tPA) is the only FDA-approved treatment for acute stroke, but its use remains limited. Progesterone (PROG) has shown neuroprotection in ischemia, but before clinical testing, we must determine how it affects hemorrhagic transformation in tPA-treated ischemic rats. Male Sprague-Dawley rats underwent middle cerebral artery occlusion with reperfusion at 4.5 hours and tPA treatment at 4.5 hours, or PROG treatment intraperitoneally at 2 hours followed by subcutaneous injection at 6 hours post occlusion. Rats were killed at 24 hours and brains evaluated for cerebral hemorrhage, swelling, blood-brain barrier (BBB) permeability, and levels of matrix metalloproteinase-9 (MMP-9), vascular endothelial growth factor level (VEGF), and tight junction (TJ) proteins. We also evaluated PROG's efficacy in preventing tPA-induced impairment of transendothelial electrical resistance (TEER) and TJ proteins under hypoxia/reoxygenation in the endothelial cells. Delayed tPA treatment induced significant hemorrhagic conversion and brain swelling. Treatment with PROG plus tPA ameliorated hemorrhage, hemispheric swelling, BBB permeability, MMP-9 induction, and VEGF levels compared with controls. Progesterone treatment significantly prevented tPA-induced decrease in TEER and expression of occludin and claudin-5, and attenuated VEGF levels in culture media subjected to hypoxia. The study concluded that PROG may extend the time window for tPA administration in ischemic stroke and reduce hemorrhagic conversion.

  14. 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.

  15. Implications of Biofilm Formation on Urological Devices

    Science.gov (United States)

    Cadieux, Peter A.; Wignall, Geoffrey R.; Carriveau, Rupp; Denstedt, John D.

    2008-09-01

    Despite millions of dollars and several decades of research targeted at their prevention and eradication, biofilm-associated infections remain the major cause of urological device failure. Numerous strategies have been aimed at improving device design, biomaterial composition, surface properties and drug delivery, but have been largely circumvented by microbes and their plethora of attachment, host evasion, antimicrobial resistance, and dissemination strategies. This is not entirely surprising since natural biofilm formation has been going on for millions of years and remains a major part of microorganism survival and evolution. Thus, the fact that biofilms develop on and in the biomaterials and tissues of humans is really an extension of this natural tendency and greatly explains why they are so difficult for us to combat. Firstly, biofilm structure and composition inherently provide a protective environment for microorganisms, shielding them from the shear stress of urine flow, immune cell attack and some antimicrobials. Secondly, many biofilm organisms enter a metabolically dormant state that renders them tolerant to those antibiotics and host factors able to penetrate the biofilm matrix. Lastly, the majority of organisms that cause biofilm-associated urinary tract infections originate from our own oral cavity, skin, gastrointestinal and urogenital tracts and therefore have already adapted to many of our host defenses. Ultimately, while biofilms continue to hold an advantage with respect to recurrent infections and biomaterial usage within the urinary tract, significant progress has been made in understanding these dynamic microbial communities and novel approaches offer promise for their prevention and eradication. These include novel device designs, antimicrobials, anti-adhesive coatings, biodegradable polymers and biofilm-disrupting compounds and therapies.

  16. Surgical navigation in urology: European perspective.

    Science.gov (United States)

    Rassweiler, Jens; Rassweiler, Marie-Claire; Müller, Michael; Kenngott, Hannes; Meinzer, Hans-Peter; Teber, Dogu

    2014-01-01

    Use of virtual reality to navigate open and endoscopic surgery has significantly evolved during the last decade. Current status of seven most interesting projects inside the European Association of Urology section of uro-technology is summarized with review of literature. Marker-based endoscopic tracking during laparoscopic radical prostatectomy using high-definition technology reduces positive margins. Marker-based endoscopic tracking during laparoscopic partial nephrectomy by mechanical overlay of three-dimensional-segmented virtual anatomy is helpful during planning of trocar placement and dissection of renal hilum. Marker-based, iPAD-assisted puncture of renal collecting system shows more benefit for trainees with reduction of radiation exposure. Three-dimensional laser-assisted puncture of renal collecting system using Uro-Dyna-CT realized in an ex-vivo model enables minimal radiation time. Electromagnetic tracking for puncture of renal collecting system using a sensor at the tip of ureteral catheter worked in an in-vivo model of porcine ureter and kidney. Attitude tracking for ultrasound-guided puncture of renal tumours by accelerometer reduces the puncture error from 4.7 to 1.8 mm. Feasibility of electromagnetic and optical tracking with the da Vinci telemanipulator was shown in vitro as well as using in-vivo model of oesophagectomy. Target registration error was 11.2 mm because of soft-tissue deformation. Intraoperative navigation is helpful during percutaneous puncture collecting system and biopsy of renal tumour using various tracking techniques. Early clinical studies demonstrate advantages of marker-based navigation during laparoscopic radical prostatectomy and partial nephrectomy. Combination of different tracking techniques may further improve this interesting addition to video-assisted surgery.

  17. Delayed Ejaculation

    Science.gov (United States)

    ... of stress Delayed ejaculation Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  18. Delayed Ejaculation

    Science.gov (United States)

    ... the penis Psychological causes of delayed ejaculation include: Depression, anxiety or other mental health conditions Relationship problems due to stress, poor communication or other concerns Anxiety about performance Poor body image Cultural or religious taboos Differences between the reality ...

  19. Concurrent Delay in Construction Disputes

    DEFF Research Database (Denmark)

    Cavaleri, Sylvie Cécile

    period of delay can potentially be attributed to several events falling within both parties' spheres of responsibility, commonly termed concurrent delay, is rarely regulated in construction contracts in spite of its common occurrence. This book analyses both the theoretical foundations and the practical......Delay is one of the issues most frequently encountered in today’s construction industry; it causes significant economic damage to all parties involved. Construction contracts, standard and bespoke, almost invariably consider delay from a perspective of single liability. If the event causing...... solutions to the issue of concurrent delay in a comparative perspective between common and civil law systems, with an emphasis on Danish and English law....

  20. Effect of treatment with cyclophosphamide in low doses upon the onset of delayed type hypersensitivity in mice chronically infected with Trypanosoma cruzi: involvement of heart interstitial dendritic cells.

    Science.gov (United States)

    Thé, Torriceli Souza; Portella, Renata Siqueira; Guerreiro, Marcos Lázaro; Andrade, Sonia Gumes

    2013-09-01

    Acute infection with Trypanosoma cruzi results in intense myocarditis, which progresses to a chronic, asymptomatic indeterminate form. The evolution toward this chronic cardiac form occurs in approximately 30% of all cases of T. cruzi infection. Suppression of delayed type hypersensitivity (DTH) has been proposed as a potential explanation of the indeterminate form. We investigated the effect of cyclophosphamide (CYCL) treatment on the regulatory mechanism of DTH and the participation of heart interstitial dendritic cells (IDCs) in this process using BALB/c mice chronically infected with T. cruzi. One group was treated with CYCL (20 mg/kg body weight) for one month. A DTH skin test was performed by intradermal injection of T. cruzi antigen (3 mg/mL) in the hind-footpad and measured the skin thickness after 24 h, 48 h and 72 h. The skin test revealed increased thickness in antigen-injected footpads, which was more evident in the mice treated with CYCL than in those mice that did not receive treatment. The thickened regions were characterised by perivascular infiltrates and areas of necrosis. Intense lesions of the myocardium were present in three/16 cases and included large areas of necrosis. Morphometric evaluation of lymphocytes showed a predominance of TCD8 cells. Heart IDCs were immunolabelled with specific antibodies (CD11b and CD11c) and T. cruzi antigens were detected using a specific anti-T. cruzi antibody. Identification of T. cruzi antigens, sequestered in these cells using specific anti-T. cruzi antibodies was done, showing a significant increase in the number of these cells in treated mice. These results indicate that IDCs participate in the regulatory mechanisms of DTH response to T. cruzi infection.

  1. Application of artificial intelligence to the management of urological cancer.

    Science.gov (United States)

    Abbod, Maysam F; Catto, James W F; Linkens, Derek A; Hamdy, Freddie C

    2007-10-01

    Artificial intelligence techniques, such as artificial neural networks, Bayesian belief networks and neuro-fuzzy modeling systems, are complex mathematical models based on the human neuronal structure and thinking. Such tools are capable of generating data driven models of biological systems without making assumptions based on statistical distributions. A large amount of study has been reported of the use of artificial intelligence in urology. We reviewed the basic concepts behind artificial intelligence techniques and explored the applications of this new dynamic technology in various aspects of urological cancer management. A detailed and systematic review of the literature was performed using the MEDLINE and Inspec databases to discover reports using artificial intelligence in urological cancer. The characteristics of machine learning and their implementation were described and reports of artificial intelligence use in urological cancer were reviewed. While most researchers in this field were found to focus on artificial neural networks to improve the diagnosis, staging and prognostic prediction of urological cancers, some groups are exploring other techniques, such as expert systems and neuro-fuzzy modeling systems. Compared to traditional regression statistics artificial intelligence methods appear to be accurate and more explorative for analyzing large data cohorts. Furthermore, they allow individualized prediction of disease behavior. Each artificial intelligence method has characteristics that make it suitable for different tasks. The lack of transparency of artificial neural networks hinders global scientific community acceptance of this method but this can be overcome by neuro-fuzzy modeling systems.

  2. 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.

  3. 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

  4. The role of human papilloma virus in urological malignancies.

    Science.gov (United States)

    Heidegger, Isabel; Borena, Wegene; Pichler, Renate

    2015-05-01

    Human papillomavirus (HPV) is associated with cancer of the cervix uteri, penis, vulva, vagina, anus and oropharynx. However, the role of HPV infection in urological tumors is not yet clarified. HPV appears not to play a major causative role in renal and testicular carcinogenesis. However, HPV infection should be kept in mind regarding cases of prostate cancer, as well as in a sub-group of patients with bladder cancer with squamous differentiation. Concerning the role of HPV in penile cancer incidence, it is a recognized risk factor proven in a large number of studies. This short review provides an update regarding recent literature on HPV in urological malignancies, thereby, also discussing possible limitations on HPV detection in urological cancer. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  5. '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...... 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......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...

  6. 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.

  7. Urological Emergency Admissions to a Community Hospital: A Review

    Science.gov (United States)

    Atkins, Sam O.

    1983-01-01

    A one-year study was conducted on the impact of emergency admissions to the 125-bed Southwest Community Hospital in Atlanta, Georgia. During the study in 1979, 70 urological emergency room admissions were made, of which 44 (62.8 percent) were males and 26 (37.2 percent) were females. In comparison, 93 admissions were made directly from the private office. The study considered the timeliness of diagnosis and treatment, surgical procedures performed, impact on urological emergency room nursing and medical personnel, physician response to notification, cost containment, and implied legal ramifications and organization structure. Thus, an immediate close scrutiny of urological emergency admission at the nonuniversity affiliated Southwest Community Hospital was permitted. PMID:6876189

  8. 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.

  9. 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.

  10. 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

  11. Identifying content for simulation-based curricula in urology: a national needs assessment.

    Science.gov (United States)

    Nayahangan, Leizl Joy; Bølling Hansen, Rikke; Gilboe Lindorff-Larsen, Karen; Paltved, Charlotte; Nielsen, Bjørn Ulrik; Konge, Lars

    2017-12-01

    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 to identify technical procedures in urology that should be included in a simulation-based curriculum for residency training. A national needs assessment was performed using the Delphi method involving 56 experts with significant roles in the education of urologists. Round 1 identified technical procedures that newly qualified urologists should perform. Round 2 included a survey using an established needs assessment formula to explore: the frequency of procedures; the number of physicians who should be able to perform the procedure; the risk and/or discomfort to patients when a procedure is performed by an inexperienced physician; and the feasibility of simulation training. Round 3 involved elimination and reranking of procedures according to priority. The response rates for the three Delphi rounds were 70%, 55% and 67%, respectively. The 34 procedures identified in Round 1 were reduced to a final prioritized list of 18 technical procedures for simulation-based training. The five procedures that reached the highest prioritization were cystoscopy, transrectal ultrasound-guided biopsy of the prostate, placement of ureteral stent, insertion of urethral and suprapubic catheter, and transurethral resection of the bladder. The prioritized list of technical procedures in urology that were identified as highly suitable for simulation can be used as an aid in the planning and development of simulation-based training programs.

  12. Genitourinary Prosthetics: A Primer for the Non-urologic Surgeon.

    Science.gov (United States)

    Lavien, Garjae; Zaid, Uwais; Peterson, Andrew C

    2016-06-01

    Genitourinary prosthetics are used for correction of functional deficits and to improve the quality of lives of affected patients. General surgeons must evaluate patients scheduled for nonurologic surgery with urologic devices that can impact their perioperative management. Lack of recognition of these prosthetics preoperatively can lead to unnecessary morbidity for the patient and have legal implications for the surgeon. Close consultation with a urologist may avoid common complications associated with these devices and allows for surgical assistance when operative misadventures do occur. This article reviews 3 common urologic prosthetics: testicular prosthesis, artificial urinary sphincter, and penile prosthesis. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Past, present and future of urological robotic surgery.

    Science.gov (United States)

    Jeong, Wooju; Kumar, Ramesh; Menon, Mani

    2016-03-01

    The first urologic robotic program in the world was built at the Vattikuti Urology Institute, Henry Ford Hospital Detroit, Michigan, in 2000 under the vision of surgical innovator, Dr. Mani Menon for the radical prostatectomy. The robot-assisted radical prostatectomy continues being modified with techniques to improve perioperative and surgical outcomes. The application of robotic surgical technique has since been expanded to the bladder and upper urinary tract surgery. The evolution of surgical technique and its expansion of application will continue to improve quality, outcome parameters and experience for the patients.

  14. Past, present and future of urological robotic surgery

    Directory of Open Access Journals (Sweden)

    Wooju Jeong

    2016-03-01

    Full Text Available The first urologic robotic program in the world was built at the Vattikuti Urology Institute, Henry Ford Hospital Detroit, Michigan, in 2000 under the vision of surgical innovator, Dr. Mani Menon for the radical prostatectomy. The robot-assisted radical prostatectomy continues being modified with techniques to improve perioperative and surgical outcomes. The application of robotic surgical technique has since been expanded to the bladder and upper urinary tract surgery. The evolution of surgical technique and its expansion of application will continue to improve quality, outcome parameters and experience for the patients.

  15. Modelling delays in pharmacokinetics

    International Nuclear Information System (INIS)

    Farooqi, Z.H.; Lambrecht, R.M.

    1990-01-01

    Linear system analysis has come to form the backbone of pharmacokinetics. Natural systems usually involve time delays, thus models incorporating them would be an order closer approximation to the real world compared to those that do not. Delays may be modelled in several ways. The approach considered in this study is to have a discrete-time delay dependent rate with the delay respresenting the duration between the entry of a drug into a compartment and its release in some form (may be as a metabolite) from the compartment. Such a delay may be because of one or more of several physiological reasons, like, formation of a reservoir, slow metabolism, or receptor binding. The mathematical structure this gives rise to is a system of delay-differential equations. Examples are given of simple one and two compartment systems with drugs like bumetanide, carbamazepine, and quinolone-caffeine interaction. In these examples generally a good fit is obtained and the suggested models form a good approximation. 21 refs., 6 figs

  16. CanMEDS scholars: A national survey on urology residents' attitudes towards research during training.

    Science.gov (United States)

    Solaja, Ogi; Skinner, Thomas A A; Mcgregor, Thomas B; Siemens, D Robert

    2017-12-22

    Participation in scholarly activity is an important tenet of residency training and is firmly entrenched in Canada since the introduction of CANMEDS roles by the Royal College of Physicians and Surgeons. As Canadian residency programs transition to competency-based training, it will remain important to understand how to best implement and encourage scholarly pursuits among resident trainees. The objective of this study was to understand the experiences, attitudes, and barriers that surgical residents face when pursuing research during their training. An anonymous, cross-sectional, self-report questionnaire was administered to chief residents of all English-speaking urology programs in Canada in 2015. Questions were open- and closed-ended, including an agreement score based on a five-point Likert scale. Questions addressed residents' involvement in and attitudes towards research, as well as their perceptions of the utility of research involvement during training. The residents were also asked about the support they received and potential areas to improve the attainment of this competency. Descriptive and correlative statistics were used to analyze the responses. There was a 100% overall response rate to the questionnaire. This study revealed that Canadian urology residents have a high rate of participation in scholarly work, with the vast majority (94%) publishing at least one manuscript with a mean of four papers. Despite this, there appeared to be significant variation in the respondent's experiences, including protected time for research. Furthermore, many residents appeared unconvinced of the importance of research involvement, with only 51% agreement that participation was important to their overall training. As well, a significant number of residents reported largely external, rather than internal, motivations for research participation, such as attaining a preferred fellowship (66% agreement). While the majority of respondents felt (66% agreement) that the

  17. High acceptability of a newly developed urological practical skills training program.

    NARCIS (Netherlands)

    Vries, A.H. de; Luijk, S.J. van; Scherpbier, A.J.J.A.; Hendrikx, A.J.M.; Koldewijn, E.L.; Wagner, C.; Schout, B.M.A.

    2015-01-01

    Background: Benefits of simulation training are widely recognized, but its structural implementation into urological curricula remains challenging. This study aims to gain insight into current and ideal urological practical skills training and presents the outline of a newly developed skills

  18. High acceptability of a newly developed urological practical skills training program

    NARCIS (Netherlands)

    de Vries, A.H.; van Luijk, S.J.; Scherpbier, A.J.J.A.; Hendrikx, A.J.M.; Koldewijn, E.L.; Wagner, C.; Schout, B.M.A.

    2015-01-01

    Background: Benefits of simulation training are widely recognized, but its structural implementation into urological curricula remains challenging. This study aims to gain insight into current and ideal urological practical skills training and presents the outline of a newly developed skills

  19. 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.

  20. [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.

  1. 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 ...

  2. 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.

  3. Radiographer Delivered Fluoroscopy Reduces Radiation Exposure During Endoscopic Urological Procedures.

    Science.gov (United States)

    Martin, J; Hennessey, D B; Young, M; Pahuja, A

    2016-01-01

    The 1999 Ionising Radiation Regulations recommend that medical professionals using ionising radiation should aim to keep exposure as 'low as reasonably practicable'. Urologists regularly use fluoroscopy during endoscopic surgical procedures. In some institutions, this is delivered by a radiographer whereas in others, it is delivered by the urological surgeon. To determine if radiographer-delivered fluoroscopy can reduce the exposure to ionising radiation during urological procedures. An analysis of 395 consecutive patients, who underwent endoscopic urological procedures requiring fluoroscopy, was performed simultaneously across two institutions, over a 4 month period. 321 patients were matched and included in the analysis. Radiographer delivered fluoroscopy was associated with reduced ionising radiation exposure for retrograde pyelography procedures ED 0.09626 vs. 1.323 mSev, p= 0.0003, and endoscopic stone surgeries ED 0.3066 Vs. 0.5416 mSev, p=0.0039, but not for ureterorenoscopic stone surgeries 0.4880 vs. 0.2213 mSev, p=0.8292. Radiographer delivered fluoroscopy could reduce the patient's exposure to ionising radiation for some urological procedures.

  4. Urological complications after living-donor renal transplantation.

    Science.gov (United States)

    El-Mekresh, M; Osman, Y; Ali-El-Dein, B; El-Diasty, T; Ghoneim, M A

    2001-03-01

    To determine the incidence and management of urological complications after 1200 consecutive live-donor renal transplantations, all of which were carried out in one centre; the possible risk factors and the effect on patient and graft survival were also assessed. Data were retrieved from an electronic database; the incidence of urological complications was determined, and correlated with relevant risk factors by univariate and multivariate analysis. The effect on patient and graft survival was assessed using Kaplan-Meier statistics. There were 100 complications in 96 patients (8%); urinary leaks occurred in 37, ureteric strictures in 23 and lymphoceles causing ureteric obstruction in 17. Percutaneous needle biopsy was complicated by haematuria and clot anuria in six patients. Late complications included 11 cases of stones, four of bladder malignancy and two of haemorrhagic cystitis. There was evidence that the age of the recipients (effect on the incidence of urological complications. However, their development did not influence graft or patient survival. When there is meticulous attention to the technical details, renal transplantation should incur few urological complications. Early intervention with percutaneous drainage reduces morbidity and the likelihood loss of graft function. Proper and prompt management should not affect the graft and/or the patient's survival.

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

    African Journals Online (AJOL)

    African Journal of Urology. Journal Home · ABOUT THIS JOURNAL · 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 ...

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

    African Journals Online (AJOL)

    The parameters studied were the histological type of the cancer, patient age and trends over a 15-year period. 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 ...

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

    African Journals Online (AJOL)

    Abuja is Nigeria's capital with a population of about 4 million residents. There are a total of fourteen public general and specialist hospitals with 6 consultant Urologists working in only three of these hospital serving the population. It is not known what proportion of the total surgical workload in Abuja is urological. Objective: ...

  8. 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 ...

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

    African Journals Online (AJOL)

    A peek into the outpatient services would, therefore, give an insight into the common medical problems in a given discipline. (1). This study has similar demographic features to one done on inpatients in the same institution two years earlier and confirms the generally accepted knowledge that urology is a specialty dealing.

  10. 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.

  11. 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.

  12. Tumor banks: the cornerstone of basic research in urology

    Directory of Open Access Journals (Sweden)

    Sabrina T. Reis

    2010-06-01

    Full Text Available PURPOSE: Tumor banks have the primary responsibility for collecting, cataloging, storing and disseminating samples of tissues, cells and fluids, which are used by researchers to identify diagnostic molecular markers, prognostic indicators and therapeutic targets. The objective of this review was to describe a simple, reliable and reproducible protocol for obtaining and storing samples of urological tumors. MATERIALS AND METHODS: Urogenital tumor tissues were collected by the surgeons from the Urology Division of University of Sao Paulo Medical School. The obtained surgical specimens were immediately placed in liquid nitrogen, dry ice or in a tube containing RNAlater ®, and then stored by cryopreservation (-80°C. A mirror fragment was fixed in 10% formalin processed routinely and embedded in Paraplast®. RESULTS: We developed a protocol for the collection, cataloging, storage, conservation and use of tumor samples. During a period of one year the Urological Tumor Bank of the Urology Division stored 274 samples of prostate, bladder, kidney, penis and testicle tumors of different histological types, 74 urine and 271 serum samples. CONCLUSIONS: Having biological materials characterized and available along with the clinical patient information provides an integrated portrait of the patients and their diseases facilitating advances in molecular biology. It also promotes the development of translational research improving methods of diagnosis and cancer treatment.

  13. Common Pediatric Urological Disorders: Clinical and radiological evaluation

    OpenAIRE

    Robson, Wm. Lane M.; Leung, Alexander K.C.; Boag, Graham S.

    1991-01-01

    The clinical and radiological presentations of 12 pediatric urological disorders are described. The described disorders include pyelonephritis, vesicoureteral reflux, ureteropelvic obstruction, ureterovesical obstruction, ectopic ureterocele, posterior urethral valves, multicystic dysplastic kidney, polycystic kidney disease, ectopic kidney, staghorn calculi, urethral diverticulum, and urethral meatal stenosis.

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

    African Journals Online (AJOL)

    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. Prostate cancer accounted for 44.1%, urinary bladder 31.7%, kidney 17.3%, testis 5.8% and penis ...

  15. Adverse events and readmissions after day-case urological surgery

    Directory of Open Access Journals (Sweden)

    Alvaro Paez

    2007-06-01

    Full Text Available OBJECTIVE: The literature lacks of studies on postoperative outcomes after urological ambulatory surgery. Our study aims to identify parameters associated with postoperative complications within 30 days after ambulatory urological surgery. MATERIALS AND METHODS: Adjusted and unadjusted comparisons between clinical features and postoperative outcome (complicated and uncomplicated. RESULTS: Postoperative course was complicated in 5% of the patients. Discharge schedule was not completed in 1.1% while unplanned visits resulted in admission in 0.5%. Multivariate analyses could only confirm the independent effect of type of anesthesia and diagnosis-related group (DRG relative weight. CONCLUSIONS: Ambulatory urological surgery can be safe in terms of postoperative complications. In the present study surgery under general anesthesia, or a higher DRG relative weight procedure, increased the risk of complications compared to surgery under regional or local anesthesia or lower DRG relative weight operations. Patients scheduled for general anesthesia or undergoing complex urological procedures should be warned about an increased risk of postoperative incidents and/or readmission.

  16. Implications of miscoding urological procedures in an era of financial austerity - 'Every Penny Counts'.

    Science.gov (United States)

    Cheema, Zubair A; Khwaja, Sikandar A

    2015-06-01

    The study aimed to find out any inaccuracy in coding of elective urology procedures and associated financial implications. Retrospective audit and re-audit. Introduction of payment by results was introduced in the NHS in England in 2002. This meant that hospitals are paid on individual patient basis according to their human resource group (HRG) rather than a block contract. Current coding system uses office of population census and surveys classification. These along with other variables determine the final human resource group code defining final payment. None. Retrospective analysis of coding for all inpatient urological procedures was performed over a period of two months. All documented Office of Population Census and Surveys codes were recorded and reviewed by urology trainee along with the head of professional coders. As a result of first analysis the deficiencies were identified and revised Office of Population Census and Surveys codes were used to generate the final human resource group codes. After six months a re-audit was done. In the initial study, 121 cases were reviewed. Twenty per cent of these cases were miscoded. The revised Office of Population Census and Surveys codes led to change of final human resource group code and hence recovery of a payment of £10,716. Analysis after six months showed a considerable improvement with incorrect coding reduced to 11%. Our findings highlight potential discrepancies in coding which can lead to significant financial loss. It is important that surgeons involve and train the coding department so that coding errors can be avoided. This will put us in better position to deal with Nicolson Challenge.

  17. Path of translational discovery of urological complications of obesity and diabetes.

    Science.gov (United States)

    Daneshgari, Firouz; Liu, Guiming; Hanna-Mitchell, Ann T

    2017-05-01

    Diabetes mellitus (DM) is a prevalent chronic disease. Type 1 DM (T1DM) is a metabolic disorder that is characterized by hyperglycemia in the context of absolute lack of insulin, whereas type 2 DM (T2DM) is due to insulin resistance-related relative insulin deficiency. In comparison with T1DM, T2DM is more complex. The natural history of T2DM in most patients typically involves a course of obesity to impaired glucose tolerance, to insulin resistance, to hyperinsulinemia, to hyperglycemia, and finally to insulin deficiency. Obesity is a risk factor of T2DM. Diabetes causes some serious microvascular and macrovascular complications, such as retinopathy, nephropathy, neuropathy, angiopathy and stroke. Urological complications of obesity and diabetes (UCOD) affect quality of life, but are not well investigated. The urological complications in T1DM and T2DM are different. In addition, obesity itself affects the lower urinary tract. The aim of this perspective is to review the available data, combined with the experience of our research teams, who have spent a good part of last decade on studies of association between DM and lower urinary tract symptoms (LUTS) with the aim of bringing more focus to the future scientific exploration of UCOD. We focus on the most commonly seen urological complications, urinary incontinence, bladder dysfunction, and LUTS, in obesity and diabetes. Knowledge of these associations will lead to a better understanding of the pathophysiology underlying UCOD and hopefully assist urologists in the clinical management of obese or diabetic patients with LUTS. Copyright © 2017 the American Physiological Society.

  18. 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.

  19. Gender differences in promotions and scholarly productivity in academic urology.

    Science.gov (United States)

    Awad, Mohannad A; Gaither, Thomas W; Osterberg, E Charles; Yang, Glen; Greene, Kirsten L; Weiss, Dana A; Anger, Jennifer T; Breyer, Benjamin N

    2017-10-01

    The gender demographics within urology are changing as more women are entering the workforce. Since research productivity strongly influence career advancement, we aim to characterize gender differences in scholarly productivity and promotions in a cohort of graduated academic urologists. Urologists who graduated between 2002 and 2008 from 34 residency programs affiliated with the top 50 urology hospitals as ranked in 2009 by U.S. News & World Report were followed longitudinally. Only urologists affiliated with an academic teaching hospital were included for analysis. A total of 543 residents graduated, 459 (84.5%) males and 84 (15.5%) females. Of these, 173 entered academia, 137 (79.2%) males and 36 (20.8%) females. Women had fewer publications compared to men (mean 19.3 versus 61.7, p = 0.001). Fewer women compared to men were promoted from assistant professor 11 (30.6%) versus 83 (60.6%), p = 0.005. Fewer women achieved associate professor 10 (27.8%) versus 67 (48.9%), p = 0.005 or professor ranks 1 (2.8%) versus 16 (11.7%), p = 0.005 respectively compared to men. In a multivariate logistic regression analysis, after controlling for the number of total publications and number of years since graduation, gender was not predictive of achieving promotion, OR = 0.81 (95% CI 0.31-2.13), p = 0.673. Women are underrepresented in senior faculty roles in urology. Scholarly productivity seems to play a major role in academic promotion within urology. With increasing women in academic urology, further studies are needed to explore predictors of promotion and how women can achieve higher leadership roles in the field.

  20. Human papillomaviruses in urological malignancies: a critical assessment.

    Science.gov (United States)

    Tolstov, Yanis; Hadaschik, Boris; Pahernik, Sascha; Hohenfellner, Markus; Duensing, Stefan

    2014-01-01

    Infection with human papillomaviruses (HPVs) is intimately associated with anogenital tract malignancies including cervical and vulvar cancer, a subset of oropharyngeal cancers and certain types of skin cancer. A number of urological tumors have likewise been suggested to be associated with high-risk HPV infection; however, many studies are hampered by a limited number of detection methods. The goal of this review article is to define a set of key criteria when implicating a virus in a human cancer and to apply these criteria to HPV infection in urological cancers. We performed a survey of the literature to corroborate the evidence to support a causal relationship between HPV infection and major urological malignancies. A number of previous reports have implicated HPVs in urological malignancies including penile, prostate, and bladder cancer. Most reports, however, rely only on a limited number of detection methods and frequently use contamination-prone polymerase chain reaction based methods. To firmly establish a link between a viral infection and a human malignancy, it is paramount that an array of techniques is employed and that the virus is ultimately traced by either direct visualization or, in the case of viral genome that has integrated into the host genome, detection of viral genes and gene products as well as functional cellular perturbations. In any case, seroepidemiological studies are likewise crucial to support the evidence. Such evidence for a role of HPV in urological malignancies based on currently available techniques is only present for penile squamous cell carcinomas. An increasing number of immunocompromised patients as well as novel developments in patient care may change the spectrum of HPV-associated neoplasms. This is examplified by results demonstrating a role of HPVs in rare urothelial carcinomas with squamous differentiation in patients with neurogenic bladder. Hence, it is important to keep HPV infection in mind when confronted with

  1. Urological disorders in chronic kidney disease in children cohort: clinical characteristics and estimation of glomerular filtration rate.

    Science.gov (United States)

    Dodson, Jennifer L; Jerry-Fluker, Judith V; Ng, Derek K; Moxey-Mims, Marva; Schwartz, George J; Dharnidharka, Vikas R; Warady, Bradley A; Furth, Susan L

    2011-10-01

    Urological disorders are the most common cause of pediatric chronic kidney disease. We determined the characteristics of children with urological disorders and assessed the agreement between the newly developed bedside glomerular filtration rate estimating formula with measured glomerular filtration rate in 586 patients in the Chronic Kidney Disease in Children study. The Chronic Kidney Disease in Children study is a prospective, observational cohort of children recruited from 48 sites in the United States and Canada. Eligibility requirements include age 1 to 16 years and estimated glomerular filtration rate by original Schwartz formula 30 to 90 ml/min/1.73 m(2). Baseline demographics, clinical variables and glomerular filtration rate were assessed. Bland-Altman analysis was conducted to assess agreement between estimated and measured glomerular filtration rates. Of the 586 participants with at least 1 glomerular filtration rate measurement 348 (59%) had an underlying urological diagnosis (obstructive uropathy in 118, aplastic/hypoplastic/dysplastic kidneys in 104, reflux in 87 and other condition in 39). Among these patients median age was 9 years, duration of chronic kidney disease was 7 years and age at first visit with a urologist was less than 1 year. Of the patients 67% were male, 67% were white and 21% had a low birth weight. Median height was in the 24th percentile. Median glomerular filtration rate as measured by iohexol plasma disappearance was 44.8 ml/min/1.73 m(2). Median glomerular filtration rate as estimated by the Chronic Kidney Disease in Children bedside equation was 44.3 ml/min/1.73 m(2) (bias = -0.5, 95% CI -1.7 to 0.7, p = 0.44). Underlying urological causes of chronic kidney disease were present in 59% of study participants. These children were diagnosed early in life, and many had low birth weight and growth delay. There is good agreement between the newly developed Chronic Kidney Disease in Children estimating equations and measured

  2. Potential applications of low-energy shock waves in functional urology.

    Science.gov (United States)

    Wang, Hung-Jen; Cheng, Jai-Hong; Chuang, Yao-Chi

    2017-08-01

    A shock wave, which carries energy and can propagate through a medium, is a type of continuous transmitted sonic wave with a frequency of 16 Hz-20 MHz. It is accompanied by processes involving rapid energy transformations. The energy associated with shock waves has been harnessed and used for various applications in medical science. High-energy extracorporeal shock wave therapy is the most successful application of shock waves, and has been used to disintegrate urolithiasis for 30 years. At lower energy levels, however, shock waves have enhanced expression of vascular endothelial growth factor, endothelial nitric oxide synthase, proliferating cell nuclear antigen, chemoattractant factors and recruitment of progenitor cells; shock waves have also improved tissue regeneration. Low-energy shock wave therapy has been used clinically with musculoskeletal disorders, ischemic cardiovascular disorders and erectile dysfunction, through the mechanisms of neovascularization, anti-inflammation and tissue regeneration. Furthermore, low-energy shock waves have been proposed to temporarily increase tissue permeability and facilitate intravesical drug delivery. The present review article provides information on the basics of shock wave physics, mechanisms of action on the biological system and potential applications in functional urology. © 2017 The Japanese Urological Association.

  3. Fifth joint meeting of the American Urological Association and the Japanese Urological Association International Affiliate Society Meeting at the 105th Annual Meeting of the American Urological Association.

    Science.gov (United States)

    Myers, Robert P; Seki, Narihito; Gotoh, Momokazu; Chai, Toby C; Kaplan, Steven A; Inoue, Keiji; Trachtenberg, John; Kikuchi, Eiji; Nishiyama, Hiroyuki; Chang, Sam S; Lee, Cheryl; Muto, Satoru; Ito, Kazuto; Andriole, Gerald L; Eto, Masatoshi; Sumitomo, Makoto; Kamba, Tomomi; Wood, Chrsitopher G; Margulis, Vitaly; Naito, Seiji; Egawa, Shin

    2010-08-01

    We are heartily grateful for the warm support of all of the people concerned, including the moderators and panelists of both societies for giving us the opportunity to hold the 5(th) American Urological Association/Japanese Urological Association (AUA/JUA) International Affiliate Society Meeting, held once again at the 105th Annual Meeting of the American Urological Association (29 May-3 June 2010, San Francisco, California, USA). The year of 2010 is a memorable one, being the start of reciprocal collaborations between the AUA and the JUA. The JUA, in collaboration with the AUA, is promoting an academic exchange program whereby outstanding and promising Japanese and American junior faculty members will be given the opportunity to work in the USA and Japan for 1 month. The program not only allows the sharing of knowledge and experience, but also is designed to foster a closer alliance between the AUA and JUA, and assists in identifying future leaders within both organizations. The AUA and JUA will have an exhibit booth at each other's annual meeting, promoting our new joint activities. Both the JUA and AUA will organize educational courses in Hawaii in 2011. With all of these activities, the JUA hopes it will provide greater opportunities for young Japanese urologists to participate in educational projects in the USA. We would like to thank Professor Anton J. Bueschen, President of AUA, Professor Robert C Flanigan, Secretary General of AUA and the staff of the AUA and JUA for supporting our program. At the same time, we need the support of all the members and their valuable suggestions. We look forward to further participation of AUA members to this meeting. Seiji Naito md, President of JUA Shin Egawa md, Chairman of the International Committee of JUA.

  4. METHODICAL BASES OF ESTIMATION GLOMERULAR FILTRATION RATE IN UROLOGICAL PRACTICE

    Directory of Open Access Journals (Sweden)

    M. M. Batiushin

    2017-01-01

    Full Text Available The article presents a review of methodological issues of estimation of glomerular filtration rate in urologic practice. Author examine the current international and national recommendations, in particular by KDIGO, the recommendations of the scientific society of nephrologists of Russia, Association of urologists of Russia, the results of comparative analysis of different methods of assessing glomerular filtration rate. It is shown that the currently calculated methods of assessment of glomerular filtration rate have advantages over technique of clearance. The advantages and disadvantages of methods for calculating glomerular filtration rate by the formula of Cockcroft-Gault and MDRD. The author lists the pathological conditions in urological practice, in which there is a need to assess glomerular filtration rate, given nomograms and links to online calculators for quick and easy calculation of glomerular filtration rate.

  5. Urologic robotic surgery in Korea: past and present.

    Science.gov (United States)

    Seo, Ill Young

    2015-08-01

    Since 2005 when the da Vinci surgical system was approved as a medical device by the Korean Ministry of Health and Welfare, 51 systems have been installed in 40 institutions as of May 2015. Although robotic surgery is not covered by the national health insurance service in Korea, it has been used in several urologic fields as a less invasive surgery. Since the first robotic-assisted laparoscopic radical prostatectomy in 2005, partial nephrectomy, radical cystectomy, pyeloplasty, and other urologic surgeries have been performed. The following should be considered to extend the indications for robotic surgery: training systems including accreditation, operative outcomes from follow-up results, and cost-effectiveness. In this review, the history and current status of robotic surgeries in Korea are presented.

  6. 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.

  7. Reprocessing and reuse of urological armamentarium: How correct are we!

    Directory of Open Access Journals (Sweden)

    Krutik Vipulbhai Raval

    2017-01-01

    Full Text Available Healthcare is expensive for a large proportion of the population in spite of high per capita income and good health insurance penetration. In an effort to reduce cost of the procedure, reprocessing of devices was started in the late 1970s. Reprocessing practice includes various measures such as proper cleaning, disinfection, and sterilization procedures. As reprocessing is aimed at reducing cost, there is a potential risk of compromising patient safety due to cross contamination after inadequate sterilization. There is also risk of performance alteration of urological reprocessed devices during sterilization/disinfection processing. Therefore, there is a need for formulating proper guidelines to decide methods of reprocessing for various urological equipment. There is also need to discuss the problematic areas that urologists face and to find their solutions. A PubMed search was made in September 2016, using key words “reprocessing of medical devices,” “Single Use Devices,” “methods of reprocessing of devices in clinical practice,” “use of formalin chamber,” “urological disposable sterilization,” etc., After excluding duplicates, all English articles were reviewed by title and abstract. Full texts of selected articles were obtained, and these articles were cross-referenced to find any other related articles. All the articles were reviewed. A product can be reused if it can be economically reprocessed with validated protocols with preservation of its function. There is no reason to discard it after one use. This practice is useful for controlling economics of a urological case and to reduce the financial burden. Current Food and Drug Administration guidelines are stringent. The contamination described to test the sterilization process in the suggested guidelines actually does never exist in clinical practice. Therefore, new guidelines considering the clinical practice scenario are desirable.

  8. Errors and risks of urological X-ray diagnostics

    International Nuclear Information System (INIS)

    Blech, M.; Truss, F.

    1987-01-01

    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. (orig.) [de

  9. Reprocessing and reuse of urological armamentarium: How correct are we!

    Science.gov (United States)

    Raval, Krutik Vipulbhai; Chaudhari, Rajeev; Khant, Shahil Rameshbhai; Joglekar, Omkar; Patel, Dipen

    2017-01-01

    Healthcare is expensive for a large proportion of the population in spite of high per capita income and good health insurance penetration. In an effort to reduce cost of the procedure, reprocessing of devices was started in the late 1970s. Reprocessing practice includes various measures such as proper cleaning, disinfection, and sterilization procedures. As reprocessing is aimed at reducing cost, there is a potential risk of compromising patient safety due to cross contamination after inadequate sterilization. There is also risk of performance alteration of urological reprocessed devices during sterilization/disinfection processing. Therefore, there is a need for formulating proper guidelines to decide methods of reprocessing for various urological equipment. There is also need to discuss the problematic areas that urologists face and to find their solutions. A PubMed search was made in September 2016, using key words "reprocessing of medical devices," "Single Use Devices," "methods of reprocessing of devices in clinical practice," "use of formalin chamber," "urological disposable sterilization," etc., After excluding duplicates, all English articles were reviewed by title and abstract. Full texts of selected articles were obtained, and these articles were cross-referenced to find any other related articles. All the articles were reviewed. A product can be reused if it can be economically reprocessed with validated protocols with preservation of its function. There is no reason to discard it after one use. This practice is useful for controlling economics of a urological case and to reduce the financial burden. Current Food and Drug Administration guidelines are stringent. The contamination described to test the sterilization process in the suggested guidelines actually does never exist in clinical practice. Therefore, new guidelines considering the clinical practice scenario are desirable.

  10. Surgical site infection rates following laparoscopic urological procedures.

    Science.gov (United States)

    George, Arvin K; Srinivasan, Arun K; Cho, Jane; Sadek, Mostafa A; Kavoussi, Louis R

    2011-04-01

    Surgical site infections have been categorized by the Centers for Medicare and Medicaid Services as "never events". The incidence of surgical site infection following laparoscopic urological surgery and its risk factors are poorly defined. We evaluated surgical site infection following urological laparoscopic surgery and identified possible factors that may influence occurrence. Patients who underwent transperitoneal laparoscopic procedures during a 4-year period by a single laparoscopic surgeon were retrospectively reviewed. Surgical site infections were identified postoperatively and defined using the Centers for Disease Control criteria. Clinical parameters, comorbidities, smoking history, preoperative urinalysis and culture results as well as operative data were analyzed. Nonparametric testing using the Mann-Whitney U test, multivariable logistic regression and Spearman's rank correlation coefficient were used for data analysis. In 556 patients undergoing urological laparoscopic procedures 14 surgical site infections (2.5%) were identified at mean postoperative day 21.5. Of the 14 surgical site infections 10 (71.4%) were located at a specimen extraction site. Operative time, procedure type and increasing body mass index were significantly associated with the occurrence of surgical site infections (p = 0.007, p = 0.019, p = 0.038, respectively), whereas history of diabetes mellitus (p = 0.071) and intraoperative transfusion (p = 0.053) were found to trend toward significance. Age, gender, positive urine culture, steroid use, procedure type and smoking history were not significantly associated with surgical site infection. Body mass index and operative time remained significant predictors of surgical site infection on multivariate logistic regression analysis. Surgical site infection is an infrequent complication following laparoscopic surgery with the majority occurring at the specimen extraction site. Infection is associated with prolonged operative time and

  11. 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.

  12. Implementing Assessments of Robotic-Assisted Technical Skill in Urologic Education: A Systematic Review and Synthesis of the Validity Evidence.

    Science.gov (United States)

    Goldenberg, Mitchell G; Lee, Jason Y; Kwong, Jethro Cc; Grantcharov, Teodor P; Costello, Anthony

    2018-03-31

    To systematically review and synthesize the validity evidence supporting intraoperative and simulation-based assessments of technical skill in urologic robotic-assisted surgery (RAS), and make evidence-based recommendations for the implementation of these assessments in urologic training. A literature search of the MEDLINE, PsycINFO and Embase databases was performed. Articles using technical skill and simulation-based assessments in RAS were abstracted. Only studies involving urology trainees or faculty were included in the final analysis. Multiple tools for the assessment of technical robotic skill have been published, with mixed sources of validity evidence to support their use. These evaluations have been used in both the ex vivo and in vivo settings. Performance evaluations range from global rating scales to psychometrics, and assessments are carried out through automation, expert analysts, and crowdsourcing. There have been rapid expansions in approaches to robotic technical skills assessment, both in simulated and clinical settings. Alternative approaches to assessment in RAS such as crowdsourcing and psychometrics remain under investigation. Evidence to support the use of these metrics in high-stakes decisions is likely insufficient at present. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  13. Delayed ejaculation

    Science.gov (United States)

    ... right stimulation. Therapy often involves a series of "homework" assignments. In the privacy of your home, you ... must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get ...

  14. [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.

  15. Static dosimetry space image in which urology diagnostics are performed

    International Nuclear Information System (INIS)

    Banduka, M.S.; Vasic, D.D.

    2002-01-01

    Background. The effects of the dispersed radiation described theoretically imply complex picture of interaction of the photon beam with the patient's body, as well as its dispersion on other structures. Basic theoretical laws of this phenomenon are highlighted, thus giving the opportunity to model the effect in total. Material and methods. The measurements of the absorbed dose in the air give isodose curves that show distribution of the radiation dose. For the urological procedures standard urological diagnostic methods were being used. Results. Through a large series of measuring, we got the distribution of the radiation dose in space, where urology diagnostics is being made using the X-ray. The parameters determining this picture are the most frequent ones in the total number of 20 random cases taken in General Hospital in Doboj, Bosnia and Herzegovina. Conclusions. Static dosimetric picture of the space (radiation zone) in the general sense is useful before all for organisation of the diagnostic procedures utilising ionised radiation. Obtained in any way, this picture enables an insight into the three-dimensional distribution of the dosage on the basis of which it is possible to correct the organisation of the diagnostics being performed under these conditions. The values of the radiation dosage show it is necessary to use the protecting means prescribed by law. For more frequent exposure, it would be useful to make a dynamic dosimetric picture for professional exposure and assessment of the radiation risk of these persons. (author)

  16. [De novo urologic tumors in kidney transplant patients].

    Science.gov (United States)

    Rodríguez Faba, O; Breda, A; Gausa, L; Palou, J; Villavicencio, H

    2015-03-01

    The ability of a transplant recipient to accept a graft depends on the ability of immunosuppressive drugs to regulate the immune system. Such treatments have been associated with tumor promotion and progression. A systematic literature review was carried out. Electronic searches were performed in PubMed database. The searching criterion was "urological tumors in kidney transplant recipients". The most important issues regarding incidence, urological tumor-specific features, and relevant ones about the treatment are summarized. In renal transplant, 15% of all tumors are urological neoplasias; furthermore, they are the leading neoplastic cause of death. In transplant population the incidence rate of renal cell carcinoma (RCC), transitional cell bladder carcinoma (TCBC), testicular carcinoma (TC) and prostate cancer are increased 15, 3, 3 and 2 times respectively. Treatments used in transplant patients are similar to those employed in the general population:radical nephrectomy for the native kidney and conservative surgery for the graft are indicated for RCC. Radical prostatectomy is technically feasible for localized PC.Regarding to transitional cell carcinoma BCG or MMC is not contraindicated. The incidence rate of cancer has increased among transplant population. These tumors can be managed following the same criteria than in general population. Because in this population the prognosis is worse for the immunosuppression, closer monitoring is required. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. 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.

  18. Therapeutic applications of lasers in urology: an update.

    Science.gov (United States)

    Fried, Nathaniel M

    2006-01-01

    There has been renewed interest in the use of lasers for minimally invasive treatment of urologic diseases in recent years. The introduction of more compact, higher power, less expensive and more user-friendly solid-state lasers, such as the holmium:yttrium-aluminum-garnet (YAG), frequency-doubled neodymium:YAG and diode lasers has made the technology more attractive for clinical use. The availability of small, flexible, biocompatible, inexpensive and disposable silica optical fiber delivery systems for use in flexible endoscopes has also promoted the development of new laser procedures. The holmium:YAG laser is currently the workhorse laser in urology since it can be used for multiple soft- and hard-tissue applications, including laser lithotripsy, benign prostate hyperplasia, bladder tumors and strictures. More recently, higher power potassium-titanyl-phosphate lasers have been introduced and show promise for the treatment of benign prostatic hyperplasia. On the horizon, newer and more effective photosensitizing drugs are being tested for potential use in photodynamic therapy of bladder and prostate cancer. Additionally, new experimental lasers such as the erbium:YAG, Thulium and Thulium fiber lasers, may provide more precise incision of soft tissues, more efficient laser lithotripsy and more rapid prostate ablation. This review provides an update on the most important new clinical and experimental therapeutic applications of lasers in urology over the past 5 years.

  19. [Exponential use of social media in medicine: example of the interest of Twitter(©) in urology].

    Science.gov (United States)

    Rouprêt, M; Misraï, V

    2015-01-01

    Social media (#SoMe) has changed the face of modern medicine. Our purpose was to asses the potential interest of Twitter in the field of urology. A systematic review of the literature has been performed using PubMed without timeline restriction with the following keywords (MeSH): social media; Web 2.0; Twitter; Internet; network; urology; journal club; education. There were 3 categories of interest of Twitter in the field of urology: spread of scientific knowledge, scientific interaction during medical conferences and medical education and international medical debates. The unique spread of evidence-based-medecine through traditional scientific journals in paper version is over. Main scientific journals in urology and scientific societies are now using a Twitter account and became virtual. They use new bibliometrics available on #SoMe to estimate the social impact. Twitter allows for a better interactivity of doctors attending scientific conferences. Exponential use of Twitter is in the interest of speakers and leaders, audience and scientific societies. Lastly, medical academic education and continuing medical education can be achieved through #SoMe. Twitter became a lively virtual platform for scientific debates for complex oncological cases (dematerialized tumor board). Twitter is also a place for intense scientific discussion during virtual journal club without geographic or timeline restriction. Physicians need to respect the rules for a wise use of #SoMe in order not to break the Hippocratic Oath. There is a revolution around #SoMe and Twitter in the spread of scientific knowledge and academic teaching. International urologists are already committed in this evolution and France should also get involved. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  20. Systematic reviews of observational studies of risk of thrombosis and bleeding in urological surgery (ROTBUS): introduction and methodology.

    Science.gov (United States)

    Tikkinen, Kari A O; Agarwal, Arnav; Craigie, Samantha; Cartwright, Rufus; Gould, Michael K; Haukka, Jari; Naspro, Richard; Novara, Giacomo; Sandset, Per Morten; Siemieniuk, Reed A; Violette, Philippe D; Guyatt, Gordon H

    2014-12-23

    Pharmacological thromboprophylaxis in the peri-operative period involves a trade-off between reduction in venous thromboembolism (VTE) and an increase in bleeding. Baseline risks, in the absence of prophylaxis, for VTE and bleeding are known to vary widely between urological procedures, but their magnitude is highly uncertain. Systematic reviews and meta-analyses addressing baseline risks are uncommon, needed, and require methodological innovation. In this article, we describe the rationale and methods for a series of systematic reviews of the risks of symptomatic VTE and bleeding requiring reoperation in urological surgery. We searched MEDLINE from January 1, 2000 until April 10, 2014 for observational studies reporting on symptomatic VTE or bleeding after urological procedures. Additional studies known to experts and studies cited in relevant review articles were added. Teams of two reviewers, independently assessed articles for eligibility, evaluated risk of bias, and abstracted data. We derived best estimates of risk from the median estimates among studies rated at the lowest risk of bias. The primary endpoints were 30-day post-operative risk estimates of symptomatic VTE and bleeding requiring reoperation, stratified by procedure and patient risk factors. This series of systematic reviews will inform clinicians and patients regarding the trade-off between VTE prevention and bleeding. Our work advances standards in systematic reviews of surgical complications, including assessment of risk of bias, criteria for arriving at best estimates of risk (including modeling of timing of events and dealing with suboptimal data reporting), dealing with subgroups at higher and lower risk of bias, and use of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate certainty in estimates of risk. The results will be incorporated in the upcoming European Association Urology Guideline on Thromboprophylaxis. PROSPERO CRD42014010342.

  1. [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.

  2. Restoration of uridine 5′-triphosphate-suppressed delayed rectifying K+ currents by an NO activator KMUP-1 involves RhoA/Rho kinase signaling in pulmonary artery smooth muscle cells

    Directory of Open Access Journals (Sweden)

    Zen-Kong Dai

    2016-12-01

    Full Text Available We have demonstrated that KMUP-1 (7-[2-[4-(2-chlorobenzenepiperazinyl]ethyl]-1,3-dimethylxanthine blunts monocrotaline-induced pulmonary arterial hypertension by altering Ca2+ sensitivity, K+-channel function, endothelial nitric oxide synthase activity, and RhoA/Rho kinase (ROCK expression. This study further investigated whether KMUP-1 impedes uridine 5′-triphosphate (UTP-inhibited delayed rectifying K+ (KDR current in rat pulmonary arteries involved the RhoA/ROCK signaling. Pulmonary artery smooth muscle cells (PASMCs were enzymatically dissociated from rat pulmonary arteries. KMUP-1 (30μM attenuated UTP (30μM-mediated membrane depolarization and abolished UTP-enhanced cytosolic Ca2+ concentration. Whole-cell patch-clamp electrophysiology was used to monitor KDR currents. A voltage-dependent KDR current was isolated and shown to consist of a 4-aminopyridine (5mM-sensitive component and an insensitive component. The 4-aminopyridine sensitive KDR current was suppressed by UTP (30μM. The ROCK inhibitor Y27632 (30μM abolished the ability of UTP to inhibit the KDR current. Like Y27632, KMUP-1 (30μM similarly abolished UTP-inhibited KDR currents. Superfused protein kinase A and protein kinase G inhibitors (KT5720, 300nM and KT5823, 300nM did not affect UTP-inhibited KDR currents, but the currents were restored by adding KMUP-1 (30μM to the superfusate. KMUP-1 reversal of KDR current inhibition by UTP predominantly involves the ROCK inhibition. The results indicate that the RhoA/ROCK signaling pathway plays a key role in eliciting PASMCs depolarization caused by UTP, which would result in pulmonary artery constriction. KMUP-1 blocks UTP-mediated PASMCs depolarization, suggesting that it would prevent abnormal pulmonary vasoconstriction.

  3. The impact of non-urologic drugs on sexual function in men

    Directory of Open Access Journals (Sweden)

    Ferdinando Fusco

    2014-03-01

    Full Text Available Sexual dysfunctions have commonly been reported as the resulting side effects of many drugs. To understand the impact of a single drug, the mechanism of action of the most commonly prescribed drugs and the physiological mechanisms of sexual function have to be taken into dual consideration. Psychotropic drugs (Antidepressants, Antipsychotics and Antiepileptic in particular result in both short and long-term effects on sexual function. Antihypertensive drugs have also produced evidence certifying their role in determining sexual dysfunction. Patients affected with sexual dysfunction are often aged and assume several drugs and, while Iatrogenic sexual dysfunction is prevalent in men, urological drugs are not the only drugs to be held accountable. Many different drugs acting on different sites and with several mechanisms of action can induce sexual dysfunction. The drug classes involved are widely diffused and frequently assumed in combination therapies.

  4. [Epidemiology of urological symptoms in neurological disorders. A prospective analysis in a center for neurological rehabilitation].

    Science.gov (United States)

    Zellner, M

    2008-06-01

    The frequency of urological symptoms and malfunctions was determined in a representative group of patients in a neurological rehabilitation center in Northern Bavaria. All 225 consecutive inpatients between October 2002 and April 2003 were questioned by an experienced neuro-urologist about relevant urological symptoms. The Barthel index, IPSS, and a simple quality of life score were ascertained in addition. We tried to analyze indication, frequency, and quality of any treatment for previous urological symptoms in the assigning institution. An assessment of the known therapy of urological symptoms in pretreating facilities was documented in 190 patients (84.4%). In 105 cases (55.3%) treatment was appraised as sufficient (including all patients without urological symptoms) and not sufficient in 85 cases (44.7%). At the time of admission into the rehabilitation center no urological symptoms were seen in 78 cases (35.1%); 144 patients (64.9%) presented with relevant urological symptoms. It could be pointed out that patients with urological symptoms without adequate treatment lost quality of life significantly, both at medical and at subjective assessment. Total morbidity of patients with urological symptoms was shown to be worse regarding Barthel index, IPSS, and quality of life assessed by IPSS. By providing continuous neuro-urologically qualified support, deficits due to inadequate pretreatment could be compensated in comparison to the group with appropriate pretreatment. A further optimization of the rehabilitation potential of neurologically ill patients seems possible by an implementation of urological base measures into the neurological treatment routine and improved urological training of neurological treatment teams.

  5. Emergence of Integrated Urology-Radiation Oncology Practices in the State of Texas

    International Nuclear Information System (INIS)

    Jhaveri, Pavan M.; Sun Zhuyi; Ballas, Leslie; Followill, David S.; Hoffman, Karen E.; Jiang Jing; Smith, Benjamin D.

    2012-01-01

    Purpose: Integrated urology-radiation oncology (RO) practices have been advocated as a means to improve community-based prostate cancer care by joining urologic and radiation care in a single-practice environment. However, little is known regarding the scope and actual physical integration of such practices. We sought to characterize the emergence of such practices in Texas, their extent of physical integration, and their potential effect on patient travel times for radiation therapy. Methods and Materials: A telephone survey identified integrated urology-RO practices, defined as practices owned by urologists that offer RO services. Geographic information software was used to determine the proximity of integrated urology-RO clinic sites with respect to the state's population. We calculated patient travel time and distance from each integrated urology-RO clinic offering urologic services to the RO treatment facility owned by the integrated practice and to the nearest nonintegrated (independent) RO facility. We compared these times and distances using the Wilcoxon-Mann-Whitney test. Results: Of 229 urology practices identified, 12 (5%) offered integrated RO services, and 182 (28%) of 640 Texas urologists worked in such practices. Approximately 53% of the state population resides within 10 miles of an integrated urology-RO clinic site. Patients with a diagnosis of prostate cancer at an integrated urology-RO clinic site travel a mean of 19.7 miles (26.1 min) from the clinic to reach the RO facility owned by the integrated urology-RO practice vs 5.9 miles (9.2 min) to reach the nearest nonintegrated RO facility (P<.001). Conclusions: Integrated urology-RO practices are common in Texas and are generally clustered in urban areas. In most integrated practices, the urology clinics and the integrated RO facilities are not at the same location, and driving times and distances from the clinic to the integrated RO facility exceed those from the clinic to the nearest

  6. [Current state, challenges and prospects for the development of the Russian urological service].

    Science.gov (United States)

    Krivonos, O V; Skachkova, E I; Malkhasian, V A; Pushkar', D Iu

    2012-01-01

    The present study was dedicated to the analysis of the incidence, prevalence and mortality from diseases of the urogenital system. The data on the effectiveness of the hospital bed usage, the patient profile at hospital, the treatment timing and outcomes, surgical activities in urological hospitals, the state of staff assistance in urological service, the efficacy of usage of working time of urologist and human resource of Russian urological service were analyzed. Data analysis revealed a number of issues of administrative and legal nature, which cause modest efficiency of activity of urological service. The ways for solutions of these problems are presented.

  7. 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.

  8. 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.

  9. [Surgery of inferior vena cava-associated urological tumor lesions].

    Science.gov (United States)

    Weber, M; Meyer, F; Liehr, U B; Halloul, Z

    2013-10-01

    Tumor lesions of the inferior vena cava are extremely challenging with regard to adequate therapeutic management also in advanced malignant urological tumor lesions which can be caused by malignant adhesion, impression and tumor infiltration from the surrounding tissue. This can be the case with metastases from a seminoma or testicular carcinoma (differential diagnosis: primary vena cava leiomyosarcoma), tumor-associated growth into and within the inferior vena cava originating from renal cell carcinoma or carcinoma of the pararenal gland. The aim of this overview was to summarize current clinical and operative experiences in the treatment of inferior vena cava-associated urological tumor lesions, perioperative management, individual-specific and finding-adapted surgical technique and possible outcome, including prognostic considerations from clinical daily practice and representative data found in the literature. The primary aim of the surgical approach is to achieve R0 resection with reconstruction of the inferior vena cava lumen providing a reasonable risk-benefit ratio, which comprises i) complete resection and substitution of the inferior vena cava by a prosthesis along the previous extent of tumor growth, ii) partial resection of the vena cava wall with subsequent patch-plasty or tangential resection with primary suture or iii) removal of the vena cava thrombus after cavotomy. Particular attention should be paid to tumor thrombi reaching the right atrium which need to be extracted after sternotomy and atriotomy using an extracorporeal circulation (cardiac surgeon). For surgical planning, subdivision of the inferior vena cava into three segments, infracardiac, infrahepatic and infrarenal third, has been proven and tested. The current development status and advances in surgical approaches as well as advances in medical technology allow the successful approach to such advanced stage urological tumor manifestations. A deciding factor is the abdominal and

  10. 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. PMID:26620455

  11. Eight-MHz RF-hyperthermia for advanced urological malignancies

    International Nuclear Information System (INIS)

    Hisazumi, Haruo; Nakajima, Kazuyoshi

    1986-01-01

    Eight-MHz radiofrequency hyperthermia (H) using a Thermotron-RF Model 8, and its combination with irradiation (RH), anticancer drugs (CH) or anticancer drugs plus irradiation (CRH), were carried out for a total of 48 urological malignancies: 10 cases of renal cancer, 1 of renal pelvic cancer, 2 of uretetral cancer, 19 of bladder cancer, 5 of prostatic cancer, 9 of metastatic lesion of urological cancers and 2 of other urological cancers. All had failed in previous treatments, or had not undergone surgery because of their poor general condition. Four cases, including 2 of bladder cancer, 1 of prostatic cancer and 1 of metastatic lesion of bladder cancer, were treated with H. Twenty-five cases, including 3 renal cancer cases, were treated with RH. Seven of the 10 cases of renal cancer were treated with mitomycin C-microcapsule embolization prior to RH (CRH). Twelve of the 23 cases with urothelial cancer or its metastasis, including 1 of renal pelvic cancer, 10 of bladder cancer and 1 of metastatic lesion of bladder cancer, received combined treatment of THP-adriamycin, one of the derivatives of adriamycin, by i.v. and RF-heating (CH). Hyperthermia was given twice a week, totalling 10 sessions in 5 weeks. Intratumoral temperature was kept above 42.5 deg C for 30 to 40 minutes during one-hour heating. Complete tumor disappearance was obtained in the 5 bladder cancer cases. Partial tumor regression, defined as a regression of 50 % or more, was obtained in 11 cases. As side effects, mild skin burns and anorexia were observed in approximately 30 to 40 % of cases. Seven obese cases, who had subcutaneous tissue 15 mm thick or more, developed fat tissue induration after treatment. (author)

  12. 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.

  13. 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.

  14. 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.

  15. Time-Delay Interferometry

    Directory of Open Access Journals (Sweden)

    Massimo Tinto

    2014-08-01

    Full Text Available Equal-arm detectors of gravitational radiation allow phase measurements many orders of magnitude below the intrinsic phase stability of the laser injecting light into their arms. This is because the noise in the laser light is common to both arms, experiencing exactly the same delay, and thus cancels when it is differenced at the photo detector. In this situation, much lower level secondary noises then set the overall performance. If, however, the two arms have different lengths (as will necessarily be the case with space-borne interferometers, the laser noise experiences different delays in the two arms and will hence not directly cancel at the detector. In order to solve this problem, a technique involving heterodyne interferometry with unequal arm lengths and independent phase-difference readouts has been proposed. It relies on properly time-shifting and linearly combining independent Doppler measurements, and for this reason it has been called time-delay interferometry (TDI. This article provides an overview of the theory, mathematical foundations, and experimental aspects associated with the implementation of TDI. Although emphasis on the application of TDI to the Laser Interferometer Space Antenna (LISA mission appears throughout this article, TDI can be incorporated into the design of any future space-based mission aiming to search for gravitational waves via interferometric measurements. We have purposely left out all theoretical aspects that data analysts will need to account for when analyzing the TDI data combinations.

  16. Pilot Validation Study of the European Association of Urology Robotic Training Curriculum.

    Science.gov (United States)

    Volpe, Alessandro; Ahmed, Kamran; Dasgupta, Prokar; Ficarra, Vincenzo; Novara, Giacomo; van der Poel, Henk; Mottrie, Alexandre

    2015-08-01

    The development of structured and validated training curricula is one of the current priorities in robot-assisted urological surgery. To establish the feasibility, acceptability, face validity, and educational impact of a structured training curriculum for robot-assisted radical prostatectomy (RARP), and to assess improvements in performance and ability to perform RARP after completion of the curriculum. A 12-wk training curriculum was developed based on an expert panel discussion and used to train ten fellows from major European teaching institutions. The curriculum included: (1) e-learning, (2) 1 wk of structured simulation-based training (virtual reality synthetic, animal, and cadaveric platforms), and (3) supervised modular training for RARP. The feasibility, acceptability, face validity, and educational impact were assessed using quantitative surveys. Improvement in the technical skills of participants over the training period was evaluated using the inbuilt validated assessment metrics on the da Vinci surgical simulator (dVSS). A final RARP performed by fellows on completion of their training was assessed using the Global Evaluative Assessment of Robotic Skills (GEARS) score and generic and procedure-specific scoring criteria. The median baseline experience of participants as console surgeon was 4 mo (interquartile range [IQR] 0-6.5 mo). All participants completed the curriculum and were involved in a median of 18 RARPs (IQR 14-36) during modular training. The overall score for dVSS tasks significantly increased over the training period (p10 (scale 4-16) for all procedural steps using a generic dedicated scoring tool. In performance comparison using this scoring tool, the experts significantly outperformed the fellows (mean score for all steps 13.6 vs 11). The European robot-assisted urologic training curriculum is acceptable, valid, and effective for training in RARP. This study shows that a 12-wk structured training program including simulation

  17. Place of radiation therapy for the treatment of gynecologic and urologic tumors in 1994; Place de la radiotherapie dans les tumeurs gynecologiques et urologiques. Le point en 1994

    Energy Technology Data Exchange (ETDEWEB)

    Maulard-Durdux, C.; Housset, M. [Hopital Saint-Louis, 75 - Paris (France)

    1995-06-01

    External-beam radiation therapy and brachytherapy are currently used both as curative and as palliative therapy in patients with gynecologic and urologic tumors. Ionizing radiation plays a key role in the locoregional control of uterine and prostatic tumors, in particular in combination with surgery. External-beam radiation therapy in combination with concomitant radiosensitizing chemotherapy may allow conservation of the bladder in patients with infiltrating vesical tumors classically treated by cystectomy. It has beneficial effects on some of the most incapacitating complications of these cancers: its hemostatic effect is valuable in patients with vaginal bleeding or hematuria and it relieves the pain due to bone metastases, which are particularly common in prostatic cancer. Furthermore, use of high energy accelerators, development of better imaging techniques, and advances in dosimetry have substantially reduced the rate of delayed radiation-induced complications. Thus, external-beam radiation therapy and brachytherapy are important tools for the treatment of gynecologic and urologic tumors. A discussion is provided of the role of radiation therapy in the four most common types of gynecologic and urologic cancer: cancers of the prostate, bladder, uterine cervix, and uterine corpus. (authors). 52 refs., 2 tabs.

  18. DELAYED EFFECTS OF RADIATION ON THE HUMAN CENTRAL NERVOUS SYSTEM. EARLY AND LATE DELAYED REACTIONS,

    Science.gov (United States)

    Two cases of delayed effects of radiation on the central nervous system of man are reported. One demonstrates the rare early delayed reaction which...involvement. This patient is an extreme example of the well-documented late delayed effects of radiation and is presented for contrast with the patient in

  19. 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.

  20. Delayed Senescence

    Science.gov (United States)

    2004-01-01

    Researcher Dr. Yi Li developed a technique to manipulate certain characteristics of plant growth such as anit-senescence. For example, the tobacco leaf was clipped from a transgenic plant (right), and a wildtype plant (left). During ground-based laboratory studies, both leaves were left in a darkened area for 4 months. When retrieved, the wildtype plant leaf was dried-out and the transgenic leaf remained fresh and green. A variation of this technology that involves manipulating plant hormones has been conducted in space-based studies on tomato plants through BioServe Space Technologies. The transport and distribution of auxin, an important plant hormone has shown to be influenced by microgravity, which could lead to improving the quality of fruits and vegetables grown on Earth.

  1. Developments in urologic oncology «OncoForum»: The best of 2015.

    Science.gov (United States)

    Gómez-Veiga, F; Alcaraz-Asensio, A; Burgos-Revilla, J; Cózar-Olmo, J

    2016-01-01

    To review the latest evidence on the oncologic urology of prostate, renal and bladder tumours, analysing their impact on daily clinical practice and future medium to long-term regimens. We review the abstracts on prostate, renal and bladder cancer presented at the 2015 congresses (EAU, AUA, ASCO, ESMO y ASTRO) that received the best evaluations by the OncoForum committee. Cabozantinib could represent a new second-line (or subsequent) treatment option for patients with advanced renal cancer. In muscle-invasive bladder cancer, the genetic expression profile could predict the clinical benefit of neoadjuvant therapy in treating urothelial tumours. In metastatic castration-resistant prostate cancer, results were presented from various studies that evaluated the addition of chemotherapy to standard treatment with androgen deprivation, showing a reduction in the progression risk and higher PSA response rates. New options for the second-line treatment of renal cancer were presented. In metastatic castration-resistant prostate cancer, various studies have been published on treatment with enzalutamide, which has been shown to delay the symptomatic disease and benefit overall survival. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Usefulness of fetal MR imaging for congenital urological anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Akasaka, Yoshinobu; Sugimura, Kazuro [Kobe Univ. (Japan). Graduate School of Medicine; Kanegawa, Kimio [Kobe Children' s Hospital (Japan)

    2002-04-01

    Despite the fact that congenital urological anomalies are not rare, the role of fetal MRI in these disorders has not been well defined. We evaluated the usefulness of MRI in the prenatal diagnosis of patients with such anomalies. A total of 23 cases were included in this study. The 23 cases were divided as follows: 7 cases of bilateral renal agenesis or severe hypogenesis (Potter sequence: PS), 8 cases of multicystic dysplastic kidney (2 cases were bilateral: MCDK), 5 cases of hydronephrosis (HN), one case of hydroureteronephrosis (HUN) and 2 cases of HN or HUN with duplication (DUP). In this study the scan time for fetal MRI was approximately 30 seconds for one sequence. Overall, the diagnostic accuracy was 65.2%; 85.2% for PS, 87.5% for MCDK, 60.0% for HN, 50.0% for HUN and 0% for DUP. Even though imaging quality was relatively poor for motion artifact in this series, we were able to diagnose PS and MCDK because of associated lung hypoplasia and its characteristic shape. The diagnosis of HN, HUN and DUP was difficult. HN was sometimes misdiagnosed as a retroperitoneal cystic mass because the dilation of calices was obscured in severe cases. In HUN and DUP cases dilation of the ureter was unclear. However, using HASTE or true FISP sequence may solve this problem. Based on this data, we conclude that fetal MRI is useful for prenatal diagnosis of urological anomalies. (author)

  3. Artificial neural networks for decision-making in urologic oncology.

    Science.gov (United States)

    Anagnostou, Theodore; Remzi, Mesut; Lykourinas, Michael; Djavan, Bob

    2003-06-01

    The authors are presenting a thorough introduction in Artificial Neural Networks (ANNs) and their contribution to modern Urologic Oncology. The article covers a description of Artificial Neural Network methodology and points out the differences of Artificial Intelligence to traditional statistic models in terms of serving patients and clinicians, in a different way than current statistical analysis. Since Artificial Intelligence is not yet fully understood by many practicing clinicians, the authors have reviewed a careful selection of articles in order to explore the clinical benefit of Artificial Intelligence applications in modern Urology questions and decision-making. The data are from real patients and reflect attempts to achieve more accurate diagnosis and prognosis, especially in prostate cancer that stands as a good example of difficult decision-making in everyday practice. Experience from current use of Artificial Intelligence is also being discussed, and the authors address future developments as well as potential problems such as medical record quality, precautions in using ANNs or resistance to system use, in an attempt to point out future demands and the need for common standards. The authors conclude that both methods should continue to be used in a complementary manner. ANNs still do not prove always better as to replace standard statistical analysis as the method of choice in interpreting medical data.

  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. 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.

  6. The Expanding Role of Advanced Practice Providers in Urologic Procedural Care.

    Science.gov (United States)

    Langston, Joshua P; Duszak, Richard; Orcutt, Venetia L; Schultz, Heather; Hornberger, Brad; Jenkins, Lawrence C; Hemingway, Jennifer; Hughes, Danny R; Pruthi, Raj S; Nielsen, Matthew E

    2017-08-01

    To understand the role of Advanced Practice Providers (APPs) in urologic procedural care and its change over time. As the population ages and the urologic workforce struggles to meet patient access demands, the role of APPs in the provision of all aspects of urologic care is increasing. However, little is currently known about their role in procedural care. Commonly performed urologic procedures were linked to Current Procedural Terminology (CPT) codes from 1994 to 2012. National Medicare Part B beneficiary claims frequency was identified using Physician Supplier Procedure Summary Master Files. Trends were studied for APPs, urologists, and all other providers nationally across numerous procedures spanning complexity, acuity, and technical skill set requirements. Between 1994 and 2012, annual Medicare claims for urologic procedures by APPs increased dramatically. Cystoscopy increased from 24 to 1820 (+7483%), transrectal prostate biopsy from 17 to 834 (+4806%), complex Foley catheter placement from 471 to 2929 (+522%), urodynamics testing from 41 to 9358 (+22,727%), and renal ultrasound from 18 to 4500 (+24,900%) CONCLUSION: We found dramatic growth in the provision of urologic procedural care by APPs over the past 2 decades. These data reinforce the known expansion of the APP role in urology and support the timeliness of ongoing collaborative multidisciplinary educational efforts to address unmet needs in education, training, and guideline formation to maximize access to urologic procedural services. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. 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.

  8. 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.

  9. 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.

  10. Possibilities of FDG-PET in diagnosis of urological tumors

    International Nuclear Information System (INIS)

    Kawamoto, Ken; Nakagawa, Masayuki

    2004-01-01

    The aim of this study was to determine the value of 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) in evaluating patients with urological tumors. FDG-PET scans were taken in 116 patients with urological diseases. The number of patients with prostatic disease, renal disease and adrenal disease was 86 (74.1%), 10 and 10, respectively. Seven patients with bladder tumors who had previously undergone either cystectomy or transurethral resection of bladder cancer (TUR-Bt) received FDG-PET scan for medical check-up. Three patients with testicular disease were also included in this series. In patients with prostatic disease, 41 patients were already diagnosed as having prostate cancer and FDG-PET was performed for medical check-up. Forty-five patients were suspected of having prostate cancer because of the FDG accumulation and/or a rise in serum prostatic specific antigen (PSA). Of these patients, 9 were diagnosed as having prostate cancer by biopsy. Serum PSA levels were elevated in all 9 patients, however FDG-PET findings were false-negative in 4 of the 9 patients. In patients with renal disease, 2 of the 4 patients suspected of having renal cell carcinoma actually had benign diseases. In one patient with a renal mass, FDG-PET was false-negative. All 6 patients with metastatic adrenal tumors showed positive findings in FDG-PET, and the patients with nonhypersecreting adrenal masses showed negative findings in FDG-PET. In three patients with seminoma, viable metastatic foci were successfully detected by FDG-PET after chemotherapy. In the present study, FDG-PET was not superior to tumor markers, such as serum PSA and conventional imaging modalities for the detection of prostate cancer and renal cell carcinoma. However, in patients with nonhypersecreting adrenal masses or a metastatic adrenal tumor, FDG-PET may provide significant functional information for tissue characterization. Moreover FDG-PET can be useful for the detection of residual viable carcinoma

  11. 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

  12. Comparison between angiography and CT scan in the urologic field

    International Nuclear Information System (INIS)

    Fujioka, Toshio; Takao, Masaya; Odajima, Kunio; Nakamura, Hiroshi

    1988-01-01

    Seventy-five consecutive patients with urological diseases were examined preoperatively by means of computerized tomography and renal angiography. Classification of the diseases were 53 renal diseases which included renal cell carcinoma, sarcoma, cyst, renal bleeding, arteriovenous fistula, trauma, hydronephrosis and tuberculosis, 11 vesical diseases which included bladder tumor and endometriosis, 9 adrenal diseases which included primary aldosteronism, Cushing syndrome, pheochromocytoma, and metastatic tumor, and 1 case of intra-abdominal testes. For renal diseases, both angiography and CT were useful imaging tools. For vesical diseases, CT was a more useful imaging method but, for adrenal diseases, angiography was superior to CT. CT offers certain advantages over conventional techniques but, in the near future, it may be replaced by MRI. On the contrary, angiography will remain popular for a long time, because angiography is the only way to show which vessels feed organs. (author)

  13. Fat, demented and stupid: An unrecognized legacy of pediatric urology?

    Science.gov (United States)

    Cooper, Christopher S

    2017-08-01

    The human body is an unfathomably intricate structure consisting of many connected and intertwined systems. This makes it impossible for therapeutic interventions to selectively target only one physiologic system without some impact or side effects on all the other systems. The resiliency of the human body modifies and disguises side effects, some of which may be undetectable for years and not apparent without scientific investigation. Pediatric urologists employ relatively few medications for the common conditions they treat and in general these consist of antibiotics, anticholinergics, and anesthetics. Although harm from early side effects is well recognized, recent medical literature suggests there may be other side effects of these common interventions that aren't as well recognized. Antibiotics have been added to livestock feed as growth promoters for three-quarters of a century. Antibiotics alter the microbiota of the intestinal tract and these alterations have been demonstrated to impact growth, metabolism, and the risk of obesity in animals and humans. To date, the long-term impact of daily antibiotic prophylaxis in children with such pediatric urology conditions as vesicoureteral reflux or prenatal hydronephrosis have not been published. Similarly, there are no studies assessing long-term effects of anticholinergic use on cognition in children despite research demonstrating an increased risk of dementia in adults using anticholinergics. Research in animals and children recently led the FDA to issue a warning regarding the risk of lengthy use of general anesthesia on cognitive development in children. This review raises the possibility that antibiotics in children may alter growth, anticholinergics may increase their risk of dementia later in life, and anesthetics may impair their cognitive development. The possibility of such an unrecognized legacy from current therapeutic interventions should give all physicians, including pediatric urologists, pause for

  14. 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.

  15. Urological injuries following gynecological operations--our experience in a teaching hospital in Nigeria.

    Science.gov (United States)

    Chianakwana, G U; Okafor, P I S; Ikechebelu, J I; Mbonu, Okechukwu O

    2006-01-01

    Various grades of urological injuries occur following gynecological operations. Some are recognized during or after surgery but others pass unnoticed. To study the urological injuries that follow gynecological operations in our centre. Retrospective study. Nnamdi Azikiwe University Teaching Hospital, Nnewi Nigeria, a third generation tertiary institution serving rural, semi-urban, and urban communities. Searching through the records, all the gynecological operations performed in our centre from 1st July 1998 to 30th June 2003 were reviewed. Those patients in whom there were documented evidences of urological injuries were noted. Similarly, all the urological injuries treated in our institution during the same period but resulting from gynecological operations carried out in peripheral hospitals were also noted. From the relevant medical records, the following data were extracted: type of gynecological operation, nature of urological injury, time when injury was detected, status of the surgeon, management modalities, and outcome. A total of 37 urological injuries occurred but, because of incomplete records in five, only 32 patients were included in this study. Ligation of the ureters following hysterectomy was the most common injury and occurred in 28 (87.5%) of the patients. Ureteric ligation is a common urological injury following gynecological operations in our centre.

  16. Recursive Delay Calculation Unit for Parametric Beamformer

    DEFF Research Database (Denmark)

    Nikolov, Svetoslav; Jensen, Jørgen Arendt; Tomov, Borislav Gueorguiev

    2006-01-01

    This paper presents a recursive approach for parametric delay calculations for a beamformer. The suggested calculation procedure is capable of calculating the delays for any image line defined by an origin and arbitrary direction. It involves only add and shift operations making it suitable...

  17. Urology – a specialty that will be faced by all future doctors

    Directory of Open Access Journals (Sweden)

    Miah S

    2016-01-01

    Full Text Available Saiful Miah,1 Karl H Pang2 1Department of Urology, Royal Hallamshire Hospital, 2Academic Urology Unit, School of Medicine and Biomedical Sciences at the University of Sheffield, Sheffield, UKWe read with great interest the articles by Shah, and Ah-kee and Khan regarding the various potential methods that could increase the exposure of undergraduate medical students to smaller specialties.1,2 We would like to draw attention to a small but high clinical volume specialty, ie, urology.Read the original article by ShahRead the original article by Ah-kee and Khan 

  18. Delay and environmental costs of truck crashes

    Science.gov (United States)

    2013-03-01

    This report presents estimates of certain categories of costs of truck- and bus-involved crashes. Crash related costs estimated as part of this study include vehicle delay costs, emission costs, and fuel consumption costs. In addition, this report al...

  19. Delayed Single Stage Perineal Posterior Urethroplasty

    International Nuclear Information System (INIS)

    Ali, S.; Shahnawaz; Shahzad, I.; Baloch, M. U.

    2015-01-01

    Objective: To determine the delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture/distraction defect. Study Design: Descriptive case series. Place and Duration of Study: Department of Urology, Jinnah Postgraduate Medical Centre, Karachi, from January 2009 to December 2011. Methodology: Patients were selected for delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture / distraction defect. All were initially suprapubically catheterized followed by definitive surgery after at least 3 months. Results: Thirty male patients were analyzed with a mean follow-up of 10 months, 2 patients were excluded as they developed failure in first 3 months postoperatively. Mean patients age was 26.25 ± 7.9 years. On follow-up, 7 patients (23.3 percentage) experienced recurrent stricture during first 10 months. Five (16.6 percentage) patients were treated successfully with single direct visual internal urethrotomy. Two patients (6.6 percentage) had more than one direct visual internal urethrotomy and considered failed. Re-do perineal urethroplasty was eventually performed. The overall success rate was 93.3 percentage with permissive criteria allowing single direct visual internal urethrotomy and 76.6% with strict criteria allowing no more procedures postoperatively. Conclusion: Posterior anastomotic urethroplasty offers excellent long-term results to patients with posterior urethral trauma and distraction defect even after multiple prior procedures. (author)

  20. Reporting and Staging of Testicular Germ Cell Tumors: The International Society of Urological Pathology (ISUP) Testicular Cancer Consultation Conference Recommendations.

    Science.gov (United States)

    Verrill, Clare; Yilmaz, Asli; Srigley, John R; Amin, Mahul B; Compérat, Eva; Egevad, Lars; Ulbright, Thomas M; Tickoo, Satish K; Berney, Daniel M; Epstein, Jonathan I

    2017-06-01

    The International Society of Urological Pathology held a conference devoted to issues in testicular and penile pathology in Boston in March 2015, which included a presentation and discussion led by the testis microscopic features working group. This conference focused on controversies related to staging and reporting of testicular tumors and was preceded by an online survey of the International Society of Urological Pathology members. The survey results were used to initiate discussions, but decisions were made by expert consensus rather than voting. A number of recommendations emerged from the conference, including that lymphovascular invasion (LVI) should always be reported and no distinction need be made between lymphatic or blood invasion. If LVI is equivocal, then it should be regarded as negative to avoid triggering unnecessary therapy. LVI in the spermatic cord is considered as category pT2, not pT3, unless future studies provide contrary evidence. At the time of gross dissection, a block should be taken just superior to the epididymis to define the base of the spermatic cord, and direct invasion of tumor in this block indicates a category of pT3. Pagetoid involvement of the rete testis epithelium must be distinguished from rete testis stromal invasion, with only the latter being prognostically useful. Percentages of different tumor elements in mixed germ cell tumors should be reported. Although consensus was reached on many issues, there are still areas of practice that need further evidence on which to base firm recommendations.

  1. 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.

  2. Changing Current Practice in Urology: Improving Guideline Development and Implementation Through Stakeholder Engagement.

    Science.gov (United States)

    MacLennan, Sara J; MacLennan, Steven; Bex, Axel; Catto, James W F; De Santis, Maria; Glaser, Adam W; Ljungberg, Borje; N'Dow, James; Plass, Karin; Trapero-Bertran, Marta; Van Poppel, Hendrik; Wright, Penny; Giles, Rachel H

    2017-08-01

    Effective stakeholder integration for guideline development should improve outcomes and adherence to clinical practice guidelines. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  3. 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

  4. [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.

  5. Baicalin Attenuates Blood-Brain Barrier Disruption and Hemorrhagic Transformation and Improves Neurological Outcome in Ischemic Stroke Rats with Delayed t-PA Treatment: Involvement of ONOO--MMP-9 Pathway.

    Science.gov (United States)

    Chen, Hansen; Guan, Binghe; Chen, Xi; Chen, Xingmiao; Li, Caiming; Qiu, Jinhua; Yang, Dan; Liu, Ke Jian; Qi, Suhua; Shen, Jiangang

    2017-12-23

    Tissue plasminogen activator (t-PA) has a restrictive therapeutic window within 4.5 h after ischemic stroke with the risk of hemorrhagic transformation (HT) and neurotoxicity when it is used beyond the time window. In the present study, we tested the hypothesis that baicalin, an active compound of medicinal plant, could attenuate HT in cerebral ischemia stroke with delayed t-PA treatment. Male Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) for 4.5 h and then continuously received t-PA infusion (10 mg/kg) for 0.5 h and followed by 19-h reperfusion. Baicalin (50, 100, 150 mg/kg) was administrated via femoral vein at 4.5 h after MCAO cerebral ischemia. Delayed t-PA infusion significantly increased the mortality rate, induced HT, blood-brain barrier (BBB) damage, and apoptotic cell death in the ischemic brains and exacerbated neurological outcomes in cerebral ischemia-reperfusion rats at 24 h after MCAO cerebral ischemia. Co-treatment of baicalin significantly reduced the mortality rates, ameliorated the t-PA-mediated BBB disruption and HT. Furthermore, baicalin showed to directly scavenge peroxynitrite and inhibit MMP-9 expression and activity in the ischemic brains with the delayed t-PA treatment. Baicalin had no effect on the t-PA fibrinolytic function indicated by t-PA activity assay. Taken together, baicalin could attenuate t-PA-mediated HT and improve the outcomes of ischemic stroke treatment possibly via inhibiting peroxynitrite-mediated MMP-9 activation.

  6. 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

    scintigraphies. Using the European Association of Paediatric Urology guidance would have missed three urological patients, one with initial surgery, and avoided 46 scintigraphies. Investigating patients under two years with ultrasound and scintigraphy, and just ultrasound in children over two years, would have...... 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....

  7. 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.

  8. 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.

  9. [Evaluation of clinical competence in urology: innovative approach based on performance observation].

    Science.gov (United States)

    Sibert, L; Grand'Maison, P; Charlin, B; Grise, P

    1997-09-01

    The authors present a pilot project for the evaluation of clinical skills in urology using a method of evaluation based on observation of real performance. An objective and structured clinical examination (OSCE) applied to urology was developed according to a precise predetermined design: 1) Identification of the objectives to be evaluated. 2) Choice of sampling of clinical situations representative of routine urological practice. 3) Construction, on the basis of these cases, of physician-patient interaction stations and question stations, with, for each case, weighting of objectives, construction of observation grids and writing of instructions for candidates, simulated patients and observers. An OSCE circuit of 10 clinical cases and 16 stations was constructed. The main poles of activity and urological settings were represented. Objective complementary investigations, diagnosis and treatment received the highest weightings. The reliability coefficient, the content validity and the construct validity will be verified on the basis of the overall score obtained by candidate. Establishment of the score and the expected results in terms of reliability, validity, and feasibility are discussed. The psychometric qualities of the OSCE have been demonstrated. Although a single instrument is not sufficient, it is currently the measuring tool which most closely approximates ideal evaluation of clinical skills. If the feasibility of this method is confirmed, this pilot project in urology could provide a new approach to evaluation strategies and could participate in the current reflection concerning urology training.

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

    International Nuclear Information System (INIS)

    Lajer, Henrik; Thranov, Ingrid R.; Skovgaard, Lene T.; Engelholm, Svend Aa

    2002-01-01

    Purpose: To provide longitudinal data on urologic morbidity after radiotherapy and brachytherapy for cervical carcinoma. Methods and Materials: Five-year longitudinal urologic morbidity data were recorded from 177 consecutive patients of median age 59 years (range: 22-86 years) with cervical carcinoma receiving radiotherapy with curative intent at the Copenhagen University Hospital, Denmark. FIGO stages (%) were as follows: Stage I (15), Stage II (30), Stage III (54), and Stage IV (1). Late morbidity was calculated as cumulative incidence based on actuarial estimates. Results: The 5-year cumulative incidence based on actuarial estimates of urologic morbidity Grades 1 + 2 + 3, Grades 2 + 3, and Grade 3 were 62%, 32%, and 5%, respectively. Frequencies of urologic morbidity in the 54 recurrence-free survivors at the end of follow-up indicated some reversibility in the case of Grades 1 and 2 morbidity. Conclusion: With the longitudinal design used in the present study, a rate of mild and moderate morbidity higher than that found in most of the previously reported literature was observed, giving cause for concern and underlining the importance of further longitudinal studies on this subject, specifically studies that relate to the background urologic morbidity in the female population, as well as to the fact that urologic morbidity might regress

  11. [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.

  12. Simulation training in video-assisted urologic surgery.

    Science.gov (United States)

    Hoznek, András; Salomon, Laurent; de la Taille, Alexandre; Yiou, René; Vordos, Dimitrios; Larre, Stéphane; Abbou, Clément-Claude

    2006-03-01

    The current system of surgical education is facing many challenges in terms of time efficiency, costs, and patient safety. Training using simulation is an emerging area, mostly based on the experience of other high-risk professions like aviation. The goal of simulation-based training in surgery is to develop not only technical but team skills. This learning environment is stress-free and safe, allows standardization and tailoring of training, and also objectively evaluate performances. The development of simulation training is straightforward in endourology, since these procedures are video-assisted and the low degree of freedom of the instruments is easily replicated. On the other hand, these interventions necessitate a long learning curve, training in the operative room is especially costly and risky. Many models are already in use or under development in all fields of video-assisted urologic surgery: ureteroscopy, percutaneous surgery, transurethral resection of the prostate, and laparoscopy. Although bench models are essential, simulation increasingly benefits from the achievements and development of computer technology. Still in its infancy, virtual reality simulation will certainly belong to tomorrow's teaching tools.

  13. Secondary data sources for health services research in urologic oncology.

    Science.gov (United States)

    Cole, Alexander P; Friedlander, David F; Trinh, Quoc-Dien

    2018-04-01

    Though secondary data analyses of large datasets may reduce logistical and financial barriers required to perform significant and innovative work, such research requires specialized skills in data handling and statistical techniques as well as thorough and detailed knowledge of the data sources being used. To provide an overview of several common types of secondary data, focusing on strengths, weaknesses and examples of how these data may be used for health services research. Secondary data comprise a broad and heterogeneous category. This review covers several large categories of such data with examples of their use and discussions about their strengths and weaknesses. Sources include administrative data, claims-based datasets, electronic health records health surveys, patient or disease or both registries, quality improvement initiatives, as well as data from existing trials. Linkages of different types of data may expand the scope of questions answerable using secondary data analysis. Specific strengths and weaknesses of each type of dataset are discussed along with examples from the recent urologic literature. Choice of the appropriate data source should be tailored to the specific research question as well as the research resources and expertise available. Appropriate decisions about which data to use are the foundation for valid, high-impact research using secondary data. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Laparoscopy in Urology Practice at a Tertiary Care Centre

    International Nuclear Information System (INIS)

    Quddus, M. B.; Mahmud, S. M.

    2014-01-01

    Objective: To describe the results of laparoscopic procedures at a Urology - Nephrology tertiary care centre. Study Design: Case series / observational study. Place and Duration of Study: The Kidney Centre Postgraduate Training Institute, Karachi, from August 2007 to March 2012. Methodology: Medical records of all planned laparoscopic surgery conducted during the study period were reviewed. Those cases which to open surgery were excluded. All were performed by a single surgeon, initially as supervised and later independently. Data was maintained for demographic data, procedure details, length of hospital stay, and complications including conversion to open surgeries. Data was analyzed through SPSS 17.0. Results: There were 36 planned laparoscopic surgeries in the specified period. Out of 36 cases, 8 were converted to open surgery. Those who underwent laparoscopic surgery include two diagnostic procedures and renal cyst deroofing each, four ureterolithotomy, nineteen simple nephrectomy and one radical nephrectomy. So in total 28 cases were performed on 15 females and 13 males with mean age of 33.01 A +- 10.9 years. The mean operative time was 216 A +- 100 minutes and mean length of hospital stay was as 2.7 A +- 1.04 days. There were 10 complications in 28 cases, majority being Clavien Grade II including 7% (2/28) blood transfusion. Conclusion: There are technical challenges in learning laparoscopy for practicing urologists. Following some learning model in a systematic manner will help surmounting the technical challenges in learning laparoscopy. (author)

  15. Clinical application of positron emission tomography imaging in urologic tumors

    International Nuclear Information System (INIS)

    Tang Ganghua; Wu Guangyuan

    2007-01-01

    Positron emission tomography (PET) is an advanced noninvasive molecular imaging modality that is being investigated for use in the differentiation, diagnosis, and guiding therapy ora variety of cancer types. FDG PET has the unique clinical value in the differentiation, diagnosis, and monitoring therapy of prostate, such as bladder, renal, and testicle cancer. However, high false-positive and false-negative findings are observed in the detection of these tumors with FDG PET. 11 C-Choline (CH) and 11 C-acetate (AC) can overcome the pitfall of FDG, and appear to be more successful than FGD in imaging prostate cancer and bladder cancer. The short half-life of 11 C prevents the widespread use of CH and AC and 18 F-fluorocholine (FCH) and 18 F-fluoroacetate (FAC) seem to be potential tracers. Potential clinical value of the new PET tracers, such as 3'-deoxy-3'- 18 F-fluorothymidine (FLT), 18 F-fluorodihydrotestosterone (FDHT), and 9-(4- 18 F-3-hydroxymethylbutyl)-guanine( 18 F-FHBG) in the detection of urologic tumors, can deserve further study. (authors)

  16. Critical appraisal of technical problems with robotic urological surgery.

    Science.gov (United States)

    Nayyar, Rishi; Gupta, Narmada P

    2010-06-01

    To record the technical problems and complications associated with the use of da Vinci S robotic system (Intuitive Surgical, Sunnyvale, CA, USA) and to review previous reports. We analysed our records for all machine- or instrument-related errors during the course of 340 consecutive robot-assisted urological operations at our centre from July 2006 to March 2009, using one robotic machine. The cause of the error (machine or human), troubleshooting methods and consequences of the errors were evaluated. The overall device failure rate was 10.9% (37/340). The most frequent technical problems were related to robotic instruments (23/37). Other failures included colour/hue changes in the console image, intermittent double vision, fused illuminator bulb and problems with the master tool-manipulator device (hand-piece unit), patient cart circuitry, patient-side manipulator arm, closed-circuit camera unit or camera cable. Of 37 problems, 28 (76%) were surmountable during the course of surgery. The overall conversions to standard open/laparoscopic procedure attributable to mechanical failures of the robot were 0.6% (2/340). There were no complications or direct harm to the patient in any case. Most faults could be corrected or bypassed with some addition to operating room time. Despite an association of various types of new technical problems with robotic surgery, it provides a safe mode of minimally invasive surgery with very low conversion rates attributable to it, and no direct patient injury.

  17. 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.

  18. Prevalence and trends of selected urologic conditions for VA healthcare users

    Directory of Open Access Journals (Sweden)

    Fischer Michael J

    2006-11-01

    Full Text Available Abstract Background Conducted as part of the Urologic Diseases in America project whose aim was to quantify the burden of urologic diseases on the American public, this study focuses on Veterans Health Administration (VHA users as a special population to supplement data on overall prevalence rates and trends in the United States. Veterans comprise 25% of the male population 18 years or older and contribute substantially to the overall burden of urologic conditions. The objective of this study is to describe the prevalence rates and trends of urologic cancers and selected benign conditions from 1999 to 2002 for VHA users. Methods VHA administrative files for 1999 – 2002 and Medicare claims files for the same years were used to identify those who had a diagnosis of qualifying urologic conditions. Results Among the conditions evaluated, prostate cancer was listed as a primary diagnosis for 5.4% of VHA users in 2002, followed in decreasing prevalence by erectile dysfunction (2.9%, renal mass (1.5%, interstitial cystitis (1.4%, and prostatitis (1.1%. Age-adjusted rates showed significant increases for renal mass (31%, interstitial cystitis (14%, and erectile dysfunction (8% between 1999 and 2002. Systematic variations in prevalence rates and trends were observed by age, race/ethnicity, and region. Those in the Western region generally had lower age-adjusted prevalence rates and their increases were also slower than other regions. Addition of Medicare data resulted in large increases (21 to 489% in prevalence among VHA users, suggesting substantial amount of non-VA urological care provided to VHA users. Conclusion Prevalence rates for many urologic diseases increased between 1999 and 2002, which were not entirely attributable to the aging of veterans. This changing urologic disease burden has substantial implications for access to urologic care and treatment capacity, especially in light of the level of urologic care delivered to veterans by

  19. Update for the practicing pathologist: The International Consultation On Urologic Disease-European association of urology consultation on bladder cancer

    Science.gov (United States)

    Amin, Mahul B; Smith, Steven C; Reuter, Victor E; Epstein, Jonathan I; Grignon, David J; Hansel, Donna E; Lin, Oscar; McKenney, Jesse K; Montironi, Rodolfo; Paner, Gladell P; Al-Ahmadie, Hikmat A; Algaba, Ferran; Ali, Syed; Alvarado-Cabrero, Isabel; Bubendorf, Lukas; Cheng, Liang; Cheville, John C; Kristiansen, Glen; Cote, Richard J; Delahunt, Brett; Eble, John N; Genega, Elizabeth M; Gulmann, Christian; Hartmann, Arndt; Langner, Cord; Lopez-Beltran, Antonio; Magi-Galluzzi, Cristina; Merce, Jorda; Netto, George J; Oliva, Esther; Rao, Priya; Ro, Jae Y; Srigley, John R; Tickoo, Satish K; Tsuzuki, Toyonori; Umar, Saleem A; Van der Kwast, Theo; Young, Robert H; Soloway, Mark S

    2016-01-01

    The International Consultations on Urological Diseases are international consensus meetings, supported by the World Health Organization and the Union Internationale Contre le Cancer, which have occurred since 1981. Each consultation has the goal of convening experts to review data and provide evidence-based recommendations to improve practice. In 2012, the selected subject was bladder cancer, a disease which remains a major public health problem with little improvement in many years. The proceedings of the 2nd International Consultation on Bladder Cancer, which included a ‘Pathology of Bladder Cancer Work Group,’ have recently been published; herein, we provide a summary of developments and consensus relevant to the practicing pathologist. Although the published proceedings have tackled a comprehensive set of issues regarding the pathology of bladder cancer, this update summarizes the recommendations regarding selected issues for the practicing pathologist. These include guidelines for classification and grading of urothelial neoplasia, with particular emphasis on the approach to inverted lesions, the handling of incipient papillary lesions frequently seen during surveillance of bladder cancer patients, descriptions of newer variants, and terminology for urine cytology reporting. PMID:25412849

  20. Discounting of Monetary Rewards That Are Both Delayed and Probabilistic: Delay and Probability Combine Multiplicatively, Not Additively

    Science.gov (United States)

    Vanderveldt, Ariana; Green, Leonard; Myerson, Joel

    2015-01-01

    The value of an outcome is affected both by the delay until its receipt (delay discounting) and by the likelihood of its receipt (probability discounting). Despite being well-described by the same hyperboloid function, delay and probability discounting involve fundamentally different processes, as revealed, for example, by the differential effects…

  1. Absent abdominal muscles, nephro-urologic abnormalities, and ...

    African Journals Online (AJOL)

    Absent abdominal muscles, cryptorchidism, and hydroureteronephrosis are known to occur in the prune belly syndrome (PBS). We present a male with absent abdominal muscles, severe neurologic damage, with global developmental delay, hydroureteronephrosis, and cryptorchidism. The patient also had arthrogryposis ...

  2. 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

  3. 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

    2017-08-01

    To evaluate the prevalence of frailty, a known predictor of poor outcomes, among patients presenting to an academic nononcologic urology practice and to examine whether frailty differs among patients who did and did not undergo urologic surgery. 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 seconds), prefrail (11-14 seconds), and frail (≥15 seconds). 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. 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 seconds; 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 seconds for patients with urinary tract infections); however, no difference existed between patients who did and did not undergo surgery (P = .94). 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. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. 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.

  5. 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.

  6. 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

  7. ALGORITHM FOR MANAGEMENT OF HYPERTENSIVE PATIENTS UNDERWENT UROLOGY INTERVENTIONS

    Directory of Open Access Journals (Sweden)

    S. S. Davydova

    2013-01-01

    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

  8. Pharmacological aspects of the antibiotics used for urological diagnostic procedures.

    Science.gov (United States)

    Mazzei, Teresita; Diacciati, Sara

    2014-10-01

    Surgical antimicrobial prophylaxis is the use of an antibiotic before, during, or shortly after a urological procedure to prevent postoperative infections such as urinary tract or wound infection. The optimal antimicrobial drug must be microbiologically active against the most frequent potential pathogens and have good pharmacological properties. Correct timing of antimicrobial prophylaxis is the first critical issue in determining treatment efficacy. The antibiotic must be administered before the start of the surgical procedure in order to ensure a high tissue level at the time of microbial contamination. If using an oral antibiotic, this must be administered 1-3 hours before the operation and a parenteral antibiotic should be administered at the induction of anaesthesia. The antibiotics potentially useful for antimicrobial prophylaxis are the beta-lactams, cotrimoxazole, fluoroquinolones, and fosfomycin trometamol. The criteria for choosing the optimal antibiotic include an appropriate antimicrobial spectrum, favourable pharmacokinetic parameters (especially good tissue penetration), and elevated safety or tolerability. The use of cotrimoxazole must be restricted due to increasing chemoresistance. Unfortunately fluoroquinolone-based regimens, once the mainstay of prophylaxis guidelines, are increasingly ineffective due to a constant increase in multidrug-resistant (MDR) Gram-negative bacteria. The same concerns apply with regard to the second and third generation cephalosporins that have problems of resistance and, if administered orally, do not sufficiently penetrate prostatic tissue. An appropriate beta-lactam could be an aminopenicillin combined with a beta-lactamase inhibitor. Fosfomycin trometamol can also be a good potential choice due to its elevated activity against MDR Gram-negative bacteria and its favourable pharmacokinetic parameters, including an elevated penetration into prostatic tissue.

  9. Nuclear Medicine in Pediatric Nephro-Urology: An Overview.

    Science.gov (United States)

    Mendichovszky, Iosif; Solar, Bernardita Troncoso; Smeulders, Naima; Easty, Marina; Biassoni, Lorenzo

    2017-05-01

    In the context of ante-natally diagnosed hydronephrosis, the vast majority of children with a dilated renal pelvis do not need any surgical treatment, as the dilatation resolves spontaneously with time. Slow drainage demonstrated at Tc-99m-mercaptoacetyltriglycine (MAG3) renography does not necessarily mean obstruction. Obstruction is defined as resistance to urinary outflow with urinary stasis at the level of the pelvic-ureteric junction (PUJ) which, if left untreated, will damage the kidney. Unfortunately this definition is retrospective and not clinically helpful. Therefore, the identification of the kidney at risk of losing function in an asymptomatic patient is a major research goal. In the context of renovascular hypertension a DMSA scan can be useful before and after revascularisation procedures (angioplasty or surgery) to assess for gain in kidney function. Renal calculi are increasingly frequent in children. Whilst the vast majority of patients with renal stones do not need functional imaging, DMSA scans with SPECT and a low dose limited CT can be very helpful in the case of complex renal calculi. Congenital renal anomalies such as duplex kidneys, horseshoe kidneys, crossed-fused kidneys and multi-cystic dysplastic kidneys greatly benefit from functional imaging to identify regional parenchymal function, thus directing further management. Positron emission tomography (PET) is being actively tested in genito-urinary malignancies. Encouraging initial reports suggest that F-18-fluorodeoxyglucose (FDG) PET is more sensitive than CT in the assessment of lymph nodal metastases in patients with genito-urinary sarcomas; an increased sensitivity in comparison to isotope bone scans for skeletal metastatic disease has also been reported. Further evaluation is necessary, especially with the promising advent of PET/MRI scanners. Nuclear Medicine in paediatric nephro-urology has stood the test of time and is opening up to new exciting developments. Copyright © 2017

  10. 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

  11. Effect of Music on Outpatient Urological Procedures: A Systematic Review and Meta-Analysis from the European Association of Urology Section of Uro-Technology.

    Science.gov (United States)

    Kyriakides, Rena; Jones, Patrick; Geraghty, Robert; Skolarikos, Andreas; Liatsikos, Evangellos; Traxer, Olivier; Pietropaolo, Amelia; Somani, Bhaskar K

    2018-05-01

    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 1,023, 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

  12. Controllability of nonlinear delay oscillating systems

    Directory of Open Access Journals (Sweden)

    Chengbin Liang

    2017-05-01

    Full Text Available In this paper, we study the controllability of a system governed by second order delay differential equations. We introduce a delay Gramian matrix involving the delayed matrix sine, which is used to establish sufficient and necessary conditions of controllability for the linear problem. In addition, we also construct a specific control function for controllability. For the nonlinear problem, we construct a control function and transfer the controllability problem to a fixed point problem for a suitable operator. We give a sufficient condition to guarantee the nonlinear delay system is controllable. Two examples are given to illustrate our theoretical results by calculating a specific control function and inverse of a delay Gramian matrix.

  13. Dynamics of microbubble oscillators with delay coupling

    Science.gov (United States)

    Heckman, C. R.; Sah, S. M.; Rand, R. H.

    2010-10-01

    We investigate the stability of the in-phase mode in a system of two delay-coupled bubble oscillators. The bubble oscillator model is based on a 1956 paper by Keller and Kolodner. Delay coupling is due to the time it takes for a signal to travel from one bubble to another through the liquid medium that surrounds them. Using techniques from the theory of differential-delay equations as well as perturbation theory, we show that the equilibrium of the in-phase mode can be made unstable if the delay is long enough and if the coupling strength is large enough, resulting in a Hopf bifurcation. We then employ Lindstedt's method to compute the amplitude of the limit cycle as a function of the time delay. This work is motivated by medical applications involving noninvasive localized drug delivery via microbubbles.

  14. 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.

  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. 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 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.

  17. 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

  18. 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%.

  19. Trainee involvement increases precut rates and delays access to the common bile duct without an increase in procedure-related adverse events: a brave new world of ERCP training?

    Science.gov (United States)

    Voiosu, Theodor; Voiosu, Andrei; Benguş, Andreea; Rimbaş, Mihai; Mateescu, Bogdan

    2018-03-01

    Selective cannulation of the desired duct is a key element in ERCP procedures and an important step in the training of fellows. However, there is limited data about technical success and patient safety for ERCPs conducted in a training setting.We aimed to evaluate the impact of trainee involvement on the cannulation technique and procedure related outcomes at ERCP. We conducted an observational study of all ERCP conducted in an endoscopy unit with an on-going training program. Patient related data and procedure-related data (method of cannulation, time to cannulation, degree of trainee involvement, technical success and procedure-related adverse events) were collected using a standard form. The method of cannulation, time to cannulation and procedure-related adverse events were compared between ERCPs with trainee involvement and those without. 641 consecutive ERCPs were evaluated and 474 native papilla cases performed by 4 trainers and 3 trainees were included in the final analysis. Trainees were involved in 171 procedures (36.1%), achieving cannulation of the desired duct in 50.8% of the cases. Cannulation rates were similar in the trainee group compared to the control group (91.7% vs. 88.7%) and there was no increase in the rate of adverse events. However, cannulation time was significantly longer in the trainee group with a significant increase in the rate of precut use (32.1% vs. 23.4%, p < 0.001). Trainee involvement resulted in longer cannulation times and increased use of precut sphincterotomy, but, was not associated with an increased risk of procedure related adverse events.

  20. Digital time delay

    Science.gov (United States)

    Martin, A.D.

    1986-05-09

    Method and apparatus are provided for generating an output pulse following a trigger pulse at a time delay interval preset with a resolution which is high relative to a low resolution available from supplied clock pulses. A first lumped constant delay provides a first output signal at predetermined interpolation intervals corresponding to the desired high resolution time interval. Latching circuits latch the high resolution data to form a first synchronizing data set. A selected time interval has been preset to internal counters and corrected for circuit propagation delay times having the same order of magnitude as the desired high resolution. Internal system clock pulses count down the counters to generate an internal pulse delayed by an internal which is functionally related to the preset time interval. A second LCD corrects the internal signal with the high resolution time delay. A second internal pulse is then applied to a third LCD to generate a second set of synchronizing data which is complementary with the first set of synchronizing data for presentation to logic circuits. The logic circuits further delay the internal output signal with the internal pulses. The final delayed output signal thereafter enables the output pulse generator to produce the desired output pulse at the preset time delay interval following input of the trigger pulse.

  1. Delayed Sequence Intubation

    DEFF Research Database (Denmark)

    Weingart, Scott D; Trueger, N Seth; Wong, Nelson

    2015-01-01

    assessed. RESULTS: A total of 62 patients were enrolled: 19 patients required delayed sequence intubation to allow nonrebreather mask, 39 patients required it to allow NIPPV, and 4 patients required it for nasogastric tube placement. Saturations increased from a mean of 89.9% before delayed sequence...

  2. Combined Use of Duloxetine and Olanzapine in the Treatment of Urologic Chronic Pelvic Pain Syndromes Refractory to Conventional Treatment: A Case Report

    Science.gov (United States)

    Shan, Liping; Zhou, Die

    2018-01-01

    Patients with urologic chronic pelvic pain syndromes (UCPPS) report interstitial cystitis/bladder pain syndrome and/or chronic prostatitis/chronic pelvic pain syndrome. The pathogenesis of these syndromes remains unclear and there is currently no standard treatment. UCPPS is, therefore, often misdiagnosed and its management is complex. The present case report involves a 62-year-old male patient with UCPPS whose main presentation is painful bladder filling and painful urgency refractory to conventional treatment with medication, which was successfully treated with the combined use of duloxetine and olanzapine. The combined use of duloxetine and olanzapine may become a new therapeutic option in the management of UCPPS. PMID:29397676

  3. American Dream Delayed

    DEFF Research Database (Denmark)

    Khorunzhina, Natalia; Miller, Robert A.

    This paper investigates the delay in homeownership and a subsequent reduction in homeownership rate observed over the past decades. We focus on the delay in giving birth to children and increased labor market participation as contributing factors to homeownership dynamics for prime-age female hou......, fertility decisions and labor supply alternatives faced by the individuals over different stages of the life cycle. The delays in giving birth and buying first home arise endogenously.......This paper investigates the delay in homeownership and a subsequent reduction in homeownership rate observed over the past decades. We focus on the delay in giving birth to children and increased labor market participation as contributing factors to homeownership dynamics for prime-age female...

  4. Trainee involvement increases precut rates and delays access to the common bile duct without an increase in procedure-related adverse events: a brave new world of ERCP training?

    Directory of Open Access Journals (Sweden)

    Voiosu Theodor

    2018-03-01

    Full Text Available Background and aims. Selective cannulation of the desired duct is a key element in ERCP procedures and an important step in the training of fellows. However, there is limited data about technical success and patient safety for ERCPs conducted in a training setting.We aimed to evaluate the impact of trainee involvement on the cannulation technique and procedure related outcomes at ERCP.

  5. Mapping the landscape of urology: A new media-based cross-sectional analysis of public versus academic interest.

    Science.gov (United States)

    Borgmann, Hendrik; Salem, Johannes; Baunacke, Martin; Boehm, Katharina; Groeben, Christer; Schmid, Marianne; Siegel, Fabian P; Huber, Johannes

    2018-03-08

    To quantify public and academic interest in the urological field using a novel new media-based methodology. We systematically measured public and academic interest in 56 urological keywords and combined in nine subspecialties. Public interest was quantified as video views on YouTube. Academic interest was quantified as article citations using Microsoft Academic Search. The public-to-academic interest ratio was calculated for a comparison of subspecialties as well as for diseases and treatments. For the selected 56 urological keywords, we found 226 617 591 video views on YouTube and 2 146 287 citations in the academic literature. The public-to-academic interest ratio was highest for the subspecialties robotic urology (ratio 6.3) and andrological urology (ratio 4.6). Prostate cancer was the central urological disease combining both a high public (20% of all video views) and academic interest (26% of all citations, ratio 0.8). Further diseases/treatments of high public interest were premature ejaculation (ratio 54.4), testicular cancer (ratio 11.4), erectile dysfunction (ratio 5.5) and kidney transplant (ratio 3.7). Urological treatments had a higher public-to-academic interest ratio (median ratio 0.25) than diseases (median ratio 0.05; P = 0.029). A quantification of academic and public interest in the urological field is feasible using a novel new media-based methodology. We found several mismatches in public versus academic interest in urological diseases and treatments, which has implications for research strategies, conference planning and patient information projects. Regular re-assessments of the public and academic interest landscape can contribute to detecting and proving trends in the field of urology. © 2018 The Japanese Urological Association.

  6. 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

  7. 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.

  8. Evolution of the Application of Techniques Derived from Abdominal Transplant Surgery in Urologic Oncology.

    Science.gov (United States)

    González, Javier; Gaynor, Jeffrey J; Alameddine, Mahmoud; Ciancio, Gaetano

    2018-02-05

    The techniques derived from abdominal transplant surgery have become a major actor in recent surgical evolution by providing a more optimal solution for urologic malignancies hosted in the upper abdomen. To describe in detail the objectives, rationale, relevant milestones, and surgical maneuvers of the so-called transplant techniques as applied to complex urologic oncology cases. The transplant-based surgical approach aims to decrease perioperative complications by improving tumor accessibility and field visibility through an enhanced exposure (via the use of a transverse incision, a specific retractor, and specific surgical maneuvers). A sequence of milestones inspired these advances, which finally brought the technique into maturation. The transplant-based approach has demonstrated its safety and usefulness even in the low-volume practice of more complicated urologic oncology, offering protection against the occurrence of perioperative adverse events and placing us at the gates of a new stage of surgical innovation.

  9. [Anesthesia in urology: notes on its history and development in Spain, 1847 to 1950].

    Science.gov (United States)

    Franco, A; Cortés, J; Hernández, B; Alvarez, J

    2007-01-01

    This review of the historical course of anesthesia performed in the context of urology in Spain relies on primary sources: doctoral theses, dissertations, published articles, inaugural addresses, conference proceedings, and books belonging to various archives and libraries. We collected a large number of documents relating to urology and of particular interest regarding anesthesia, classified them, and subjected them to critical analysis. This allowed us to carefully follow the development of anesthesia and urology itself, both of which attained notable clinical and scientific importance in Spain. Anesthesia with chloroform and incomplete anesthesia were the norm during the second half of the 19th century. However, during the first half of the 20th century, the most widely used techniques were the application of ether or spinal or local infusions, although epidural and intravenous techniques were also mentioned.

  10. 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.

  11. Advanced Practice Nursing in Pediatric Urology: experience report in the Federal District.

    Science.gov (United States)

    Souza, Bruna Marcela Lima de; Salviano, Cristiane Feitosa; Martins, Gisele

    2018-01-01

    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. This is an experience report regarding the implementation of an outpatient service aimed at children and adolescents with symptoms of bladder and bowel dysfunction. 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. 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.

  12. [Delayed appendectomy because of diagnostic malpractice: Experiences of the Arbitration Board of the North German Medical Associations].

    Science.gov (United States)

    Vinz, Heinrich; von Bülow, Markward; Neu, Johann

    2015-01-01

    From 2000 to 2012, 447 panel proceedings concerning acute appendicitis were evaluated. 271 cases (57 %) were related to alleged diagnostic malpractice. This was confirmed in 176 cases (67 %). The following medical specialities were involved (m = quote of malpractice): general surgery 33 %, m = 51 %; paediatric surgery 3 %, m = 44 %; general practitioner and prehospital emergency services 24 %, m = 62 %; internal medicine 19 %, m = 70 %; paediatrics 13 %, m = 57 %; gynaecology 3 %, m = 91 %; urology 2 %, m = 17 %. The most frequent misdiagnosis was gastroenteritis (43 % in adults, 69 % in children), obviously based on the concomitant symptom of diarrhoea. Surgery revealed all stages of advanced appendicitis up to peritoneal sepsis, organic failure and death (n = 5). The evaluation of the files and the experts' reports of the 176 cases of diagnostic malpractice allowed to define the following basic failures, which led to unjustified delay of operation: careless history-taking, no or incomplete physical examination, no follow-up investigations, incorrect interpretation of the patient's complaints and clinical findings, no or incomplete documentation. Conducting a thorough investigation is essential to avoiding diagnostic malpractice. Internal analysis of failures or near failures may contribute to reducing the number of future cases of malpractice. Copyright © 2015. Published by Elsevier GmbH.

  13. Use of General Surgery and Urology Online Modules in Medical Education

    Directory of Open Access Journals (Sweden)

    Chang

    2016-03-01

    Full Text Available Background Web-based learning is increasingly used as an adjunct to, and a replacement for, traditional learning methods. We investigated the impact of web-based learning modules in improving the delivery of undergraduate medical education in general surgery and urology. Objectives To determine if online learning modules improve student performance in general surgery and urology. To determine if previous use of online learning modules promote future utilization of such modules among students. Materials and Methods Four general surgical and urologic web-based learning modules were delivered as an adjunct to traditional teaching via an online learning management system to fourth year medical students in 2009 and 2010. Each module contained 40 identical pre-module and post-module questions which allow analysis of change in student performance after delivery of these modules. The student t-test and Fisher’s exact test were used for statistical analysis. Results In urology, the mean pre-module score was 22.4 (SD 4.3 and the mean post-module score was 33.0 (SD 2.1 (P < 0.001. Students who completed all the pre-module and post-module questions had a mean increase of 12.8 score points (SD 3.9. In general surgery, significantly more students completed all of the pre-module (42.7% vs. 27.5% and post-module (23.2% vs. 7.3% questions for the general surgical modules in 2010 compared to the urology modules in 2009 (P ≤ 0.001. Conclusions The introduction of web-based general surgery and urologic learning modules as an adjunct to traditional teaching improved student knowledge, and their usage improved over time.

  14. 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 media was higher among Canadian residents for the Internet (p media play a dominant role in the education of urology residents. The primary 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.

  15. 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.

  16. 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.

  17. Delayed power analysis

    International Nuclear Information System (INIS)

    Adamovich, L.A.; Azarov, V.V.

    1999-01-01

    Time dependent core power behavior in a nuclear reactor is described with well-known neutron kinetics equations. At the same time, two portions are distinguished in energy released from uranium nuclei fission; one released directly at fission and another delayed (residual) portion produced during radioactive decay of fission products. While prompt power is definitely described with kinetics equations, the delayed power presentation still remains outstanding. Since in operation the delayed power part is relatively small (about 6%) operation, it can be neglected for small reactivity disturbances assuming that entire power obeys neutron kinetics equations. In case of a high negative reactivity rapidly inserted in core (e.g. reactor scram initiation) the prompt and delayed components can be calculated separately with practically no impact on each other, employing kinetics equations for prompt power and known approximation formulas for delayed portion, named residual in this specific case. Under substantial disturbances the prompt component in the dynamic process becomes commensurable with delayed portion, thus making necessary to take into account their cross impact. A system of differential equations to describe time-dependent behavior of delayed power is presented. Specific NPP analysis shows a way to significantly simplify the task formulation. (author)

  18. Single-centre experience of retroperitoneoscopic approach in urology with tips to overcome the steep learning curve

    Directory of Open Access Journals (Sweden)

    Aneesh Srivastava

    2016-01-01

    Full Text Available Context: The retroperitoneoscopic or retroperitoneal (RP surgical approach has not become as popular as the transperitoneal (TP one due to the steeper learning curve. Aims: Our single-institution experience focuses on the feasibility, advantages and complications of retroperitoneoscopic surgeries (RS performed over the past 10 years. Tips and tricks have been discussed to overcome the steep learning curve and these are emphasised. Settings and Design: This study made a retrospective analysis of computerised hospital data of patients who underwent RP urological procedures from 2003 to 2013 at a tertiary care centre. Patients and Methods: Between 2003 and 2013, 314 cases of RS were performed for various urological procedures. We analysed the operative time, peri-operative complications, time to return of bowel sound, length of hospital stay, and advantages and difficulties involved. Post-operative complications were stratified into five grades using modified Clavien classification (MCC. Results: RS were successfully completed in 95.5% of patients, with 4% of the procedures electively performed by the combined approach (both RP and TP; 3.2% required open conversion and 1.3% were converted to the TP approach. The most common cause for conversion was bleeding. Mean hospital stay was 3.2 ± 1.2 days and the mean time for returning of bowel sounds was 16.5 ± 5.4 h. Of the patients, 1.4% required peri-operative blood transfusion. A total of 16 patients (5% had post-operative complications and the majority were grades I and II as per MCC. The rates of intra-operative and post-operative complications depended on the difficulty of the procedure, but the complications diminished over the years with the increasing experience of surgeons. Conclusion: Retroperitoneoscopy has proven an excellent approach, with certain advantages. The tips and tricks that have been provided and emphasised should definitely help to minimise the steep learning curve.

  19. 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.

  20. 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.

  1. Delayed puberty in boys

    Science.gov (United States)

    ... In most cases, delayed puberty is simply a matter of growth changes beginning later than usual, sometimes ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  2. Delayed puberty in girls

    Science.gov (United States)

    ... with too little body fat, gaining a bit of weight may help trigger puberty. If delayed puberty is caused by a disease or an eating disorder, treating the cause may help puberty to develop normally. If puberty ...

  3. Vernier Delay Unit

    Energy Technology Data Exchange (ETDEWEB)

    Pierce, W.B.

    1984-10-01

    This module will accept differential ECL pulses from the auxiliary rear panel or NIM level pulses from the front panel. The pulses are produced at the output with a fixed delay that is software programmable in steps of 0.1 ns over the range of 0.1 to 10.5 ns. Multiple outputs are available at the front panel. Minimum delay through the module is 9 ns.

  4. Choice and reinforcement delay

    OpenAIRE

    Gentry, G. David; Marr, M. Jackson

    1980-01-01

    Previous studies of choice between two delayed reinforcers have indicated that the relative immediacy of the reinforcer is a major determinant of the relative frequency of responding. Parallel studies of choice between two interresponse times have found exceptions to this generality. The present study looked at the choice by pigeons between two delays, one of which was always four times longer than the other, but whose absolute durations were varied across conditions. The results indicated th...

  5. The European Urology Residents Education Programme Hands-on Training Format: 4 Years of Hands-on Training Improvements from the European School of Urology.

    Science.gov (United States)

    Somani, Bhaskar K; Van Cleynenbreugel, Ben; Gozen, Ali; Palou, Jaun; Barmoshe, Sas; Biyani, Shekhar; Gaya, Josep M; Hellawell, Giles; Pini, Gio; Oscar, Faba R; Sanchez Salas, Rafael; Macek, Petr; Skolarikos, Andreas; Wagner, Christian; Eret, Viktor; Haensel, Stephen; Siena, Giampaolo; Schmidt, Marek; Klitsch, Max; Vesely, Stepan; Ploumidis, Achilles; Proietti, Silvia; Kamphuis, Guido; Tokas, Theodore; Geraghty, Rob; Veneziano, Dominico

    2018-03-14

    The European School of Urology (ESU) started the European Urology Residents Education Programme (EUREP) in 2003 for final year urology residents, with hands-on training (HOT) added later in 2007. To assess the geographical reach of EUREP, trainee demographics, and individual quality feedback in relation to annual methodology improvements in HOT. From September 2014 to October 2017 (four EUREP courses) several new features have been applied to the HOT format of the EUREP course: 1:1 training sessions (2015), fixed 60-min time slots (2016), and standardised teaching methodology (2017). The resulting EUREP HOT format was verified by collecting and prospectively analysing the following data: total number of participants attending different HOT courses; participants' age; country of origin; and feedback obtained annually. A total of 796 participants from 54 countries participated in 1450 HOT sessions over the last 4 yr. This included 294 (20%) ureteroscopy (URS) sessions, 237 (16.5%) transurethral resection (TUR) sessions, 840 (58%) basic laparoscopic sessions, and 79 (5.5%) intermediate laparoscopic sessions. While 712 residents (89%) were from Europe, 84 (11%) were from non-European nations. Of the European residents, most came from Italy (16%), Germany (15%), Spain (15%), and Romania (8%). Feedback for the basic laparoscopic session showed a constant improvement in scores over the last 4 yr, with the highest scores achieved last year. This included feedback on improvements in tutor rating (p=0.017), organisation (ptraining curriculum with wet laboratory or cadaveric courses in this format, although these could be performed in other training centres in conjunction with EUREP. The EUREP trainee demographics show that the purpose of the course is being achieved, with excellent feedback reported. While European trainees dominate the demographics, participation from a number of non-European countries suggests continued ESU collaboration with other national societies and

  6. 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 o...

  7. 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

  8. [Social medical/public health assessment of the ability to work regarding urological and urooncological diseases].

    Science.gov (United States)

    Zermann, D-H; Hoffmann, W; Vahlensieck, W

    2017-01-01

    The primary objectives of modern urooncological treatment concepts are quality of life, reintegration and participation. Urological rehabilitation supports the overcoming of side effects of disease and treatment, which is necessary for the timely return to work life. Social medical assessment reflects the individual overall results of the entire treatment process concerning oncological prognosis, physical and mental capacity and resilience.

  9. [The future of urological care: the current situation in healthcare political environment].

    Science.gov (United States)

    Knieps, F; Ex, P

    2012-08-01

    The healthcare system is the largest economic market in Germany. The specific requirements demand an intelligent mixture of market, self-administration and federal regulation, which must be permanently adapted to continuously altering environmental conditions. Urological care exemplifies the adaptation of healthcare to altered economic, social and medical environmental conditions.

  10. 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

  11. 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

  12. Review Article: Practical Aspects of Testosterone Deficiency Syndrome in Clinical Urology

    OpenAIRE

    Hisham A. Mosli

    2012-01-01

    In this review we describe the clinical manifestations associated with testosterone deficiency in aging men, termed the testosterone deficiency syndrome (TDS). Since aging men suffer from multiple urological and andrological symptoms, TDS is an important medical condition to be suspected, recognized, clinically and biochemically diagnosed and therefore effectively and successfully treated.

  13. Fluoroscopy time during uncomplicated unilateral ureteroscopy for urolithiasis decreases with urology resident experience.

    Science.gov (United States)

    Weld, Lancaster R; Nwoye, Uzoamaka O; Knight, Richard B; Baumgartner, Timothy S; Ebertowski, James S; Stringer, Matthew T; Kasprenski, Matthew C; Weld, Kyle J

    2015-01-01

    To determine predictors of fluoroscopy time during uncomplicated, unilateral ureteroscopy for urolithiasis performed by urology residents during the first 2 years of residency. The patient charts and computed tomography scans of consecutive, unilateral, uncomplicated ureteroscopy cases for urolithiasis were retrospectively reviewed. The cases were performed by beginning urology residents over the course of their first 2 years of urology residency training. A total of 200 ureteroscopy cases were reviewed. The mean stone diameter was 7.1 (±3.2) mm. Forty-three percent of cases were performed for renal stones and 58 % for ureteral stones. The mean operative time was 80.2 (±36.9) min. The mean fluoroscopy time was 69.1 (±38.2) s. No significant differences existed between cases performed by each of the two residents, and no statistical differences in case difficulty were observed throughout the study period. Linear regression analysis revealed the strongest association with lower fluoroscopy time to be increasing resident experience (p fluoroscopy time decreased by 79 % from 135 to 29 s per case. Other significant factors associated with increasing fluoroscopy time were placement of a postoperative stent under fluoroscopic guidance (p Fluoroscopy time during uncomplicated, unilateral ureteroscopy for urolithiasis decreases with increasing urology resident operative experience. Other technical options during ureteroscopy were also found to influence fluoroscopy time.

  14. High level of patient satisfaction and comfort during diagnostic urological procedures performed by urologists and residents.

    NARCIS (Netherlands)

    Vries, A.H. de; Lesterhuis, E.; Verweij, L.M.; Schout, B.M.A.; Horst, H.J.R. van der; Leppink, J.; Koldewijn, E.L.; Wagner, C.

    2016-01-01

    Objective. The aim of this study was to investigate how patients experience diagnostic urological procedures performed by urologists, junior residents and senior residents, and to assess the influence of procedure-related factors on patient experiences. Methods. Data were collected during 222

  15. Is there a relationship between National Institutes of Health funding and research impact on academic urology?

    Science.gov (United States)

    Colaco, Marc; Svider, Peter F; Mauro, Kevin M; Eloy, Jean Anderson; Jackson-Rosario, Imani

    2013-09-01

    Scholarly productivity in the form of research contributions is important for appointment and promotion in academic urology. Some believe that this production may require significant funding. We evaluated the relationship between National Institutes of Health (NIH) funding, academic rank and research productivity, as measured by the h-index, an objective indicator of research impact on a field. A total of 361 faculty members from the top 20 NIH funded academic urology departments were examined for research productivity, as measured by the h-index and calculated from the Scopus database (http://www.info.sciverse.com/scopus). Research productivity was compared to individual funding totals, the terminal degree and academic rank. NIH funded faculty members had statistically higher research productivity than nonfunded colleagues. Research productivity increased with increasing NIH funding. Departmental NIH funding correlated poorly with the mean department h-index. Successive academic rank was associated with increasing research productivity. Full professors had higher NIH funding awards than their junior NIH funded colleagues. There is an association among the h-index, NIH funding and academic rank. The h-index is a reliable method of assessing the impact of scholarly contributions toward the discourse in academic urology. It may be used as an adjunct for evaluating the scholarly productivity of academic urologists. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  16. 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

  17. [Interest of amoxicillin-clavulanic acid combination in urology: An update].

    Science.gov (United States)

    Bruyère, F; Dihn, A; Sotto, A

    2016-06-01

    This is a review article aiming to bring the place and manner of use of amoxicillin-clavulanic acid in urology. Data collection on the conditions of use of amoxicillin-clavulanic acid in urology has been performed from the Medline database. The following keywords were used: amoxicillin; clavulanic acid; urine; diffusion; pharmacokinetics. The selection was based on the methodology, language of publication (English/French), relevance to the topic and date of publication of the articles collected. Overall, it is clear from the literature and the national and international guidelines that amoxicillin-clavulanic acid in urinary infections can not be used in probabilistic. However, this association remains valid excepted in the treatment of male urinary tract infections due to a probable fault prostatic diffusion. Note that changing the critical concentrations by the CA-SFM/EUCAST for cystitis of this association should allow an extension of its indication in this situation. Serious adverse effects of amoxicillin-clavulanic acid remain rare. If long, the amoxicillin-clavulanic acid played a role of first order in the field of urology, the association has given way to other molecules because of the emergence of resistance. However, A-AC keeps indications in the field of antibiotic therapy in urinary tract infections, surgical antimicrobial prophylaxis and postoperative infections in urology. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  18. 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

  19. Prospective evaluation of antibiotic treatment for urological procedure in patients presenting with neurogenic bladder.

    Science.gov (United States)

    Weglinski, L; Rouzaud, C; Even, A; Bouchand, F; Davido, B; Duran, C; Salomon, J; Perronne, C; Denys, P; Chartier-Kastler, E; Dinh, A

    2016-09-01

    Patients presenting with neurogenic bladder often require urological procedures (urodynamic testing and botulinum toxin injections) and a preventive antibiotic therapy. We aimed to assess the efficacy of this little known strategy in a cohort of patients. All patients presenting with neurogenic bladder who underwent urological procedure were included in the study. They received an antibiotic therapy in accordance with the urine cytobacteriological examination results. The antibiotic therapy was initiated two days before the procedure and prolonged up until two days after the procedure if the culture was positive. Patients were treated with a single dose of fosfomycin-trometamol in case of a negative culture. The main study outcome was the occurrence of urinary tract infection (UTI), defined by a positive urine culture and symptoms, up until 14 days after the procedure. A total of 80 urological procedures were performed. Mean patient age was 47±13.1 years (sex ratio 1.22); 59 (73.8%) presented with asymptomatic bacteriuria before the procedure. Nine (11.1%) UTIs were recorded on Day 14, of which one (1.2%) was febrile. Two patients required an additional curative antibiotic therapy. No patient was hospitalized. Overall, 77.8% of UTIs were cured without antibiotic therapy. Screening and treating asymptomatic bacteriuria before urological procedures seems unnecessary and vainly exposes this population at high risk of infectious diseases to antibiotic therapies. This data should be confirmed by a randomized clinical trial. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. 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.

  1. Patient satisfaction in urology: effects of hospital characteristics, demographic data and patients' perceptions of received care.

    Science.gov (United States)

    Schoenfelder, Tonio; Schaal, Tom; Klewer, Joerg; Kugler, Joachim

    2014-09-06

    To identify factors that are significantly associated with patient satisfaction in urology and to assess the extent to which satisfaction ratings might be related to hospital and patient characteristics. Data used in this study were obtained from 1040 randomly selected urology patients discharged from nine hospitals who responded to a mailed survey. Bivariate and multivariate techniques were used to reveal relations between patient assessments of received care, hospital and patient characteristics. Bivariate analysis showed a strong association between satisfaction scores and length of stay, provider status, work load of nurses and hospital size, with weaker findings pertaining to type of hospital (teaching versus non-teaching) and patient demographics. The multivariate analysis identified nine vari­ables which are associated with overall satisfaction. Strong factors were treatment outcome, the interper­sonal manner of medical practitioners and nurses, as well as hotel aspects like accommodation and quality of food. Variables reflecting information receiving about the undergoing treatment were not found to have a significant influence on patient satisfaction. This study identified variables that are related to satisfaction in a urological setting and de­livers information about aspects of the hospital stay that are not perceived as relevant by patients. These findings support healthcare professionals with valuable information to meet needs and preferences of pa­tients in urology.

  2. High acceptability of a newly developed urological practical skills training program.

    Science.gov (United States)

    de Vries, Anna H; van Luijk, Scheltus J; Scherpbier, Albert J J A; Hendrikx, Ad J M; Koldewijn, Evert L; Wagner, Cordula; Schout, Barbara M A

    2015-09-04

    Benefits of simulation training are widely recognized, but its structural implementation into urological curricula remains challenging. This study aims to gain insight into current and ideal urological practical skills training and presents the outline of a newly developed skills training program, including an assessment of the design characteristics that may increase its acceptability. A questionnaire was sent to the urology residents (n = 87) and program directors (n = 45) of all Dutch teaching hospitals. Open- and close-ended questions were used to determine the views on current and ideal skills training and the newly developed skills training program. Eight semi-structured interviews were conducted with 39 residents and 15 program directors. All interviews were audiotaped, fully transcribed, and thereafter analyzed. Response was 87.4% for residents and 86.7% for program directors. Residents appeared to be still predominantly trained 'by doing'. Structured practical skills training in local hospitals takes place according to 12% of the residents versus 44% of the program directors (p skills training program (p = 0.51). 'Structured scheduling', 'use of peer teaching' and 'high fidelity models' were indicated as design characteristics that increase its acceptability. Current urological residency training consists of patient-related 'learning by doing', although more practice on simulation models is desired. The acceptability of implementing the presented skills-training program is high. Design characteristics that increase its acceptability are structured scheduling, the use of peer teaching and high fidelity models.

  3. Accompanying role of hepato-biliary-pancreas surgeon in urological surgery

    Directory of Open Access Journals (Sweden)

    Atsushi Nanashima

    Full Text Available Introduction: The present case reports demonstrated the accompanying surgical support from hepato-biliary-pancreas (HBP surgeons for urological surgery to secure operative safety because HBP surgeons are well experienced in dissecting techniques for mobilization of the liver or pancreas. We experienced 9 consecutive patients who underwent nephrectomy, adrenectomy or resection of retroperitoneal tumors by urological surgeons. Cardiovascular intervention was also required in cases of long tumor thrombus into the vena cava. Cases: All patients had no severe co-existing diseases except the main tumor. Reverse T-shape incision was performed in 7 cases and thoracolaparotomy in two. Dissection and mobilization at the site of severe compression by the urinary tumors were performed in three cases. Partial liver resection was performed for testicular liver metastases in two, and right hepatectomy for right renal cancer was performed in one. Encircling the vena cava and preparation of transection for tumor thrombi were performed in three, and among these, cardiovascular intervention was necessary in two because of extension into the right atrium. During admission, all patient outcomes were uneventful without severe complications. We herein showed the representative two cases of combined surgery. Discussion: and conclusion The point of this case report is the coordination between each surgeon and anesthesiologist under precise perioperative planning or management. The role of HBP surgeons is to provide information as a specialist on the operative field for urological or cardiovascular surgery to achieve operative safety. Keywords: Hepato-biliary-pancreas surgeon, Joint surgery, Urology

  4. 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

    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. 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. 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 (panalysis of a single conference analysis, assessment of global profile and not domain-specific activity, and the rapid evolution in Twitter-using habits. Results of this single conference qualitative analysis are promising for an enrichment of the scientific discussions at urologic conferences through the use of Twitter.

  5. Urological complications of Crohn's disease: entero-vesical fistula and ureteric obstruction

    International Nuclear Information System (INIS)

    Raaijmakers, P.A.M.; Boetes, C.; Strijk, S.P.; Boer, H.H.M. de; Debruyne, F.M.J.; Rosenbusch, G.

    1983-01-01

    Crohn's disease has a tendency to form fistulae and abscesses, which may lead directly to urological complications. Three patients were seen who had entero-vesical fistulae; only one of these could be demonstrated radiologically. There were also seven patients with Crohn's disease who had ureteric obstruction. (orig.) [de

  6. 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

  7. 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

  8. Basic Laparoscopic Skills Assessment Study: Validation and Standard Setting among Canadian Urology Trainees.

    Science.gov (United States)

    Lee, Jason Y; Andonian, Sero; Pace, Kenneth T; Grober, Ethan

    2017-06-01

    As urology training programs move to a competency based medical education model, iterative assessments with objective standards will be required. To develop a valid set of technical skills standards we initiated a national skills assessment study focusing initially on laparoscopic skills. Between February 2014 and March 2016 the basic laparoscopic skill of Canadian urology trainees and attending urologists was assessed using 4 standardized tasks from the AUA (American Urological Association) BLUS (Basic Laparoscopic Urological Surgery) curriculum, including peg transfer, pattern cutting, suturing and knot tying, and vascular clip applying. All performances were video recorded and assessed using 3 methods, including time and error based scoring, expert global rating scores and C-SATS (Crowd-Sourced Assessments of Technical Skill Global Rating Scale), a novel, crowd sourced assessment platform. Different methods of standard setting were used to develop pass-fail cut points. Six attending urologists and 99 trainees completed testing. Reported laparoscopic experience and training level correlated with performance (p standard setting methods to define pass-fail cut points for all 4 AUA BLUS tasks. The 4 AUA BLUS tasks demonstrated good construct validity evidence for use in assessing basic laparoscopic skill. Performance scores using the novel C-SATS platform correlated well with traditional time-consuming methods of assessment. Various standard setting methods were used to develop pass-fail cut points for educators to use when making formative and summative assessments of basic laparoscopic skill. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  9. Transgender-Related Education in Plastic Surgery and Urology Residency Programs

    Science.gov (United States)

    Morrison, Shane D.; Dy, Geolani W.; Chong, H. Jonathan; Holt, Sarah K.; Vedder, Nicholas B.; Sorensen, Mathew D.; Joyner, Byron D.

    2017-01-01

    Background With increasing public awareness of and greater coverage for gender-confirming surgery by insurers, more transgender patients are likely to seek surgical transition. The degree to which plastic surgery and urology trainees are prepared to treat transgender patients is unknown. Objective We assessed the number of hours dedicated to transgender-oriented education in plastic surgery and urology residencies, and the impact of program director (PD) attitudes on provision of such training. Methods PDs of all Accreditation Council for Graduate Medical Education–accredited plastic surgery (91) and urology (128) programs were invited to participate. Surveys were completed between November 2015 and March 2016; responses were collected and analyzed. Results In total, 154 PDs (70%) responded, and 145 (66%) completed the survey, reporting a yearly median of 1 didactic hour and 2 clinical hours of transgender content. Eighteen percent (13 of 71) of plastic surgery and 42% (31 of 74) of urology programs offered no didactic education, and 34% (24 of 71) and 30% (22 of 74) provided no clinical exposure, respectively. PDs of programs located in the southern United States were more likely to rate transgender education as unimportant or neutral (23 of 37 [62%] versus 39 of 105 [37%]; P = .017). PDs who rated transgender education as important provided more hours of didactic content (median, 1 versus 0.75 hours; P = .001) and clinical content (median, 5 versus 0 hours; P plastic surgery and urology residencies provide no education on transgender health topics, and those that do, provide variable content. PD attitudes toward transgender-specific education appear to influence provision of training. PMID:28439350

  10. 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.

  11. [Effectiveness of imipenem/cilastatin (Tienam, MSD) in treating complicated infections in urology].

    Science.gov (United States)

    Derevianko, I I; Nefedova, L A; Lavrinova, L N

    2002-01-01

    Complicated urinary infections tend to eventuate in severe pyoseptic complications--bacteriuria, sepsis. The search for methods of fighting agents of urinary infections goes in the direction of perfection of already existing methods and in the direction of design of novel antibacterial drugs. In the middle 1980s the first carbapenem drug-imipenem--was proposed for urological clinical practice. Mechanism of its action as that of the other beta-lactam antibiotics consists in impairment of synthesis of bacterial cell wall as a result of the drug penetration through the surface membrane and irreversible binding with penicillin-binding proteins. Imipenem is active against most gram-positive and gram-negative aerobic and anaerobic microorganisms which cause severe urological infections. The article presents the results of treatment of 45 patients with severe urological infections with multiple resistance of the causing agent and failure of previous treatment. Imipenem was given in a daily dose 1.5-2.0 g. Sometimes a stepwise regimen was used: 500 mg 4 times a day intravenously for the first 3-4 days, then 500 mg twice a day intramuscularly for the following 3-4 days. In detection of highly sensitive bacteria (E. coli, Proteus mirabilis) daily doses were reduced to 1 g. In long standing infection caused by Pseudomonas aeruginosa imipenem was combined with amicacin. In high surgical risk of postoperative period imipenem was given prior to surgery and continued after it for 5 to 14 days. Good therapeutic results were achieved: clinical effect reached 95.5%, antibacterial efficiency was 87.8%. Thus, imipenem is antibiotic of the first line in empirical therapy of severe bacterial infections in urology as it has a wide spectrum of antibacterial action. We believe that this drug should not be left as a reserve but used for a starting empirical therapy of severe infections in urological hospital.

  12. 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.

  13. 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

  14. Development of urologic laparoscopy in Germany, Austria, and Switzerland: a survey among urologists.

    Science.gov (United States)

    Imkamp, Florian; Herrmann, Thomas R W; Stolzenburg, Jens U; Rassweiler, Jens; Sulser, Tullio; Zimmermann, Uwe; Dziuba, Sebastian; Kuczyk, Markus A; Burchardt, Martin

    2014-12-01

    Laparoscopy introduction has dramatically changed urology. Novel techniques, such as laparoendoscopic single-site surgery (LESS) and natural orifice translumenal endoscopic surgery (NOTES), might also have substantial influence. This 2012 survey evaluated present laparoscopy use, its appraisal among urologic surgeons, laparoscopy training, and use of new techniques. Results were compared to the previous surveys, demonstrating the 10-year development of laparoscopy. A detailed questionnaire regarding demographic data, laparoscopy use, attitudes concerning laparoscopy, and novel techniques was send to 424 departments in Germany, Austria, and Switzerland. Procedures performed in 25 indications were quantitatively evaluated. The response rate was 63 % (269). Eighty-six percent of the respondents reported performing laparoscopy, compared to 54 % in 2002. Only 16 % expected economic advantages with laparoscopy, whereas 67 % expected shorter hospitalization. Seventy percent of responders anticipated comparable functional and oncological results between laparoscopic procedures and open surgery. Slow learning curves (81 %) and insufficient training facilities (32 %) were reported to impair laparoscopic surgery. On average, laparoscopic and non-laparoscopic surgical teams consisted of 2.5 and 3.5 members, respectively. LESS procedures were performed at 15 % of institutions. Twenty-two percent of respondents considered NOTES techniques valuable for future urology. Few indications (laparoscopic prostatectomies or nephrectomies) were performed frequently in specialized centers, and the rapidly increasing procedure numbers observed between 2002 and 2007 had dropped to a mild accretion. The results demonstrate broad acceptance of laparoscopy in German urologic surgery, depict the need for structured training facilities, and indicate limited impact of novel techniques (LESS and NOTES). The survey demonstrates the 10-year development of urologic laparoscopy and the broad acceptance

  15. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne

    2011-01-01

    Studies of complications following reconstructive surgery with implants among women with breast cancer are needed. As the, to our knowledge, first prospective long-term study we evaluated the occurrence of complications following delayed breast reconstruction separately for one- and two......-stage procedures. From the Danish Registry for Plastic Surgery of the Breast, which has prospectively registered data for women undergoing breast implantations since 1999, we identified 559 women without a history of radiation therapy undergoing 592 delayed breast reconstructions following breast cancer during...... of reoperation was significantly higher following the one-stage procedure. For both procedures, the majority of reoperations were due to asymmetry or displacement of the implant. In conclusion, non-radiated one- and two-stage delayed breast implant reconstructions are associated with substantial risks...

  16. Development of validated instrument to measure medical student learning in clinical urology: a step toward evidence based education.

    Science.gov (United States)

    Kerfoot, B Price; Baker, Harley; Volkan, Kevin; Church, Paul A; Federman, Daniel D; Masser, Barbara A; DeWOLF, William C

    2004-07-01

    To date published efforts to assess and improve medical student learning in urology have been limited due to the lack of an assessment tool with which to measure student learning. We report the development of a validated measure of medical student learning in urology. Four core topics in clinical urology were selected as the focus of the test development, namely prostate cancer, screening with prostate specific antigen, benign prostatic hyperplasia and erectile dysfunction. Detailed curricula and multiple choice questions were created for each topic. Content validity of the curriculum and 28 item examination was established by a panel of 2 urologists and 2 medical physicians. Instrument reliability was determined by administering the test on line to third-year surgery students. Test construct validity was established through its administration to 19 urology residents and attending physicians. Reliability of the 28-item test instrument was measured by Cronbach's alpha at 0.76 and its 1-week test-retest reliability was 0.72. All urology experts performed well on the test. Mean urological expert scores were significantly higher than mean student post-test scores (24.9 +/- 2.1 vs 17.8 +/- 3.8, 2-tailed t test p <0.001). Urological experts with greater urological training had higher scores than those with less residency training. This study documents the development of a validated measure of medical student learning in urology. This validated instrument has the potential to improve educational quality control at medical schools and facilitate the development of effective, evidence based teaching methods.

  17. A theoretical account of cognitive effects in delay discounting

    OpenAIRE

    Kurth-Nelson, Zeb; Bickel, Warren; Redish, A. David

    2012-01-01

    Although delay discounting, the attenuation of the value of future rewards, is a robust finding, the mechanism of discounting is not known. We propose a potential mechanism for delay discounting such that discounting emerges from a search process trying to determine what rewards will be available in the future. In this theory, the delay dependence of the discounting of future expected rewards arises from three assumptions. First, that evaluation of outcomes involves a search process. Second, ...

  18. Genito-urinary tuberculosis - experience with 52 urology inpatients

    African Journals Online (AJOL)

    ism. Fifty patients underwent excretory urography and the findings were very varied. Patients were treated priInarily with antituberculosis drugs, but. 58% also required some form. ofsurgery; nephrec- tomy was the commonest operation. Ureteral strictures developed in over 50% of cases with renal involvement. We conclude ...

  19. Delayed photon selfinterference

    International Nuclear Information System (INIS)

    Kessel', A.R.; Moiseev, S.A.

    1993-01-01

    Delayed photon selfinterference on a sample containing resonant two-level atoms is considered when the difference in the lengths in two optical paths exceeds the photon 'length'. It is shown that a reading pulse of the electromagnetic field can induce photon echo

  20. Permissible Delay in Payments

    Directory of Open Access Journals (Sweden)

    Yung-Fu Huang

    2007-01-01

    Full Text Available The main purpose of this paper wants to investigate the optimal retailer's lot-sizing policy with two warehouses under partially permissible delay in payments within the economic order quantity (EOQ framework. In this paper, we want to extend that fully permissible delay in payments to the supplier would offer the retailer partially permissible delay in payments. That is, the retailer must make a partial payment to the supplier when the order is received. Then the retailer must pay off the remaining balance at the end of the permissible delay period. In addition, we want to add the assumption that the retailer's storage space is limited. That is, the retailer will rent the warehouse to store these exceeding items when the order quantity is larger than retailer's storage space. Under these conditions, we model the retailer's inventory system as a cost minimization problem to determine the retailer's optimal cycle time and optimal order quantity. Three theorems are developed to efficiently determine the optimal replenishment policy for the retailer. Finally, numerical examples are given to illustrate these theorems and obtained a lot of managerial insights.

  1. Estimating Delays In ASIC's

    Science.gov (United States)

    Burke, Gary; Nesheiwat, Jeffrey; Su, Ling

    1994-01-01

    Verification is important aspect of process of designing application-specific integrated circuit (ASIC). Design must not only be functionally accurate, but must also maintain correct timing. IFA, Intelligent Front Annotation program, assists in verifying timing of ASIC early in design process. This program speeds design-and-verification cycle by estimating delays before layouts completed. Written in C language.

  2. Delays of Interconnected Flows

    Science.gov (United States)

    Sorger, U.; Suchanecki, Z.

    2011-07-01

    A rigorous approach to flows of particles in networks is presented. Under the assumption of independence of the transversal flows the asymptotic distributions of inter-delay times between particles are shown to be log-normal. In the case of dependent transversal traffic the ARCH and GARCH time series models, as well as martingale approach, have been applied.

  3. Plasmas for Transition Delay

    NARCIS (Netherlands)

    Kotsonis, M.; Boon, P.; Veldhuis, L.

    2009-01-01

    This paper describes the experimental investigation of the properties of Dielectric Barrier Discharge (DBD) actuators aimed at transition delay techniques. A wide range of geometrical configurations are tested as well as several electrical operational conditions. For the majority of the measurements

  4. 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

  5. Comparative evaluation of prophylactic single-dose intravenous antibiotic with postoperative antibiotics in elective urologic surgery

    Directory of Open Access Journals (Sweden)

    Mohammad K Moslemi

    2010-11-01

    Full Text Available Mohammad K Moslemi1, Seyed M Moosavi Movahed2, Akram Heidari3, Hossein Saghafi2, Mehdi Abedinzadeh41Department of Urology, 2Department of Nephrology, 3Department of Health, Kamkar Hospital, Qom University of Medical Sciences, Qom, Iran; 4Department of Urology, Moradi Hospital, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, IranBackground: Unrestricted antibiotic use is very common in Iran. As a result, emergence of resistant organisms is commonplace. Antibiotic prophylaxis in surgery consists of a short antibiotic course given immediately before the procedure in order to prevent development of a surgical site infection. The basic principle of prophylaxis is to maintain effective concentrations of an antibiotic active against the commonest pathogens during the entire surgery.Materials and methods: We prospectively investigated 427 urologic surgery cases in our department between August 2008 and September 2009 (Group1. As reference cases, we retrospectively reviewed 966 patients who underwent urologic surgery between May 2004 and May 2008 (Group 2 who were administered antibiotics without any restriction. Prophylactic antibiotics such as cefazolin were administered intravenously according to our protocol. Postoperative body temperature, peripheral white blood cell counts, urinalysis, and urine culture were checked.Results: To judge perioperative infections, wound condition and general condition were evaluated in terms of surgical site infection, as well as remote infection and urinary tract infection, up to postoperative day 30. Surgical site infection was defined as the presence of swelling, tenderness, redness, or drainage of pus from the wound, superficially or deeply. Remote infection was defined as occurrence of pneumonia, sepsis, or urinary tract infection. Perioperative infection rates (for surgical site and remote infection in Group 1 and Group 2 were nine of 427 (2.6% and 24 of 966 (2.5%, respectively. Surgical

  6. Delayed antibiotic prescriptions for respiratory infections.

    Science.gov (United States)

    Spurling, Geoffrey Kp; Del Mar, Chris B; Dooley, Liz; Foxlee, Ruth; Farley, Rebecca

    2017-09-07

    Concerns exist regarding antibiotic prescribing for respiratory tract infections (RTIs) owing to adverse reactions, cost, and antibacterial resistance. One proposed strategy to reduce antibiotic prescribing is to provide prescriptions, but to advise delay in antibiotic use with the expectation that symptoms will resolve first. This is an update of a Cochrane Review originally published in 2007, and updated in 2010 and 2013. To evaluate the effects on clinical outcomes, antibiotic use, antibiotic resistance, and patient satisfaction of advising a delayed prescription of antibiotics in respiratory tract infections. For this 2017 update we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, Issue 4, 2017), which includes the Cochrane Acute Respiratory Infection Group's Specialised Register; Ovid MEDLINE (2013 to 25 May 2017); Ovid Embase (2013 to 2017 Week 21); EBSCO CINAHL Plus (1984 to 25 May 2017); Web of Science (2013 to 25 May 2017); WHO International Clinical Trials Registry Platform (1 September 2017); and ClinicalTrials.gov (1 September 2017). Randomised controlled trials involving participants of all ages defined as having an RTI, where delayed antibiotics were compared to immediate antibiotics or no antibiotics. We defined a delayed antibiotic as advice to delay the filling of an antibiotic prescription by at least 48 hours. We considered all RTIs regardless of whether antibiotics were recommended or not. We used standard Cochrane methodological procedures. Three review authors independently extracted and collated data. We assessed the risk of bias of all included trials. We contacted trial authors to obtain missing information. For this 2017 update we added one new trial involving 405 participants with uncomplicated acute respiratory infection. Overall, this review included 11 studies with a total of 3555 participants. These 11 studies involved acute respiratory infections including acute otitis media (three studies

  7. Effects of delaying the operation of a nuclear power plant

    International Nuclear Information System (INIS)

    Hill, L.J.; Rainey, J.A.; Tepel, R.C.; Van Dyke, J.W.

    1983-12-01

    This report documents a study of an actual 24-month nuclear power plant licensing delay. A representative utility was chosen for examination. The research was oriented toward determination of the licensing delay's impact on the utility's operating results, ratepayers, and security issues. The methodology utilized to estimate those impacts involved the recursive interaction of a generation costing program to estimate replacement fuel costs and a financial regulatory model to concomitantly determine the impact on the utility, its ratepayers and security issues. The latter model was executed under six alternate scenarios: (1) no delay in the plant's operation; (2) a 24-month delay; (3) a 24-month delay but further assuming all replacement power was generated by coal-fired plants; (4) a 24-month delay assuming all replacement power from oil-fired plants; (5) no delay but assuming the capital cost of the plant was twice as large; and (6) a 24-month delay with the capital cost of the plant twice as large. Three primary conclusions were made. First, under all scenarios, a 24-month delay in operation of the plant has an adverse impact on the utility's internal generation of funds. Second, although electricity rates are not appreciably affected by the delay, the direction of electricity price changes is contingent on the source of fuel used for replacement power. Finally, a 24-month delay has an adverse impact on the indicators used to evaluate the financial soundness of the utility in all cases under consideration

  8. Delay Discounting of Reward in ADHD: Application in Young Children

    Science.gov (United States)

    Wilson, Vanessa B.; Mitchell, Suzanne H.; Musser, Erica D.; Schmitt, Colleen F.; Nigg, Joel T.

    2011-01-01

    Background: A key underlying process that may contribute to attention-deficit/hyperactivity disorder (ADHD) involves alterations in reward evaluation, including assessing the relative value of immediate over delayed rewards. This study examines whether children with ADHD discount the value of delayed rewards to a greater degree than typically…

  9. A Study to Determine the Tripler Army Medical Center Urology Clinic's FY 2001 Outpatient Service Charges to the Veterans Administration

    National Research Council Canada - National Science Library

    Sander, Paul

    2001-01-01

    ... (509 clinic and ambulatory procedure visits) and six federal and civilian outpatient billing methodologies in order to determine fair and reasonable TAMC Urology clinic outpatient charges to the VA...

  10. 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.

  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. [Impact of Spanish-language urological publications in periodicals in the English language].

    Science.gov (United States)

    Pérez Arbej, J A; Cameo Rico, M I; Arnáiz Esteban, F; Martínez Pérez, E; Nogueras Gimeno, M A; Espuela Orgaz, R; Crespo Mayor, V

    1997-06-01

    A study was conducted to analyze the impact of the articles published by Spanish authors in the English language urological journals and those published in Spanish journals in the bibliography referenced in the English language urological literature. We randomly analyzed volumes 147, 39 and 69 of the Journal of Urology, Urology and the British Journal of Urology, respectively. All articles in the foregoing volumes were reviewed and analyzed as follows: sections, country, no of references, no of Spanish publications referenced, no of references of Spanish publications and the number of Spanish references cited in these. 356 articles were published in the Journal of Urology: of these, 59% were by American and only 6 (1.68%) were by Spanish authors, which ranked 8th according to number. These 6 articles by Spanish authors cited 84 references; of these, only 3 were Spanish publications. Overall, there were 6,708 references (mean 18.8); 6 (0.11%) were articles published by Spanish authors. In Urology, 140 articles were published: of these, 75% were by American and only one (0.71%) by Spanish authors, which ranked 6th according to number. This article by Spanish authors cited 38 references; of these, only 3 were Spanish publications. Overall, there were 2,055 references (mean 14.6); only 8 (0.38%) were articles published by Spanish authors. In the British Journal of Urology, 177 articles were published: of these, 96 (54.2%) were by British authors and only one (0.56%) by Spanis authors, which ranked 9th according to number. This article by Spanish authors cited 11 references; none of them were Spanish publications. Overall, there were 1,988 references (mean 11.2); 14 (0.7%) were articles published by Spanish authors. Spanish authors are not worse off than those of other neighbouring countries in regard to the number of articles published (1.18%) in the three journals analyzed, where most of the articles were chiefly by American or British authors. Spanish publications

  13. [The role of social media in academic training in Urology. Adequate use.

    Science.gov (United States)

    Gómez Rivas, Juan; Tortolero Blanco, Leonardo; Rodríguez Socarras, Moises; García Sanz, Miguel; Carrión, Diego M; Okhunov, Zhamshid; Veneziano, Domenico

    2018-01-01

    Social media is characterized because all its services are participative. Users of 2.0 technologies can interact easily and openly with other people, share resources and communicate immediately and simultaneously. Research improves from participatory technologies by allowing groups to share reflections, methodologies, resources and results.The social media platform with greater diffusion and use in urology is possibly Twitter because it allows to realize what is known like "microblogging", the users generate comments and brief messages through the creation of "tweets". It is possible to determine that there are three broad areas from a scientific point of view in which social media are manifested: sharing research, resources and results. The use and applications of social media become a major responsibility in the area of health and urology, obviously for reasons of privacy, scientific rigor, ethics and the nature of the medical - legal content.

  14. [On line learning in urologic surgery. The value of the 2.0 Web tools.

    Science.gov (United States)

    Castillón Vela, Ignacio T

    2018-01-01

    The field of Surgery is under the pressure of accelerated change where technological cycles get shorter and shorter, sometimes transformational. Learning and training have gotten a key role because learning curves for new techniques directly affect patient's safety and learning cycles are slower. The traditional learning model within the urology department is overwhelmed. We need new training and learning methods. The aim of this article is to perform a critical analysis of the current status of learning in urological surgery and the challenges we face, evaluating how new information and communication technologies can help us to facilitate the learning process. We also present our initial experience with on line education on upper urinary tract laparoscopic and robotic surgery using the 2.0 Web tools.

  15. [Health services research under internal (urological) control: utopia or order of the day?].

    Science.gov (United States)

    Weber, A

    2014-12-01

    Health services research investigates the structures and processes of the healthcare system under routine daily conditions. Comprehensive scientific knowledge of healthcare services research is necessary to accomplish a management tailored to the needs of the complex healthcare system. Under, over and incorrect supply should be avoided and healthcare provision should be further developed in line with supply and demand while remaining financially feasible. Additionally, cooperation should be structurally constructed across sectorial boundaries of health services resulting in the development of a transparent manageable process. A special focus in urology in this process is initially the representation of the quality of results in the reality of treatment of the most commonly occurring urological tumors. The organizational structures and technical instrumentation for these challenges are only rudimentary and the necessary measures are currently also not financially sustained.

  16. 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.

  17. 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.

  18. 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.

  19. [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.

  20. Jogging-induced spontaneous peri-renal hemorrhage: a rare urologic emergency.

    Science.gov (United States)

    Jabbour, Michel; Dalati, Mohamad-Fadi

    2014-01-01

    Spontaneous peri-renal hemorrhage (SPH), also known as Wünderlich's syndrome, is an uncommon and rare urologic emergency, which could become life-threatening, requiring immediate diagnosis and management. The diagnosis can be challenging, even with new imaging modalities, and management can vary from conservative approach, to surgical intervention. We present a case of jogging-induced SPH diagnosed using CT scan that was managed conservatively, with follow-up for up to five years using CT imaging studies.

  1. Urological Survivorship Issues Among Adolescent Boys and Young Men Who Are Cancer Survivors.

    Science.gov (United States)

    Sukhu, Troy; Ross, Sherry; Coward, R Matthew

    2018-01-27

    Urological survivorship issues encompass an area that may potentially be overlooked after treatment of childhood cancer in adolescent boys and young men. Side effects of cancer therapy may include subsequent development of erectile dysfunction (ED), hypogonadism, and infertility in adulthood. The purpose of this review is to focus on the etiology and prevalence of the range of sexual and gonadal dysfunction in adolescent boys and young men who are cancer survivors, while discussing current recommendations for evaluation and treatment. We performed a literature review of articles evaluating hypogonadism, sexual dysfunction, ED, and infertility in young men cancer survivors. There is compelling evidence that significant survivorship issues are faced by boys entering adulthood after completing cancer therapy. Overall, young men cancer survivors are much more likely to report symptoms of sexual dysfunction than the general population of men. These patients can develop ED due to physiologic and psychological changes that take place with diagnosis of a malignancy and subsequent treatment. Primary hypogonadism can arise due to pelvic radiation or chemotherapy, and central hypogonadism may arise from pituitary insufficiency after brain radiation or surgery. Infertility develops from direct damage to the Sertoli cells and germinal epithelium from radiotherapy or chemotherapy. Cancer survivors who are men should therefore be screened for these important urological survivorship issues, although exact surveillance strategies remain unclear. Urological survivorship issues including ED, hypogonadism, and infertility are common among cancer survivors and result in significant morbidity. Due to the medical complexity of cancer survivorship, the population of adolescent and young adult survivors would benefit from a network of multidisciplinary survivorship experts to aid the transition into adulthood. Improved research efforts may help to clarify risk factors and to develop

  2. Effect of Spatial Cognitive Ability on Gain in Robot-Assisted Surgical Skills of Urological Surgeons.

    Science.gov (United States)

    Teishima, Jun; Hattori, Minoru; Inoue, Shogo; Hieda, Keisuke; Kobatake, Kohei; Shinmei, Shunsuke; Egi, Hiroyuki; Ohdan, Hideki; Matsubara, Akio

    2016-01-01

    Although previous studies have demonstrated the needs for a spatial cognitive ability that can give an accurate understanding of the position, orientation, and size and form of the objects in endoscopic surgery, there has been no study on the relationship between the skills of robot-assisted surgery and spatial cognitive ability. To assess the effect of spatial cognitive ability on gain in robot-assisted surgical skills of urological surgeons. The robot-assisted surgery skills of 24 urological surgeons who had no previous experience with the Mimic dV-Trainer (MdVT) and had not been the main surgeon in robot-assisted surgery and 20 volunteer medical students who had no previous experience of the MdVT were assessed by using a program consisting of 4 kinds of tasks. Their performances were recorded using a built-in scoring algorithm. Their spatial cognitive abilities were also assessed using a mental rotation test. Although there was a significant correlation between the spatial cognitive ability and a score of 2 for the more difficult tasks for student groups using the MdVT, there was no significant correlation between them for all tasks for groups of urological surgeons. The results of the present study indicate that differences in spatial cognitive ability in urological surgeons have no effect on the gain in fundamental robot-assisted surgery skills whereas there was a significant correlation between the spatial cognitive ability and fundamental robot-assisted surgical skills in the volunteers. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  3. 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

  4. A new wave of urologists? Graduating urology residents' practices of and attitudes toward social media.

    Science.gov (United States)

    Jain, Kunal; Fervaha, Gagan; Fuoco, Michael B; Leveridge, Michael J

    2018-03-19

    Social media (SoMe) have revolutionized healthcare, but physicians remain hesitant to adopt SoMe in their practices. We sought to assess graduating urology residents' practices of and attitudes toward SoMe. A close-ended questionnaire, employing five-point Likert scales, was distributed to all final-year residents (n=100) in Canadian urology training programs in 2012, 2014, and 2016 to assess SoMe usage and perceived usefulness. All (100%) questionnaires were completed. Respondents frequently used online services for personal (100%) and professional (96%) purposes. Most (92%) used SoMe. Many (73%) frequently used SoMe for personal purposes, but few (12%) frequently used SoMe for professional purposes. While a majority (59%) opposed direct patient interaction online, most supported using SoMe to provide patients with static information (76%) and collaborate with colleagues (65%). Many (70-73%) were optimistic that novel solutions to privacy issues in online communications will arise, making SoMe and email contact with patients conceivable. Few (2-8%) were aware and had read guidelines and legislations regarding physician online practices; however, awareness of medical associations' and institutional SoMe policies significantly increased over time (pprofessional settings and were wary of using it in patient care. Nevertheless, they were optimistic toward its integration in urology and supported its use in physician-physician communication. Considering SoMe's increased influence on urology and graduating residents' limited awareness of guidelines and legislations, postgraduate medical educators should encourage residents to become more familiar with current online communication recommendations.

  5. 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.

  6. Stochastic two-delay differential model of delayed visual feedback effects on postural dynamics.

    Science.gov (United States)

    Boulet, Jason; Balasubramaniam, Ramesh; Daffertshofer, Andreas; Longtin, André

    2010-01-28

    We report on experiments and modelling involving the 'visuo-postural control loop' in the upright stance. We experimentally manipulated an artificial delay to the visual feedback during standing, presented at delays ranging from 0 to 1 s in increments of 250 ms. Using stochastic delay differential equations, we explicitly modelled the centre-of-pressure (COP) and centre-of-mass (COM) dynamics with two independent delay terms for vision and proprioception. A novel 'drifting fixed point' hypothesis was used to describe the fluctuations of the COM with the COP being modelled as a faster, corrective process of the COM. The model was in good agreement with the data in terms of probability density functions, power spectral densities, short- and long-term correlations (Hurst exponents) as well the critical time between the two ranges. This journal is © 2010 The Royal Society

  7. [Treatment of urolithiasis in children and adolescents with extracorporeal lithotripsy and adjuvant urologic procedures].

    Science.gov (United States)

    Cueva Martínez, A; Braun, P M; Martínez Portillo, F J; Hoang-Böhm, J; Jünemann, K P; Alken, P; Köhrmann, K U

    2001-01-01

    To determine the efficacy of ESWL treatment in children and the need for auxiliary urological procedures. In a retrospective analysis we investigated the number of auxiliary procedures and the stone-free rate in children after ESWL treatment. 28 girls and 21 boys with a total of 56 stones were treated from January 1990 to January 1999. ESWL was carried out on either the Lithostar Plus or the Modulith SL20/SLX. Auxiliary procedures were subdivided into curative (ureterorenoscopy, percutaneous nephrolitholapaxy) and adjuvant (urethral stent, nephrostomy). 34.7% of the children were stone-free after the first ESWL treatment; 40.8% of the children were discharged with residual stone particles ready for spontaneous passage; 24.5% underwent re-ESWL treatment. Auxiliary urological procedures were required in 28.6% of the cases (adjuvant 18.3%, curative 10.3%). Extracorporeal shock wave lithotripsy is also a highly effective method of treatment for urolithiasis in children. However, curative or adjuvant auxiliary urological measures are required. In order to achieve high success rates, it is advisable to perform this method of treatment in centers with broad experience in ESWL and endourological procedures in children.

  8. Deinfibulation for treating urologic complications of type III female genital mutilation: A systematic review.

    Science.gov (United States)

    Effa, Emmanuel; Ojo, Olumuyiwa; Ihesie, Austin; Meremikwu, Martin M

    2017-02-01

    Women and girls who have undergone type III female genital mutilation (FGM) may suffer urologic complications such as recurrent urinary tract infections, obstruction, stones, and incontinence. To assess the effectiveness of deinfibulation for preventing and treating urologic complications in women and girls living with FGM. The following major databases were searched from inception to August 2015: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, SCOPUS, Web of Science, and ClinicalTrials.gov without language restrictions. Randomized controlled studies (RCTs) or observational studies with controls were considered. We screened the results of the search independently for potentially relevant studies and applied inclusion and exclusion criteria for the full texts of the relevant studies. No RCTs were found. We found three case reports and a retrospective case review, all of which were excluded. There is no evidence on the use of deinfibulation to improve urologic complications among women with type III FGM. Current clinical practice may be informed by anecdotal evidence from case reports. Appropriate RCTs and observational studies with comparison groups in countries where FGM is common are needed. PROSPERO registration: CRD42015024901. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  9. 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.

  10. Urological recommedations of Hadji Pasha’s, a Turkish aged doctor in Anatolia

    Directory of Open Access Journals (Sweden)

    Mehmet Yıldırım

    2016-08-01

    Full Text Available Objective: Urinary tract conditions have been an important part of diseases from antiquity until today. Historically, many plants and herbs have been used for the treatment of urinary disorders. Methods: Celâlüddîn Hızır bin Ali el-Konevi (Hadji Pasha is one of the most famous physician who lived in Anatolia between 13th and 14th centuries. He has written one of the most important medical books of that era, "Müntehab-ıŞifa" (solution of wellness in Turkish. General medical information about the diseases in this book, focus on diagnosis and treatment. Results: The herbal solutions for urological disorders such as, urinary incontinence, urinary stones or erection problems are told in this section.   Conclusion: Many of the herbal medicines addressed in this book are being widely used in current medicine, but the usage of these herbals in daily urology practice is limited. In this study, we aimed to share the advices for the urological diseases and therelated herbal medicines that are named in Hadji Pasha’s book, " Müntehab-ıŞifa ", with today's physicians.

  11. [Update on laparoscopic electrosurgical devices and their use in complex urologic procedures].

    Science.gov (United States)

    Boukheir, G; Aoun, F; Albisinni, S; Roumeguère, T

    2017-04-01

    Laparoscopy is the standard of care for many urologic procedures and witnesses nowadays technological advancements. Hemostasis is highly important in laparoscopy since bleeding could rapidly alter the operative conditions. The objective of this review is to expose the different electrosurgical techniques, their history and their applications in urology. A literature review was overdone using the following terms "laparoscopic electrosurgery" and/or "nephrectomy" and/or "prostatectomy". Two hundred and forty articles were found through Pubmed. After reviewing the title and the content of these articles, 18 were eligible for the following review. The different electrosurgical techniques and their technological evolution are exposed. Physical properties of each system are exposed as well. Advantages and limitations of each system are also reviewed and analyzed. Bipolar electrosurgery with thermofusion and ultrasound technology can achieve good results in terms of nerve sparing for radical laparoscopic prostatectomies. They can both be used in partial nephrectomies. However, they can compromise the surgical resection margins. Hybrid systems seem to have an important role in urological laparoscopic procedures despite the scarce number of available studies. 3. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Urology residents experience comparable workload profiles when performing live porcine nephrectomies and robotic surgery virtual reality training modules.

    Science.gov (United States)

    Mouraviev, Vladimir; Klein, Martina; Schommer, Eric; Thiel, David D; Samavedi, Srinivas; Kumar, Anup; Leveillee, Raymond J; Thomas, Raju; Pow-Sang, Julio M; Su, Li-Ming; Mui, Engy; Smith, Roger; Patel, Vipul

    2016-03-01

    In pursuit of improving the quality of residents' education, the Southeastern Section of the American Urological Association (SES AUA) hosts an annual robotic training course for its residents. The workshop involves performing a robotic live porcine nephrectomy as well as virtual reality robotic training modules. The aim of this study was to evaluate workload levels of urology residents when performing a live porcine nephrectomy and the virtual reality robotic surgery training modules employed during this workshop. Twenty-one residents from 14 SES AUA programs participated in 2015. On the first-day residents were taught with didactic lectures by faculty. On the second day, trainees were divided into two groups. Half were asked to perform training modules of the Mimic da Vinci-Trainer (MdVT, Mimic Technologies, Inc., Seattle, WA, USA) for 4 h, while the other half performed nephrectomy procedures on a live porcine model using the da Vinci Si robot (Intuitive Surgical Inc., Sunnyvale, CA, USA). After the first 4 h the groups changed places for another 4-h session. All trainees were asked to complete the NASA-TLX 1-page questionnaire following both the MdVT simulation and live animal model sessions. A significant interface and TLX interaction was observed. The interface by TLX interaction was further analyzed to determine whether the scores of each of the six TLX scales varied across the two interfaces. The means of the TLX scores observed at the two interfaces were similar. The only significant difference was observed for frustration, which was significantly higher at the simulation than the animal model, t (20) = 4.12, p = 0.001. This could be due to trainees' familiarity with live anatomical structures over skill set simulations which remain a real challenge to novice surgeons. Another reason might be that the simulator provides performance metrics for specific performance traits as well as composite scores for entire exercises. Novice trainees experienced

  13. The one-stop clinic as the standard of out-patient care in a hospital urology department

    Directory of Open Access Journals (Sweden)

    Alvaro Páez

    2011-10-01

    Full Text Available PURPOSE: To evaluate the performance of a 'one-stop' clinic in terms of proportion of discharges or inclusion in surgical waiting lists. MATERIALS AND METHODS: All patients were referred from primary care facilities (population 220.646 and from different departments in the hospital. Eight senior urologists, two registered nurses and two nurse attendants participated in the experience. Prior to the start of the project, referral protocols had been agreed with the primary care physicians involved. Compliance with the protocols was periodically tested. Eventually 5537 first visits (January-December 2009 where evaluable. RESULTS: Overall, the 'one-stop' format proved feasible in 74.2% of the patients (4108/5537. Patients, who successfully used the 'one-stop' format, were significantly younger than those who required additional consultations (43 vs 50 years old, respectively, Student's t test < 0.001. For obvious reasons the 'one-stop' format was universally possible in male sterilization and penile phimosis patients. Similarly, the 'one-stop' policy was applied in most consultations due to male sexual dysfunction (75% and urinary tract infection (73%. Other health problems, such as haematuria (62% and renal colic (46%, required more than one visit so that care of the patient reverted to the traditional, outpatient care model. CONCLUSION: A 'one-stop' philosophy is feasible for a number of procedures in a urological outpatient clinic. The costs to implement such an approach would be limited to managerial expenditure.

  14. Gastrointestinal and Urologic Sphincter Dysfunction in Stiff Person Syndrome.

    Science.gov (United States)

    Dumitrascu, Oana M; Tsimerinov, Evgeny I; Lewis, Richard A

    2016-12-01

    Stiff person syndrome is a neurologic disorder characterized by axial rigidity leading to progressive disability, with broad clinical spectrum. We report 2 cases with unique clinical presentation. Two young men suffered progressive urinary retention requiring bladder catheterization, anorectal spasms and constipation, complicated subsequently with lower extremity trigger-induced spasms, and gait instability. Associated symptoms revealed brainstem involvement (vertigo, diplopia, and cranial neuropathies) and dysautonomia (abnormal sweating and orthostatic hypotension). Anal manometry demonstrated incomplete relaxation of the anal sphincter. The first case was associated with diabetes mellitus type I, did not respond to classical therapies, but was responsive to rituximab. The second case responded to intravenous immunoglobulin infusions. Paraneoplastic profiles were negative, and anti-GAD65 antibody titers remained elevated despite successful therapeutic responses. We want to raise awareness that stiff person syndrome can present with esophageal, anorectal, and urethral sphincter disturbance. Rituximab is a good therapeutic option in intractable cases.

  15. Delayed Speech or Language Development

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Delayed Speech or Language Development KidsHealth / For Parents / Delayed Speech ... their child is right on schedule. How Are Speech and Language Different? Speech is the verbal expression ...

  16. Milestone assessment of minimally invasive surgery in Pediatric Urology fellowship programs.

    Science.gov (United States)

    Smith, P H; Carpenter, M; Herbst, K W; Kim, C

    2017-02-01

    Minimally invasive surgery has become an important aspect of Pediatric Urology fellowship training. In 2014, the Accreditation Council for Graduate Medical Education published the Pediatric Urology Milestone Project as a metric of fellow proficiency in multiple facets of training, including laparoscopic/robotic procedures. The present study assessed trends in minimally invasive surgery training and utilization of the Milestones among recent Pediatric Urology fellows. Using an electronic survey instrument, Pediatric Urology fellowship program directors and fellows who completed their clinical year in 2015 were surveyed. Participants were queried regarding familiarity with the Milestone Project, utilization of the Milestones, robotic/laparoscopic case volume and training experience, and perceived competency with robotic/laparoscopic surgery at the start and end of the fellowship clinical year according to Milestone criteria. Responses were accepted between August and November 2015. Surveys were distributed via e-mail to 35 fellows and 30 program directors. Sixteen fellows (46%) and 14 (47%) program directors responded. All fellows reported some robotic experience prior to fellowship, and 69% performed >50 robotic/laparoscopic surgeries during residency. Fellow robotic/laparoscopic case volume varied: three had 1-10 cases (19%), four had 11-20 cases (25%), and nine had >20 cases (56%). Supplementary or robotic training modalities included simulation (9), animal models (6), surgical videos (7), and courses (2). Comparison of beginning and end of fellowship robotic/laparoscopic Milestone assessment (Summary Fig.) revealed scores of assessments and 10 (75%) of program director assessments. End of training Milestone scores >4 were seen in 12 (75%) of fellow self-assessment and eight (57%) of program director assessments. An improvement in robotic/laparoscopic Milestone scores by both fellow self-assessment and program director assessment was observed during the course of

  17. Synchronization of conference presentation sequence using delay equalization approach

    Science.gov (United States)

    Godavari, Rakesh K.; Celenk, Mehmet

    2001-11-01

    In this paper, a delay equalization approach is proposed for cohesive conference presentation with minimal screen- freezing effect. The underlying screen-freezing effect is due to varying delays in the communication channels involved in broadcasting. In turn, this poses a threat to the goal of uniform delay distribution among data packets for synchronized presentation broadcast. We wish to achieve uniformity among packet arrival times to the recipients. This objective is achieved by transforming a given input delay distribution (D) to the desired output density through a delay equalization process. Considering a general case of between packet and frame delay distributions for a given input, the desired output is obtained through a delay equalization process. In case of a specific normal delay distribution, a memory-less system g(D) is determined as an approximation to the delay equalizer such that the equalizer output O(t)equalsg[D(t)] is uniformly distributed in the allowable delay limits of (a,b) assuring the specified quality of service (QoS) parameters. The corresponding delay is added at each recipient workstation, which acts as the wait period required before it begins its designated presentation.For a zero mean normal delay density case, the equalizer transfer function can be given in a closed from solution as O(t)equalsg[D(t)[equals(b-a)]0.5+eft(-D/$RO OTR(0)))[+a, where erf(x) is the standard error function. The histogram approximation is adopted as an asymptotically delay equalization means for general cases. This technique provides a means for modifying the dynamic range of data acquired by altering it into a desired distribution. In experimentation, equalizer characteristic functions are derived for a set of selected input delays to obtain the desired output. The delay equalizer system developed here is suited for deployment in a distributed hierarchical conferencing environment. To accommodate a broadcast continuity, the multimedia presentation is

  18. The effect of social media (#SoMe) on journal impact factor and parental awareness in paediatric urology.

    Science.gov (United States)

    O'Kelly, F; Nason, G J; Manecksha, R P; Cascio, S; Quinn, F J; Leonard, M; Koyle, M A; Farhat, W; Leveridge, M J

    2017-10-01

    Social media (SoMe) comprises a number of internet-based applications that have the capability to disseminate multimodal media and allow for unprecedented inter-user connectivity. The role of Twitter has been studied in conferences and education; moreover, there is increasing evidence that patients are more likely to use social media for their own health education. The aim of this study was to assess the impact of social media platforms on the impact factor of both urological and paediatric journals that publish on paediatric urology, and to assess parental awareness of social media in paediatric urology. A filtered Journal of Citation Reports (JCR) search was performed for the period 2012-16 for journals that published articles on paediatric urology. Journals were ranked according to impact factor, and each individual journal website was accessed to assess for the presence of social media. Parents in paediatric urology clinics and non-paediatric urology patients also filled out a questionnaire to assess for awareness and attitudes to social media. All statistical analysis was performed using Prism 6 software (Prism 6, GraphPad Software, California, USA). Overall, there were 50 urological journals and 39 paediatric journals with a mean impact factor of 2.303 and 1.766, respectively. There was an overall average increase in impact factor across all urological journals between 2012 and 16. The presence of a Twitter feed was statistically significant for a rise in impact factor over the 4 years (P = 0.017). The cohort of parents was statistically more likely to have completed post-secondary education, to have and access to a social media profile, use it for health education, and use it to access journal/physician/hospital social media accounts. This study examined, for the first time, the role of social media in paediatric urology, and demonstrated that SoMe use is associated with a positive influence in impact factor, but also a parental appetite for it

  19. [Interstitial cystitis in urology clinic: current status and problems].

    Science.gov (United States)

    Nanri, Masaharu; Nanri, Masayuki; Nanri, Kazushige

    2014-10-01

    We examined the complications in the diagnosis and treatment of interstitial cystitis in daily clinical practice. The study included 82 patients who were suspected of having interstitial cystitis at our hospital from March 2002 to April 2013. All hydrodistention procedures were performed with the aid of an anesthesiologist, as recommended by the Ministry of Health, Labour, and Welfare since April 2010. Of the 82, 20 patients were male and 62 were female, (mean age at diagnosis 53 years.) Six of the suspected cases did not have interstitial cystitis. Of the 67 patients diagnosed with interstitial cystitis during hydrodistention, 29 (43%) did not experience pain. The time taken to diagnose these asymptomatic patients was longer than that taken for those who experienced pain. Twenty-eight patients (42%) discontinued treatment because it was ineffective. Interstitial cystitis has been widely recognized, but general physicians are unable to provide a diagnosis and suggest aggressive treatment because of difficulty associated in the treatment and diagnosis. To resolve these issues, physicians should be keep in mind that interstitial cystitis involves a hypersensitive bladder, and that some patients may not experience pain. Further, knowledge about Hunner's ulcer is essential. We believe that the most important points are improving health insurance about facility criteria of hydrodistention, and evaluating behavioral modification and dietary manipulation.

  20. Delayed Macular Hole Closure

    Directory of Open Access Journals (Sweden)

    Peter Distelmaier

    2014-04-01

    Full Text Available Purpose: The presented case raises questions regarding the favorable scheduling of planned postoperative care and the ideal observation interval to decide for reoperations in macular hole surgery. Furthermore a discussion about the use of short- and long-acting gas tamponades in macular hole surgery is encouraged. Methods: We present an interventional case report and a short review of the pertinent literature. Results: We report a case of spontaneous delayed macular hole closure after vitreoretinal surgery had been performed initially without the expected success. A 73-year-old male Caucasian patient presented at our clinic with a stage 2 macular hole in his left eye. He underwent 23-gauge pars plana vitrectomy and internal limiting membrane peeling with a 20% C2F6-gas tamponade. Sixteen days after the procedure, an OCT scan revealed a persistent stage 2 macular hole, and the patient was scheduled for reoperation. Surprisingly, at the date of planned surgery, which was another 11 days later, the macular hole had resolved spontaneously without any further intervention. Conclusions: So far no common opinion exists regarding the use of short- or long-acting gas in macular hole surgery. Our case of delayed macular hole closure after complete resorption of the gas tamponade raises questions about the need and duration of strict prone positioning after surgery. Furthermore short-acting gas might be as efficient as long-acting gas. We suggest to wait with a second intervention at least 4 weeks after the initial surgery, since a delayed macular hole closure is possible.

  1. SENSITIVITY TO ANTIBIOTICS, ANTISEPTICAL NOSOCOMIAL PSEUDOMONAS AERUGINOSA, ISOLATED IN UROLOGICAL PATIENTS

    Directory of Open Access Journals (Sweden)

    Rymsha E.V.

    2015-05-01

    Full Text Available Introduction. Given the active introduction into clinical practice of new groups of antibiotics and antiseptics, the problem of treatment of purulent-inflammatory complications after prostatectomy and today is relevant. Of particular concern belated cases of diagnosis and treatment of postoperative complications in urological practice patients receiving antibiotic therapy The use of traditional antibiotics is not prevents the development of infection, because the problem of resistance of microorganisms to antibiotics and antiseptics remains relevant. The solution to the problem of development of infectious complications and prevent the formation of resistant clinical strains largely depends on the isolated pathogen, susceptibility to antimicrobial agents based on its bioavailability , ability to spread and penetrate into cells and tissues, selection of dose, interval, and route of administration to maintain minimum bactericidal concentration Material and methods. The study involved 145 patients who were treated in the urology Department of the Vinnytsia regional clinical hospital named of M. I. Pirogov. Patients underwent the surgical treatment of benign hypertrophic prostate. Material for bacteriological studies of purulent-inflammatory diseases were urine, pieces of the prostate, remote operationally, urinary catheters, through which conducted irrigation of the bladder. Specimen collection, transportation was carried out in accordance with modern requirements. Identification was done by morphological, cultural and biochemical properties. The definition of antibiotic resistance were performed according to "guidelines for the definition of sensitivity of microorganisms to antibiotics by the method of diffusion in agar using discs" (No. 2675-83, Kiev, 2007 12 .]. Evaluation of the results of determining the sensitivity of microorganisms to antibiotics was carried out on the basis of the determination of the zone of growth (mm of the studied

  2. Organophosphate induced delayed polyneuropathy.

    Science.gov (United States)

    Qureshi, Asif; Ali, Rajab; Yaqoob, M Yousuf; Saleem, Omema

    2007-07-01

    Organophosphate induced delayed polyneuropathy (OPIDP) is a rare sensory-motor distal axonopathy, which usually occur after ingestion of large doses of certain organophosphate insecticide. The clinical picture is characterized by the distal paresis in lower limb associated with sensory symptoms. Electrodiagnostic studies show a motor axonal neuropathy. This case occurred in a 14 years old girl who developed cramping pain in both calves associated with lower limbs paresis 6 weeks after accidental organophosphate poisoning. After another week, she also developed weakness in both hands. Electrophysiological study was characterized by an axonal polyneuropathy pattern. Patient improved upon oral multivitamin therapy and physiotherapy.

  3. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne

    2012-01-01

    We evaluated the association between radiation therapy and severe capsular contracture or reoperation after 717 delayed breast implant reconstruction procedures (288 1- and 429 2-stage procedures) identified in the prospective database of the Danish Registry for Plastic Surgery of the Breast during...... of radiation therapy was associated with a non-significantly increased risk of reoperation after both 1-stage (HR = 1.4; 95% CI: 0.7-2.5) and 2-stage (HR = 1.6; 95% CI: 0.9-3.1) procedures. Reconstruction failure was highest (13.2%) in the 2-stage procedures with a history of radiation therapy. Breast...

  4. Vehicle barrier with access delay

    Science.gov (United States)

    Swahlan, David J; Wilke, Jason

    2013-09-03

    An access delay vehicle barrier for stopping unauthorized entry into secure areas by a vehicle ramming attack includes access delay features for preventing and/or delaying an adversary from defeating or compromising the barrier. A horizontally deployed barrier member can include an exterior steel casing, an interior steel reinforcing member and access delay members disposed within the casing and between the casing and the interior reinforcing member. Access delay members can include wooden structural lumber, concrete and/or polymeric members that in combination with the exterior casing and interior reinforcing member act cooperatively to impair an adversarial attach by thermal, mechanical and/or explosive tools.

  5. Patient delay in cancer studies

    DEFF Research Database (Denmark)

    Andersen, Rikke Sand; Vedsted, Peter; Olesen, Frede

    2009-01-01

    BACKGROUND: There is no validated way of measuring the prevalence and duration of patient delay, and we do not know how people perceive and define the time intervals they are asked to report in patient delay studies. This lack of a validated measure hampers research in patient delay...... as symptoms related to a specific cancer diagnosis is embedded within a social and cultural context. We therefore cannot assume that respondents define delay periods in identical ways. SUMMARY: In order to improve the validity of patient delay studies, it is suggested that research be strengthened on three...

  6. Epidemiology of delayed ejaculation.

    Science.gov (United States)

    Di Sante, Stefania; Mollaioli, Daniele; Gravina, Giovanni Luca; Ciocca, Giacomo; Limoncin, Erika; Carosa, Eleonora; Lenzi, Andrea; Jannini, Emmanuele A

    2016-08-01

    A large body of literature on diminished ejaculatory disorders has been generated without the use of a clear diagnostic definition. Many studies have not distinguished between the orgasm and ejaculation disorders leading to doubtful results. Delayed ejaculation (DE) is one of the diminished ejaculatory disorders, which range from varying delays in ejaculatory latency to a complete inability to ejaculate. The present review is aimed at providing a comprehensive overview of the current knowledge on the definition and epidemiology of diminished ejaculatory disorders. We focus on the acquired diseases, such as benign prostatic hyperplasia (BPH) and specific drug regimens that may cause an iatrogenic form of ejaculatory disorder. In addition, the impact of aging is discussed since the prevalence of DE appears to be moderately but positively related to age. Finally, we also focus on the importance of the hormonal milieu on male ejaculation. To date, evidence on the endocrine control of ejaculation is derived from small clinical trials, but the evidence suggests that hormones modulate the ejaculatory process by altering its overall latency.

  7. Stationary distributions of stochastic processes described by a linear neutral delay differential equation

    International Nuclear Information System (INIS)

    Frank, T D

    2005-01-01

    Stationary distributions of processes are derived that involve a time delay and are defined by a linear stochastic neutral delay differential equation. The distributions are Gaussian distributions. The variances of the Gaussian distributions are either monotonically increasing or decreasing functions of the time delays. The variances become infinite when fixed points of corresponding deterministic processes become unstable. (letter to the editor)

  8. Comparative study of scientific publications in urology and nephrology journals originating from USA, China and Japan (2001-2010).

    Science.gov (United States)

    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

    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. 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 and China were retrieved from the "PubMed" and "Web of Knowledge" online databases. The annual number of total scientific articles increased significantly from 2001 to 2010 in China, and has ranked second in the world since 2006. In the field of urology and nephrology, the annual number increased significantly from 2001 to 2010 in USA and China; but not in Japan. The share of articles increased significantly over time in China, decreased significantly in Japan, and remained unchanged in USA. In 2010, USA contributed 32.17% of the total world output in urology and nephrology field and ranked 1(st); Japan contributed 5.19% and ranked 5(th); China contributed 3.83% and ranked 9(th). Publications from USA had the highest accumulated IFs and the highest total citations of articles (USA>Japan>China, pnephrology journals (USA(35165)>Japan(6704)>China(2233), pJapan>China, pnephrology journals in the past decade, it still lags far behind USA and Japan in the field of urology and nephrology in terms of quantity and quality.

  9. Clinical and preclinical treatment of urologic diseases with phosphodiesterase isoenzymes 5 inhibitors: an update

    Directory of Open Access Journals (Sweden)

    Wen-Hao Zhang

    2016-01-01

    Full Text Available Phosphodiesterase isoenzymes 5 inhibitors (PDE5-Is are the first-line therapy for erectile dysfunction (ED. The constant discoveries of nitric oxide (NO/cyclic guanosine monophosphate (cGMP cell-signaling pathway for smooth muscle (SM control in other urogenital tracts (UGTs make PDE5-Is promising pharmacologic agents against other benign urological diseases. This article reviews the literature and contains some previously unpublished data about characterizations and activities of PDE5 and its inhibitors in treating urological disorders. Scientific discoveries have improved our understanding of cell-signaling pathway in NO/cGMP-mediated SM relaxation in UGTs. Moreover, the clinical applications of PDE5-Is have been widely recognized. On-demand PDE5-Is are efficacious for most cases of ED, while daily-dosing and combination with testosterone are recommended for refractory cases. Soluble guanylate cyclase (sGC stimulators also have promising role in the management of severe ED conditions. PDE5-Is are also the first rehabilitation strategy for postoperation or postradiotherapy ED for prostate cancer patients. PDE5-Is, especially combined with α-adrenoceptor antagonists, are very effective for benign prostatic hyperplasia (BPH except on maximum urinary flow rate (Q max with tadalafil recently proved for BPH with/without ED. Furthermore, PDE5-Is are currently under various phases of clinical or preclinical researches with promising potential for other urinary and genital illnesses, such as priapism, premature ejaculation, urinary tract calculi, overactive bladder, Peyronie′s disease, and female sexual dysfunction. Inhibition of PDE5 is expected to be an effective strategy in treating benign urological diseases. However, further clinical studies and basic researches investigating mechanisms of PDE5-Is in disorders of UGTs are required.

  10. Evaluation of Prostate Cancer Risk Calculators for Shared Decision Making Across Diverse Urology Practices in Michigan.

    Science.gov (United States)

    Auffenberg, Gregory B; Merdan, Selin; Miller, David C; Singh, Karandeep; Stockton, Benjamin R; Ghani, Khurshid R; Denton, Brian T

    2017-06-01

    To compare the predictive performance of a logistic regression model developed with contemporary data from a diverse group of urology practices to that of the Prostate Cancer Prevention Trial (PCPT) Risk Calculator version 2.0. With data from all first-time prostate biopsies performed between January 2012 and March 2015 across the Michigan Urological Surgery Improvement Collaborative (MUSIC), we developed a multinomial logistic regression model to predict the likelihood of finding high-grade cancer (Gleason score ≥7), low-grade cancer (Gleason score ≤6), or no cancer on prostate biopsy. The performance of the MUSIC model was evaluated in out-of-sample data using 10-fold cross-validation. Discrimination and calibration statistics were used to compare the performance of the MUSIC model to that of the PCPT risk calculator in the MUSIC cohort. Of the 11,809 biopsies included, 4289 (36.3%) revealed high-grade cancer; 2027 (17.2%) revealed low-grade cancer; and the remaining 5493 (46.5%) were negative. In the MUSIC model, prostate-specific antigen level, rectal examination findings, age, race, and family history of prostate cancer were significant predictors of finding high-grade cancer on biopsy. The 2 models, based on similar predictors, had comparable discrimination (multiclass area under the curve = 0.63 for the MUSIC model and 0.62 for the PCPT calculator). Calibration analyses demonstrated that the MUSIC model more accurately predicted observed outcomes, whereas the PCPT risk calculator substantively overestimated the likelihood of finding no cancer while underestimating the risk of high-grade cancer in this population. The PCPT risk calculator may not be a good predictor of individual biopsy outcomes for patients seen in contemporary urology practices. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. [Antibiotic stewardship (ABS). Definition, contents, necessity and practice on examples of current clinical-urological controversies].

    Science.gov (United States)

    Schneidewind, L; Kranz, J; Boehm, K; Spachmann, P; Siegel, F; Huck, N; Fritsche, H M

    2016-04-01

    Infectious diseases caused by multi-resistant pathogens are increasing worldwide and are posing a challenge to German urology as well. Furthermore, there is a limited perspective of new antibiotic developments. One way out of this dilemma is a differentiated handling and use of antibiotics (antibiotic stewardship, ABS). The aim of this review is to identify key issues in modern urological antibiotic therapy, which can be considered as exemplary for the whole topic of ABS. This includes a review of the current data of the individual topics, including thought-provoking impulse for future clinical application and research. The research group "infectious diseases" of GeSRU Academics identified the following central topics: excessive use of fluoroquinolones, diagnosis and treatment of urethritis and perioperative antibiotic prophylaxis. Subsequently, we performed a literature research in MEDLINE to uncover controversies and open questions of the individual topics within the meaning of ABS. The analysis of modern antibiotic therapy in urology shows numerous open questions in all quality dimensions of ABS: structural quality (e.g. through improved training of medical staff in the differentiated use of antibiotics), process quality (e.g. by improved adherence to existing infectiological guidelines, here in particular the perioperative prophylaxis and therapy of urethritis) and outcome (e.g. by detection of resistance rates and infection rates). The overarching and common goal is to avoid a post-antibiotic era. ABS programmes and a 10-point plan of the federal government are considered positive political developments in this area but do not release the individual urologist from a personal responsibility as part of his daily routine. A critical analysis of the topic "antibiotic treatment" is essential.

  12. Practical recommendations for performing ultrasound scanning in the urological and andrological fields

    Directory of Open Access Journals (Sweden)

    Pasquale Martino

    2014-03-01

    Full Text Available Aim: US scanning has been defined as the urologist’s stethoscope. These recommendations have been drawn up with the aim of ensuring minimum standards of excellence for ultrasound imaging in urological and andrological practice. A series of essential recommendations are made, to be followed during ultrasound investigations in kidney, prostate, bladder, scrotal and penile diseases. Methods: Members of the Imaging Working Group of the Italian Society of Urology (SIU in collaboration with the Italian Society of Ultrasound in Urology, Andrology and Nephrology (SIEUN identified expert Urologists, Andrologists, Nephrologists and Radiologists. The recommendations are based on review of the literature, previously published recommendations, books and the opinions of the experts. The final document was reviewed by national experts, including members of the Italian Society of Radiology. Results: Recommendations are listed in 5 chapters, focused on: kidney, bladder, prostate and seminal vesicles, scrotum and testis, penis, including penile echo-doppler. In each chapter clear definitions are made of: indications, technological standards of the devices, the method of performance of the investigation. The findings to be reported are described and discussed, and examples of final reports for each organ are included. In the tables, the ultrasound features of the principal male uro-genital diseases are summarized. Diagnostic accuracy and second level investigations are considered. Conclusions: Ultrasound is an integral part of the diagnosis and follow-up of diseases of the urinary system and male genitals in patients of all ages, in both the hospital and outpatient setting. These recommendations are dedicated to enhancing communication and evidence-based medicine in an inter- and multi-disciplinary approach. The ability to perform and interpret ultrasound imaging correctly has become an integral part of clinical practice in uro-andrology, but intra and inter

  13. Reporting and methodological quality of meta-analyses in urological literature

    Directory of Open Access Journals (Sweden)

    Leilei Xia

    2017-04-01

    Full Text Available Purpose To assess the overall quality of published urological meta-analyses and identify predictive factors for high quality. Materials and Methods We systematically searched PubMed to identify meta-analyses published from January 1st, 2011 to December 31st, 2015 in 10 predetermined major paper-based urology journals. The characteristics of the included meta-analyses were collected, and their reporting and methodological qualities were assessed by the PRISMA checklist (27 items and AMSTAR tool (11 items, respectively. Descriptive statistics were used for individual items as a measure of overall compliance, and PRISMA and AMSTAR scores were calculated as the sum of adequately reported domains. Logistic regression was used to identify predictive factors for high qualities. Results A total of 183 meta-analyses were included. The mean PRISMA and AMSTAR scores were 22.74 ± 2.04 and 7.57 ± 1.41, respectively. PRISMA item 5, protocol and registration, items 15 and 22, risk of bias across studies, items 16 and 23, additional analysis had less than 50% adherence. AMSTAR item 1, “a priori” design, item 5, list of studies and item 10, publication bias had less than 50% adherence. Logistic regression analyses showed that funding support and “a priori” design were associated with superior reporting quality, following PRISMA guideline and “a priori” design were associated with superior methodological quality. Conclusions Reporting and methodological qualities of recently published meta-analyses in major paper-based urology journals are generally good. Further improvement could potentially be achieved by strictly adhering to PRISMA guideline and having “a priori” protocol.

  14. Widespread use of internet, applications, and social media in the professional life of urology residents

    Science.gov (United States)

    Salem, Johannes; Borgmann, Hendrik; Baunacke, Martin; Boehm, Katharina; Hanske, Julian; MacNeily, Andrew; Meyer, Christian; Nestler, Tim; Schmid, Marianne; Huber, Johannes

    2017-01-01

    Introduction Digital media have revolutionized communication and information dissemination in healthcare. We aimed to quantify and evaluate professional digital media use among urology residents. Methods We designed a 17-item survey to assess usage and perceived usefulness of digital media, as well as communication type and device type and distributed it via email to 143 Canadian and 721 German urology residents. Results In total, 58 (41% response rate) residents from Canada and 170 (24% response rate) from Germany reported professional usage rates of 100% on the internet, 89% on apps, and 46% on social media (SoMe). For professional use, residents spent a median of 30 minutes per day on the internet, 10 minutes on apps, and 15 minutes on SoMe. 100% rated the internet, 89% apps, and 31% SoMe as useful for clinical practice. Most (94%) used digital media for communication with colleagues and 23% for communication with patients. Digital media use was allocated to desktop computers (55%) and mobile devices (45%). Canadian residents had higher usage rates of apps (96% vs. 86%; p=0.042) and SoMe (65% vs. 39%; p=0.002) and longer daily usage times for the internet, apps, and SoMe than German residents (pmedia are an integral part of the daily professional practice of urology residents, reflected by high usage rates and perceived usefulness of the internet and apps, and the growing importance of SoMe. Urologists should strive to progressively exhaust the vast potential of digital media for academic and clinical practice. PMID:29382458

  15. Are urological procedures in tetraplegic patients safely performed without anesthesia? a report of three cases

    Directory of Open Access Journals (Sweden)

    Vaidyanathan Subramanian

    2012-02-01

    Full Text Available Abstract Background Some tetraplegic patients may wish to undergo urological procedures without anaesthesia, but these patients can develop autonomic dysreflexia if cystoscopy and vesical lithotripsy are performed without anaesthesia. Case presentation We describe three tetraplegic patients, who developed autonomic dysreflexia when cystoscopy and laser lithotripsy were carried out without anesthesia. In two patients, who declined anaesthesia, blood pressure increased to more than 200/110 mmHg during cystoscopy. One of these patients developed severe bleeding from bladder mucosa and lithotripsy was abandoned. Laser lithotripsy was carried out under subarachnoid block a week later in this patient, and this patient did not develop autonomic dysreflexia. The third patient with C-3 tetraplegia had undergone correction of kyphoscoliotic deformity of spine with spinal rods and pedicular screws from the level of T-2 to S-2. Pulmonary function test revealed moderate to severe restricted curve. This patient developed vesical calculus and did not wish to have general anaesthesia because of possible need for respiratory support post-operatively. Subarachnoid block was not considered in view of previous spinal fixation. When cystoscopy and laser lithotripsy were carried out under sedation, blood pressure increased from 110/50 mmHg to 160/80 mmHg. Conclusion These cases show that tetraplegic patients are likely to develop autonomic dysreflexia during cystoscopy and vesical lithotripsy, performed without anaesthesia. Health professionals should educate spinal cord injury patients regarding risks of autonomic dysreflexia, when urological procedures are carried out without anaesthesia. If spinal cord injury patients are made aware of potentially life-threatening complications of autonomic dysreflexia, they are less likely to decline anaesthesia for urological procedures. Subrachnoid block or epidural meperidine blocks nociceptive impulses from urinary bladder

  16. Widespread use of internet, applications, and social media in the professional life of urology residents.

    Science.gov (United States)

    Salem, Johannes; Borgmann, Hendrik; Baunacke, Martin; Boehm, Katharina; Hanske, Julian; Macneily, Andrew; Meyer, Christian; Nestler, Tim; Schmid, Marianne; Huber, Johannes

    2017-09-01

    Digital media have revolutionized communication and information dissemination in healthcare. We aimed to quantify and evaluate professional digital media use among urology residents. We designed a 17-item survey to assess usage and perceived usefulness of digital media, as well as communication type and device type and distributed it via email to 143 Canadian and 721 German urology residents. In total, 58 (41% response rate) residents from Canada and 170 (24% response rate) from Germany reported professional usage rates of 100% on the internet, 89% on apps, and 46% on social media (SoMe). For professional use, residents spent a median of 30 minutes per day on the internet, 10 minutes on apps, and 15 minutes on SoMe. 100% rated the internet, 89% apps, and 31% SoMe as useful for clinical practice. Most (94%) used digital media for communication with colleagues and 23% for communication with patients. Digital media use was allocated to desktop computers (55%) and mobile devices (45%). Canadian residents had higher usage rates of apps (96% vs. 86%; p=0.042) and SoMe (65% vs. 39%; p=0.002) and longer daily usage times for the internet, apps, and SoMe than German residents (pmedia are an integral part of the daily professional practice of urology residents, reflected by high usage rates and perceived usefulness of the internet and apps, and the growing importance of SoMe. Urologists should strive to progressively exhaust the vast potential of digital media for academic and clinical practice.

  17. Profile and scientific production of CNPq researchers in Nephrology and Urology.

    Science.gov (United States)

    Oliveira, Eduardo A; Pécoits-Filho, Roberto; Quirino, Isabel G; Oliveira, Maria Christina; Martelli, Daniela Reis; Lima, Leonardo S; Martelli, Hercílio

    2011-03-01

    This study aimed at evaluating the profile and scientific production of researchers in Nephrology and Urology, receiving grants in the area of Clinical Medicine from the Brazilian National Research Council. The standardized online curriculum vitae (Curriculum Lattes) of 39 researchers in Medicine receiving grants in the 2006-2008 triennium were included in the analysis. The variables analyzed were: gender, affiliation, time from completion of the PhD program, scientific production, and supervision of undergraduate students, and master's and PhD programs. Males (74.4%) and category 2 grants (56.4%) predominated. The following three Brazilian states are responsible for 90% of the researchers: São Paulo (28; 71.8%); Rio Grande do Sul (4; 10.3%); and Minas Gerais (3; 7.7%). Four institutions are responsible for 70% of the researchers: UNIFESP (14; 36%); USP (8; 20.5%); UFMG (3, 7.7%); and UNICAMP (3; 7.7%). Considering the academic career, the assessed researchers published 3,195 articles in medical journals, with a median of 75 articles per researcher (QI = 52-100). The researchers received a total of 25,923 citations at the database Web of Science®, with a median of 452 citations per researcher (QI = 161-927). The average number of citations per article was 13.8 citations (SD = 11.6). The Southeastern region of Brazil concentrates researchers in Nephrology and Urology. Our study has shown an increase in the scientific production of most researchers in the last five years. By knowing the profile of researchers in Nephrology and Urology, more effective strategies to encourage the scientific production and the demand for resources to finance research projects can be defined.

  18. Delayed cure bismaleimide resins

    Science.gov (United States)

    Adams, Johnnie E.; Jamieson, Donald R.

    1984-08-07

    Polybismaleimides prepared by delayed curing of bis-imides having the formula ##STR1## wherein R.sub.1 and R.sub.2 each independently is H, C.sub.1-4 -alkyl, C.sub.1-4 -alkoxy, Cl or Br, or R.sub.1 and R.sub.2 together form a fused 6-membered hydrocarbon aromatic ring, with the proviso that R.sub.1 and R.sub.2 are not t-butyl or t-butoxy; X is O, S or Se; n is 1-3; and the --(CH.sub.2).sub.n -- group, optionally, is substituted by 1-3 methyl groups or by fluorine.

  19. Transfer delay audit.

    Science.gov (United States)

    Alraqi, S; Coughlan, R

    2007-05-01

    The purpose was to determine the average transfer time taken for acute patients to arrive to the medical unit from the time of referral by an A/E officer. We included the first 200 consecutive patients with completed records. 86 were men and 114 women, aged between 14 and 96 years. Transfer time was calculated as the difference from the time of referral by the A/E officer in UCHG to the time of arrival to the medical unit in MPH. The average transfer time for all patients was 91.5 minutes. The longest was in the second (17:00-24:00) interval with a mean of 105 minutes. 26.5% of patients arrived later than 2 hours after referral. Our findings confirm the existence of unacceptably long transfer time for a significant number of patients. Causes for this delay should be searched for to help find and implement solutions.

  20. Delay tolerant networks

    CERN Document Server

    Gao, Longxiang; Luan, Tom H

    2015-01-01

    This brief presents emerging and promising communication methods for network reliability via delay tolerant networks (DTNs). Different from traditional networks, DTNs possess unique features, such as long latency and unstable network topology. As a result, DTNs can be widely applied to critical applications, such as space communications, disaster rescue, and battlefield communications. The brief provides a complete investigation of DTNs and their current applications, from an overview to the latest development in the area. The core issue of data forward in DTNs is tackled, including the importance of social characteristics, which is an essential feature if the mobile devices are used for human communication. Security and privacy issues in DTNs are discussed, and future work is also discussed.

  1. Multimoded reflective delay lines and their application to resonant delay line rf pulse compression systems

    Directory of Open Access Journals (Sweden)

    Sami G. Tantawi

    2004-03-01

    Full Text Available Pulse compression systems for future linear colliders, such as NLC and JLC, involve hundreds of kilometers of waveguide runs. These waveguides are highly overmoded to reduce the rf losses. In this paper we present a novel idea for utilizing these waveguides several times by using different modes. This idea is suitable for reflective delay lines. All the modes being used have low-loss characteristics. We describe mechanically simple mode transducers that switch the propagation mode from one configuration to another with no observable dispersion. We apply this technique to a resonant delay line pulse compression system. We also present experimental results that verify these theoretical developments.

  2. [Imaging for evaluation of urologic abnormalities in infants with fetal hydronephrosis: advances and controversies].

    Science.gov (United States)

    Dias, Cristiane Santos; Silva, José Maria Penido; Marciano, Renata Cristiane; Bouzada, Maria Candida Ferrarez; Parisotto, Viviane Marino; Sanches, Sandra; Rodrigues, Carlos José Simal; Duarte, Mariana Guerra; Simões e Silva, Ana Cristina; de Oliveira, Eduardo Araujo

    2012-01-01

    Recent advances in prenatal diagnosis resulted in an improvement of detection and management of urinary tract abnormalities. Prenatal ultrasonography allows to identify urological abnormalities that otherwise would not be seen until later in life, when complications occur. The voiding cystourethrogram can be reserved for selected patients. Nuclear medicine exams should be performed in cases of moderate and severe hydronephrosis. A review of the current literature on postnatal approach of prenatal hydronephrosis was performed. Data obtained were compared with the records of the Pediatric Nephrology Unit HC/UFMG regarding management and follow-up of children with uropathies detected while investigating for fetal hydronephrosis.

  3. Consultation on urological specimens from referred cancer patients using real-time digital microscopy

    DEFF Research Database (Denmark)

    Holten-Rossing, Henrik; Larsen, Lise Grupe; Toft, Birgitte Grønkaer

    2016-01-01

    requirements. The aim was to evaluate whether real-time digital microscopy for urological cancer specimens during the primary diagnostic process can replace subsequent physical slide referral and reassessment without compromising diagnostic safety. METHODS: From May to October 2014, tissue specimens from 130...... Finetek) was employed. The Pathology Department at Næstved Hospital was equipped with a digital microscope and three consultant pathologists were stationed at Rigshospitalet with workstations optimized for digital microscopy. Representative slides for each case were selected for consultation and live...

  4. The alchemy of jargon: etymologies of urologic neologisms. number 6: the language of the urogenital system.

    Science.gov (United States)

    Shelfer, Lochlan

    2009-11-01

    As the scientific community is increasingly severed from the study of linguistics, the underlying significance of their common technical words is becoming blurred. This article will focus on the genesis of terminology of the urogenital system. These notes will give a detailed background of the history of technical terms, including how they came into being, whence they were derived, and how they impacted the scientific community through the ages. In this installment, following terms are analyzed: Penis, Ampulla, Vas Deferens, Epididymis, Gonad, and Bladder. This analysis of the history and significance of scientific terms common to the urological community works towards a fortification of their power by offering a reminder of their origins.

  5. The development and current status of minimally invasive surgery to manage urological complications after renal transplantation

    Directory of Open Access Journals (Sweden)

    Ravindra B Sabnis

    2016-01-01

    Conclusion: Minimally invasive techniques have a critical role in the management of urological complications after renal transplantation. Urinary leakage should be managed with complete decompression. Percutaneous drainage should be the first line of treatment for lymphocele that is symptomatic or causing ureteric obstruction. Laparoscopic lymphocele deroofing is successful in aspiration-resistant cases. Deflux is highly successful for the management of complicated low-grade kidney transplant reflux. The principles of stone management in a native solitary kidney are applied to the transplanted kidney. Early identification and treatment of bladder outlet obstruction after renal transplantation can prevent urinary leakage and obstructive uropathy.

  6. Thiel embalming method for cadaver preservation: a review of new training model for urologic skills training.

    Science.gov (United States)

    Healy, Samuel E; Rai, Bhavan Prasad; Biyani, Chandra Shekhar; Eisma, Roos; Soames, Roger W; Nabi, Ghulam

    2015-03-01

    The use of endourology training models is on the rise. Surgical practice is moving toward a more minimally invasive approach and deficits in surgical exposure by enforcement of the European Working Time Directive call for simulation models to be anatomically sound. Thiel-embalmed cadavers have been found to demonstrate efficacy in tissue quality, elasticity, and handling in addition to playing a role in teaching and training. This review summarizes the current status of the Thiel method and its role in urologic skills training. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Location Estimation using Delayed Measurements

    DEFF Research Database (Denmark)

    Bak, Martin; Larsen, Thomas Dall; Nørgård, Peter Magnus

    1998-01-01

    When combining data from various sensors it is vital to acknowledge possible measurement delays. Furthermore, the sensor fusion algorithm, often a Kalman filter, should be modified in order to handle the delay. The paper examines different possibilities for handling delays and applies a new techn...... technique to a sensor fusion system for estimating the location of an autonomous guided vehicle. The system fuses encoder and vision measurements in an extended Kalman filter. Results from experiments in a real environment are reported......When combining data from various sensors it is vital to acknowledge possible measurement delays. Furthermore, the sensor fusion algorithm, often a Kalman filter, should be modified in order to handle the delay. The paper examines different possibilities for handling delays and applies a new...

  8. [Improvement of the recruitment of surgery interns derived from the Epreuves Nationales Classantes (National-Ranking Exam): practical solution applied to urology].

    Science.gov (United States)

    Beley, Sébastien; Dubosq, Francis; Simon, Pascal; Larré, Stéphane; Battisti, Simon; Ballereau, Charles; Boublil, Véronique; Richard, François; Rouprêt, Morgan

    2005-12-01

    To analyse the value of an urology initiation session proposed to young interns to improve recruitment of the discipline since the introduction of the new National-Ranking Exam (NRE). In October 2004, the 77 interns appointed to surgery in Paris on the basis of the ENC participated in a one-day urology initiation session organized by the AFUF, at the AP-HP School of Surgery. All interns were given a questionnaire at the beginning of the session to record the following data: age, gender, teaching hospital, a student attachment in urology and desired specialization as a function of the surgical training programmes proposed by the ENC. Items concerning the desired specialization were resubmitted to the interns at the end of the session. Population. 77 interns, 48 females (62.3%) and 29 males (37.7%) with a mean age of 25.2 +/- 5 years (range: 23-31). 55 interns had trained at a Parisian teaching hospital (67%) and 22 (28.6%) had trained at a provincial teaching hospital. 16 interns (20.8%) had completed at least one urology attachment during their medical training. Desired specialization. Orthopaedics was the discipline most frequently cited (n = 20; 26%). Urology was chosen by 8 interns (10.40%), who had all completed an urology attachment during their medical training. At the end of the urology initiation session, another 8 interns expressed the desire to specialize in urology. Of the 16 potential urology interns, 9 (56.2%) confirmed that their decision was final. Urology occupies a special place and remains a popular surgical speciality among students. Organization of practical sessions constitutes a solution to inform, create an emulation and motivate surgery interns to choose urology.

  9. Control systems with network delay

    OpenAIRE

    Şabanoviç, Asif; Sabanovic, Asif; Ohnishi, Kouhei; Yashiro, Daisuke; Acer, Merve; Ş.-Behliloviç, Nadira; S.-Behlilovic, Nadira

    2009-01-01

    In this paper motion control systems with delay in measurement and control channels are discussed and a new structure of the observer-predictor is proposed. The feature of the proposed system is enforcement of the convergence in both the estimation and the prediction of the plant output in the presence of the variable, unknown delay in both measurement and in the control channels. The estimation is based on the available data – undelayed control input, the delayed measurement of position o...

  10. Modeling delay in genetic networks: From delay birth-death processes to delay stochastic differential equations

    International Nuclear Information System (INIS)

    Gupta, Chinmaya; López, José Manuel; Azencott, Robert; Ott, William; Bennett, Matthew R.; Josić, Krešimir

    2014-01-01

    Delay is an important and ubiquitous aspect of many biochemical processes. For example, delay plays a central role in the dynamics of genetic regulatory networks as it stems from the sequential assembly of first mRNA and then protein. Genetic regulatory networks are therefore frequently modeled as stochastic birth-death processes with delay. Here, we examine the relationship between delay birth-death processes and their appropriate approximating delay chemical Langevin equations. We prove a quantitative bound on the error between the pathwise realizations of these two processes. Our results hold for both fixed delay and distributed delay. Simulations demonstrate that the delay chemical Langevin approximation is accurate even at moderate system sizes. It captures dynamical features such as the oscillatory behavior in negative feedback circuits, cross-correlations between nodes in a network, and spatial and temporal information in two commonly studied motifs of metastability in biochemical systems. Overall, these results provide a foundation for using delay stochastic differential equations to approximate the dynamics of birth-death processes with delay

  11. Modeling delay in genetic networks: from delay birth-death processes to delay stochastic differential equations.

    Science.gov (United States)

    Gupta, Chinmaya; López, José Manuel; Azencott, Robert; Bennett, Matthew R; Josić, Krešimir; Ott, William

    2014-05-28

    Delay is an important and ubiquitous aspect of many biochemical processes. For example, delay plays a central role in the dynamics of genetic regulatory networks as it stems from the sequential assembly of first mRNA and then protein. Genetic regulatory networks are therefore frequently modeled as stochastic birth-death processes with delay. Here, we examine the relationship between delay birth-death processes and their appropriate approximating delay chemical Langevin equations. We prove a quantitative bound on the error between the pathwise realizations of these two processes. Our results hold for both fixed delay and distributed delay. Simulations demonstrate that the delay chemical Langevin approximation is accurate even at moderate system sizes. It captures dynamical features such as the oscillatory behavior in negative feedback circuits, cross-correlations between nodes in a network, and spatial and temporal information in two commonly studied motifs of metastability in biochemical systems. Overall, these results provide a foundation for using delay stochastic differential equations to approximate the dynamics of birth-death processes with delay.

  12. Heterogeneous delay-induced asynchrony and resonance in a small-world neuronal network system

    Science.gov (United States)

    Yu, Wen-Ting; Tang, Jun; Ma, Jun; Yang, Xianqing

    2016-06-01

    A neuronal network often involves time delay caused by the finite signal propagation time in a given biological network. This time delay is not a homogenous fluctuation in a biological system. The heterogeneous delay-induced asynchrony and resonance in a noisy small-world neuronal network system are numerically studied in this work by calculating synchronization measure and spike interval distribution. We focus on three different delay conditions: double-values delay, triple-values delay, and Gaussian-distributed delay. Our results show the following: 1) the heterogeneity in delay results in asynchronous firing in the neuronal network, and 2) maximum synchronization could be achieved through resonance given that the delay values are integer or half-integer times of each other.

  13. Systemic delay propagation in the US airport network.

    Science.gov (United States)

    Fleurquin, Pablo; Ramasco, José J; Eguiluz, Victor M

    2013-01-01

    Technologically driven transport systems are characterized by a networked structure connecting operation centers and by a dynamics ruled by pre-established schedules. Schedules impose serious constraints on the timing of the operations, condition the allocation of resources and define a baseline to assess system performance. Here we study the performance of an air transportation system in terms of delays. Technical, operational or meteorological issues affecting some flights give rise to primary delays. When operations continue, such delays can propagate, magnify and eventually involve a significant part of the network. We define metrics able to quantify the level of network congestion and introduce a model that reproduces the delay propagation patterns observed in the U.S. performance data. Our results indicate that there is a non-negligible risk of systemic instability even under normal operating conditions. We also identify passenger and crew connectivity as the most relevant internal factor contributing to delay spreading.

  14. Ranking of Delay Factors for Makkah’s Construction Industry

    Directory of Open Access Journals (Sweden)

    Al-Emad Nashwan

    2017-01-01

    Full Text Available This paper presents identification of significant delay factors encountered by Makkah’s construction industry using quantitative approach. A structured questionnaire developed based on literature review was verified through pilot study involved selected construction experts. Questionnaire survey was conducted amongst Makkah construction practitioners include contractors, consultants and project management consultancy. The survey managed to collect 100 valid responses which were used to rank the factors using average index approach. Results of the analysis for 10 most significant factors causing construction delay in Makkah construction industry are Difficulties in financing project by contractor, Poor coordination between parties, Shortage of manpower, Delays in producing design documents, Improper planning and scheduling of the project, Delay in progress payments, Low productivity level of labour, Poor communication between parties, Unqualified workforce and Poor contract management. This finding is helpful to Makkah construction’s community particularly projects’ stakeholders in avoiding potential delay for their future projects.

  15. Delay in treatment seeking of smear positive tuberculous patients

    International Nuclear Information System (INIS)

    Bhatti, A.T.; Zahid, M.

    2010-01-01

    To assess and identify the causes and circumstances leading to delays in health seeking and diagnosis of tuberculosis patients as they often present with advance disease resulting in increased morbidity and mortality. Settings Department of Tuberculosis, DOTS clinic DHQ Hospital, Vehari. Methodology One (author) inspiration diagnosed smear positive pulmonary tuberculosis patients were included. Information was gathered through interviews and from TB-01 card. Results Maximum patients were in age group of 16-40 years. Median patient delay was 4-6 months; jobless, homeless personnel had longer delay. The main reason for delay was that the symptoms were not considered serious enough. Delay in presentation of smear positive cases may be due to the lack of awareness of patients and the incompetence of some health workers. Training and supervision of staff and awareness campaigns targeted at the population and involvement of private sector will improve TB control in Vehari. (author)

  16. PRECISION TIME-DELAY CIRCUIT

    Science.gov (United States)

    Creveling, R.

    1959-03-17

    A tine-delay circuit which produces a delay time in d. The circuit a capacitor, an te back resistance, connected serially with the anode of the diode going to ground. At the start of the time delay a negative stepfunction is applied to the series circuit and initiates a half-cycle transient oscillatory voltage terminated by a transient oscillatory voltage of substantially higher frequency. The output of the delay circuit is taken at the junction of the inductor and diode where a sudden voltage rise appears after the initiation of the higher frequency transient oscillations.

  17. Systematic of delayed neutron parameters

    International Nuclear Information System (INIS)

    Isaev, S.G.; Piksaikin, V.M.

    2000-01-01

    The experimental studies of the energy dependence of the delayed neutron (DN) parameters for various fission systems has shown that the behaviour of a some combination of delayed neutron parameters has a similar features. On the basis of this findings the systematics of delayed neutron experimental data for thorium, uranium, plutonium and americium isotopes have been investigated with the purpose to find a correlation of DN parameters with characteristics of fissioning system as well as a correlation between the delayed neutron parameters themselves. It was presented the preliminary results which were obtained during study the physics interpretation of the results [ru

  18. Time Delay of CGM Sensors

    Science.gov (United States)

    Schmelzeisen-Redeker, Günther; Schoemaker, Michael; Kirchsteiger, Harald; Freckmann, Guido; Heinemann, Lutz; del Re, Luigi

    2015-01-01

    Background: Continuous glucose monitoring (CGM) is a powerful tool to support the optimization of glucose control of patients with diabetes. However, CGM systems measure glucose in interstitial fluid but not in blood. Rapid changes in one compartment are not accompanied by similar changes in the other, but follow with some delay. Such time delays hamper detection of, for example, hypoglycemic events. Our aim is to discuss the causes and extent of time delays and approaches to compensate for these. Methods: CGM data were obtained in a clinical study with 37 patients with a prototype glucose sensor. The study was divided into 5 phases over 2 years. In all, 8 patients participated in 2 phases separated by 8 months. A total number of 108 CGM data sets including raw signals were used for data analysis and were processed by statistical methods to obtain estimates of the time delay. Results: Overall mean (SD) time delay of the raw signals with respect to blood glucose was 9.5 (3.7) min, median was 9 min (interquartile range 4 min). Analysis of time delays observed in the same patients separated by 8 months suggests a patient dependent delay. No significant correlation was observed between delay and anamnestic or anthropometric data. The use of a prediction algorithm reduced the delay by 4 minutes on average. Conclusions: Prediction algorithms should be used to provide real-time CGM readings more consistent with simultaneous measurements by SMBG. Patient specificity may play an important role in improving prediction quality. PMID:26243773

  19. The impact of the National Treatment Purchase Fund on numbers of core urology training cases at University Hospital Galway.

    LENUS (Irish Health Repository)

    Harney, T J

    2011-06-01

    Since the National Treatment Purchase Fund (NTPF) scheme was introduced in 2002, public patients waiting longer than three months for investigations and treatment are offered care in the private medical sector. Our aim was to assess the impact of the NTPF scheme on the number of training cases performed at University Hospital Galway (UHG). The number and type of urological procedures performed in the private medical sector under the NTFP scheme in 2008 were obtained from the UHG waiting list office. The number of these procedures performed on public patients by trainees at UHG in 2008 was determined retrospectively by reviewing theatre records. A significant number of core urology procedures were performed in the private sector via the NTPF scheme. Cancer centre designation and implementation of the EWTD will also place further pressures on urological training opportunities in Ireland.

  20. Further triple integral approach to mixed-delay-dependent stability of time-delay neutral systems.

    Science.gov (United States)

    Wang, Ting; Li, Tao; Zhang, Guobao; Fei, Shumin

    2017-09-01

    This paper studies the asymptotic stability for a class of neutral systems with mixed time-varying delays. Through utilizing some Wirtinger-based integral inequalities and extending the convex combination technique, the upper bound on derivative of Lyapunov-Krasovskii (L-K) functional can be estimated more tightly and three mixed-delay-dependent criteria are proposed in terms of linear matrix inequalities (LMIs), in which the nonlinearity and parameter uncertainties are also involved, respectively. Different from those existent works, based on the interconnected relationship between neutral delay and state one, some novel triple integral functional terms are constructed and the conservatism can be effectively reduced. Finally, two numerical examples are given to show the benefits of the proposed criteria. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  1. Reconstructive Urology

    Directory of Open Access Journals (Sweden)

    Fikret Fatih Önol

    2014-11-01

    Full Text Available In the treatment of urethral stricture, Buccal Mucosa Graft (BMG and reconstruction is applied with different patch techniques. Recently often prefered, this approach is, in bulber urethra strictures of BMG’s; by “ventral onley”, in pendulous urethra because of thinner spingiosis body, which provides support and nutrition of graft; by means of “dorsal inley” being anastomosis. In the research that Cordon et al. did, they compared conventional BMJ “onley” urethroplast and “pseudo-spongioplasty” which base on periurethral vascular tissues to be nourished by closing onto graft. In repairment of front urethras that spongiosis supportive tissue is insufficient, this method is defined as peripheral dartos [çevre dartos?] and buck’s fascia being mobilized and being combined on BMG patch. Between the years 2007 and 2012, assessment of 56 patients with conventional “ventral onley” BMG urethroplast and 46 patients with “pseudo-spongioplasty” were reported to have similar success rates (80% to 84% in 3.5 year follow-up on average. While 74% of the patients that were applied pseudo-spongioplasty had disease present at distal urethra (pendulous, bulbopendulous, 82% of the patients which were applied conventional onley urethroplast had stricture at proximal (bulber urethra yet. Also lenght of the stricture at the pseudo-spongioplasty group was longer in a statistically significant way (5.8 cm to 4.7 cm on average, p=0.028. This study which Cordon et al. did, shows that conditions in which conventional sponjiyoplasti is not possible, periurethral vascular tissues are adequate to nourish BMG. Even it is an important technique in terms of bringing a new point of view to today’s practice, data especially about complications that may show up after pseudo-spongioplasty usage on long distal strictures (e.g. appearance of urethral diverticulum is not reported. Along with this we think that, providing an oppurtinity to patch directly without urethra mobilization need or extra dissection in the conditions that surgeon has preferred BMG in distal urethra reconstruction, this method will be a valuable alternative in the selected facts.

  2. [Delayed posthypoxic leukoencephalopathy: case reports].

    Science.gov (United States)

    Okuda, Shiho; Ueno, Masao; Hayakawa, Michiko; Araki, Manabu; Kanda, Fumio; Takano, Shin

    2012-01-01

    Delayed posthypoxic leukoencephalopathy (DPL) is a rare and less well known complication of hypoxic brain injury. Although it is well known that anoxic or hypoxic injury produces acute neurologic deficits, DPL typically manifests days to weeks after apparent recovery from an obtunded state, and patients with DPL demonstrate cognitive impairment, high brain dysfunction, parkinsonism, or psychosis. MRI findings of the brain demonstrate deep white matter abnormalities. We report 2 cases of DPL after hypoxia due to benzodiazepine overdose. Both of our patients had normal arylsulfatase A activity. Although DPL is seen in carbon monoxide poisoning, pseudodeficiency of arylsulfatase A activity, or drug overdose with heroin or morphine, there are only some previous studies of DPL caused by an overdose with benzodiazepine. It is unclear whether neurotoxicity from the drug in addition to hypoxia alone is involved, however, it is important to note that overdose of common drugs as sleeping medicine can cause DPL. Since DPL may often be misdiagnosed and be subjected to unnecessary treatments, it is also important to understand its unique clinical course and MRI findings. With prompt recognition of DPL, we expect that more cases of DPL caused by overdose with benzodiazepine will be diagnosed, because benzodiazepine overdoses are common.

  3. The effect of preoperative intravenous dexketoprofen trometamol on postoperative pain in minor outpatient urologic surgery.

    Science.gov (United States)

    Bolat, Özgür; Erhan, Elvan; Deniz, Mustafa Nuri

    2013-09-01

    The aim of this prospective double-blind randomized study was to compare the effectiveness of preoperative dexketoprofen trometamol for acute postoperative pain in patients undergoing minor outpatient urologic surgery. Sixty male patients (ASA I and II) undergoing varicocelectomy and testicular sperm extraction (TESE) with standard laryngeal mask airway (LMA) anesthesia were randomly divided into two groups. Patients in Group I (n=30) received 50 mg of dexketoprofen trometamol iv before induction, whereas patients in Group II (n=30) received saline. All patients received standard LMA anesthesia (propofol, sevoflurane and N2O/O2). Analgesic efficacy was evaluated by self-assessment of pain intensity (VAS) at regular intervals. Vital signs, side effects and time to reach a postanesthesia discharge score (PADS) of ≥9 were also recorded. Paracetamol 1 gr iv and tramadol 100 mg iv were used for rescue analgesia. Demographic data and duration of surgery were similar in both groups. There was no significant difference between groups with respect to postoperative pain scores and side effects. Although more patients in Group II (60%) required rescue analgesia compared to Group I (33.3%), the difference did not reach statistical significance. Preoperative IV use of dexketoprofen trometamol iv did not decrease the need for rescue analgesia in patients undergoing minor outpatient urological surgery.

  4. Assessment of selected cognitive processes in elderly patients after urologic surgery.

    Science.gov (United States)

    Wioletta, Mędrzycka-Dąbrowska; Sebastian, Dąbrowski; Andrzej, Basiński

    2016-01-01

    The issue of postoperative disorders of cognitive functions is a highly topical problem as more and more elderly people undergo medical treatments. Patients may lose the ability of assimilating information and their linguistic functions may deteriorate. Cognitive disorders may result in the temporary exclusion of the patient from social activity. The purpose of the paper was to assess the incidence of certain cognitive disorders in the elderly after urological surgeries. The study was conducted in a group of 218 patients aged over 65, male and female, after an urological surgery under different types of anesthesia. Standardized neuropsychological tests of cognitive functions were employed in the study. Analysis of the data showed that in the control group were obtained similar results in the study of the first and second. However, in the test group demonstrated a reduction cognitive function in all the tests in a second study. The reduction of cognitive functions in the study group was observed in all the domains but it was the most marked in visual memory tests. Postoperative reduction of cognitive functions is correlated with the patient's age, education and mood. Postoperative reduction of cognitive functions is not correlated with the type of surgery, anesthesia and its duration. Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  5. Asymptomatic Bacteriuria in Clinical Urological Practice: Preoperative Control of Bacteriuria and Management of Recurrent UTI

    Directory of Open Access Journals (Sweden)

    Tommaso Cai

    2016-01-01

    Full Text Available Asymptomatic bacteriuria (ABU is a common clinical condition that often leads to unnecessary antimicrobial use. The reduction of antibiotic overuse for ABU is consequently an important issue for antimicrobial stewardship and to reduce the emergence of multidrug resistant strains. There are two issues in everyday urological practice that require special attention: the role of ABU in pre-operative prophylaxis and in women affected by recurrent urinary tract infections (rUTIs. Nowadays, this is the time to think over our practice and change our way of thinking. Here, we aimed to summarize the current literature knowledge in terms of ABU management in patients undergoing urological surgery and in patients with rUTIs. In the last years, the approach to patient with ABU has changed totally. Prior to all surgical procedures that do not enter the urinary tract, ABU is generally not considered as a risk factor, and screening and treatment are not considered necessary. On the other hand, in the case of all procedures entering the urinary tract, ABU should be treated in line with the results of a urine culture obtained before the procedure. In patients affected by rUTIs, ABU can even have a protective role in preventing symptomatic recurrence, particularly when Enterococcus faecalis (E. faecalis has been isolated.

  6. Development of a near-infrared spectroscopy instrument for applications in urology.

    Science.gov (United States)

    Macnab, Andrew J; Stothers, Lynn

    2008-10-01

    Near infrared spectroscopy (NIRS) is an established technology using photons of light in the near infrared spectrum to monitor changes in tissue of naturally occurring chromophores, including oxygenated and deoxygenated hemoglobin. Technology and methodology have been validated for measurement of a range of physiologic parameters. NIRS has been applied successfully in urology research; however current instruments are designed principally for brain and muscle study. To describe development of a NIRS instrument specifically designed for monitoring changes in chromophore concentration in the bladder detrusor in real time, to facilitate research to establish the role of this non-invasive technology in the evaluation of patients with voiding dysfunction The portable continuous wave NIRS instrument has a 3 laser diode light source (785, 808 and 830 nanometers), fiber optic cables for light transmission, a self adhesive patient interface patch with an emitter and sensor, and software to detect the difference between the light transmitted and received by the instrument. Software incorporated auto-attenuates the optical signals and converts raw optical data into chromophore concentrations displayed graphically. The prototype was designed, tested, and iteratively developed to achieve optimal suprapubic transcutaneous monitoring of the detrusor in human subjects during bladder filling and emptying. Evaluation with simultaneous invasive urodynamic measurement in men and women indicates good specificity and sensitivity of NIRS chromophore concentration changes by receiver operator curve analysis, and correlation between NIRS data and urodynamic pressures. Urological monitoring with this NIRS instrument is feasible and generates data of potential diagnostic value.

  7. Reliability and validity of the General Health Questionnaire (GHQ-12) among urological patients: a Malaysian study.

    Science.gov (United States)

    Quek, K F; Low, W Y; Razack, A H; Loh, C S

    2001-10-01

    This present study was undertaken to validate the English version of the General Health Questionnaire (GHQ-12) in urological patients. Validity and reliability were studied in patients with lower urinary tract symptoms (LUTS) and patients without LUTS. Reliability was evaluated using the test-retest method and internal consistency was assessed using Cronbach's alpha. Sensitivity to change was expressed as the effect size in the pre-intervention versus post-intervention score in additional patients with benign prostatic hyperplasia (BPH) who underwent transurethral resection of the prostate (TURP). Internal consistency was excellent. A high degree of internal consistency was observed for each of the 12 items with Cronbach's alpha value of 0.37-0.79, while total scores was 0.79 in the population study. Test-retest correlation coefficient for the 12 items score were highly significant. Intraclass correlation coefficient was high (0.35-0.79). It showed a high degree of sensitivity and specificity to the effects of treatment. A high degree of significant level between baseline and post-treatment scores were observed across all 12 items in the treatment cohort but not in the control group. The GHQ-12 is suitable, reliable, valid and sensitive to clinical change in urological disorders.

  8. “Image and Treat” – An Individualized Approach to Urological Tumors

    Science.gov (United States)

    Bouchelouche, Kirsten; Capala, Jacek

    2010-01-01

    Purpose of review 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 has only recently been applied to these malignancies. Nuclear medicine plays an increasing 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 Recent findings Tumour-specific targets in uro-oncology are showing promising results for development of personalized therapy using positron emission tomography/computed tomography (PET/CT) molecular imaging and radioimmunotherapy (RIT). The antibody cG250, which binds to carbonic anhydrase IX (CAIX), is being evaluated as a radiolabelled imaging and therapeutic agent in clear cell renal cell carcinoma (ccRCC). 124I -cG250 PET/CT has demonstrated excellent targeting of ccRCC. Prostate specific membrane antigen (PSMA) is a promising target for both PET/CT and RIT of prostate cancer. HER2 may be another potential target in bladder and prostate cancer. Summary Tumour-specific targets and biomarkers are being studied for PET/CT and RIT. This may lead to development of new therapeutic strategies. However, considerable investment in new research will be required for personalized medicine to be routinely used in uro-oncology. PMID:20150811

  9. [Radionuclide therapy for the treatment of skeletal metastases of urological malignancies: a forgotten therapy?].

    Science.gov (United States)

    Badawi, J K

    2012-08-01

    Many patients suffering from urological or non-urological malignancies develop bone metastases. One symptom often found is severe skeletal pain which siginificantly lowers the quality of life. Further symptoms are pathological fractures, spinal cord compression and hypercalcemia. The systemic radiopharmaceutical therapy represents an important systemic treatment option, in addition to chemotherapy, hormone therapy, external beam radiation, bisphosphonates and analgesics. The radionuclide therapy is rarely used and often used in a later phase of disease, mainly known for the bone pain palliation. This review article should help remind physicians to use this interesting therapy. It focuses on the common radionuclides Strontium-89-chloride, Samarium-153-EDTMP (ethylene-diamine-tetra-methylene-phosphonate) and Rhenium-186-HEDP (hydroxyethylidene-diphosphonate), their physical characteristics and differences, contraindications of the therapy like spinal cord compression and side effects. Additionally, potential tumoricidal activity and improvement of survival are discussed when using the radionuclides repetitively or in combination. The European and German guidelines are included. Furthermore, the combination of radionuclides and bisphosphonates or chemotherapy are briefly discussed, based on available clinical studies. Additionally, alpharadin (radium-223 chloride) is discussed, an experimental radiopharmaceutical under clinical evaluation, which emits alpha-radiation. In phase III clinical trials, it was shown to significantly increase the median overall survival in patients with bone metastases from advanced prostate cancer. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Preliminary Study of Pet Owner Adherence in Behaviour, Cardiology, Urology, and Oncology Fields

    Directory of Open Access Journals (Sweden)

    Zita Talamonti

    2015-01-01

    Full Text Available Successful veterinary treatment of animals requires owner adherence with a prescribed treatment plan. The aim of our study was to evaluate and compare the level of adherence of the owners of patients presented for behavioural, cardiological, urological, and oncological problems. At the end of the first examination, each owner completed a questionnaire. Then, the owners were called four times to fill out another questionnaire over the phone. With regard to the first questionnaire, statistically significant data concern behavioral medicine and cardiology. In the first area the owner’s worry decreases during the follow-up and the number of owners who would give away the animal increases. In cardiology, owners who think that the pathology harms their animal’s quality of life decreased significantly over time. With regard to the 9 additional follow-up questions, in behavioural medicine and urology the owner’s discomfort resulting from the animal’s pathology significantly decreases over time. Assessment of adherence appears to be an optimal instrument in identifying the positive factors and the difficulties encountered by owners during the application of a treatment protocol.

  11. Antidepressant Drugs for Chronic Urological Pelvic Pain: An Evidence-Based Review

    Directory of Open Access Journals (Sweden)

    Christos Papandreou

    2009-01-01

    Full Text Available The use of antidepressant drugs for the management of chronic pelvic pain has been supported in the past. This study aimed to evaluate the available evidence for the efficacy and acceptability of antidepressant drugs in the management of urological chronic pelvic pain. Studies were selected through a comprehensive literature search. We included all types of study designs due to the limited evidence. Studies were classified into levels of evidence according to their design. Ten studies were included with a total of 360 patients. Amitriptyline, sertraline, duloxetine, nortriptyline, and citalopram are the antidepressants that have been reported in the literature. Only four randomized controlled trials (RCTs were identified (two for amitriptyline and two for sertraline with mixed results. We conclude that the use of antidepressants for the management of chronic urological pelvic pain is not adequately supported by methodologically sound RCTs. From the existing studies amitriptyline may be effective in interstitial cystitis but publication bias should be considered as an alternative explanation. All drugs were generally well tolerated with no serious events reported.

  12. Magnetic resonance imaging in the assessment of urologic disease: an all-in-one approach

    Energy Technology Data Exchange (ETDEWEB)

    Verswijvel, G.A.; Oyen, R.H.; Vaninbrouckx, J.; Bosmans, H.; Marchal, G. [University Hospital, Leuven (Belgium). Dept. of Radiology; Van Poppel, H.P.; Goethuys, H. [Catholic University of Leuven (Belgium). Dept. of Urology; Maes, B. [Catholic University of Leuven (Belgium). Dept. of Nephrology

    2000-10-01

    The aim of this study was to evaluate an ''all-in-one'' MR procedure to examine the kidneys, the renal vascular supply and renal perfusion, and the urinary tract. In 64 patients (58 with urologic disease and 6 healthy volunteers), MR was performed including: (a) T1- and T2-weighted imaging; (b) 3D contrast-enhanced MR angiography (MRA), including the renal arteries, renal veins, as well as renal perfusion; and (c) 3D contrast-enhanced MR urography (MRU) in the coronal and sagittal plane. For the latter, low- and high-resolution images were compared. Prior to gadolinium injection, 0.1 mg/kg body weight of furosemide was administered intravenously. The results were compared with correlative imaging modalities (ultrasonography, intravenous urography, CT), ureterorenoscopy and/or surgical-pathologic findings. Visualization of the renal parenchyma, the vascular supply, and the collecting system was adequate in all cases, both in nondilated and in dilated systems and irrespective of the renal function. One infiltrating urothelial cancer was missed; there was one false-positive urothelial malignancy. Different MR techniques can be combined to establish an all-in-one imaging modality in the assessment of diseases which affect the kidneys and urinary tracts. Continuous refinement of the applied MR techniques and further improvements in spatial resolution is needed to expand the actual imaging possibilities and to create new tracts and challenges in the MR evaluation of urologic disease. (orig.)

  13. Pomegranate Extracts in the Management of Men's Urologic Health: Scientific Rationale and Preclinical and Clinical Data

    Directory of Open Access Journals (Sweden)

    Kroeger N.

    2013-01-01

    Full Text Available Multiple strands of research provide growing evidence that diet, nutrition, and life style play a role in the development and the course of urological diseases. Numerous micronutrients and polyphenols found in soy, green tea, and many fruits and vegetables have been described to impact diseases including erectile dysfunction, benign prostatic hyperplasia, and prostate cancer. However, oftentimes these reports lack both a scientific rationale and supportive evidence base. The efficacy of pomegranate, on the other hand, in the modulation of central biological processes like inflammation, hypoxia, and oxidative stress that are important in the pathogenesis of urological maladies has been robustly demonstrated in preclinical in vitro and in vivo studies. Moreover, clinical trials have further supported its use in the treatment of several diseases, in particular in the management of prostate cancer. Herein, we critically review the scientific knowledge about the current role and future prospects for the use of pomegranate extracts in the therapy of erectile dysfunction, benign prostatic hyperplasia, and prostate cancer.

  14. Clinical Application of Human Urinary Extracellular Vesicles in Kidney and Urologic Diseases

    Directory of Open Access Journals (Sweden)

    Giuseppe De Palma

    2016-06-01

    Full Text Available Extracellular vesicles (EVs have been isolated in different body fluids, including urine. The cargo of urinary EVs is composed of nucleic acids and proteins reflecting the physiological and possibly pathophysiological state of cells lining the nephron and the urinary tract. Urinary EVs have been confirmed to contain low amounts of various types of RNA that play a role in intercellular communication by transferring genetic information. This communication through EV RNAs includes both continuation of normal physiological processes and conditioning in disease mechanisms. Although proteins included in urinary EVs represent only 3% of the whole-urine proteome, urinary EVs can influence cells in the renal epithelia not only by delivering RNA cargo, but also by delivering a wide range of proteins. Since urine is a readily available biofluid, the discovery of EVs has opened a new field of biomarker research. The potential use of urinary EV RNAs and proteins as diagnostic biomarkers for various kidney and urologic diseases is currently being explored. Here, we review recent studies that deal in identifying biomarker candidates for human kidney and urologic diseases using urinary EVs and might help to understand the pathophysiology.

  15. Urine cytology in the evaluation of urological malignancy revisited: is it still necessary?

    LENUS (Irish Health Repository)

    Falebita, Opeyemi Adegboyega

    2012-01-31

    OBJECTIVE: We aim to determine if urine cytology was still necessary as a routine part of the evaluation for the presence of urological malignancy and to evaluate its cost effectiveness. METHODS: Urine cytology reports over a 6-year period (2000-2005) were retrieved from our institution\\'s pathology department database. Patients with urine cytology positive for malignant cells were identified. We retrospectively reviewed the charts of these patients for age, sex, flexible cystoscopy and radiological imaging results. The cost of urine cytology was retrieved from the pathology department. RESULTS: There were a total of 2,568 urine cytological examinations. Of these, 25 were positive for malignant cells. There were 19 male (76%) and 6 female (24%) patients with a mean age of 72 years (range: 49-97). In 21 patients with positive cytology, a bladder tumor was identified at flexible cystoscopy and\\/or imaging studies. For a positive cytology yield of 1%, EUR 210,000 was spent. CONCLUSIONS: Routine urine cytology was not cost effective and did not add to the diagnostic yield beyond cystoscopy and diagnostic imaging. It may be omitted in the initial evaluation of urological malignancy.

  16. [Evaluation of the maturity of a Urology Department in terms of Quality. Management and Quality improvement operative objectives].

    Science.gov (United States)

    Luján, Marcos; Mora, José Ramón; Pascual, Carlos; Chiva, Vicente; Diz, Manuel R; Martín, Carlos; Gamarra, Manuela; del Carmen López, Maria

    2015-01-01

    The objective of quality management is the identification of improvement areas to achieve total client and other involved agents satisfaction. In this paper we describe the start up of a Quality Improvement Plan (QIP) in a Urology Department. We assessed the current maturity and performance of the Unit by means of self-evaluation with a questionnaire adapted to the 2009 ISO 9004 standard by all the professionals in the unit (Physicians and Nurses). All the items in the questionnaire are based in attributes and evaluation lines gathered in the five chapters of the Standard. The areas of improvement were identified and specific objectives were established and collected in the QIP with indicators for their measurement, responsible individuals, chronogram and results evaluation. After implementation of the quality improvement actions, a second self-evaluation was performed to start a new cycle. After the first evaluation we observed a high global performance (61%). Analyzed by sections, the highest level was achieved in the human resources management chapter (73%) and the lowest in quality management (30%) due to the absence of a process management approach. After identification of improvement areas, we defined projects and activities to be developed, in the process management context. The second evaluation, after the implementation of process management in the unit, showed an improvement in the maturity level of the Unit, reaching an 83%. The management of a clinical department cannot be limited to continuous improvisation. A process management approach is necessary, finishing with the usual defects of the generated product (variability, errors, omissions, waiting lists). Excellence in the quality of health care is an essential objective in every healthcare organization and standardization models, such as 2009 ISO 9004 standard, are the right way for that purpose.

  17. Fundamental Matrix for a Class of Point Delay Linear Systems

    International Nuclear Information System (INIS)

    Sen, M. de la; Alastruey, C. F.

    1998-01-01

    It is difficult to establish explicit analytic forms for fundamental matrices of delayed linear systems. In this paper, an explicit form of exponential type is given for such a matrix in the case of punctual delays. The existence of real and complex fundamental matrices, for the case of real parameterizations of the differential system, is studied and discussed. Some additional commutativity properties involving the matrices parameters and the fundamental matrices as well as explicit expressions for the solution of the delayed differential system are also given. (Author)

  18. Patterns of delayed marriage: how special are the Irish?

    Science.gov (United States)

    Schellenberg, J A

    1991-02-01

    "This paper deals with delayed marriage and singlehood among the Irish as a focus for the study of the persistence of ethnic characteristics. Patterns of delayed marriage in Ireland in the nineteenth and twentieth centuries are reviewed, and evidence is also presented that Irish persons in other countries (especially in the United States) continue to show significantly higher rates of singlehood and postponed marriage than persons of other nationality groups. Discussion includes how delayed marriage became common in Ireland during the past 150 years and what may be involved in the apparent persistence of this pattern today in Ireland and among the Irish in other countries." excerpt

  19. Acceleration feedback improves balancing against reflex delay

    Science.gov (United States)

    Insperger, Tamás; Milton, John; Stépán, Gábor

    2013-01-01

    A model for human postural balance is considered in which the time-delayed feedback depends on position, velocity and acceleration (proportional–derivative–acceleration (PDA) feedback). It is shown that a PDA controller is equivalent to a predictive controller, in which the prediction is based on the most recent information of the state, but the control input is not involved into the prediction. A PDA controller is superior to the corresponding proportional–derivative controller in the sense that the PDA controller can stabilize systems with approximately 40 per cent larger feedback delays. The addition of a sensory dead zone to account for the finite thresholds for detection by sensory receptors results in highly intermittent, complex oscillations that are a typical feature of human postural sway. PMID:23173196

  20. Approximating chaotic saddles for delay differential equations.

    Science.gov (United States)

    Taylor, S Richard; Campbell, Sue Ann

    2007-04-01

    Chaotic saddles are unstable invariant sets in the phase space of dynamical systems that exhibit transient chaos. They play a key role in mediating transport processes involving scattering and chaotic transients. Here we present evidence (long chaotic transients and fractal basins of attraction) of transient chaos in a "logistic" delay differential equation. We adapt an existing method (stagger-and-step) to numerically construct the chaotic saddle for this system. This is the first such analysis of transient chaos in an infinite-dimensional dynamical system, and in delay differential equations in particular. Using Poincaré section techniques we illustrate approaches to visualizing the saddle set, and confirm that the saddle has the Cantor-like fractal structure consistent with a chaotic saddle generated by horseshoe-type dynamics.

  1. Approximating chaotic saddles for delay differential equations

    Science.gov (United States)

    Taylor, S. Richard; Campbell, Sue Ann

    2007-04-01

    Chaotic saddles are unstable invariant sets in the phase space of dynamical systems that exhibit transient chaos. They play a key role in mediating transport processes involving scattering and chaotic transients. Here we present evidence (long chaotic transients and fractal basins of attraction) of transient chaos in a “logistic” delay differential equation. We adapt an existing method (stagger-and-step) to numerically construct the chaotic saddle for this system. This is the first such analysis of transient chaos in an infinite-dimensional dynamical system, and in delay differential equations in particular. Using Poincaré section techniques we illustrate approaches to visualizing the saddle set, and confirm that the saddle has the Cantor-like fractal structure consistent with a chaotic saddle generated by horseshoe-type dynamics.

  2. Delayed onset muscle soreness: is massage effective?

    Science.gov (United States)

    Nelson, Nicole

    2013-10-01

    Despite the widespread occurrence of delayed onset muscle soreness (DOMS), there is little consensus as to the exact cause or which treatments may be most effective at alleviating symptoms. Greater understanding of DOMS can give sports medicine and fitness professionals an opportunity to help prevent or speed recovery of this performance limiting condition. This article will review the DOMS literature, including the potential role of psychosocial factors and explore studies which involve massage therapy as a treatment modality. Articles from PubMed, MEDLINE, Google Scholar, and references from articles are included in this review. Search words and phrases included delayed onset muscle soreness, repeated bout effect, massage effectiveness, exercise induced muscle damage, and eccentric exercise. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. High resolution digital delay timer

    Science.gov (United States)

    Martin, Albert D.

    1988-01-01

    Method and apparatus are provided for generating an output pulse following a trigger pulse at a time delay interval preset with a resolution which is high relative to a low resolution available from supplied clock pulses. A first lumped constant delay (20) provides a first output signal (24) at predetermined interpolation intervals corresponding to the desired high resolution time interval. Latching circuits (26, 28) latch the high resolution data (24) to form a first synchronizing data set (60). A selected time interval has been preset to internal counters (142, 146, 154) and corrected for circuit propagation delay times having the same order of magnitude as the desired high resolution. Internal system clock pulses (32, 34) count down the counters to generate an internal pulse delayed by an interval which is functionally related to the preset time interval. A second LCD (184) corrects the internal signal with the high resolution time delay. A second internal pulse is then applied to a third LCD (74) to generate a second set of synchronizing data (76) which is complementary with the first set of synchronizing data (60) for presentation to logic circuits (64). The logic circuits (64) further delay the internal output signal (72) to obtain a proper phase relationship of an output signal (80) with the internal pulses (32, 34). The final delayed output signal (80) thereafter enables the output pulse generator (82) to produce the desired output pulse (84) at the preset time delay interval following input of the trigger pulse (10, 12).

  4. System delays in breast cancer

    African Journals Online (AJOL)

    we notice a discrepancy in incidence rates between various ethnic/race .... Thailand. 180. 2. 3. 5 to diagnosis NOT treatment‡. This study. South Africa 45. -. 2.5. 3. 1.25. 3. -. 10. *Total delay refers to totals for available datasets and not necessarily mean delay to treatment/surgery commencement. †Montella et al. presented ...

  5. Magnetic bearing optical delay line

    NARCIS (Netherlands)

    Dool, T.C. van den; Kamphues, F.G.; Fouss, B.; Henrioulle, K.; Hogenhuis, H.

    2004-01-01

    TNO TPD, in close cooperation with Micromega-Dynamics and Dutch Space, has developed an advanced Optical Delay Line (ODL) for use in PRIMA, GENIE and other ground based interferometers. The delay line design is modular and flexible, which makes scaling for other applications a relatively easy task.

  6. #FakeNobelDelayReasons

    CERN Multimedia

    2013-01-01

    Tuesday’s hour-long delay of the Nobel Prize in Physics announcement was (and still is) quite the cause for speculation. But on the Twittersphere, it was simply the catalyst for some fantastic puns, so-bad-they're-good physics jokes and other shenanigans. Here are some of our favourite #FakeNobelDelayReasons.    

  7. Picosecond resolution programmable delay line

    International Nuclear Information System (INIS)

    Suchenek, Mariusz

    2009-01-01

    The note presents implementation of a programmable delay line for digital signals. The tested circuit has a subnanosecond delay range programmable with a resolution of picoseconds. Implementation of the circuit was based on low-cost components, easily available on the market. (technical design note)

  8. Project delay analysis of HRSG

    Science.gov (United States)

    Silvianita; Novega, A. S.; Rosyid, D. M.; Suntoyo

    2017-08-01

    Completion of HRSG (Heat Recovery Steam Generator) fabrication project sometimes is not sufficient with the targeted time written on the contract. The delay on fabrication process can cause some disadvantages for fabricator, including forfeit payment, delay on HRSG construction process up until HRSG trials delay. In this paper, the author is using semi quantitative on HRSG pressure part fabrication delay with configuration plant 1 GT (Gas Turbine) + 1 HRSG + 1 STG (Steam Turbine Generator) using bow-tie analysis method. Bow-tie analysis method is a combination from FTA (Fault tree analysis) and ETA (Event tree analysis) to develop the risk matrix of HRSG. The result from FTA analysis is use as a threat for preventive measure. The result from ETA analysis is use as impact from fabrication delay.

  9. Delay discounting of different commodities.

    Science.gov (United States)

    Weatherly, Jeffrey N; Terrell, Heather K; Derenne, Adam

    2010-01-01

    When outcomes are delayed, their value is decreased. Delay discounting is a much-studied topic because it is correlated with certain disorders (e.g., pathological gambling). The present study attempts to determine how people would delay discount a number of different commodities, ranging from money to dating partners to federal education legislation. Participants completed delay discounting tasks pertaining to 5 different commodities, with a different set of 5 commodities for 2 groups. Results showed that different commodities were often discounted differently. Both data sets were also subjected to factor analysis. A 2-factor solution was found for both, suggesting that there are multiple "domains" of commodities. This finding is of interest because it suggests that measuring delay discounting for one commodity within a particular domain of commodities will be predictive of how people discount other commodities within that domain but will not be predictive of how they discount commodities within another domain.

  10. Delayed radiation neuropathy

    International Nuclear Information System (INIS)

    Nagashima, Toshiko; Miyamoto, Kazuto; Beppu, Hirokuni; Hirose, Kazuhiko; Yamada, Katsuhiro

    1981-01-01

    A case of cervical plexus neuropathy was reported in association with chronic radio-dermatitis, myxedema with thyroid adenoma and epiglottic tumor. A 38-year-old man has noticed muscle weakness and wasting of the right shoulder girdle since age 33. A detailed history taking revealed a previous irradiation to the neck because of the cervical lymphadenopathy at age 10 (X-ray 3,000 rads), keroid skin change at age 19, obesity and edema since 26, and hoarseness at 34. Laryngoscopic examination revealed a tumor on the right vocal cord, diagnosed as benign papilloma by histological study. In addition, there were chronic radio-dermatitis around the neck, primary hypothyroidism with a benign functioning adenoma on the right lobe of the thyroid, the right phrenic nerve palsy and the right recurrent nerve palsy. All these lesions were considered to be the late sequellae of radiation to the neck in childhood. Other neurological signs were weakness and amyotrophy of the right shoulder girdle with patchy sensory loss, and areflexia of the right arm. Gross power was fairly well preserved in the right hand. EMG showed neurogenic changes in the tested muscles, suggesting a peripheral nerve lesion. Nerve conduction velocities were normal. No abnormal findings were revealed by myelography and spinal CT. The neurological findings of the patient were compatible with the diagnosis of middle cervical plexus palsy apparently due to late radiation effect. In the literature eight cases of post-radiation neuropathy with a long latency have been reported. The present case with the longest latency after the radiation should be included in the series of the reported cases of ''delayed radiation neuropathy.'' (author)

  11. Delayed radiation neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Nagashima, T.; Miyamoto, K.; Beppu, H.; Hirose, K.; Yamada, K. (Tokyo Metropolitan Neurological Hospital (Japan))

    1981-07-01

    A case of cervical plexus neuropathy was reported in association with chronic radio-dermatitis, myxedema with thyroid adenoma and epiglottic tumor. A 38-year-old man has noticed muscle weakness and wasting of the right shoulder girdle since age 33. A detailed history taking revealed a previous irradiation to the neck because of the cervical lymphadenopathy at age 10 (X-ray 3,000 rads), keroid skin change at age 19, obesity and edema since 26, and hoarseness at 34. Laryngoscopic examination revealed a tumor on the right vocal cord, diagnosed as benign papilloma by histological study. In addition, there were chronic radio-dermatitis around the neck, primary hypothyroidism with a benign functioning adenoma on the right lobe of the thyroid, the right phrenic nerve palsy and the right recurrent nerve palsy. All these lesions were considered to be the late sequellae of radiation to the neck in childhood. Other neurological signs were weakness and amyotrophy of the right shoulder girdle with patchy sensory loss, and areflexia of the right arm. Gross power was fairly well preserved in the right hand. EMG showed neurogenic changes in the tested muscles, suggesting a peripheral nerve lesion. Nerve conduction velocities were normal. No abnormal findings were revealed by myelography and spinal CT. The neurological findings of the patient were compatible with the diagnosis of middle cervical plexus palsy apparently due to late radiation effect. In the literature eight cases of post-radiation neuropathy with a long latency have been reported. The present case with the longest latency after the radiation should be included in the series of the reported cases of ''delayed radiation neuropathy.'' (author).

  12. Ambiguous involvement

    DEFF Research Database (Denmark)

    Dannesboe, Karen Ida

    2016-01-01

    This edited collection shows that good parenthood is neither fixed nor stable. The contributors show how parenthood is equally done by men, women and children, in and through practices involving different normative guidelines. The book explores how normative layers of parenthood are constituted...... by notions such as good childhood, family ideals, national public health and educational strategies. The authors illustrate how different versions of parenthood coexist and how complex sets of actions are demanded to fulfil today’s expectations of parenthood in Western societies. This interdisciplinary book...

  13. Serious renal and urological complications in fast-track primary total hip and knee arthroplasty; a detailed observational cohort study

    DEFF Research Database (Denmark)

    Bjerregaard, Lars S; Jorgensen, 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 o...

  14. Molecular markers increase precision of the European Association of Urology non-muscle invasive bladder cancer progression risk groups

    DEFF Research Database (Denmark)

    Van Kessel, Kim E.; van der Keur, Kirstin A.; Dyrskjøt, Lars

    2018-01-01

    PURPOSE: The European Association of Urology (EAU) guidelines for non-muscle invasive bladder cancer (NMIBC) recommend risk stratification based on clinicopathological parameters. Our aim was to investigate the added value of biomarkers to improve risk stratification of NMIBC. EXPERIMENTAL DESIGN...

  15. Application of anatomically accurate, patient-specific 3D printed models from MRI data in urological oncology

    International Nuclear Information System (INIS)

    Wake, N.; Chandarana, H.; Huang, W.C.; Taneja, S.S.; Rosenkrantz, A.B.

    2016-01-01

    Highlights: • We examine 3D printing in the context of urologic oncology. • Patient-specific 3D printed kidney and prostate tumor models were created. • 3D printed models extend the current capabilities of conventional 3D visualization. • 3D printed models may be used for surgical planning and intraoperative guidance.

  16. Evaluating the Accreditation Council on Graduate Medical Education core clinical competencies: techniques and feasibility in a urology training program.

    Science.gov (United States)

    Miller, David C; Montie, James E; Faerber, Gary J

    2003-10-01

    We describe several traditional and novel techniques for teaching and evaluating the Accreditation Council on Graduate Medical Education (ACGME) core clinical competencies in a urology residency training program. The evolution and underpinnings of the ACGME Outcome Project were reviewed. Several publications related to the evaluation of clinical competencies as well as current assessment techniques at our institution were also analyzed. Several tools for the assessment of clinical competencies have been developed and refined in response to the ACGME Outcome project. Standardized patient encounters and expanded patient satisfaction surveys may prove useful with regard to assessing resident professionalism, patient care and communication skills. A feasible and possibly undervalued technique for evaluating a number of core competencies is the implementation of formal written appraisals of the nature and quality of resident performance at departmental conferences. The assessment of competency in practice based learning and systems based practice may be achieved through innovative exercises, such as practice guideline development, that assess the evidence for various urologic interventions as well as the financial and administrative aspects of such care. We describe several contemporary methods for teaching and evaluating the core clinical competencies in a urology training program. While the techniques described are neither comprehensive nor feasible for every program, they nevertheless provide an important starting point for a meaningful exchange of ideas in the urological graduate medical education community.

  17. Prostatic Artery Embolization After Failed Urological Interventions for Benign Prostatic Obstruction: A Case Series of Three Patients

    Energy Technology Data Exchange (ETDEWEB)

    Bhatia, Shivank S., E-mail: sbhatia1@med.miami.edu; Dalal, Ravi, E-mail: rdalal@med.miami.edu [University of Miami – Miller School of Medicine, Department of Radiology (United States); Gomez, Christopher, E-mail: Cgomez7@med.miami.edu [University of Miami – Miller School of Medicine, Department of Urology (United States); Narayanan, Govindarajan, E-mail: gnarayanan@med.miami.edu [University of Miami – Miller School of Medicine, Department of Radiology (United States)

    2016-08-15

    Benign prostate obstruction with associated lower urinary tract symptoms is a common diagnosis with multiple minimally invasive treatment options available. Herein, the authors describe three patients who failed prior different urological interventions who underwent prostate artery embolization with a subsequent improvement in symptoms. The positive response suggests that embolization may be an effective treatment alternative in this subset of patients.

  18. Fractional delayed damped Mathieu equation

    Science.gov (United States)

    Mesbahi, Afshin; Haeri, Mohammad; Nazari, Morad; Butcher, Eric A.

    2015-03-01

    This paper investigates the dynamical behaviour of the fractional delayed damped Mathieu equation. This system includes three different phenomena (fractional order, time delay, parametric resonance). The method of harmonic balance is employed to achieve approximate expressions for the transition curves in the parameter plane. The n = 0 and n = 1 transition curves (both lower and higher order approximations) are obtained. The dependencies of these curves on the system parameters and fractional orders are determined. Previous results for the transition curves reported for the damped Mathieu equation, delayed second-order oscillator, and fractional Mathieu equation are confirmed as special cases of the results for the current system.

  19. Ergodic Interference Alignment with Delayed Feedback

    OpenAIRE

    Kang, Myung Gil; Choi, Wan

    2013-01-01

    We propose new ergodic interference alignment techniques for $K$-user interference channels with delayed feedback. Two delayed feedback scenarios are considered -- delayed channel information at transmitter (CIT) and delayed output feedback. It is proved that the proposed techniques achieve total $2K/(K+2)$ DoF which is higher than that by the retrospective interference alignment for the delayed feedback scenarios.

  20. [Typification and screening of irregular antibodies. Establishing its use at a urology department].

    Science.gov (United States)

    Vázquez Blanc, Salvador; Molina Arrebola, María Angustias; Giménez López, María José; Abad Vivas-Pérez, José Ignacio; Avila Fernández, Raimundo; Goñi Zurita, María José; Avivar Oyonarte, Cristóbal; Narbona Calvo, Benjamín; Jiménez López, Juan

    2003-01-01

    To achieve a better use of the packed red blood cells stock at our centre's blood bank, and to analyse cost-savings associated with the implementation of the type and screen (T/S) technology. We analyse the results, complications and cost-savings achieved with the use of T/S at the Urology Department in our centre, for the transurethral resection of bladder tumour and prostate. A total of 232 T/S were performed; 3 patients required blood transfusions (1.3%). No complications appeared. Total cost-savings from December 1999 to December 2001 were 7.620 Euros (1,267,861.3 pesetas). T/S is a safe procedure allowing a better use of blood stocks in a hospital with a substantial economic saving.

  1. Simulation in paediatric urology and surgery, part 2: An overview of simulation modalities and their applications.

    Science.gov (United States)

    Nataraja, R M; Webb, N; Lopez, P J

    2018-02-02

    Surgical training has changed radically in the last few decades. The traditional Halstedian model of time-bound apprenticeship has been replaced with competency-based training. In our previous article, we presented an overview of learning theory relevant to clinical teaching; a summary for the busy paediatric surgeon and urologist. We introduced the concepts underpinning current changes in surgical education and training. In this next article, we give an overview of the various modalities of surgical simulation, the educational principles that underlie them, and potential applications in clinical practice. These modalities include; open surgical models and trainers, laparoscopic bench trainers, virtual reality trainers, simulated patients and role-play, hybrid simulation, scenario-based simulation, distributed simulation, virtual reality, and online simulation. Specific examples of technology that may be used for these modalities are included but this is not a comprehensive review of all available products. Copyright © 2018 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  2. The impact of the 2005 International Society of Urological Pathology consensus guidelines on Gleason grading

    DEFF Research Database (Denmark)

    Berg, Kasper D; Thomsen, Frederik B; Nerstrøm, Camilla

    2016-01-01

    OBJECTIVES: To investigate whether the International Society of Urological Pathology (ISUP) 2005 revision of the Gleason grading system has influenced the risk of biochemical recurrence (BCR) after radical prostatectomy (RP), as the new guideline implies that some prostate cancers previously graded......, clinical tumour category, PSA level, and margin status to patients undergoing RP between 1 January 2008 and 31 December 2011 (post-ISUP group). Patients were followed until BCR defined as a PSA level of ≥0.2 ng/mL. Risk of BCR was analysed in a competing-risk model. RESULTS: The median follow-up was 9.......5 years in the pre-ISUP group and 4.8 years in the post-ISUP group. The 5-year cumulative incidences of BCR were 34.0% and 13.9% in the pre-ISUP and post-ISUP groups, respectively (P

  3. Construction and evaluation of urinary bladder bioreactor for urologic tissue-engineering purposes.

    LENUS (Irish Health Repository)

    Davis, Niall F

    2012-01-31

    OBJECTIVE: To design and construct a urinary bladder bioreactor for urologic tissue-engineering purposes and to compare the viability and proliferative activity of cell-seeded extracellular matrix scaffolds cultured in the bioreactor with conventional static growth conditions. MATERIALS AND METHODS: A urinary bladder bioreactor was designed and constructed to replicate physiologic bladder dynamics. The bioreactor mimicked the filling pressures of the human bladder by way of a cyclical low-delivery pressure regulator. In addition, cell growth was evaluated by culturing human urothelial cells (UCs) on porcine extracellular matrix scaffolds in the bioreactor and in static growth conditions for 5 consecutive days. The attachment, viability, and proliferative potential were assessed and compared with quantitative viability indicators and by fluorescent markers for intracellular esterase activity and plasma membrane integrity. Scaffold integrity was characterized with scanning electron microscopy and 4\\

  4. The alchemy of jargon: Etymologies of urologic neologisms. Number 5: oncology and its vocabulary.

    Science.gov (United States)

    Shelfer, Lochlan

    2009-09-15

    As the scientific community is increasingly severed from the study of linguistics, the underlying significance of their common technical words is becoming blurred. This article will focus on the genesis of terminology in the field of Oncology. These notes will give a detailed background of the history of technical terms, including how they came into being, whence they were derived, and how they impacted the scientific community through the ages. In this installment, following terms are analyzed: Oncology, Cancer, Carcinoma, Metastasis, Neoplasm, Malignant, and Benign. This analysis of the history and significance of scientific terms common to the urological community works towards a fortification of their power by offering a reminder of their origins. Prostate 69: 1369-1371, 2009. (c) 2009 Wiley-Liss, Inc.

  5. E-learning teaches attendings "how to" objectively assess pediatric urology trainees' surgery skills for orchiopexy.

    Science.gov (United States)

    Fernandez, Nicolas; Maizels, Max; Farhat, Walid; Smith, Edwin; Liu, Dennis; Chua, Michael; Bhanji, Yasin

    2017-11-09

    Established methods to train pediatric urology surgery by residency training programs require updating in response to administrative changes such as new, reduced trainee duty hours. Therefore, new objective methods must be developed to teach trainees. We approached this need by creating e-learning to teach attendings objective assessment of trainee skills using the Zwisch scale, an established assessment tool. The aim of this study was to identify whether or not e-learning is an appropriate platform for effective teaching of this assessment tool, by assessing inter-rater correlation of assessments made by the attendings after participation in the e-learning. Pediatric orchiopexy was used as the index case. An e-learning tool was created to teach attending surgeons objective assessment of trainees' surgical skills. First, e-learning content was created which showed the assessment method videotape of resident surgery done in the operating room. Next, attendings were enrolled to e-learn this method. Finally, the ability of enrollees to assess resident surgery skill performance was tested. Namely, test video was made showing a trainee performing inguinal orchiopexy. All enrollees viewed the same online videos. Assessments of surgical skills (Zwisch scale) were entered into an online survey. Data were analyzed by intercorrelation coefficient kappa analysis (strong correlation was ICC ≥ 0.7). A total of 11 attendings were enrolled. All accessed the online learning and then made assessments of surgical skills trainees showed on videotapes. The e-learning comprised three modules: 1. "Core concepts," in which users learned the assessment tool methods; 2. "Learn to assess," in which users learned how to assess by watching video clips, explaining the assessment method; and 3. "Test," in which users tested their skill at making assessments by watching video clips and then actively inputting their ratings of surgical and global skills as viewed in the video clips (Figure

  6. Assessment of urology patients' perspective about the importance and compliance of patient privacy

    Directory of Open Access Journals (Sweden)

    Hadi Jafari Manesh

    2014-07-01

    Full Text Available The purpose of this cross-sectional study was to assess the urology patients' perspective about the patient privacy "Importance" and "Compliance". 210 patients were selected by cluster random sampling method. The tool for data collection was an 18-item questionnaire about the patient privacy that was completed through interview. The validity and reliability of the questionnaire were calculated by content validity and Cronbach's alpha. From the viewpoint of the patients, immediate treatment action (100%, providing a clean and safe environment (100% and covering non-essential areas (93% were the most important elements, respectively. The patients' privacy "Compliance" was observed only in 34% of patients. The patient privacy compliance is very low; therefore, it needs to be taken into account more seriously.

  7. Chemical composition of gases surgeons are exposed to during endoscopic urological resections.

    Science.gov (United States)

    Weston, Robin; Stephenson, Richard N; Kutarski, Paul W; Parr, Nigel J

    2009-11-01

    To identify any potentially harmful chemical constituents of the gaseous plume produced from urological endoscopic diathermy. Chemical analysis was performed on the gaseous plume produced from prostatic resections and vaporizations using gas chromatography with mass spectroscopy and high-performance liquid chromatography using ultraviolet and visible light detection. In addition, carbon monoxide levels were analyzed using a portable catalytic flammable gas sensor. This study identified a cocktail of volatile organic hydrocarbons produced during these procedures, some of which are known carcinogens. The most significant finding being high levels of carbon monoxide. From this preliminary study, we advocate the use of smoke evacuator systems for all urologists regularly performing these procedures, and suggest that further research is required to investigate potential long-term complications to the urologist.

  8. [Urology and National Socialism illustrated by the example of Leopold Casper (1859-1959)].

    Science.gov (United States)

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

    2009-09-01

    Leopold Casper (1859-1959) was one of the founders of the German Urological Society (DGfU) in 1906. He introduced functional kidney testing and a special cystoscope for ureteral catheterization. In 1913 he was president of the 4th congress held in the German capital Berlin. His textbook on genito-urinary diseases was translated by Charles W. Bonney in 1910 and proved the high quality of his scientific work. As a Jew he was forced to leave Nazi Germany later on in 1933 and from 1941 onwards he lived in New York. The anniversary of his 150th birthday should be remembered with special focus on the exodus of Jewish German scientists during the Nazi period.

  9. The impact of a structured clinical training course on interns' self-reported confidence with core clinical urology skills.

    Science.gov (United States)

    Browne, C; Norton, S; Nolan, J M; Whelan, C; Sullivan, J F; Quinlan, M; Sheikh, M; Mc Dermott, T E D; Lynch, T H; Manecksha, R P

    2018-02-01

    Undergraduate training in core urology skills is lacking in many Irish training programmes. Our aim was to assess newly qualified doctors' experience and confidence with core urological competencies. A questionnaire survey covering exposure to urology and confidence with core clinical skills was circulated to all candidates. The group then attended a skills course covering male/female catheterisation, insertion of three-way catheters, bladder irrigation and management of long-term suprapubic catheters. The groups were re-surveyed following the course. Forty-five interns completed the pre-course questionnaire (group 1) and 27 interns completed the post-course questionnaire (group 2). 24/45 (53%) had no experience of catheter insertion on a patient during their undergraduate training. 26/45 (58%) were unsupervised during their first catheter insertion. 12/45 (27%) had inserted a female catheter. 18/45 (40%) had inserted a three-way catheter. 12/45 (27%) had changed a suprapubic catheter. 40/45 (89%) in group 1 reported 'good' or 'excellent' confidence with male urinary catheterisation, compared to 25/27 (92.5%) in group 2. 18/45 (40%) in group 1 reported 'none' or 'poor' confidence with female catheterisation, compared to 7/27 (26%) in group 2. 22/45 (49%) in group 1 reported 'none' or 'poor' confidence with insertion of three-way catheters, compared to 2/27 (7%) in group 2. 32/45 (71%) in group 1 reported 'none' or 'poor' confidence in changing long-term suprapubic catheters, falling to 3/27 (11%) in group 2. This study raises concerns about newly qualified doctors' practical experience in urology. We suggest that this course improves knowledge and confidence with practical urology skills and should be incorporated into intern induction.

  10. Quantifying Nonindex Hospital Readmissions and Care Fragmentation after Major Urological Oncology Surgeries in a Nationally Representative Sample.

    Science.gov (United States)

    Chappidi, Meera R; Kates, Max; Stimson, C J; Bivalacqua, Trinity J; Pierorazio, Phillip M

    2017-01-01

    We quantified the underestimation of hospital readmission rates that can occur with institutional databases and the incidence of care fragmentation among patients undergoing urological oncology procedures in a nationally representative database. The 2013 Nationwide Readmissions Database was queried for patients undergoing prostatectomy, cystectomy, nephroureterectomy, nephrectomy, partial nephrectomy and retroperitoneal lymph node dissection for urological malignancies. Nationally representative 30 and 90-day readmission and care fragmentation rates were calculated for all procedures. Readmission rates with and without nonindex hospital readmissions were compared with Pearson's chi-square test. Multivariable logistic regression models were used to identify predictors of care fragmentation at 90-day followup. For all surgical procedures readmission rates were consistently underestimated by 17% to 29% at 90-day followup. The rates of care fragmentation among readmitted patients were similar for all procedures, ranging from 24% to 34% at 90-day followup. Overall 1 in 4 readmitted patients would not be captured in institutional databases and 1 in 3 readmitted patients experienced care fragmentation. Multivariable models did not identify a predictor of care fragmentation that was consistent across all procedures. The high rate of underestimation of readmission rates across all urological oncology procedures highlights the importance of linking institutional and payer claims databases to provide more accurate estimates of perioperative outcomes and health care utilization. The high rate of care fragmentation across all procedures emphasizes the need for future efforts to understand the clinical relevance of care fragmentation in patients with urological malignancies, and to identify patients at risk along with potentially modifiable risk factors for care fragmentation. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier

  11. [Use of social media by French urologists: Results from a study of the National French Urological Association].

    Science.gov (United States)

    Misrai, V; Castagnola, C; Descotes, J-L; Rouprêt, M

    2015-06-01

    Social Media (SoMe) have changed the face of modern medicine. Our purpose was to make an inventory on the use of SoMe within urologists members of the French Urological Association (AFU). A 15 questions-survey was sent by email 2 months to urologists AFU members before the 108th French Congress of Urology (#CFU2014). At the same time, the activity of urologists using Twitter was analyzed over the period of the national conference with the symplur software (www.symplur.com). Overall, 270 (17.3%) surveys were completed. Only 50% of responders had an online SoMe account. The most commonly used social media platforms were: Facebook (36.1%) followed by LinkedIn (28.2%), Google+ (19.6%), YouTube (18.7%) and Twitter (17.4%). The use of SoMe was higher in the age groups 30-40 and 40-50 years than in older age groups (83% versus 36%). Only 38.7% of respondents reported using SoMe in a professional field. At the congress #CFU2014, there were over 1000 tweets generated by 173 different contributors. Only a minority of French urologists have reported to be connected to SoMe and a predominantly personal use. The emergence of Twitter in French urological conferences is very new but seems promising. Further studies are needed, especially within the members of the residents French urological association to better characterize the true impact of SoMe in urology. 4. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  12. Comparative Study of Scientific Publications in Urology and Nephrology Journals Originating from USA, China and Japan (2001–2010)

    Science.gov (United States)

    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 and China were retrieved from the “PubMed” and “Web of Knowledge” online databases. Results The annual number of total scientific articles increased significantly from 2001 to 2010 in China, and has ranked second in the world since 2006. In the field of urology and nephrology, the annual number increased significantly from 2001 to 2010 in USA and China; but not in Japan. The share of articles increased significantly over time in China, decreased significantly in Japan, and remained unchanged in USA. In 2010, USA contributed 32.17% of the total world output in urology and nephrology field and ranked 1st; Japan contributed 5.19% and ranked 5th; China contributed 3.83% and ranked 9th. Publications from USA had the highest accumulated IFs and the highest total citations of articles (USA>Japan>China, pnephrology journals (USA(35165)>Japan(6704)>China(2233), pJapan>China, pnephrology journals in the past decade, it still lags far behind USA and Japan in the field of urology and nephrology in terms of quantity and quality. PMID:22870301

  13. Prospective study analyzing risk factors and characteristics of healthcare-associated infections in a Urology ward

    Directory of Open Access Journals (Sweden)

    José Medina-Polo

    2017-01-01

    Full Text Available Purpose: Healthcare-associated infections (HAIs in urological patients have special features due to specific risk factors. Our objective was to evaluate the characteristics and risk factors for HAIs in patients hospitalized in a Urology ward. Materials and Methods: We evaluated prospectively, from 2012 to 2015, the incidence, types and risk factor for HAIs, microbiological and resistance patterns. Results: The incidence of HAIs was 6.3%. The most common types were urinary infections (70.5% and surgical site infections (22.1%. Univariate analysis showed an increased risk of HAIs among patients with American Society of Anesthesiologists physical status classification system III–IV (odds ratio [OR], 1.39; p<0.001, immunosuppression (OR, 1.80; p=0.013, previous urinary infection (OR, 4.46; p<0,001, and urinary catheter before admission (OR, 1.74; p<0.001. The surgical procedures with the highest incidence of HAIs were radical cystectomy (54.2% and renal surgery (8.7%. The most frequently isolated microorganisms were Escherichia coli (25.1%, Enterococcus spp. (17.5%, Klebsiella spp. (13.5% and Pseudomonas aeruginosa (12.3%. Enterococcus sp was the most common microorganism after radical cystectomy and in surgical site infections, E. coli showed resistance rates of 53.5% for fluoroquinolones, 9.3% for amikacin. The percentage of extended-spectrum betalactamase producing E. coli was 24.7%. Klebsiella spp. showed resistance rates of 47.8% for fluoroquinolones, 7.1% for amikacin and 4.3% for carbapenems. Enterococcus spp showed resistance rates of 1.7% for vancomycin and; P. aeruginosa of 33.3% for carbapenems and 26.2% for amikacin. Conclusions: Comorbidities, previous urinary infections, and urinary catheter are risk factors for HAIs. The microorganisms most commonly isolated were E. coli , Enterococcus and P. aeruginosa . Prospective monitoring may decrease the incidence of infections.

  14. Aesthetic, urological, orthopaedic and functional outcomes in complex bladder exstrophy-epispadias′s management

    Directory of Open Access Journals (Sweden)

    Bertin Dibi Kouame

    2015-01-01

    Full Text Available Background: Postoperative complications are related to the surgical procedures, of failures of initial bladder closure and influence the urological, aesthetical and orthopaedic outcomes. Materials and Methods: We reviewed four patients who underwent complex bladder exstrophy-epispadias repair over a period of 14 years. The outcomes of treatment were assessed using, aesthetic, urological and orthopaedic examination data. Orthopaedic complications were explored by a radiography of the pelvis. Results: Out of four patients who underwent bladder exstrophy surgical management, aesthetic, functional outcomes and complications in the short and long follow-up were achieved in three patients. The first patient is a male and had a good penis aspect. He has a normal erection during micturition with a good jet miction. He has a moderate urinary incontinence, which requires diaper. In the erection, his penis-measures 4 cm long and 3 cm as circumference. The second patient was a female. She had an unsightly appearance of the female external genitalia with bipartite clitoris. Urinary continence could not be assessed; she did not have the age of cleanness yet. The third patient had a significant urinary leakage due to the failure of the epispadias repair. He has a limp, a pelvic obliquity, varus and internal rotation of the femoral head. He has an inequality of limbs length. Pelvis radiograph shows the right osteotomy through the ilium bone, the left osteotomy through the hip joint at the acetabular roof. Conclusion: When, the epispadias repair is performed contemporary to initial bladder closure, its success is decisive for urinary continence. In the female, surgical revision is required after the initial bladder closure for an aesthetic appearance to the external genitalia. Innominate osteotomy must be performed with brilliancy amplifier to avoid osteotomy through to the hip joint to prevent inequality in leg length.

  15. Urology residents training in laparoscopic surgery. Development of a virtual reality model.

    Science.gov (United States)

    Gutiérrez-Baños, J L; Ballestero-Diego, R; Truan-Cacho, D; Aguilera-Tubet, C; Villanueva-Peña, A; Manuel-Palazuelos, J C

    2015-11-01

    The training and learning of residents in laparoscopic surgery has legal, financial and technological limitations. Simulation is an essential tool in the training of residents as a supplement to their training in laparoscopic surgery. The training should be structured in an appropriate environment, with previously established and clear objectives, taught by professionals with clinical and teaching experience in simulation. The training should be conducted with realistic models using animals and ex-vivo tissue from animals. It is essential to incorporate mechanisms to assess the objectives during the residents' training progress. We present the training model for laparoscopic surgery for urology residents at the University Hospital Valdecilla. The training is conducted at the Virtual Hospital Valdecilla, which is associated with the Center for Medical Simulation in Boston and is accredited by the American College of Surgeons. The model is designed in 3 blocks, basic for R1, intermediate for R2-3 and advanced for R4-5, with 9 training modules. The training is conducted in 4-hour sessions for 4 afternoons, for 3 weeks per year of residence. Residents therefore perform 240 hours of simulated laparoscopic training by the end of the course. For each module, we use structured objective assessments to measure each resident's training progress. Since 2003, 9 urology residents have been trained, in addition to the 5 who are currently in training. The model has undergone changes according to the needs expressed in the student feedback. The acquisition of skills in a virtual reality model has enabled the safe transfer of those skills to actual practice. A laparoscopic surgery training program designed in structured blocks and with progressive complexity provides appropriate training for transferring the skills acquired using this model to an actual scenario while maintaining patient safety. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Implementation of medical scribes in an academic urology practice: an analysis of productivity, revenue, and satisfaction.

    Science.gov (United States)

    McCormick, Benjamin J; Deal, Allison; Borawski, Kristy M; Raynor, Mathew C; Viprakasit, Davis; Wallen, Eric M; Woods, Michael E; Pruthi, Raj S

    2018-04-10

    Pressure on physicians to increase productivity is rising in parallel with administrative tasks, regulations, and the use of electronic health records (EHRs). Physician extenders and clinical pathways are already in use to increase productivity and reduce costs and burnout, but other strategies are required. We evaluated whether implementation of medical scribes in an academic urology clinic would affect productivity, revenue, and patient/provider satisfaction. Six academic urologists were assigned scribes for 1 clinic day per week for 3 months. Likert-type patient and provider surveys were developed to evaluate satisfaction with and without scribes. Matched clinic days in the year prior were used to evaluate changes in productivity and physician/hospital charges and revenue. After using scribes for 3 months, providers reported increased efficiency (p value = 0.03) and work satisfaction (p value = 0.03), while seeing a mean 2.15 more patients per session (+ 0.96 return visits, + 0.99 new patients, and + 0.22 procedures), contributing to an additional 2.6 wRVUs, $542 in physician charges, and $861 in hospital charges per clinic session. At a gross collection rate of 36%, actual combined revenue was + $506/session, representing a 26% increase in overall revenue. At a cost of $77/session, the net financial impact was + $429 per clinic session, resulting in a return-to-investment ratio greater than 6:1, while having no effect on patient satisfaction scores. Additionally, with scribes, clinic encounters were closed a mean 8.9 days earlier. Implementing medical scribes in academic urology practices may be useful in increasing productivity, revenue, and provider satisfaction, while maintaining high patient satisfaction.

  17. Surgical wound infection in urology. Analysis of risk factors and associated microorganisms.

    Science.gov (United States)

    Alonso-Isa, M; Medina-Polo, J; Lara-Isla, A; Pérez-Cadavid, S; Arrébola-Pajares, A; Sopeña-Sutil, R; Benítez-Sala, R; Justo-Quintas, J; Gil-Moradillo, J; Passas-Martínez, J B; Tejido-Sánchez, A

    2017-03-01

    Open surgery continues to have a fundamental role in urology, and one of its main complications is surgical wound infection. Our objective was to analyse surgical wound infection in patients who underwent surgery in our Department of Urology and to assess the risk factors, microorganisms and resistances by type of surgery. This was a prospective observational study that included 940 patients: 370 abdominal/open lumbar surgeries and 570 genitoperineal surgeries. We analysed age, sex, comorbidities, stay and type of surgery, as well as the causal microorganisms and antibiotic resistances. For genitoperineal surgery, we found 15 cases (2.6%) of surgical wound infection associated with previous urinary catheterisation. Most of the isolated microorganisms corresponded to enterobacteriaceae, highlighting the resistance to beta-lactam. In abdominal/lumbar surgery, we found 41 cases (11.1%) of surgical wound infection. The incidence rate was 3.3% in prostate surgery; 9.8% in renal surgery; and 45.0% in cystectomy. Heart disease was associated with a higher incidence rate of surgical wound infection. The most common microorganisms were Enterococcus spp. (27.1%), E.coli (22.9%) and Staphylococcus aureus (14.6%). Enterococcus and beta-lactamase-producing E.coli are resistant to ampicillin in 37.5% and 41.7% of cases, respectively. We found a low incidence rate of surgical wound infection in genitoperineal surgery, compared with renal surgery and cystectomy. The presence of heart disease and carrying a previous urinary catheter are factors associated with surgical wound infection. Enterococcus and E.coli are the most common pathogens, with high rates of resistance. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Bifurcations in stochastic equations with delayed feedback

    Science.gov (United States)

    Gaudreault, Mathieu

    The bifurcation diagram of a model stochastic differential equation with delayed feedback is presented. We are motivated by recent research on stochastic effects in models of transcriptional gene regulation. We start from the normal form for a pitchfork bifurcation, and add multiplicative or parametric noise and linear delayed feedback. The latter is sufficient to originate a Hopf bifurcation in that region of parameters in which there is a sufficiently strong negative feedback. We find a sharp bifurcation in parameter space, and define the threshold as the point in which the stationary distribution function p(x) changes from a delta function at the trivial state x = 0 to p( x) ˜ xalpha at small x (with alpha = 1 exactly at threshold). We find that the bifurcation threshold is shifted by fluctuations relative to the deterministic limit by an amount that scales linearly with the noise intensity. Analytical expressions for pitchfork and Hopf bifurcation thresholds are given for the model considered. Our results assume that the delay time tau is small compared to other characteristic time scales, not a significant limitation close to the bifurcation line. A pitchfork bifurcation line is found, the location of which depends on the conditional average , where x(t) is the dynamical variable. This conditional probability incorporates the combined effect of fluctuation correlations and delayed feedback. We also find a Hopf bifurcation line which is obtained by a multiple scale expansion around the oscillatory solution near threshold. We solve the Fokker-Planck equation associated with the slowly varying amplitudes and use it to determine the threshold location. In both cases, the predicted bifurcation lines are in excellent agreement with a direct numerical integration of the governing equations. Contrary to the known case involving no delayed feedback, we show that the stochastic bifurcation lines are shifted relative to the deterministic limit and hence that the

  19. Fractional variational principles with delay

    International Nuclear Information System (INIS)

    Baleanu, Dumitru; Abdeljawad, Thabet Maaraba; Jarad, Fahd

    2008-01-01

    The fractional variational principles within Riemann-Liouville fractional derivatives in the presence of delay are analyzed. The corresponding Euler-Lagrange equations are obtained and one example is analyzed in detail

  20. Linear rotary optical delay lines

    Science.gov (United States)

    Guerboukha, Hichem; Qu, Hang; Skorobogatiy, Maksim

    2016-03-01

    We present a semi-analytical solution for the design of a high-speed rotary optical delay line that use a combination of two rotating curvilinear reflectors. We demonstrate that it is possible to design an infinite variety of the optical delay lines featuring linear dependence of the optical delay on the rotation angle. This is achieved via shape optimization of the rotating reflector surfaces. Moreover, a convenient spatial separation of the incoming and outgoing beams is possible. For the sake of example, we present blades that fit into a circle of 10cm diameter. Finally, a prototype of a rotary delay line is fabricated using CNC machining, and its optical properties are characterized.