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Sample records for delayed urological involvement

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

    NARCIS (Netherlands)

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

    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

  2. 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

  3. [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.

  4. 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 ...

  5. 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.

  6. A hybrid approach to parameter identification of linear delay differential equations involving multiple delays

    Science.gov (United States)

    Marzban, Hamid Reza

    2018-05-01

    In this paper, we are concerned with the parameter identification of linear time-invariant systems containing multiple delays. The approach is based upon a hybrid of block-pulse functions and Legendre's polynomials. The convergence of the proposed procedure is established and an upper error bound with respect to the L2-norm associated with the hybrid functions is derived. The problem under consideration is first transformed into a system of algebraic equations. The least squares technique is then employed for identification of the desired parameters. Several multi-delay systems of varying complexity are investigated to evaluate the performance and capability of the proposed approximation method. It is shown that the proposed approach is also applicable to a class of nonlinear multi-delay systems. It is demonstrated that the suggested procedure provides accurate results for the desired parameters.

  7. Urological injuries following trauma

    International Nuclear Information System (INIS)

    Bent, C.; Iyngkaran, T.; Power, N.; Matson, M.; Hajdinjak, T.; Buchholz, N.; Fotheringham, T.

    2008-01-01

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

  8. Urological injuries following trauma

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-12-15

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

  9. Urological injuries following trauma.

    Science.gov (United States)

    Bent, C; Iyngkaran, T; Power, N; Matson, M; Hajdinjak, T; Buchholz, N; Fotheringham, T

    2008-12-01

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

  10. 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

  11. [Fetal urology].

    Science.gov (United States)

    Jakobovits, Akos; Jakobovits, Antal

    2009-06-14

    Although it becomes vitally important only after birth, renal function already plays significant role in maintaining fetal metabolic equilibrium. The kidneys significantly contribute to production of amniotic fluid. Adequate amount of amniotic fluid is needed to stimulate the intrauterine fetal respiratory activity. Intrauterine breathing is essential for lung development. As a result, oligohydramnion is conducive to pulmonary hypoplasia. The latter may lead to neonatal demise soon after birth. In extrauterine life kidneys eliminate nitrogen containing metabolic byproducts. Inadequate renal function results therefore lethal uremia. Integrity of ureters and the urethra is essential for the maintenance of renal function. Retention of urine causes degeneration of the functional units of the kidneys and ensuing deterioration of renal function. Intrauterine kidney puncture or shunt procedure may delay this process in some cases. On the other hand, once renal function has been damaged, no therapy can restart it. Certain anomalies of renal excretory pathways may also be associated with other congenital abnormalities, making the therapeutic efforts pointless. Presence of these associated intrauterine defects makes early pregnancy termination a management alternative, as well as it affects favorably perinatal mortality rates.

  12. Early and delayed Tc-99m ECD brain SPECT in SLE patients with CNS involvement

    International Nuclear Information System (INIS)

    Kikukawa, Kaoru; Toyama, Hiroshi; Katayama, Masao

    2000-01-01

    We compared early and delayed Tc-99m ECD SPECT scans in 32 SLE patients (Group 1, definite neuropsychiatric disorders; Group 2, minor neurologic symptoms or normal) with those of normal controls by visual inspection and semi-quantitative evaluation. With visual interpretation, 13 out of 14 patients in Group 1 (93%) and 7 out of 18 patients in Group 2 (39%) had diffuse uneven decrease in early scans. Seven patients in Group 2 (39%) who had normal early scans demonstrated focal decrease in the medial frontal lobe in delayed scans. With cerebral region to cerebellar ratios, in early scans, the medial frontal lobe in Group 1 and Group 2 was significantly lower than in normal controls, and lateral frontal lobe and occipital lobes in Group 1 were significantly lower than in normal controls. Nevertheless, in delayed scans, every cortical region except for the parietal lode in Groups 1 and 2 was significantly lower than in normal controls. The retention rates in all regions in SLE patients were significantly lower than in normal controls. No case showed SPECT improvement on follow-up studies in either group in spite of clinical improvement. Delayed Tc-99m ECD brain SPECT of high sensitivity might be useful in detecting CNS involvement. Although the SPECT findings did not correlate with the neuropsychiatric symptoms, early and delayed Tc-99m ECD SPECT seems to provide useful objective diagnostic information in SLE patients. (author)

  13. 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.

  14. Basic science research in urology training.

    Science.gov (United States)

    Eberli, D; Atala, A

    2009-04-01

    The role of basic science exposure during urology training is a timely topic that is relevant to urologic health and to the training of new physician scientists. Today, researchers are needed for the advancement of this specialty, and involvement in basic research will foster understanding of basic scientific concepts and the development of critical thinking skills, which will, in turn, improve clinical performance. If research education is not included in urology training, future urologists may not be as likely to contribute to scientific discoveries.Currently, only a minority of urologists in training are currently exposed to significant research experience. In addition, the number of physician-scientists in urology has been decreasing over the last two decades, as fewer physicians are willing to undertake a career in academics and perform basic research. However, to ensure that the field of urology is driving forward and bringing novel techniques to patients, it is clear that more research-trained urologists are needed. 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.

  15. Delayed rectifier potassium channels are involved in SO2 derivative-induced hippocampal neuronal injury.

    Science.gov (United States)

    Li, Guangke; Sang, Nan

    2009-01-01

    Recent studies implicate the possible neurotoxicity of SO(2), however, its mechanisms remain unclear. In the present study, we investigated SO(2) derivative-induced effect on delayed rectifier potassium channels (I(K)) and cellular death/apoptosis in primary cultured hippocampal neurons. The results demonstrate that SO(2) derivatives (NaHSO(3) and Na(2)SO(3), 3:1M/M) effectively augmented I(K) and promoted the activation of delayed rectifier potassium channels. Also, SO(2) derivatives increased neuronal death percentage and contributed to the formation of DNA ladder in concentration-dependent manners. Interestingly, the neuronal death and DNA ladder formation, caused by SO(2) derivatives, could be attenuated by the delayed rectifier potassium channel blocker (tetraethylammonium, TEA), but not by the transient outward potassium channel blocker (4-aminopyridine, 4-AP). It implies that stimulating delayed rectifier potassium channels were involved in SO(2) derivative-caused hippocampal neuronal insults, and blocking these channels might be one of the possibly clinical treatment for SO(2)-caused neuronal dysfunction.

  16. Paediatric urological investigations - dose comparison between urology-related and CT irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Page, Mark; Florescu, Cosmin [Southern Health, Diagnostic Imaging, Melbourne (Australia); Johnstone, Lilian [Monash Children' s Hospital, Department of Paediatrics, Melbourne (Australia); Habteslassie, Daniel [Monash University, Department of Medicine, Melbourne (Australia); Ditchfield, Michael [Southern Health, Diagnostic Imaging, Melbourne (Australia); Monash Children' s Hospital, Diagnostic Imaging, Melbourne (Australia); Monash University, Department of Medicine, Melbourne (Australia)

    2013-07-15

    Urological investigation in children frequently involves high radiation doses; however, the issue of radiation for these investigations receives little attention compared with CT. To compare the radiation dose from paediatric urological investigations with CT, which is commonly regarded as the more major source of radiation exposure. We conducted a retrospective audit in a tertiary paediatric centre of the number and radiation dose of CT scans, micturating cystourethrography exams and urological nuclear medicine scans from 2006 to 2011. This was compared with radiation doses in the literature and an audit of the frequency of these studies in Australia. The tertiary centre audit demonstrated that the ratio of the frequency of urological to CT examinations was 0.8:1 in children younger than 17 years. The ratio of the radiation dose of urological to CT examinations was 0.7:1. The ratio in children younger than 5 years was 1.9:1. In Australia the frequency of urological procedures compared with CT was 0.4:1 in children younger than 17 years and 3.1:1 in those younger than 5 years. The ratio of radiation-related publications was 1:9 favouring CT. The incidence and radiation dose of paediatric urological studies is comparable to those of CT. Nevertheless the radiation dose of urological procedures receives considerably less attention in the literature. (orig.)

  17. 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.

  18. Hopf bifurcations of a ratio-dependent predator–prey model involving two discrete maturation time delays

    International Nuclear Information System (INIS)

    Karaoglu, Esra; Merdan, Huseyin

    2014-01-01

    Highlights: • A ratio-dependent predator–prey system involving two discrete maturation time delays is studied. • Hopf bifurcations are analyzed by choosing delay parameters as bifurcation parameters. • When a delay parameter passes through a critical value, Hopf bifurcations occur. • The direction of bifurcation, the period and the stability of periodic solution are also obtained. - Abstract: In this paper we give a detailed Hopf bifurcation analysis of a ratio-dependent predator–prey system involving two different discrete delays. By analyzing the characteristic equation associated with the model, its linear stability is investigated. Choosing delay terms as bifurcation parameters the existence of Hopf bifurcations is demonstrated. Stability of the bifurcating periodic solutions is determined by using the center manifold theorem and the normal form theory introduced by Hassard et al. Furthermore, some of the bifurcation properties including direction, stability and period are given. Finally, theoretical results are supported by some numerical simulations

  19. [Doping and urologic tumors].

    Science.gov (United States)

    Pinto, F; Sacco, E; Volpe, A; Gardi, M; Totaro, A; Calarco, A; Racioppi, M; Gulino, G; D'Addessi, A; Bassi, P F

    2010-01-01

    Several substances such as growth hormone (GH), erythropoietin (Epo), and anabolic steroids (AS) are improperly utilized to increase the performance of athletes. Evaluating the potential cancer risk associated with doping agents is difficult since these drugs are often used at very high doses and in combination with other licit or illicit drugs. The GH, via its mediator, the insulin-like growth factor 1 (IGF-1), is involved in the development and progression of cancer. Animal studies suggested that high levels of GH/IGF-1 increase progression of androgen-independent prostate cancer. Clinical data regarding prostate cancer are mostly based on epidemiological studies or indirect data such as IGF-1 high levels in patients with prostate cancer. Even if experimental studies showed a correlation between Epo and cancer, no clinical data are currently available on cancer development related to Epo as a doping agent. Androgens are involved in prostate carcinogenesis modulating genes that regulate cell proliferation, apoptosis and angiogenesis. Most information on AS is anecdotal (case reports on prostate, kidney and testicular cancers). Prospective epidemiologic studies failed to support the hypothesis that circulating androgens are positively associated with prostate cancer risk. Currently, clinical and epidemiological studies supporting association between doping and urological neoplasias are not available. Nowadays, exposure to doping agents starts more prematurely with a consequent longer exposition period; drugs are often used at very high doses and in combination with other licit or illicit drugs. Due to all these elements it is impossible to predict all the side effects, including cancer; more detailed studies are therefore necessary.

  20. Molecular characterization of a novel X-linked syndrome involving developmental delay and deafness.

    Science.gov (United States)

    Hildebrand, Michael S; de Silva, Michelle G; Tan, Tiong Yang; Rose, Elizabeth; Nishimura, Carla; Tolmachova, Tanya; Hulett, Joanne M; White, Susan M; Silver, Jeremy; Bahlo, Melanie; Smith, Richard J H; Dahl, Hans-Henrik M

    2007-11-01

    X-linked syndromes associated with developmental delay and sensorineural hearing loss (SNHL) have been characterized at the molecular level, including Mohr-Tranebjaerg syndrome and Norrie disease. In this study we report on a novel X-linked recessive, congenital syndrome in a family with developmental delay and SNHL that maps to a locus associated with mental retardation (MR) for which no causative gene has been identified. The X-linked recessive inheritance and congenital nature of the syndrome was confirmed by detailed clinical investigation and the family history. Linkage mapping of the X-chromosome was conducted to ascertain the disease locus and candidate genes were screened by direct sequencing and STRP analysis. The recessive syndrome was mapped to Xp11.3-q21.32 and a deletion was identified in a regulatory region upstream of the POU3F4 gene in affected family members. Since mutations in POU3F4 cause deafness at the DFN3 locus, the deletion is the likely cause of the SNHL in this family. The choroideremia (CHM) gene was also screened and a novel missense change was identified. The alteration changes the serine residue at position 89 in the Rab escort 1 protein (REP-1) to a cysteine (S89C). Prenylation of Rab proteins was investigated in patients and the location of REP-1 expression in the brain determined. However, subsequent analysis revealed that this change in CHM was polymorphic having no effect on REP-1 function. Although the causative gene at the MR locus in this family has not been identified, there are a number of genes involved in syndromic and nonsyndromic forms of MR that are potential candidates. Copyright 2007 Wiley-Liss, Inc.

  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. 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

  3. 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

  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. Maximum principle for a stochastic delayed system involving terminal state constraints.

    Science.gov (United States)

    Wen, Jiaqiang; Shi, Yufeng

    2017-01-01

    We investigate a stochastic optimal control problem where the controlled system is depicted as a stochastic differential delayed equation; however, at the terminal time, the state is constrained in a convex set. We firstly introduce an equivalent backward delayed system depicted as a time-delayed backward stochastic differential equation. Then a stochastic maximum principle is obtained by virtue of Ekeland's variational principle. Finally, applications to a state constrained stochastic delayed linear-quadratic control model and a production-consumption choice problem are studied to illustrate the main obtained result.

  6. 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.

  7. Premature ejaculation and serotonergic antidepressants-induced delayed ejaculation : the involvement of the serotonergic system

    NARCIS (Netherlands)

    Waldinger, MD; Berendsen, HHG; Blok, BFM; Olivier, B; Holstege, G

    Premature ejaculation has generally been considered a psychosexual disorder with psychogenic aetiology. Although still mainly treated by behavioural therapy, in recent years double-blind studies have indicated the beneficial effects of some of the serotonergic antidepressants (SSRIs) in delaying

  8. EMERGENCY UROLOGIC IN PREGNANCY

    Directory of Open Access Journals (Sweden)

    Putu Surya Utami

    2013-12-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE A variety of anatomical and physiological changes occurring during pregnancy, which can affect any organ system. Urological problems in pregnancy represent a diagnostic and therapeutic challenge. Urinary tract symptoms in pregnant women comprise urinary tract infection, acute pyelonephritis, acute urinary retention, hematuria, placenta percreta, nefrolithiasis, uropathy obstructive, and malignancy urologic. A multidisciplinary approach is necessary, from the anesthetic and obstetric team. In this review, I will discuss the common urological problems that occur during pregnancy and outline an approach to their management. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Calibri","sans-serif"; mso-bidi-font-family:"Times New Roman";}

  9. 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

  10. Health services research in urology.

    Science.gov (United States)

    Yu, Hua-Yin; Ulmer, William; Kowalczyk, Keith J; Hu, Jim C

    2011-06-01

    Health services research (HSR) is increasingly important given the focus on patient-centered, cost-effective, high-quality health care. We examine how HSR affects contemporary evidence-based urologic practice and its role in shaping future urologic research and care. PubMed, urologic texts, and lay literature were reviewed for terms pertaining to HSR/outcomes research and urologic disease processes. HSR is a broad discipline that focuses on access, cost, and outcomes of Health care. Its use has been applied to a myriad of urologic conditions to identify deficiencies in access, to evaluate cost-effectiveness of therapies, and to evaluate structural, process, and outcome quality measures. HSR utilizes an evidence-based approach to identify the most effective ways to organize/manage, finance, and deliver high-quality urologic care and to tailor care optimized to individuals.

  11. Coding for urologic office procedures.

    Science.gov (United States)

    Dowling, Robert A; Painter, Mark

    2013-11-01

    This article summarizes current best practices for documenting, coding, and billing common office-based urologic procedures. Topics covered include general principles, basic and advanced urologic coding, creation of medical records that support compliant coding practices, bundled codes and unbundling, global periods, modifiers for procedure codes, when to bill for evaluation and management services during the same visit, coding for supplies, and laboratory and radiology procedures pertinent to urology practice. Detailed information is included for the most common urology office procedures, and suggested resources and references are provided. This information is of value to physicians, office managers, and their coding staff. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. A model of a fishery with fish stock involving delay equations.

    Science.gov (United States)

    Auger, P; Ducrot, Arnaud

    2009-12-13

    The aim of this paper is to provide a new mathematical model for a fishery by including a stock variable for the resource. This model takes the form of an infinite delay differential equation. It is mathematically studied and a bifurcation analysis of the steady states is fulfilled. Depending on the different parameters of the problem, we show that Hopf bifurcation may occur leading to oscillating behaviours of the system. The mathematical results are finally discussed.

  13. Urological oncology. 2. ed.

    International Nuclear Information System (INIS)

    Ammon, J.; Karstens, J.H.; Rathert, P.

    1981-01-01

    The cooperation between urologists and radiologists has brought about new ideas for the therapy of malignant tumours of the urogenital tract. This and the development of new techniques of diagnosis and therapy has brought about a need for revision of present diagnostic and therapeutical conceptions. With the introduction of the TNM classification system for nearly all tumours of the urogenital system, it has become obligatory to have a list of indications for the various techniques to determine the T-, N-, or M-nature of a tumour. Except for tumours of the female genitals, also diagnosis and therapy are based on the new classification system. The use of computerized tomography will have to be re-evaluated. To say the least, it is a decisive aid in physical and technical irradiation planning. The fundamentals of systematic diagnosis and therapy are listed in a table. Cytostatic treatment and combined radio-/chemotherapy must be considered. Side-effects of radiotherapy and their treatment are of practical importance. Post-therapeutical treatment receives special attention. The documented cooperation between radiophysics, radiobiology, radiology, and urology has yielded new knowledge in the sense of a comprehensive conception of urological oncology. (orig./MG) [de

  14. 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 ...

  15. 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

  16. 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

  17. 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.

  18. 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.…

  19. Laser in urology

    International Nuclear Information System (INIS)

    Breisland, H.O.

    1991-01-01

    The neodymium YAG laser is particularly suited for endoscopic urologic surgery because the YAG laser light can be conducted in flexible fibers. Superficial bladder tumours can be treated under local anaesthesia in the outpatient department. The frequency of local recurrences is low, significantly lower than after electrosection or electrocoagulation. Selected cases of T2-muscle invasive bladder tumours can be cured with laser coagulation applied subsequently to transurethral resection. Combined treatment with electrosection and laser coagulation of localized prostatic cancer is a promising method which compares favourably with results obtained by other treatment modalities. Tumours in the upper urinary tract can be laser-treated through ureteroscopes or nephroscopes, but the treatment should be limited to low stage, low grade tumours. Laser is the treatment of choice for intraurethral condylomatas. Laser treatment of penil carcinoma gives excellent cosmetic and functional results and few local recurrences. Laser lithotripsy is a new technique for treatment of ureteric stones and photodynamic laser therapy is a promising tecnique for treatment of carcinoma in situ in the bladder empithelium. However, neither of these techniques are available for clinical use in Norway as yet. 17 refs., 3 figs., 1 tabs

  20. Mechanisms involved in the p62-73 idiopeptide-modulated delay of lupus nephritis in SNF(1) mice.

    Science.gov (United States)

    Nyland, J F; Stoll, M L; Jiang, F; Feng, F; Gavalchin, J

    2012-12-01

    The F(1) progeny of the (SWR × NZB) cross develop a lupus-like disease with high serum titers of autoantibodies, and increased frequency and severity of immune complex-mediated glomerulonephritis in females. In previous work, we found that an idiotypic peptide corresponding to aa62-73 (p62-73) of the heavy chain variable region of autoantibody 540 (Id(LN)F(1)) induced the proliferation of p62-73 idiotype-reactive T cell clones. Further, monthly immunization of pre-nephritic SNF(1) female mice with p62-73 resulted in decreased nephritis and prolonged life spans. Here we show that this treatment modulated proliferative responses to Id(LN)F(1) antigen, including a reduction in the population of idiopeptide-presenting antigen-presenting cells (APCs), as early as two weeks after immunization (10 weeks of age). Th1-type cytokine production was increased at 12 weeks of age. The incidence and severity of nephritis was reduced by 14 weeks compared to controls. Clinical indicators of nephritis, specifically histological evidence of glomerulonephritis and urine protein levels, were reduced by 20 weeks. Together these data suggest that events involved in the mechanism(s) whereby p62-73 immunization delayed nephritis occurred early after immunization, and involved modulation of APCs, B and T cell populations.

  1. 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

  2. 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

    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...

  3. 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.

  4. Surgical pathology of urologic diseases

    International Nuclear Information System (INIS)

    Javadpour, N.; Barsky, S.H.

    1987-01-01

    This text details recent advances in methods for detecting, diagnosing, and managing genitourinary diseases. Included are chapters on imaging techniques (including magnetic resonance imaging, computed tomography, and ultrasound; tumor markers (such as alphafetoprotein, human chorionic gonadotropin, prostatic specific antigen, and T-antigens); immunocytochemistry; pediatric urologic pathology; and other key topics

  5. 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.

  6. 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)

  7. Ginseng gintonin activates the human cardiac delayed rectifier K+ channel: involvement of Ca2+/calmodulin binding sites.

    Science.gov (United States)

    Choi, Sun-Hye; Lee, Byung-Hwan; Kim, Hyeon-Joong; Jung, Seok-Won; Kim, Hyun-Sook; Shin, Ho-Chul; Lee, Jun-Hee; Kim, Hyoung-Chun; Rhim, Hyewhon; Hwang, Sung-Hee; Ha, Tal Soo; Kim, Hyun-Ji; Cho, Hana; Nah, Seung-Yeol

    2014-09-01

    Gintonin, a novel, ginseng-derived G protein-coupled lysophosphatidic acid (LPA) receptor ligand, elicits [Ca(2+)]i transients in neuronal and non-neuronal cells via pertussis toxin-sensitive and pertussis toxin-insensitive G proteins. The slowly activating delayed rectifier K(+) (I(Ks)) channel is a cardiac K(+) channel composed of KCNQ1 and KCNE1 subunits. The C terminus of the KCNQ1 channel protein has two calmodulin-binding sites that are involved in regulating I(Ks) channels. In this study, we investigated the molecular mechanisms of gintonin-mediated activation of human I(Ks) channel activity by expressing human I(Ks) channels in Xenopus oocytes. We found that gintonin enhances IKs channel currents in concentration- and voltage-dependent manners. The EC50 for the I(Ks) channel was 0.05 ± 0.01 μg/ml. Gintonin-mediated activation of the I(Ks) channels was blocked by an LPA1/3 receptor antagonist, an active phospholipase C inhibitor, an IP3 receptor antagonist, and the calcium chelator BAPTA. Gintonin-mediated activation of both the I(Ks) channel was also blocked by the calmodulin (CaM) blocker calmidazolium. Mutations in the KCNQ1 [Ca(2+)]i/CaM-binding IQ motif sites (S373P, W392R, or R539W)blocked the action of gintonin on I(Ks) channel. However, gintonin had no effect on hERG K(+) channel activity. These results show that gintonin-mediated enhancement of I(Ks) channel currents is achieved through binding of the [Ca(2+)]i/CaM complex to the C terminus of KCNQ1 subunit.

  8. [Sensible cooperation in urology].

    Science.gov (United States)

    Jonitz, H

    2006-08-01

    The main features of the reform of the healthcare system disclosed by the grand coalition on 4 July 2006 include, among other points, annulment of all budgets, payment for services rendered at fixed euro rates, and introduction of complex flat rates starting in 2009. The direct and medium-term consequences involve establishment of a health fund, but also drawing on tax money, e.g., to cofinance underage children. In addition, hospital outpatient departments in specialty fields are to be completely opened. All of these measures can lead to a marked reduction of specialized practices. All in all, one must bear in mind that establishing a "health fund" represents de facto the institution of state-run medicine.

  9. Involvement of cannabinoid system in the nucleus accumbens on delay-based decision making in the rat.

    Science.gov (United States)

    Fatahi, Zahra; Sadeghi, Bahman; Haghparast, Abbas

    2018-01-30

    The nucleus accumbens (NAc) plays a fundamental role in decision making and anticipation of reward. In addition, exogenous cannabinoids affect the behavior of humans and animals including disruption of short-term memory and cognitive impairments. Therefore, in this study, cannabinoid agonist and antagonist were administrated into the NAc to determine the effect of cannabinoid activation in the entire NAc on delay-based decision making. Rats were trained on a cost-benefit T-maze decision making task in which the animals were well-trained to choose between a small/immediate reward and a large/delay reward. After training, the animals were implanted with guide cannulae in the NAc. On test day, they received cannabinoid agonist (Win 55,212-2; 10, 50 and 100μM) and/or antagonist (AM251; 45μM) into the NAc. Percentage of high reward choice and latency of reward achievement were evaluated. Results showed that cannabinoid agonist administration caused a decrease in high reward choice such that rats selected small/immediate reward instead of large/delay reward. Moreover, in agonist-treated animals latency of reward achievement increased. Effects of cannabinoid activation on delay-based decision making with equivalent delays demonstrated that if the delay was equated on both arm goals, animals still had a preference for the high/delay reward, showing the results was not caused by an impairment of spatial preference or memory. These finding clarified that cannabinoid system activation in the entire NAc plays a critical role in the regulation of delay-based decision making. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Changes in urological surgical techniques

    Directory of Open Access Journals (Sweden)

    Oktay Üçer

    2010-06-01

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

  11. "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.

  12. UROLOGY

    African Journals Online (AJOL)

    Introduction. There is a paucity of published local data describing indications for and outcomes of nephrectomy in South. Africa. It appears that patients with renal cell carcinoma. (RCC) in KwaZulu-Natal (KZN) present at a young age with advanced disease. Furthermore, there is concern that there is a high complication rate ...

  13. Decision making in urological surgery.

    Science.gov (United States)

    Abboudi, Hamid; Ahmed, Kamran; Normahani, Pasha; Abboudi, May; Kirby, Roger; Challacombe, Ben; Khan, Mohammed Shamim; Dasgupta, Prokar

    2012-06-01

    Non-technical skills are important behavioural aspects that a urologist must be fully competent at to minimise harm to patients. The majority of surgical errors are now known to be due to errors in judgment and decision making as opposed to the technical aspects of the craft. The authors reviewed the published literature regarding decision-making theory and in practice related to urology as well as the current tools available to assess decision-making skills. Limitations include limited number of studies, and the available studies are of low quality. Decision making is the psychological process of choosing between alternative courses of action. In the surgical environment, this can often be a complex balance of benefit and risk within a variable time frame and dynamic setting. In recent years, the emphasis of new surgical curriculums has shifted towards non-technical surgical skills; however, the assessment tools in place are far from objective, reliable and valid. Surgical simulators and video-assisted questionnaires are useful methods for appraisal of trainees. Well-designed, robust and validated tools need to be implemented in training and assessment of decision-making skills in urology. Patient safety can only be ensured when safe and effective decisions are made.

  14. 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.)

  15. 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.

  16. 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

  17. The Current State of Telemedicine in Urology.

    Science.gov (United States)

    Miller, Adam; Rhee, Eugene; Gettman, Matthew; Spitz, Aaron

    2018-03-01

    Telemedicine use in urology is an evolving practice. In this article, the authors review the early experience of telemedicine specifically as it relates to urologic practice and discuss the future implications and the utility of telemedicine as it applies to other fields. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Nanotechnology applications in urology: a review.

    Science.gov (United States)

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

    2014-11-01

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

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

    OpenAIRE

    Rahimi Movaghar V

    2001-01-01

    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. Alt...

  20. Assessment of the performance of the American Urological Association symptom score in 2 distinct patient populations.

    Science.gov (United States)

    Johnson, Timothy V; Schoenberg, Evan D; Abbasi, Ammara; Ehrlich, Samantha S; Kleris, Renee; Owen-Smith, Ashli; Gunderson, Kristin; Master, Viraj A

    2009-01-01

    Recent research suggests that low education and illiteracy may drive misunderstanding of the American Urological Association Symptom Score, a key tool in the American Urological Association benign prostatic hyperplasia guidelines. It is unclear whether misunderstanding is confined to patients of low socioeconomic status. Therefore, we reevaluated the prevalence and impact of this misunderstanding in a county vs university hospital population. This prospective study involved 407 patients from a county hospital and a university hospital who completed the American Urological Association Symptom Score as self-administered and then as interviewer administered. Responses were compared by calculating correlation coefficients and weighted kappa statistics to assess patient understanding of the American Urological Association Symptom Score. Multivariate logistic regression analyses were used to examine the association between patient characteristics and poor understanding of the American Urological Association Symptom Score. Of the patients 72% understood all 7 American Urological Association Symptom Score questions. Of the measured demographic variables only education level significantly affected this understanding. Compared to patients with more than 12 years of education county hospital patients with less than 9 years of education were 57.06 times more likely to misunderstand the American Urological Association Symptom Score (95% CI 14.32-329.34) while university hospital patients with less than 9 years of education were 38.27 times more likely to misunderstand the American Urological Association Symptom Score (95% CI 1.69-867.83). Of county hospital patients 31% and of university hospital patients 21% significantly misrepresented their symptom severity according to current guidelines. Patients with low education regardless of location are more likely to misunderstand the American Urological Association Symptom Score, misrepresent their symptoms and, therefore, receive

  1. 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

  2. Spanish urological schools (1880-1970).

    Science.gov (United States)

    Pérez-Albacete, M

    2018-05-11

    We researched the start of urological specialisation in Spain, from the end of the 19th century to the institution of the education system (resident medical intern) to learn about the centres and individuals who created the urological teaching units and training schools in which the first Spanish urologists specialised their training. We extracted the references from books on the history of urology, from periodic urological publications and from the posters on history submitted to the congresses of the Spanish Urological Association and filled in the data and dates with the Historical Dictionary of Spanish Urologists. There are 30 urological specialization centres, 8 with official accreditation recognised by the corresponding ministry but whose official status is unknown. These centres are in the urology departments of large Spanish hospitals, university clinic hospitals and in private schools directed by notable urologists. There are 14 main centres, corresponding chronologically to the following cities: Madrid, Barcelona, Santiago de Compostela, Seville, Las Palmas of Gran Canaria, Cadiz, Santander, Valencia, Granada, Bilbao, San Sebastian, Oviedo, Zaragoza and Salamanca. Urological training in Spain from the end of the 19th century to the first half of the 20th century was well-established, both in officially accredited centres and in the urology departments of the main hospitals, in university clinic hospitals and in private schools and clinics. The training was directed by experienced urologists who ensured proper teaching and training, a method that persisted until the institution of the resident medical intern system in 1970. Copyright © 2018 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. 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.

  4. Impact of global medicine on urologic education.

    Science.gov (United States)

    Shukla, Aseem R

    2011-04-01

    Collaborative and academic partnerships between institutions in North America and those in resource-limited nations are a burgeoning trend. Leveraging the academic quality and outcomes-based infrastructure of university medical centers to increase surgical capacity in regions where urologic disease burden is immense offers potentially bilateral opportunities. Host institutions benefit from exposure to contemporary surgical approaches, while the surgical volume enables larger-scale collaborative outcome studies and exposure of residents-in-training to rare pathophysiology. This article surveys this growing trend in globalizing health care specific to urology, and the development of a program focused on urologic education at a tertiary referral center in India.

  5. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology biopsy instrument. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Diagnostic Devices § 876.1075 Gastroenterology-urology biopsy instrument. (a) Identification. A gastroenterology-urology biopsy instrument is a...

  6. 21 CFR 876.4370 - Gastroenterology-urology evacuator.

    Science.gov (United States)

    2010-04-01

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

  7. 21 CFR 876.4530 - Gastroenterology-urology fiberoptic retractor.

    Science.gov (United States)

    2010-04-01

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

  8. Electric Car Users’ Time of Charging Problem under Peak Load Pricing When Delay in Charging Time Involves Uncertain Cost

    DEFF Research Database (Denmark)

    Fetene, Gebeyehu Manie

    The problem of peak load arises when demand fluctuates over time while the pro- duction technology is not flexible (or making it flexible is economically inefficient) and/or when a product is non-storable (or storage cost is huge). Peak load is a com- mon problem in consumption of public utilities......, on the one hand, observed cost saving benefit of postponing the time of charging to off-peak lower fee of charging and, on the other hand, the cost of delay in departure time for planned trips and uncertain cost of late charging associated with likelihood occur- rence of unanticipated trip before the car...... of electricity. The electric vehicle (EV) users choice of time of charging problem under PLP is different from that of general households using energy for house appliances since there is uncertain cost to the former as- sociated with likelihood occurrence of unanticipated trips such as visiting hospital...

  9. Pharmacological Characterization of the Mechanisms Involved in Delayed Calcium Deregulation in SH-SY5Y Cells Challenged with Methadone

    Directory of Open Access Journals (Sweden)

    Sergio Perez-Alvarez

    2012-01-01

    Full Text Available Previously, we have shown that SH-SY5Y cells exposed to high concentrations of methadone died due to a necrotic-like cell death mechanism related to delayed calcium deregulation (DCD. In this study, we show that, in terms of their Ca2+ responses to 0.5 mM methadone, SH-SY5Y cells can be pooled into four different groups. In a broad pharmacological survey, the relevance of different Ca2+-related mechanisms on methadone-induced DCD was investigated including extracellular calcium, L-type Ca2+ channels, μ-opioid receptor, mitochondrial inner membrane potential, mitochondrial ATP synthesis, mitochondrial Ca2+/2Na+-exchanger, reactive oxygen species, and mitochondrial permeability transition. Only those compounds targeting mitochondria such as oligomycin, FCCP, CGP 37157, and cyclosporine A were able to amend methadone-induced Ca2+ dyshomeostasis suggesting that methadone induces DCD by modulating the ability of mitochondria to handle Ca2+. Consistently, mitochondria became dramatically shorter and rounder in the presence of methadone. Furthermore, analysis of oxygen uptake by isolated rat liver mitochondria suggested that methadone affected mitochondrial Ca2+ uptake in a respiratory substrate-dependent way. We conclude that methadone causes failure of intracellular Ca2+ homeostasis, and this effect is associated with morphological and functional changes of mitochondria. Likely, this mechanism contributes to degenerative side effects associated with methadone treatment.

  10. 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.

    2016-05-01

    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.

  11. 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.

  12. Phosphodiesterase inhibitors in clinical urology.

    Science.gov (United States)

    Ückert, Stefan; Kuczyk, Markus A; Oelke, Matthias

    2013-05-01

    To date, benign diseases of the male and female lower urinary and genital tract, such as erectile dysfunction, bladder overactivity, lower urinary tract symptomatology secondary to benign prostatic hyperplasia and symptoms of female sexual dysfunction (including arousal and orgasmic disorders), can be therapeutically approached by influencing the function of the smooth musculature of the respective tissues. The use of isoenzyme-selective phosphodiesterase (PDE) inhibitors is considered a great opportunity to treat various diseases of the human urogenital tract. PDE inhibitors, in particular the PDE5 (cyclic GMP PDE) inhibitors avanafil, lodenafil, sildenafil, tadalafil, udenafil and vardenafil, are regarded as efficacious, having a fast onset of drug action and an improved effect-to-adverse event ratio, combining a high response rate with the advantage of an on-demand intake. The purpose of this review is to summarize recent as well as potential future indications, namely, erectile dysfunction, Peyronie's disease, overactive bladder, urinary stone disease, lower urinary tract symptomatology secondary to benign prostatic hyperplasia and premature ejaculation, for the use of PDE inhibitors in clinical urology.

  13. Hydrogen peroxide-induced reduction of delayed rectifier potassium current in hippocampal neurons involves oxidation of sulfhydryl groups.

    Science.gov (United States)

    Hasan, Sonia M K; Redzic, Zoran B; Alshuaib, Waleed B

    2013-07-03

    This study examined the effect of H2O2 on the delayed rectifier potassium current (IKDR) in isolated hippocampal neurons. Whole-cell voltage-clamp experiments were performed on freshly dissociated hippocampal CA1 neurons of SD rats before and after treatment with H2O2. To reveal the mechanism behind H2O2-induced changes in IKDR, cells were treated with different oxidizing and reducing agents. External application of membrane permeable H2O2 reduced the amplitude and voltage-dependence of IKDR in a concentration dependent manner. Desferoxamine (DFO), an iron-chelator that prevents hydroxyl radical (OH) generation, prevented H2O2-induced reduction in IKDR. Application of the sulfhydryl-oxidizing agent 5,5 dithio-bis-nitrobenzoic acid (DTNB) mimicked the effect of H2O2. Sulfhydryl-reducing agents dithiothreitol (DTT) and glutathione (GSH) alone did not affect IKDR; however, DTT and GSH reversed and prevented the H2O2-induced inhibition of IKDR, respectively. Membrane impermeable agents GSH and DTNB showed effects only when added intracellularly identifying intracellular sulfhydryl groups as potential targets for hydroxyl-mediated oxidation. However, the inhibitory effects of DTNB and H2O2 at the positive test potentials were completely and partially abolished by DTT, respectively, suggesting an additional mechanism of action for H2O2, that is not shared by DTNB. In summary, this study provides evidence for the redox modulation of IKDR, identifies hydroxyl radical as an intermediate oxidant responsible for the H2O2-induced decrease in current amplitude and identifies intracellular sulfhydryl groups as an oxidative target. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. "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.

  15. Trends in urological stone disease.

    Science.gov (United States)

    Turney, Benjamin W; Reynard, John M; Noble, Jeremy G; Keoghane, Stephen R

    2012-04-01

    To summarize the changes in prevalence and treatment of upper urinary tract stone disease in the UK over the last 10 years. Data from the Hospital Episode Statistics (HES) website (http://www.hesonline.nhs.uk) were extracted, summarized and presented. The number of upper urinary tract stone hospital episodes increased by 63% to 83,050 in the 10-year period. The use of shock wave lithotripsy (SWL) for treating all upper tract stones increased from 14,491 cases in 2000-2001 to 22,402 cases in 2010 (a 55% increase) with a 69% increase in lithotripsy for renal stones. There was a 127% increase in the number of ureteroscopic stone treatments from 6,283 to 14,242 cases over the 10-year period with a 49% increase from 2007/2008 to 2009/2010. There was a decline in open surgery for upper tract stones from 278 cases in 2000/2001 to 47 cases in 2009/2010 (an 83% reduction). Treatment for stone disease has increased substantially in comparison with other urological activity. In 2009/2010, SWL was performed almost as frequently as transurethral resection of the prostate or transurethral resection of bladder tumour, ureteroscopy for stones was performed more frequently than nephrectomy, radical prostatectomy and cystectomy combined, and percutaneous nephrolithotomy was performed more frequently than cystectomy. The present study highlights the increase in prevalence and treatment of stone disease in the UK over the last 10 years. If this trend continues it has important implications for workforce planning, training, service delivery and research in the field of urolithiasis. © 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

  16. Personal finances of urology residents in Canada.

    Science.gov (United States)

    Teichman, J M; Tongco, W; MacNeily, A E; Smart, M

    2000-12-01

    We examined how Urology residents in Canada manage their personal finances. A survey instrument was designed to elicit information on demographics, expenses, savings and incomes. The questionnaire was completed by 40 Urology residents attending the 2000 Queen's Urology Exam Skills Training (QUEST) program. Twenty-eight residents (70%) had educational debt (median debt $50 000). Seventeen residents (45%) paid credit card interest charges within the last year. Four residents (10%) maintained an unpaid credit card balance > $7500 at 17% annual interest rate. Twenty-six residents (67%) contributed to Registered Retirement Savings Program (RRSP) accounts. Seventeen residents (44%) contributed to non-RRSP retirement accounts. Nineteen residents (50%) budgeted expenses. Median resident income was $45 000. Thirteen residents (34%) had cash reserves < $250. Many residents save little, and incur substantial debt over and above educational loans. Many residents would benefit from instruction concerning prudent financial management. Residents should be informed of the consequences of low saving and high debt.

  17. “A Tree Must Be Bent While It Is Young”: Teaching Urological Surgical Techniques to Schoolchildren

    Science.gov (United States)

    Buntrock, Stefan

    2012-01-01

    Background 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. Objectives To teach surgical skills to schoolchildren in order to attract them to urology as a professional choice later in life. Materials and Methods 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. Results 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. Conclusions Making use of virtual reality to attract and educate a new generation of urologists is an important step in designing the future of urology. PMID:23573467

  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...... deviation and plaque size were observed. Four studies on erectile dysfunction (ED) including 337 participants were included. Using International Index of Erectile Function (IIEF-EF) and erectile hardness scale (EHS) data suggested a significant positive effect of ESWT in phosphodiesterase-5 inhibitor (PDE-5...

  19. [Evaluation of the activity of a urological emergency unit in university hospital].

    Science.gov (United States)

    Martin, L; Pillot, P; Bardonnaud, N; Lillaz, J; Chabannes, E; Bernardini, S; Guichard, G; Bittard, H; Kleinclauss, F

    2014-01-01

    To determine the epidemiology of urological emergencies in a university hospital and the interest of a dedicated urological emergency unit. In 2008, a dedicated urological emergency unit was individualized in our department of urology. We conducted a retrospective study including all patients consulting in this unit in 2009 with epidemiological, clinical and therapeutic data. During 2009, 1257 patients consulted in this unit. Main diagnoses were acute urinary retention (303, 24.11%), renal colic (219, 17.42%), urinary infections (278, 22.11%), postoperative complications (141, 11.22%), symptomatic benign prostate hyperplasia (65, 5.17%), genitourinary cancers (61, 4.85%), trauma of urinary apparel (41, 3.26%), and spermatic cords torsion (10, 0.8%). In 99 cases (7.88%) diagnosis did not involved the urinary system. The treatment was surgical in 213 (17.7%) cases, technical procedure under local anesthesia in 368 (29.3%) and a medical treatment in 675 (53.7%) cases. Six hundred and sixty (52.5%) patients were managed ambulatory whereas 596 (47.5%) needed hospitalization. The opening of a dedicated urological emergency unit lead to 1257 emergency consultations. Frequent etiologies were acute urinary retention, renal colic and urinary infection. The creation of this unit allowed to register and to valorize this emergency activity through the ATU emergency amount. Copyright © 2013. Published by Elsevier Masson SAS.

  20. 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.

  1. Safety of gentamicin bladder irrigations in complex urological cases.

    Science.gov (United States)

    Defoor, William; Ferguson, Denise; Mashni, Susan; Creelman, Lisa; Reeves, Deborah; Minevich, Eugene; Reddy, Pramod; Sheldon, Curtis

    2006-05-01

    Recurrent urinary tract infections are common in complex pediatric urological cases, particularly those requiring clean intermittent catheterization. At our institution gentamicin bladder irrigations have been used for antimicrobial prophylaxis and to treat symptomatic bacteriuria, particularly when the infection does not involve the upper urinary tract. The purpose of this study was to assess the safety of this therapy. A retrospective study was performed of all children treated with gentamicin bladder irrigations from 1999 to 2004. The dose was 14 mg gentamicin in 30 ml saline instilled via catheter once or twice daily. Serum creatinine and random gentamicin levels were obtained according to a protocol based on risk of gentamicin toxicity. Patient demographics, laboratory results and outcomes were abstracted from the medical records. A total of 80 patients (38 males and 42 females) were identified. Median patient age was 10 years and median duration of treatment was 90 days. No patient had detectable serum gentamicin levels greater than 0.4 mg/dl. Small increases in serum creatinine were seen in 3 patients, all of whom had chronic renal insufficiency. A total of 21 patients (26%) had breakthrough UTIs, of which 5 (24%) were gentamicin resistant. No adverse events were documented. Gentamicin bladder irrigations are a helpful adjunct in the management of complex pediatric urological cases involving recurrent symptomatic bacteriuria. We no longer require intensive laboratory monitoring of low risk patients at our institution.

  2. Advances in Ultrasound Technology in Oncologic Urology

    NARCIS (Netherlands)

    Gravas, Stavros; Mamoulakis, Charalampos; Rioja, Jorge; Tzortzis, Vassilios; de Reijke, Theodor; Wijkstra, Hessel; de la Rosette, Jean

    2009-01-01

    Continuous innovations and clinical research in ultrasound (US) technology have upgraded the position of US in the imaging armamentarium of urologists. In particular, contrast-enhanced US and sonoelastography seem to be promising in the diagnosis of urologic cancers, implementation of ablative

  3. 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.

  4. 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 ...

  5. 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 ...

  6. Quantitative Analysis of Technological Innovation in Urology.

    Science.gov (United States)

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

    2018-01-01

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

  7. Health policy 2016: implications for geriatric urology.

    Science.gov (United States)

    Suskind, Anne M; Clemens, J Quentin

    2016-03-01

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

  8. [Sacral neuromodulation in urology - development and current status].

    Science.gov (United States)

    Schwalenberg, T; Stolzenburg, J-U; Kriegel, C; Gonsior, A

    2012-01-01

    Sacral neuromodulation (SNM) in urology is employed to treat refractory lower urinary tract dysfunction as well as chronic pelvic pain. Electrical stimulation of the sacral afferents (S2 - S4) causes activation and conditioning of higher autonomic and somatic neural structures and thereby influences the efferents controlling the urinary bladder, the rectum and their related sphincter systems. It is therefore possible to treat overactivity as well as hypocontractility and functional bladder neck obstruction. SNM treatment is conducted biphasically. Initially, test electrodes are placed to evaluate changes in micturition and pain parameters. If, in this first phase - called peripheral nerve evaluation (PNE test) - sufficient improvements are observed, the patient progresses to phase two which involves implantation of the permanent electrodes and impulse generator system. In recent years, the "two stage approach" with initial implantation of the permanent electrodes has been favoured as it increases treatment success rates. Long-term success rates of SNM vary significantly in the literature (50 - 80 %) due to heterogeneous patient populations as well as improved surgical approaches. With the introduction of "tined lead electrodes" (2002), tissue damage is reduced to a minimum. Technical innovation, financial feasibility (reimbursed in Germany since 2004) and wider application, especially in otherwise therapy-refractory patients or complex dysfunctions of the pelvis, have established SNM as a potent treatment option in urology. © Georg Thieme Verlag KG Stuttgart · New York.

  9. A review of the available urology skills training curricula and their validation.

    Science.gov (United States)

    Shepherd, William; Arora, Karan Singh; Abboudi, Hamid; Shamim Khan, Mohammed; Dasgupta, Prokar; Ahmed, Kamran

    2014-01-01

    The transforming field of urological surgery continues to demand development of novel training devices and curricula for its trainees. Contemporary trainees have to balance workplace demands while overcoming the cognitive barriers of acquiring skills in rapidly multiplying and advancing surgical techniques. This article provides a brief review of the process involved in developing a surgical curriculum and the current status of real and simulation-based curricula in the 4 subgroups of urological surgical practice: open, laparoscopic, endoscopic, and robotic. An informal literature review was conducted to provide a snapshot into the variety of simulation training tools available for technical and nontechnical urological surgical skills within all subgroups of urological surgery using the following keywords: "urology, surgery, training, curriculum, validation, non-technical skills, technical skills, LESS, robotic, laparoscopy, animal models." Validated training tools explored in research were tabulated and summarized. A total of 20 studies exploring validated training tools were identified. Huge variation was noticed in the types of validity sought by researchers and suboptimal incorporation of these tools into curricula was noted across the subgroups of urological surgery. The following key recommendations emerge from the review: adoption of simulation-based curricula in training; better integration of dedicated training time in simulated environments within a trainee's working hours; better incentivization for educators and assessors to improvise, research, and deliver teaching using the technologies available; and continued emphasis on developing nontechnical skills in tandem with technical operative skills. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

  10. 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.

  11. Targeting DNA Methyltranferases in Urological Tumors

    Directory of Open Access Journals (Sweden)

    Ângela Marques-Magalhães

    2018-04-01

    Full Text Available Urological cancers are a heterogeneous group of malignancies accounting for a considerable proportion of cancer-related morbidity and mortality worldwide. Aberrant epigenetic traits, especially altered DNA methylation patterns constitute a hallmark of these tumors. Nonetheless, these alterations are reversible, and several efforts have been carried out to design and test several epigenetic compounds that might reprogram tumor cell phenotype back to a normal state. Indeed, several DNMT inhibitors are currently under evaluation for therapeutic efficacy in clinical trials. This review highlights the critical role of DNA methylation in urological cancers and summarizes the available data on pre-clinical assays and clinical trials with DNMT inhibitors in bladder, kidney, prostate, and testicular germ cell cancers.

  12. 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.

  13. Minimal Invasive Urologic Surgery and Postoperative Ileus

    Directory of Open Access Journals (Sweden)

    Fouad Aoun

    2015-07-01

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

  14. Radiation protection at urological fluoroscopy working stations

    International Nuclear Information System (INIS)

    Forster, D.; Mohr, H.

    1979-01-01

    Two newly developed radiation protection devices for urological working stations are presented. The local dose to which doctor and assisting personnel are exposed during fluoroscopy and radiography was measured and the radiation burden with and without radiation protection determined. The studies show that without these devices organs such as the eyes are exposed, at a normal working distance from the table, to such an amount of scattered radiation as to reduce the permitted number of examinations per week. (Auth.)

  15. Iatrogenic urological triggers of autonomic dysreflexia

    DEFF Research Database (Denmark)

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

    2015-01-01

    pressure (BP) assessments during urological procedures were excluded. RESULTS: Forty studies were included for analysis and categorized into four groups: (1) urodynamics and cystometry; (2) cystoscopy and transurethral litholapaxy; (3) extracorporeal shock-wave lithotripsy (ESWL); and (4) other procedures...... 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...

  16. 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

  17. Unsuspected urological anomalies in asymptomatic cryptorchid boys

    International Nuclear Information System (INIS)

    Pappis, C.H.; Argianas, S.A.; Bousgas, D.; Athanasiades, E.; Pendeli Children's Hospital, Athens

    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 mTc -DTPA), if it is possible, in all patients undergoing orchiopexy for the detection of an unsuspected major renal anomaly. (orig.)

  18. 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...

  19. Contribution of modern lithotripsy to the practice of urology

    International Nuclear Information System (INIS)

    Caine, M.

    1986-01-01

    Modern lithotripsy, both the minimally invasive percutaneous method and the completely noninvasive extracorporeal shock wave lithotripsy (ESWL) technique, have far-reaching effects on the practice of urology. The patient is spared a painful operation and convalescence, as well as surgical trauma to the kidney. The urologist needs to familiarize himself with the new techniques and, with the percutaneous method, must guard against radiation. The hospital is involved in considerable expense in purchasing and installing the ESWL equipment, and should redistribute its facilities to take full advantage of the rapid turnover it permits. The nation gains considerably by minimizing workdays lost due to surgical operations and convalescence, and by reducing the number of patients with kidney stones who ultimately require dialysis

  20. 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

  1. 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.

  2. [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.

  3. Urological disorders and pregnancy: An overall experience

    Directory of Open Access Journals (Sweden)

    Debasmita Mandal

    2017-01-01

    Full Text Available Aim: Pregnancy is an anatomical and physiological altered state and the presence of various urological problems not only aggravates the disease itself, but also results in unfavourable pregnancy outcome. Aim is to highlight obstetric outcome in pregnant women with urological problems. Materials and Methods: Longitudinal prospective cohort study conducted in tertiary care hospital, IPGME and R, Kolkata from Jan 2011 to Dec 2012. All pregnant women with urological problems were included as subjects. Results: A total of 33 subjects were followed up throughout their antenatal period. Among them majority (72.72% presented with hydro nephrosis followed by hydroureter (60.6%, PUJ obstruction and pyelonephritis each with incidence of 15.15%, then urolithiasis (12.12%, nephrolithiasis (6.06% and renal abscess (12.12%. Interventions required were DJ stenting (72.72%, pyeloplasty (15.15% and others were RURSL, abscess drainage and ATT. The pregnancy outcome was complicated with preterm labor in majority of patients (45.45%, oligohydramnious (18.18%, PIH (9.09% and still birth (6.06%. Twenty four live birth were there. Majority required NICU admissions as predominantly prematurity was an important concern. Majority women with hydronephrosis underwent DJ stenting. Conclusion: Preterm labor is an important obstetric concern. Vaginal delivery is the choicest mode of termination and LSCS can be reserved for obstetric reason. DJ stenting is safe and practical approach for continuation of pregnancy with hydronephrosis. Regular follow up, vigilant antenatal care and multidisciplinary approach from urologist, obstetrician and neonatologist will bring out successful pregnancy outcome.

  4. Significance of computed tomography in urology

    International Nuclear Information System (INIS)

    Harada, Takashi

    1981-01-01

    There are more than five years since computed tomography (CT) was first introduced in this country for practical use. However, cumulative diagnostic experiences in urology have not been discussed thoroughly yet. In the Department of Urology of Kansai Medical University over 120 times CT diagnosis were attempted past three years and the instrument employed during this period has been alternative from the first generation type (ACTA 150) to the third one (CT-3W) this year as to technical advance. These cases are 70 of pelvic lesions and retroperitoneal surveys are made in the rests. As a results, detection of space occupying mass in kidney, adrenal and their surroundings was comparatively easy to deliver by this method, but there are several pitfalls to come misunderstanding in diagnosis of pelvic organs. It seems to be difficult to obtain certain result on closely packed viscera with tightly adhered connective tissue in tiny space. However, these difficulties will be solved by bladder insufflation with olive oil, for instance, and scanning in prone position. Contrast enhancement by injection of dye also give more definite results in genitourinary tract assessment. Moreover, there are much benefit in diagnosis of renal parenchymal change including lacerating renal trauma unable to be differentiated conventional method. Bolus injection of contrast material also allows to calculate CT values obtained from ROI on tomography and enables to fit the value to time-activity curve likewise scintillation scanning. In forthcomming day, new device in this field including emission-CT, NMR-CT and others will open new sight for ideal diagnostic facility in urology. (author)

  5. 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

  6. [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

  7. The Role of Scarless Procedures in Urology: A Review of Literature

    African Journals Online (AJOL)

    surgery has been steadily increasing in the recent urological literature .... also incorporate the new robotic instruments and ... discoveries related to urological NOTES is shared, c) to guide scientific evaluation and implementation of urological ...

  8. Longitudinal Gender Disparity in Female Urology Resident Primary Authorship at an American Urological Association Sectional Meeting.

    Science.gov (United States)

    Lin, Tony R; Kocher, Neil J; Klausner, Adam P; Raman, Jay D

    2017-12-01

    To further evaluate the academic representation of female urology residents in the United States, we reviewed abstracts from the Mid-Atlantic American Urological Association (MA-AUA) sectional meetings to determine if the recent increase in the number of female urology residents mirrored an increase in this group's abstract authorship. Full text abstracts from the MA-AUA meetings were analyzed from 2008 to 2014 excluding 1 joint section meeting. First-author gender was determined by querying publicly available institutional websites, social media platforms, and the U.S. News & World Report. First-author gender was indeterminable in 10 abstracts based on search criteria and these were excluded. Individual abstracts were broadly categorized based on keywords into 1 of several topics. Chi-square statistical tests examined the relationship between first-authorship gender, publication year, and abstract category. The number of female urology residents in the MA-AUA increased over the study period. A total of 484 abstracts were analyzed. Three hundred ninety-three abstracts (81%) included a male first-author, whereas 81 abstracts (17%) included a female first-author. Female first-authorship ranged from 13% to 25% annually. Comparison of male-to-female first-authorship was statistically significant in all years evaluated (P <.001). There was a statistically significant difference between male and female first-authorship in all topic categories (P <.01), except Education/Other (P = .56). Despite continued gains and increasing female representation in urology, these data highlight significantly fewer female first-authors at the regional Mid-Atlantic section meetings. Larger studies are necessary to identify contributing factors and further areas for improvement toward decreasing gender imbalances within the academic community. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. 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

  10. 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.

  11. The role of lasers in modern urology

    Science.gov (United States)

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

    2015-01-01

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

  12. New trends in minimally invasive urological surgery

    Directory of Open Access Journals (Sweden)

    Prabhakar Rajan

    2009-10-01

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

  13. First urology simulation boot camp in the United Kingdom

    Directory of Open Access Journals (Sweden)

    C.S. Biyani

    2017-09-01

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

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

    African Journals Online (AJOL)

    This study strives to and meets this important objective. 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 ...

  15. 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, ...

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

    Science.gov (United States)

    Jayakumar, Nithish; Ahmed, Kamran; Challacombe, Ben

    2016-10-01

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

  17. Do Different ADHD-Related Etiological Risks Involve Specific Neuropsychological Pathways? An Analysis of Mediation Processes by Inhibitory Control and Delay Aversion

    Science.gov (United States)

    Pauli-Pott, Ursula; Dalir, Silke; Mingebach, Tanja; Roller, Alisa; Becker, Katja

    2013-01-01

    Background: Inhibitory control (IC) has been regarded as a neuropsychological basic deficit and as an endophenotype of attention deficit/hyperactivity disorder (ADHD). Implicated here are mediation processes between etiological factors and ADHD symptoms. We thus analyze whether and to what extent executive IC and delay aversion (DA; i.e.,…

  18. [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.

  19. Urological symptoms in a subset of patients with urological chronic pelvic pain syndrome and a polysymptomatic, polysyndromic pattern of presentation.

    Science.gov (United States)

    Lai, H Henry; North, Carol S; Andriole, Gerald L; Cupps, Lori; Song, David; Ness, Timothy J; Hong, Barry A

    2014-06-01

    We characterized urological symptoms in a subset of patients with urological chronic pelvic pain syndrome who have a high somatic symptom burden and a wide symptom distribution fitting a polysymptomatic, polysyndromic presentation pattern. A total of 81 patients with urological chronic pelvic pain syndrome enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases MAPP Research Network Study at Washington University in St. Louis and University of Alabama at Birmingham sites. They completed a symptom questionnaire to assess the somatic symptom burden and its distribution, and GUPI (Genitourinary Pain Index) to assess urological chronic pelvic pain syndrome symptoms, impact on quality of life and self-reported treatment seeking behaviors for urological chronic pelvic pain symptoms. The polysymptomatic, polysyndromic symptom pattern was defined by self-report of numerous painful and nonpainful somatic symptoms across many organ systems and by symptom categories on the polysymptomatic, polysyndromic questionnaire. Patients with urological chronic pelvic pain syndrome and the symptom pattern reported more severe genitourinary pain on a Likert scale, more frequent pain in the last week and more widespread pain distribution in the genital and pelvic areas than patients with urological chronic pelvic pain syndrome without the pattern. Patients with the symptom pattern also had significantly higher scores on the GUPI pain subscale, quality of life subscale (worse) and total questionnaire scores than patients without the pattern. Patients with the pattern reported significantly more treatment seeking behavior than others. The polysymptomatic, polysyndromic pattern might be an important phenotypic factor to assess in the evaluation of urological chronic pelvic pain syndrome with clinical and research implications. This may be a distinct clinical subgroup among patients with urological chronic pelvic pain syndrome. Copyright © 2014 American Urological

  20. An Urologic Face of Chronic Lymphocytic Leukemia:Sequential Prostatic and Penis Localization

    Directory of Open Access Journals (Sweden)

    Giovanni D'Arena

    2013-01-01

    Full Text Available We report a patient with chronic lymphocytic leukemia (CLL in whom a leukemic involvement of prostate and penis occurred in the advanced phase of his disease. Obstructive urinary symptoms were indicative of prostatic CLL infiltration, followed by the occurrence of an ulcerative lesion on the glans. Histologic examination confirmed  the  neoplastic B-cell infiltration. Both localizations responded to conventional treatments. A review of the literature confirms that leukemic involvement of the genito-urinary system is   uncommon in CLL patients. However, such an involvement should be considered in CLL patients with urologic symptoms and a long history of the disease.

  1. Use of social media in urology: data from the American Urological Association (AUA).

    Science.gov (United States)

    Loeb, Stacy; Bayne, Christopher E; Frey, Christine; Davies, Benjamin J; Averch, Timothy D; Woo, Henry H; Stork, Brian; Cooperberg, Matthew R; Eggener, Scott E

    2014-06-01

    To characterise the use of social media among members of the American Urological Association (AUA), as the use of social media in medicine has greatly expanded in recent years. In December 2012 to January 2013, the AUA e-mailed a survey with 34 questions on social media use to 2000 randomly selected urologists and 2047 resident/fellow members. Additional data was collected from Symplur analytics on social media use surrounding the AUA Annual Meeting in May 2013. In all, 382 (9.4%) surveys were completed, indicating 74% of responders had an online social media account. The most commonly used social media platforms were Facebook (93%), followed in descending order by LinkedIn (46%), Twitter (36%) and Google+ (26%). Being aged social media use (83% vs 56%), with greater uptake among residents/fellows compared with attendings (86% vs 66%). Only 28% of respondents used social media partly or entirely for professional purposes. During the 2013 AUA Annual Meeting, there were >5000 tweets from >600 distinct contributors. As of early 2013, among respondents to an e-mail survey, most urologists and urology trainees used some form of social media, and its use in urology conferences has greatly expanded. © 2013 The Authors. BJU International © 2013 BJU International.

  2. Do Women Work Less Than Men in Urology: Data From the American Urological Association Census.

    Science.gov (United States)

    Porten, Sima P; Gaither, Thomas W; Greene, Kirsten L; Baradaran, Nima; Anger, Jennifer T; Breyer, Benjamin N

    2018-04-30

    To further explore the issue of work parity between male and female urologists in the context of demographics, practice characteristics, subspecialty affiliation, and planned retirement. We analyzed data from the 2014 American Urological Association census, which is a specialty wide survey distributed to the entire urology community in the United States. A total of 2204 census samples were weighted to represent 11,703 urologists who practiced in the United States in 2014. We compared clinical and nonclinical hours worked by gender after adjusting for age, practice setting, fellowship type, and whether or not the urologist performed inpatient operations. Of the 11,703 practicing urologists in the United States, female urologists make up approximately 7.7% of the workforce (n ~ 897). Female practicing urologists were younger (66.4%, women were fellowship-trained in a urologic subspecialty (54.9% vs 34.9%, P hours worked between women and men (beta-coefficient -2.8, 95% confidence interval -6.4 to 0.7, P = .12). Gender does not appear to drive the number of hours urologists work per week. There is work hour parity between women and men practicing urologists in both clinical and nonclinical hours. Women are proportionately more likely to pursue fellowship training and hold academic positions. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. The urology residency matching program in practice.

    Science.gov (United States)

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

    2000-06-01

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

  4. 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.

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

    Science.gov (United States)

    Schneider, A W; Fichtner, J

    2014-08-01

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

  6. 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.

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

    Science.gov (United States)

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

    2013-11-01

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

  8. 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

  9. 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.

  10. Heart health = urologic health and heart unhealthy = urologic unhealthy: rapid review of lifestyle changes and dietary supplements.

    Science.gov (United States)

    Moyad, Mark A

    2011-08-01

    Almost all aspects of urology are affected positively and negatively by certain lifestyle changes and dietary supplements. Some of these interventions have potential profound impacts independently or in combination with conventional therapy, others have no impact, and some could negatively impact treatment and overall health. The heart-healthiest recommendations have consistently served as the safest and most potentially effective options in urology from benign prostatic hyperplasia, chronic nonbacterial prostatitis, interstitial cystitis, multiple urologic cancers, male infertility, male and female sexual dysfunction, kidney stones, and Peyronie disease. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. 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

  12. Delayed fission

    Energy Technology Data Exchange (ETDEWEB)

    Hatsukawa, Yuichi [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    1997-07-01

    Delayed fission is a nuclear decay process that couples {beta} decay and fission. In the delayed fission process, a parent nucleus undergoes {beta} decay and thereby populates excited states in the daughter. If these states are of energies comparable to or greater than the fission barrier of the daughter, then fission may compete with other decay modes of the excited states in the daughter. In this paper, mechanism and some experiments of the delayed fission will be discussed. (author)

  13. 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.

  14. 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.

  15. 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.

  16. High fidelity simulation based team training in urology: a preliminary interdisciplinary study of technical and nontechnical skills in laparoscopic complications management.

    Science.gov (United States)

    Lee, Jason Y; Mucksavage, Phillip; Canales, Cecilia; McDougall, Elspeth M; Lin, Sharon

    2012-04-01

    Simulation based team training provides an opportunity to develop interdisciplinary communication skills and address potential medical errors in a high fidelity, low stakes environment. We evaluated the implementation of a novel simulation based team training scenario and assessed the technical and nontechnical performance of urology and anesthesiology residents. Urology residents were randomly paired with anesthesiology residents to participate in a simulation based team training scenario involving the management of 2 scripted critical events during laparoscopic radical nephrectomy, including the vasovagal response to pneumoperitoneum and renal vein injury during hilar dissection. A novel kidney surgical model and a high fidelity mannequin simulator were used for the simulation. A debriefing session followed each simulation based team training scenario. Assessments of technical and nontechnical performance were made using task specific checklists and global rating scales. A total of 16 residents participated, of whom 94% rated the simulation based team training scenario as useful for communication skill training. Also, 88% of urology residents believed that the kidney surgical model was useful for technical skill training. Urology resident training level correlated with technical performance (p=0.004) and blood loss during renal vein injury management (p=0.022) but not with nontechnical performance. Anesthesia resident training level correlated with nontechnical performance (p=0.036). Urology residents consistently rated themselves higher on nontechnical performance than did faculty (p=0.033). Anesthesia residents did not differ in the self-assessment of nontechnical performance compared to faculty assessments. Residents rated the simulation based team training scenario as useful for interdisciplinary communication skill training. Urology resident training level correlated with technical performance but not with nontechnical performance. Urology residents

  17. '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...

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. [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.

  3. 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.

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

    Science.gov (United States)

    2017-03-01

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

  5. Urology on the internet - introduction and update

    Directory of Open Access Journals (Sweden)

    Inumpudi Anand

    2000-01-01

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

  6. Laser in urology. Laser i urologien

    Energy Technology Data Exchange (ETDEWEB)

    Breisland, H.O. (Aker Sykehus, Oslo (Norway))

    1991-09-01

    The neodymium YAG laser is particularly suited for endoscopic urologic surgery because the YAG laser light can be conducted in flexible fibers. Superficial bladder tumours can be treated under local anaesthesia in the outpatient department. The frequency of local recurrences is low, significantly lower than after electrosection or electrocoagulation. Selected cases of T2-muscle invasive bladder tumours can be cured with laser coagulation applied subsequently to transurethral resection. Combined treatment with electrosection and laser coagulation of localized prostatic cancer is a promising method which compares favourably with results obtained by other treatment modalities. Tumours in the upper urinary tract can be laser-treated through ureteroscopes or nephroscopes, but the treatment should be limited to low stage, low grade tumours. Laser is the treatment of choice for intraurethral condylomatas. Laser treatment of penil carcinoma gives excellent cosmetic and functional results and few local recurrences. Laser lithotripsy is a new technique for treatment of ureteric stones and photodynamic laser therapy is a promising tecnique for treatment of carcinoma in situ in the bladder empithelium. However, neither of these techniques are available for clinical use in Norway as yet. 17 refs., 3 figs., 1 tabs.

  7. 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.

  8. 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.

  9. [Changes to diagnosis-related groups in urology in 2007. Urology in the G-DRG-System 2007].

    Science.gov (United States)

    Wenke, A; Franz, D; Pühse, G; Hertle, L; Roeder, N

    2008-02-01

    The German DRG (dose-related groups) system is updated each year by the institution dealing with the remuneration in hospitals (InEK). Once again, the German Spcoety for Urology has supported the adjustment process in a constructive manner. Analysis of the changes and their implications is highly significant for urology. This article describes and discusses the main changes in the system for the specialty of urology insofar as they concern the structure of the DRG system and the catalogues of diagnoses (ICD) and of procedures (OPS). The 2007 edition of the DRG system leads to numerous changes for urology. There are new OPS codes for partial resection of the kidney, treatment of urinary incontinence and radical resection in the pelvis minor. Additional payment for implantation of a prosthetic penis is divided with reference to the type of prosthesis. At DRG level, new DRG splits are found depending on the PCCL and patient age. Combination operations on the bladder and bowel and on the male genitalia are assigned to newly established DRGs. The changes described enhance the professional accuracy of the representations of urological care provision. New strategies designed to solve problems in representation have been established (e.g. multi-step interventions). Various problems persist, e.g. those of operations on the penis (DRG M03Z) and the need for more finely defined representation of laser treatment in urology. In the short term practicable solutions to the problem of improving the quality of representation are needed.

  10. Exenatide Delays the Progression of Nonalcoholic Fatty Liver Disease in C57BL/6 Mice, Which May Involve Inhibition of the NLRP3 Inflammasome through the Mitophagy Pathway

    Directory of Open Access Journals (Sweden)

    Ning Shao

    2018-01-01

    Full Text Available Objective. This study is aimed at investigating whether exenatide (Exe delays the progression of nonalcoholic fatty liver disease (NAFLD in C57BL/6 mice by targeting the NLRP3 inflammasome through the autophagy/mitophagy pathway. Methods. Thirty male C57BL/6 mice were randomly divided into three groups: control group (n=10, model group (n=10, and Exe (exenatide group (n=10. Mouse models of NAFLD and diabetes were established using a high-fat diet and streptozocin. Results. The levels of fasting blood glucose (FBG, total cholesterol (TC, and triglyceride (TG in the serum were significantly reduced after Exe treatment. The body weight, liver weight/body weight, and number of lipid droplets in the liver significantly decreased in Exe-treated mice. Treatment with Exe markedly reduced the levels of liver lipids, malondialdehyde (MDA, and alanine aminotransferase (ALT in serum and livers. The number of autophagosomes increased significantly in the Exe group. The expression of LC3A/B-II/I, Beclin-1, Parkin, and BNIP3L increased significantly, whereas NLRP3 and IL-1β proteins were suppressed after Exe treatment. Conclusion. We successfully established a mouse model of NAFLD and diabetes. Exe may reduce oxidative stress injury and inhibit the NLRP3 inflammasome by enhancing the autophagy/mitophagy pathway in liver, which has a protective effect on the liver in NAFLD and diabetes in C57BL/6 mice.

  11. Patient engagement in the design and execution of urologic oncology research.

    Science.gov (United States)

    Lee, Daniel J; Avulova, Svetlana; Conwill, Ralph; Barocas, Daniel A

    2017-09-01

    There have been significant effort and financial support to engage patients in the design and execution of medical research. However, little is known about the relative benefits or potential impact of involving patients in research, most efficient practices and systems to enhance their involvement, and potential barriers and challenges that are involved with engaging patients. In this review, we will discuss the value of patient centered research, review the challenges that many of these studies faced, and highlight potential future opportunities to enhance patient involvement in urologic research. An English-language literature search was performed in the electronic databases of Medline (PubMed), EMBASE, Web of Science, Google Scholar, the Cochrane Library, and on the Patient Centered Outcomes Research Institute (PCORI) website. Search items included "patient-centered research," "patient-reported outcomes" and "patient engagement" in various combinations. Although PCORI has funded almost 600 projects with $1.6 billion to improve patient centered research, the search revealed 3 studies of patient engagement in the development, management, and execution of urologic oncology research. Patient engagement in the design and execution of medical research can help align research topics to match patient priorities, improve survey and data collection tools, increase patient recruitment and participation in studies, and improve accessibility and dissemination of clinically relevant results from medical research. However, engagement patients in research requires significant investment of time, financial support, and energy from the patients, stakeholders, and researchers to provide mutual benefit. In the three studies in urologic oncology that involved patients, the patients provided a significant impact on the structure of the studies and helped improve the ability of patients to apply the results from the research studies. The benefits to involving patients in research to

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

    Science.gov (United States)

    Buhr-Riehm, B; Lenz, T

    2015-07-01

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

  13. Erectile dysfunction: prevalence, risk factors and involvement of ...

    African Journals Online (AJOL)

    ISSN: 1596-5996 (print); 1596-9827 (electronic) ... Abstract. Purpose: To explore the literature regarding prevalance, risk factors and the involvement of ..... Cigarette smoking and other vascular risk factors in vasculogenic impotence. Urology.

  14. Consultation on urological specimens from referred cancer patients using real-time digital microscopy: Optimizing the workflow

    Directory of Open Access Journals (Sweden)

    Henrik Holten-Rossing

    2016-01-01

    Full Text Available Introduction: Centralization of cancer treatment entails a reassessment of the diagnostic tissue specimens. Packaging and shipment of glass slides from the local to the central pathology unit means that the standard procedure is time-consuming and that it is difficult to comply with governmental 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 patients with urological cancer received at Næstved Hospital′s Pathology Department, and expected to be referred for further treatment at cancer unit of a university hospital, were diagnosed using standard light microscopy. In the event of diagnostic uncertainty, the VisionTek digital microscope (Sakura 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 digital consultation took place over the telephone using remote access software. Time of start and finish for each case was logged. For the physically referred cases, time from arrival to sign-out was logged in the national pathology information system, and time spent on microscopy and reporting was noted manually. Diagnosis, number of involved biopsies, grade, and stage were compared between digital microscopy and conventional microscopy. Results: Complete data were available for all 130 cases. Standard procedure with referral of urological cancer specimens took a mean of 8 min 56 s for microscopy, reporting and sign-out per case. For live digital consultations, a mean of 18 min 37 s was spent on each consultation with 4 min 43 s for each case

  15. 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

    Directory of Open Access Journals (Sweden)

    Torriceli Souza The

    2013-09-01

    Full Text Available 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.

  16. How do urology residents manage personal finances?

    Science.gov (United States)

    Teichman, J M; Bernheim, B D; Espinosa, E A; Cecconi, P P; Meyer, J; Pearle, M S; Preminger, G M; Leveillee, R J

    2001-05-01

    To examine personal financial management among residents to answer three research questions: do residents make reasonable financial choices; why do some residents not save; and what steps can be taken to improve residents' personal financial decisions. Portions of the Federal Reserve Board's Survey of Consumer Finances were modified and piloted to elicit demographic, expense, saving, and income data. The final questionnaire was completed by 151 urology residents at 20 programs. Comparing residents with the general population in the same age and income categories, the median debt/household income ratio was 2.38 versus 0.64. Residents had greater educational debt, greater noneducational debt, and lower savings. Resident participation in retirement accounts was 100% at institutions with employer-matching 401k or 403b plans, 63% at institutions with nonmatching 401k or 403b plans, and 48% at institutions without retirement plans for residents (P = 0.002). Fifty-nine percent of residents budgeted expenses, 27% had cash balances below $1000, 51% had paid interest charges on credit cards within the previous year, and 12% maintained unpaid credit card balances greater than $10,000. The median resident income was $38,400. A significant minority of residents appear not to make reasonable financial choices. Some residents save little because of a failure to budget, indebtedness, high projected income growth, or insufficient attention to personal financial management. Residents save more when they are eligible for tax-deferred retirement plans, particularly when their institution matches their contributions. Many residents would benefit from instruction concerning prudent financial management.

  17. 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.

  18. 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.

  19. The Target of 5-Lipoxygenase is a Novel Strategy over Human Urological Tumors than the Target of Cyclooxygenase-2

    Directory of Open Access Journals (Sweden)

    Masahide Matsuyama

    2008-01-01

    Full Text Available The metabolism of arachidonic acid by either the cyclooxygenase (COX or lipoxygenase (LOX pathway generates eicosanoids, which have been implicated in the pathogenesis of a variety of human diseases, including cancer. It is now considered that they play important roles in tumor promotion, progression, and metastasis, also, the involvement of COX and LOX expression and function in tumor growth and metastasis has been reported in human tumor cell lines. In this study, we examined the expression of COX and LOX in human urological tumors (renal cell carcinoma, bladder tumor, prostate cancer, testicular cancer by immunohistochemistry and RT-PCR, and we also examined the effects of COX and LOX (5- and 12-LOX inhibitors in those cells by MTT assay, hoechest staining, and flow cytometry. COX-2, 5-LOX and 12-LOX expressions were significantly more extensive and intense in malignant tissues than in normal tissues. Furthermore, 5-LOX inhibitor induced the reduction of malignant cell viability through early apoptosis. These results demonstrated COX-2 and LOX were induced in urological tumors, and 5-LOX inhibitor may mediate potent antiproliferative effects against urological tumors cells. Thus, 5-LOX may become a new target in the treatment of urological tumors.

  20. Delayed Ejaculation

    Science.gov (United States)

    ... cases, it is due to a combination of physical and psychological concerns. Psychological causes of delayed ejaculation include: Depression, anxiety or other mental health conditions Relationship problems due to stress, poor communication ...

  1. Delayed growth

    Science.gov (United States)

    ... Slow rate of growth; Retarded growth and development; Growth delay Images Toddler development References Cooke DW, Divall SA, Radovick S. Normal and aberrant growth in children. In: Melmed S, Polonsky KS, Larsen PR, ...

  2. 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.

  3. 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.

  4. 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

  5. Future of robotic surgery in urology.

    Science.gov (United States)

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

    2017-12-01

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

  6. 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.

  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. Array based characterization of a terminal deletion involving chromosome subband 15q26.2: an emerging syndrome associated with growth retardation, cardiac defects and developmental delay

    Directory of Open Access Journals (Sweden)

    Björkhem Gudrun

    2008-01-01

    Full Text Available Abstract Background Subtelomeric regions are gene rich and deletions in these chromosomal segments have been demonstrated to account for approximately 2.5% of patients displaying mental retardation with or without association of dysmorphic features. However, cases that report de novo terminal deletions on chromosome arm 15q are rare. Methods In this study we present the first example of a detailed molecular genetic mapping of a de novo deletion in involving 15q26.2-qter, caused by the formation of a dicentric chromosome 15, using metaphase FISH and tiling resolution (32 k genome-wide array-based comparative genomic hybridization (CGH. Results After an initial characterization of the dicentric chromosome by metaphase FISH, array CGH analysis mapped the terminal deletion to encompass a 6.48 megabase (Mb region, ranging from 93.86–100.34 Mb on chromosome 15. Conclusion In conclusion, we present an additional case to the growing family of reported cases with 15q26-deletion, thoroughly characterized at the molecular cytogenetic level. In the deleted regions, four candidate genes responsible for the phenotype of the patient could be delineated: IGFR1, MEF2A, CHSY1, and TM2D3. Further characterization of additional patients harboring similar 15q-aberrations might hopefully in the future lead to the description of a clear cut clinically recognizable syndrome.

  9. 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

  10. 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.

  11. Procedure competencies and job functions of the urologic advanced practice nurse.

    Science.gov (United States)

    Kleier, Jo Ann

    2009-01-01

    A 2-round modified Delphi study recruited a panel urologic advanced practice nurse experts to identify the procedure competencies and job functions unique to the role of the advanced practice nurse specializing in the care of urology patients.

  12. 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

  13. 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

  14. 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

  15. Developmental delay

    Science.gov (United States)

    Nutrition support is essential for the care of the child with developmental delay. After a thorough evaluation, an individualized intervention plan that accounts for the child’s nutrition status, feeding ability, and medical condition may be determined. Nutrition assessments may be performed at leas...

  16. 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.

  17. [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.

  18. 21 CFR 876.4730 - Manual gastroenterology-urology surgical instrument and accessories.

    Science.gov (United States)

    2010-04-01

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

  19. 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 ...

  20. 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.

  1. 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 ...

  2. 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: ...

  3. Enhanced Recovery After Surgery Protocols in Major Urologic Surgery

    Directory of Open Access Journals (Sweden)

    Natalija Vukovic

    2018-04-01

    Full Text Available The purpose of the reviewThe analysis of the components of enhanced recovery after surgery (ERAS protocols in urologic surgery.Recent findingsERAS protocols has been studied for over 20 years in different surgical procedures, mostly in colorectal surgery. The concept of improving patient care and reducing postoperative complications was also applied to major urologic surgery and especially procedure of radical cystectomy. This procedure is technically challenging, due to a major surgical resection and high postoperative complication rate that may reach 65%. Several clinical pathways were introduced to improve perioperative course and reduce the length of hospital stay. These protocols differ from ERAS modalities in other surgeries. The reasons for this are longer operative time, increased risk of perioperative transfusion and infection, and urinary diversion achieved using transposed intestinal segments. Previous studies in this area analyzed the need for mechanical bowel preparation, postoperative nasogastric tube decompression, as well as the duration of urinary drainage. Furthermore, the attention has also been drawn to perioperative fluid optimization, pain management, and bowel function.SummaryNotwithstanding partial resemblance between the pathways in major urologic surgery and other pelvic surgeries, there are still scarce guidelines for ERAS protocols in urology, which is why further studies should assess the importance of preoperative medical optimization, implementation of thoracic epidural anesthesia and analgesia, and perioperative nutritional management.

  4. Urologic daycase surgery: A five year experience | Ikuerowo ...

    African Journals Online (AJOL)

    Background: Expectedly, daycase surgery (DCS) is today witnessing a boom in developing countries as a reasonable option in the face of global economic recession, although with limited scope. Aim: The aim of this study was to describe the urologic day surgery experience at the Lagos State University Teaching Hospital, ...

  5. 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.

  6. Exciting times: Towards a totally minimally invasive paediatric urology service

    OpenAIRE

    Lazarus, John

    2011-01-01

    Following on from the first paediatric laparoscopic nephrectomy in 1992, the growth of minimally invasive ablative and reconstructive procedures in paediatric urology has been dramatic. This article reviews the literature related to laparoscopic dismembered pyeloplasty, optimising posterior urethral valve ablation and intravesical laparoscopic ureteric reimplantation.

  7. 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 ...

  8. 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 ...

  9. 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.

  10. 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.

  11. Health Policy 2016 – Implications for Geriatric Urology

    Science.gov (United States)

    Suskind, Anne M.; Clemens, J. Quentin

    2016-01-01

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

  12. 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.

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

    Science.gov (United States)

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

    2013-12-01

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

  14. Future robotic platforms in urologic surgery: Recent Developments

    Science.gov (United States)

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

    2014-01-01

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

  15. Urologic diseases in America Project: analytical methods and principal findings.

    Science.gov (United States)

    Litwin, Mark S; Saigal, Christopher S; Yano, Elizabeth M; Avila, Chantal; Geschwind, Sandy A; Hanley, Jan M; Joyce, Geoffrey F; Madison, Rodger; Pace, Jennifer; Polich, Suzanne M; Wang, Mingming

    2005-03-01

    The burden of urological diseases on the American public is immense in human and financial terms but it has been under studied. We undertook a project, Urologic Diseases in America, to quantify the burden of urological diseases on the American public. We identified public and private data sources that contain population based data on resource utilization by patients with benign and malignant urological conditions. Sources included the Centers for Medicare and Medicaid Services, National Center for Health Statistics, Medical Expenditure Panel Survey, National Health and Nutrition Examination Survey, Department of Veterans Affairs, National Association of Children's Hospitals and Related Institutions, and private data sets maintained by MarketScan Health and Productivity Management (MarketScan, Chichester, United Kingdom), Ingenix (Ingenix, Salt Lake City, Utah) and Center for Health Care Policy and Evaluation. Using diagnosis and procedure codes we described trends in the utilization of urological services. In 2000 urinary tract infections accounted for more than 6.8 million office visits and 1.3 million emergency room visits, and 245,000 hospitalizations in women with an annual cost of more than 2.4 billion dollars. Urinary tract infections accounted for more than 1.4 million office visits, 424,000 emergency room visits and 121,000 hospitalizations in men with an annual cost of more than 1 billion dollars. Benign prostatic hyperplasia was the primary diagnosis in more than 4.4 million office visits, 117,000 emergency room visits and 105,000 hospitalizations, accounting for 1.1 billion dollars in expenditures that year. Urolithiasis was the primary diagnosis for almost 2 million office visits, more than 600,000 emergency room visits, and more than 177,000 hospitalizations, totaling more than 2 billion dollars in annual expenditures. Urinary incontinence in women was the primary cause for more than 1.1 million office visits in 2000 and 452 million dollars in

  16. 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.

  17. 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.

  18. 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

  19. Delayed Puberty

    DEFF Research Database (Denmark)

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

    2017-01-01

    . The underlying reasons for the large variation in the age at pubertal onset are not fully established; however, nutritional status and socioeconomic and environmental factors are known to be influencing, and a significant amount of influencing genetic factors have also been identified. The challenges...... optimal in discriminating especially CDGP from HH. Management of the delayed puberty depends on the etiology. For boys with CDGP an observational period will often reveal imminent puberty. If puberty is not progressing spontaneously, sex steroid replacement is effective in stimulating the development...

  20. 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.

  1. 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.

  2. Benefits and Harms of Treatment of Asymptomatic Bacteriuria: A Systematic Review and Meta-analysis by the European Association of Urology Urological Infection Guidelines Panel.

    Science.gov (United States)

    Köves, Bela; Cai, Tommaso; Veeratterapillay, Rajan; Pickard, Robert; Seisen, Thomas; Lam, Thomas B; Yuan, Cathy Yuhong; Bruyere, Franck; Wagenlehner, Florian; Bartoletti, Riccardo; Geerlings, Suzanne E; Pilatz, Adrian; Pradere, Benjamin; Hofmann, Fabian; Bonkat, Gernot; Wullt, Björn

    2017-12-01

    People with asymptomatic bacteriuria (ABU) are often unnecessarily treated with antibiotics risking adverse effects and antimicrobial resistance. We performed a systematic review to determine any benefits and harms of treating ABU in particular patient groups. Relevant databases were searched and eligible trials were assessed for risk-of-bias and Grading of Recommendations, Assessment, Development and Education quality. Where possible, a meta-analysis of extracted data was performed or a narrative synthesis of the evidence was presented. After screening 3626 articles, 50 studies involving 7088 patients were included. Overall, quality of evidence ranged from very low to low. There was no evidence of benefit for patients with no risk factors, patients with diabetes mellitus, postmenopausal women, elderly institutionalised patients, patients with renal transplants, or patients prior to joint replacement, and treatment was harmful for patients with recurrent urinary tract infection (UTI). Treatment of ABU resulted in a lower risk of postoperative UTI after transurethral resection surgery. In pregnant women, we found evidence that treatment of ABU decreased risk of symptomatic UTI, low birthweight, and preterm delivery. ABU should be treated prior to transurethral resection surgery. In addition, current evidence also suggests that ABU treatment is required in pregnant women, although the results of a recent trial have challenged this view. We reviewed available scientific studies to see if people with bacteria in their urine but without symptoms of urinary tract infection should be treated with antibiotics to eliminate bacteria. For most people, treatment was not beneficial and may be harmful. Antibiotic treatment did appear to benefit women in pregnancy and those about to undergo urological surgery. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2016-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Alaric Hamacher

    2016-09-01

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

  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. Implementing assessments of robot-assisted technical skill in urological education: a systematic review and synthesis of the validity evidence.

    Science.gov (United States)

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

    2018-03-31

    To systematically review and synthesise the validity evidence supporting intraoperative and simulation-based assessments of technical skill in urological robot-assisted surgery (RAS), and make evidence-based recommendations for the implementation of these assessments in urological 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 RAS 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. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

  7. 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

  8. The dramatic increase in social media in urology.

    Science.gov (United States)

    Matta, Rano; Doiron, Chris; Leveridge, Michael J

    2014-08-01

    Social media are established tools for rapid information dissemination to a broad audience. A major use has been the compilation of conference specific messaging known as tweets via preselected hashtags on Twitter. We analyzed Twitter use between consecutive years at the AUA (American Urological Association) and CUA (Canadian Urological Association) annual meetings. Publicly available tweets containing the established meeting hashtags were abstracted from an online archive. Tweets were categorized by author type and by content as informative (based on research presented at the conference) or uninformative (unrelated to presented data) according to an established classification scheme. We analyzed 5,402 tweets during the combined 18 meeting days, of which 4,098 were original and 1,304 were rebroadcast prior tweets. There was a large increase in Twitter use at the 2013 annual meetings compared to the 2012 meetings (4,591 tweets from a total of 540 accounts vs 811 from 134). Biotechnology analysts represented the highest volume of tweets (226 or 28%) in 2012 but in 2013 this majority shifted to urologists (2,765 or 60%). Of the tweets 29% were categorized as informative in 2012, which increased to 41% at the 2013 meetings. Twitter has emerged as a significant communication platform at urological meetings. Use increased dramatically between 2012 and 2013. Urologists have increasingly led this discussion with an increased focus on data arising from meeting proceedings. This adjunct to traditional meeting activity merits the attention of urologists and the professional associations that host such meetings. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  9. Endovascular control of haemorrhagic urological emergencies: an observational study

    Directory of Open Access Journals (Sweden)

    Thorpe Peter

    2006-09-01

    Full Text Available Abstract Background Transarterial embolisation (TAE is an effective method in control of haemorrhage irrespective of the nature of urological emergency. As the technique and technology have evolved, it is now possible to perform highly selective embolisation. The aim of this study was to critically appraise feasibility and efficacy of therapeutic TAE in control of haemorrhagic urological emergencies using selective and non-selective embolisation. Specifically, we aimed to assess the impact of timing of embolisation on the requirement of blood transfusion and long-term morphological and functional follow-up of embolised organs. Methods This is a single institutional observational study carried out between March 1992 and March 2006. Records of all patients who underwent selective and non-selective angioembolisation to control bleeding in urological emergencies were reviewed. Data on success rate, periprocedural complications, timing of embolisation, requirement of blood transfusion and the long-term morphological and functional outcomes of embolised organs was recorded. Results Fourteen patients underwent endovascular control of bleeding as a result of trauma, iatrogenic injury and spontaneous perinephric haemorrhage during a period of 14 years. All these patients would have required emergency open surgery without the option of embolisation procedure. The mean time between the first presentation and embolisation was 22 hours (range 30 minutes to 60 hours. Mean pre-embolisation transfusion requirement was 6.8 units (range 0–22 units. None of the patients with successful embolisation required post-procedural blood transfusion. Permanent haemostasis was achieved in all but one patient, who required emergency nephrectomy. There were no serious procedure related post-embolisation complications. Conclusion Endovascular control using transarterial angioembolisation is an effective method for managing haematuria or haemorrhage in urological emergencies

  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. Men’s mental health: Connection to urologic health

    OpenAIRE

    Matthew, Andrew; Elterman, Dean

    2014-01-01

    Historically, the specialty of urology has focused on single-system diseases. In recent years, however, there has been increasing recognition of the interconnectivity between the various systems, such as cardiovascular disease, metabolic syndrome, erectile dysfunction and prostate cancer. This constellation of disease/syndrome and dysfunction may place urologists at the centre of men’s overall health concerns. As urologists considering taking on a leadership role in men’s health, they should ...

  13. 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.

  14. [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.

  15. 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.

  16. Training, Simulation, the Learning Curve, and How to Reduce Complications in Urology.

    Science.gov (United States)

    Brunckhorst, Oliver; Volpe, Alessandro; van der Poel, Henk; Mottrie, Alexander; Ahmed, Kamran

    2016-04-01

    Urology is at the forefront of minimally invasive surgery to a great extent. These procedures produce additional learning challenges and possess a steep initial learning curve. Training and assessment methods in surgical specialties such as urology are known to lack clear structure and often rely on differing operative flow experienced by individuals and institutions. This article aims to assess current urology training modalities, to identify the role of simulation within urology, to define and identify the learning curves for various urologic procedures, and to discuss ways to decrease complications in the context of training. A narrative review of the literature was conducted through December 2015 using the PubMed/Medline, Embase, and Cochrane Library databases. Evidence of the validity of training methods in urology includes observation of a procedure, mentorship and fellowship, e-learning, and simulation-based training. Learning curves for various urologic procedures have been recommended based on the available literature. The importance of structured training pathways is highlighted, with integration of modular training to ensure patient safety. Valid training pathways are available in urology. The aim in urology training should be to combine all of the available evidence to produce procedure-specific curricula that utilise the vast array of training methods available to ensure that we continue to improve patient outcomes and reduce complications. The current evidence for different training methods available in urology, including simulation-based training, was reviewed, and the learning curves for various urologic procedures were critically analysed. Based on the evidence, future pathways for urology curricula have been suggested to ensure that patient safety is improved. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  17. Urologic evaluation of urinary tract infection in pregnancy.

    Science.gov (United States)

    Diokno, A C; Compton, A; Seski, J; Vinson, R

    1986-01-01

    Thirty-three antepartum patients with urinary tract infections underwent urologic evaluation as soon as the infection had been successfully treated. The evaluation included history of voiding habits, cystometry, urethral calibration and cystourethroscopy. A second phase of the urologic evaluation included an excretory urogram and repeat cystometry 10-12 weeks postpartum. Sixty percent had a history of infrequent voiding, and 90% of them had a bladder capacity greater than 450 mL. Forty-one percent of the patients had a normal bladder capacity (less than 450 mL), and 85% of this group did not have any history of infrequent voiding. The radiographic evaluation postpartum in 18 of 33 patients revealed major abnormalities in 50%. These abnormalities were seen as often and were as significant in women with asymptomatic bacteriuria as in those who presented with acute pyelonephritis. The results suggest that the large bladder seen in pregnant women may be secondary to the chronic, unphysiologic habit of infrequent voiding. Furthermore, this study reinforced the fact that most pregnant women with urinary tract infection have preexisting chronic bladder or renal abnormalities that predispose them to infection. Those at risk should be identified early through a careful history and urinalysis to determine which ones need urinary prophylaxis during pregnancy. Postpartum urologic investigation should be carried out to identify any structural or functional problems; understanding them is helpful in present and future management.

  18. [Practice marketing. Data analysis of a urological group practice].

    Science.gov (United States)

    Schneider, T; Schneider, B; Eisenhardt, A; Sperling, H

    2009-07-01

    The urological practice setting in Germany has changed tremendously over the last years. Group practices with two or more urologists working together are becoming more and more popular. At the same time, marketing has become essential even for urologists. To evaluate the patient flow to our group practice, we asked all new patients to fill out a questionnaire (n=2112). We also evaluated the efficacy of our recall system. The analysis showed that patients were 18-93 years old (mean 57 years), 68% being male and 32% female. The largest age group consisted of 41-50-year-olds. The most important reasons for choosing our practice were recommendations by general practitioners in 38%, recommendations by specialists in 11%, and recommendations by friends and relatives in 27%. Five percent of the patients chose the practice because of the Internet home page and 10% because of entries in various phone books. Three percent of the patients came because of newspaper articles about the practice owners, and advertising for a urological practice. Phone books are increasingly becoming less important, and the Internet is increasingly attractive to the younger population. Recall systems can also be useful for urological practices.

  19. [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.

  20. 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.

  1. 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)

  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. [Motivation and satisfaction of residents in urology].

    Science.gov (United States)

    Enzmann, T; Buxel, H; Benzing, F

    2010-08-01

    To address the increasing shortage of qualified residents, which leads to further discontent and additional on-call rotations for the remaining physicians, an analysis of the current situation was performed. Stress in the daily working routine, not enough free time, too little pay, or too little compensatory time off for overtime as well as inadequate options for continuing education were reported to be the main elements of dissatisfaction. The economic pressure of day-to-day work continues to define the physician's role and places demands on the medical staff by burdening them with nonmedical and administrative tasks.The major causes mentioned were staff shortage and lack of support provided by supervisors and the administration. For this reason, human resource development should be considered a strategic and central goal. This requires a normative, cross-functional approach at all levels of management and inclusion of personnel departments in the strategic processes of the hospital. The most important aspects for resident satisfaction were the work environment, acceptable work-life balance and remuneration, compensation for overtime, and quality of available continuing education, which is often rated as being insufficient.Effective strategies to improve the motivation of residents comprise offering opportunities for structured continuing education, optimizing the everyday work processes, and involving employees in social networks. The establishment of feedback strategies, including recognition of residents' achievements, will help to ensure their loyalty and identification with their clinic. This can serve as a preventive measure to offset any potential willingness to change jobs.

  4. [How do residents in urology evaluate their daily routine at work-a survey analysis].

    Science.gov (United States)

    Necknig, U; Borowitz, R; Wöhr, M; Leyh, H; Weckermann, D

    2018-05-28

    The changing conditions in German hospitals is causing a shortage of young people. In order to identify starting point for improvements, the Bavarian association of urologists in collaboration with the German Society of Residents in Urology (GeSRU) conducted an online survey among residents in urology in summer of 2017. A standardised survey composed of 38 questions was distributed to participants through a mailing list of the GeSRU. Most questions were closed-ended; however, some did allow participants to respond by means of an open-ended answer. A total of 218 participants provided a total of 11,764 responses: 58% were female and 42% were male. Over 70% were aged between 31 and 35 years. In all, 29% of participants responded negatively to the question asking whether they feel like their medical studies at university prepared them well for the daily routine in their workplace. Participants particularly demanded a higher degree of practical experience during their studies, as well as more teaching of soft skills. In relation to choosing their specialisation, participants considered the intern year and their clinical traineeships as crucial factors. Participants did express appreciation of their field of specialization in relation to the broad range of available treatments, the opportunity of further specialising, the clientele of patients, the opportunity of working in a small team, innovations, and the high possibilities of opening their own medical practice. On a personal level, participants specifically wished for a more structured plan relating to their further internship, involving regular meetings. They also expressed the wish for more personalised career plans, more flexible work hours, and improved advanced training, both internally and externally. With the aim of making urology even more attractive, participants' wishes and suggestions should be taken into consideration. These, in general, involve a more structured training plan, better working

  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. 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.

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

    Science.gov (United States)

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

    2017-06-01

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

  8. 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)

  9. 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

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

    Science.gov (United States)

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

    2010-06-01

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

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Delayed puberty in girls

    Science.gov (United States)

    ... sexual development - girls; Pubertal delay - girls; Constitutional delayed puberty ... In most cases of delayed puberty, growth changes just begin later than usual, sometimes called a late bloomer. Once puberty begins, it progresses normally. This pattern runs ...

  18. Delayed Puberty (For Teens)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Delayed Puberty KidsHealth / For Teens / Delayed Puberty What's in this ... wonder if there's anything wrong. What Is Delayed Puberty? Puberty is the time when your body grows ...

  19. Evaluation of Laparoscopic Curricula in American Urology Residency Training: A 5-Year Update.

    Science.gov (United States)

    Clements, Matthew B; Morrison, Kasey Y; Schenkman, Noah S

    2016-03-01

    Medical simulation offers the advantage of improving resident skill and comfort without impacting patient care. Five years ago, we identified trends in the use of robotic and laparoscopic simulation in 2008 and 2009 at American urology residency training programs. We seek to identify the changes in the use of simulators and the presence of formal curricula in the wake of technological advances and changes in graduate medical education. Attendees of the American Urological Association (AUA) Basic Sciences Course, mostly in their second or third year of residency, were surveyed on the availability and use of laparoscopic/robotic simulators at their program, the presence of a formal curriculum, and a Likert scale questionnaire regarding face and content validity. Over a 5-year period, the availability of virtual reality robotic simulators substantially increased from 14% to nearly 60% availability in 2013. Despite this increase, the frequency of simulator use remained unchanged (p = 0.40) and the reported presence of formal curricula decreased from 41% to 34.8%. There was no significant difference in simulator use between residents in programs with or without laparoscopic/robotic curricula (p = 0.95). There was also a decrease in the percentage of residents who felt official laparoscopic curricula (93%-81%) and simulators (82%-74%) should be involved in resident education. In the past 5 years, despite evidence supporting benefits from simulator use and increasing availability, self-reported resident use has remained unchanged and the reporting of presence of laparoscopic/robotic curricula has decreased. With more dedicated investment in formal curricula, residency training programs may receive greater returns on their simulator investments, improve resident skills and comfort, and ultimately improve the quality of patient care.

  20. Crowd-sourced assessment of technical skills: an adjunct to urology resident surgical simulation training.

    Science.gov (United States)

    Holst, Daniel; Kowalewski, Timothy M; White, Lee W; Brand, Timothy C; Harper, Jonathan D; Sorenson, Mathew D; Kirsch, Sarah; Lendvay, Thomas S

    2015-05-01

    Crowdsourcing is the practice of obtaining services from a large group of people, typically an online community. Validated methods of evaluating surgical video are time-intensive, expensive, and involve participation of multiple expert surgeons. We sought to obtain valid performance scores of urologic trainees and faculty on a dry-laboratory robotic surgery task module by using crowdsourcing through a web-based grading tool called Crowd Sourced Assessment of Technical Skill (CSATS). IRB approval was granted to test the technical skills grading accuracy of Amazon.com Mechanical Turk™ crowd-workers compared to three expert faculty surgeon graders. The two groups assessed dry-laboratory robotic surgical suturing performances of three urology residents (PGY-2, -4, -5) and two faculty using three performance domains from the validated Global Evaluative Assessment of Robotic Skills assessment tool. After an average of 2 hours 50 minutes, each of the five videos received 50 crowd-worker assessments. The inter-rater reliability (IRR) between the surgeons and crowd was 0.91 using Cronbach's alpha statistic (confidence intervals=0.20-0.92), indicating an agreement level between the two groups of "excellent." The crowds were able to discriminate the surgical level, and both the crowds and the expert faculty surgeon graders scored one senior trainee's performance above a faculty's performance. Surgery-naive crowd-workers can rapidly assess varying levels of surgical skill accurately relative to a panel of faculty raters. The crowds provided rapid feedback and were inexpensive. CSATS may be a valuable adjunct to surgical simulation training as requirements for more granular and iterative performance tracking of trainees become mandated and commonplace.

  1. Urological complications of uterine leiomyoma: a review of literature.

    Science.gov (United States)

    Dagur, Gautam; Suh, Yiji; Warren, Kelly; Singh, Navjot; Fitzgerald, John; Khan, Sardar A

    2016-06-01

    Uterine leiomyomas are common gynecologic tumor in reproductive-aged women, by age 50, diagnosis shared by urologist, gynecologists and radiologists. The goal of this article is to review the current literature, study the impact of leiomyoma on female lower urinary tract, examine the cause female sexual dysfunction and provide a comprehensive review of current diagnostic, imaging studies, and current treatment of leiomyoma. Clinical leiomyoma studies published from 1956 through 2015 were identified using the PubMed search engines and the key words leiomyoma, fibroid in the current literature. Impact of leiomyoma on the lower urinary tract including female sexual dysfunction was reviewed with terms of "urinary retention", "bladder", "urethra", "dyspareunia", "incontinence", "incomplete bladder emptying", "female sexual dysfunction", and "lower urinary tract" to study the urological and sexual effects of leiomyoma. Literature related to leiomyoma was reviewed from 1965 to present. Women with uterine leiomyomata complained of pelvic pain, menstrual irregularities, infertility, lower urinary tract symptoms and sexual dysfunction. Leiomyoma is a common tumor of the uterus that often clinically impacts on the lower urinary tract and results in urological and sexual symptoms. Leiomyoma can compress and grow into and become adherent to the bladder and surrounding pelvic organs or metastasize into peritoneal organs. Leiomyoma can enlarge and compress the urinary bladder, urethra, and lower end of the ureters. Leiomyoma can cause embarrassing sexual dysfunction in females. Current literature of non-surgical and surgical therapy of leiomyoma is described.

  2. 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.

  3. 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.

  4. 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)

  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. Radiation burden to personal during surgical and urological reentgenology

    Energy Technology Data Exchange (ETDEWEB)

    Doubravsky, J; Kukacka, R

    1976-01-01

    The radiation load was measured in surgical personnel during operation of femoral neck fracture and during instrumental urological roentgenology, using film dosimetry. Here are the conclusions: (1) It is obligatory for medical personnel to use protective lead-rubber aprons during surgical and urological roentgenology. At surgical examinations, where the surgeon stands at the operating table, a short apron, covering the lower half of the body, may suffice. (2) Skiascopy, being the chief source of radiation load, should be reduced to the shortest possible time. (3) When handling the patient or film holder, protective gloves should be worn and the primary radiation beam avoided. (4) Clinical workers should be repeatedly instructed, both in theory and practice, how to work with X radiation sources. (5) In larger clinics with intensive roentgenological services the workers should be rotated; nurses should not be in the reproductive age. For newly established uro-roentgenological examination rooms the regional hygiene officer may issue regulations limiting the number of examinations per day and per person. (6) Non-roentgenologists participating in roentgenological examinations should be provided with dosimeters and included in compulsory preventive periodical examinations in accordance with the regulation ''Mandatory Measures No. 49/1967, Directives Concerning Medical Fitness for Work''.

  7. Ergonomics perspective for identifying and reducing internal operative flow disruption for laparoscopic urological surgery.

    Science.gov (United States)

    Al-Hakim, Latif; Xiao, Jiaquan; Sengupta, Shomik

    2017-12-01

    The aim of this study is to examine operative flow disruption that occurs inside the surgical field, (internal operative flow disruption (OFD)), during urological laparoscopies, and to relate those events to external ergonomics environment in terms of monitor location, level of instruments' handles, and location of surgical team members. According to the our best knowledge, this is the first study of its kind. A combination of real and video-aided observational study was conducted in the operating rooms at hospitals in Australia and China. Brain storming sessions were first conducted to identify the main internal OFD events, and the observable reasons, potential external, and latent ergonomic factors were listed. A prospective observational study was then conducted. The observer's records and the related video records of internal surgical fields were analysed. Procedures were categorised into groups based on similarity in ergonomics environment. The mapping process revealed 39 types of internal OFD events resulted from six reasons. A total of 24 procedures were selected and arranged into two groups, each with twelve procedures. Group A was carried out under satisfactory ergonomics environment, while Group B was conducted under unsatisfactory ergonomics environment. A total of 1178 OFD events were detected delaying the total observed operative times (2966 min) by 220 min (7.43%). Average OFD/h in group A was less than 15, while in group B about 29 OFD/h. There are two main latent ergonomics factors affecting the surgeon's performance; non-physiological posture and long-period static posture. The delays and number of internal OFD were nearly doubled where procedures were conducted under unsatisfactory external ergonomics environment. Some events such as stopping operation and irrelevant conversations during long procedures may have a positive influence on the surgeon's performance.

  8. 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.

  9. 77 FR 18829 - Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2012-03-28

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0001] Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting AGENCY... public. Name of Committee: Gastroenterology and Urology Devices Panel of the Medical Devices Advisory...

  10. 76 FR 71983 - Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2011-11-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting AGENCY... public. Name of Committee: Gastroenterology and Urology Devices Panel of the Medical Devices Advisory...

  11. 75 FR 57968 - Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2010-09-23

    ...] Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting AGENCY... public. Name of Committee: Gastroenterology and Urology Devices Panel of the Medical Devices Advisory... committee will discuss, make recommendations, and vote on information related to the PMA for the LAP-BAND...

  12. A subtype based analysis of urological chronic pelvic pain syndrome in men.

    Science.gov (United States)

    Davis, Seth N P; Binik, Yitzchak M; Amsel, Rhonda; Carrier, Serge

    2013-07-01

    The current conceptualization of urological chronic pelvic pain syndrome in men recognizes a wide variety of pain, psychosocial, sexual and urological symptoms and markers that may contribute to decreased quality of life. Unfortunately, this syndrome is difficult to clearly define and treat due to heterogeneous symptom profiles. We systematically describe these heterogeneous symptoms and investigated whether they could be subtyped into distinct syndromes. A total of 171 men diagnosed with urological chronic pelvic pain syndrome completed validated questionnaires, a structured genital pain interview, digital pain threshold testing and urological assessment. Pain interview results are systematically presented as descriptive information. We used k-means cluster analysis to define subtypes. Seven homogenous, distinct clusters were defined, each with a remarkably different symptom presentation. These clusters were described and related to previous hypotheses of urological chronic pelvic pain syndrome etiology. These clusters may represent distinct subtypes of urological chronic pelvic pain syndrome that can be used to guide treatment more effectively. Defining subtypes may also improve our understanding of the underlying mechanisms of urological chronic pelvic pain syndrome. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  13. Retrospective evaluation of urological admissions to emergency service of a training and research hospital.

    Science.gov (United States)

    Topaktaş, Ramazan; Altın, Selçuk; Aydın, Cemil; Akkoç, Ali; Yılmaz, Yakup

    2014-12-01

    Many patients consult emergency services with urological complaints. The aim of this study was to investigate the epidemiology, clinical presentation and treatments of urological emergency cases in a training and research hospital. We retrospectively evaluated urological emergency patients referred to the emergency unit between July 2012 and July 2013 according to age, gender, affected organ, radiological imaging techniques and treatment. Among 141.844 emergency cases, 3.113 (2.19%) were urological emergencies and 53.2% of the patients were male (mean age: 49.1), and 46.8% of them were female (median age: 42.8). The most frequent illness was genitourinary infection constituting 41.2% of the cases followed by renal colic (36.9%). Among the urological emergencies 483 (15.5%) patients were hospitalized and 152 surgical operations were performed. The mostly performed procedure was the placement of a suprapubic catheter in 34 patients constituting (22.3%) of the cases. Totally eight patients were referred to another experienced health center due to different reasons. Most of the urological emergency patients do not require emergency surgical interventions however, timely identification and management of urological emergencies with in-depth clinical evaluation are important to prevent late complications. Therefore the doctors working in emergency services must be heedful of urological emergencies.

  14. Nocturia: A non-specific but important symptom of urological disease

    NARCIS (Netherlands)

    Schneider, Tim; de la Rosette, Jean Jmch; Michel, Martin C.

    2009-01-01

    Nocturia is a prevalent symptom that can adversely affect quality of sleep and overall quality of life leading to morbidity and even mortality. Nocturia can be due to a range of urological conditions and non-urological diseases. Nocturia can be due to an insufficient bladder capacity and/or

  15. 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.

  16. 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.

  17. 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.

  18. The value of a core clinical rotation in urology for medical students.

    Science.gov (United States)

    Patel, Premal; Nayak, Jasmir G; McGregor, Thomas B

    2015-01-01

    In 2013, our institution underwent a change to the undergraduate medical curriculum whereby a clinical urology rotation became mandatory. In this paper, we evaluated the perceived utility and value of this change in the core curriculum. Third year medical students, required to complete a mandatory 1-week clinical urology rotation, were asked to complete a survey before and after their rotation. Fourth year medical students, not required to complete this rotation, were also asked to complete a questionnaire. Chi-squared and Fisher's exact test were used for data analysis. In total, 108 third year students rotated through urology during the study period. Of these, 66 (61%) completed the pre-rotation survey and 54 (50%) completed the post-rotation survey. In total, there were 110 fourth year students. Of these, 44 (40%) completed the questionnaire. After completing their mandatory rotations, students felt more comfortable managing and investigating common urological problems, such as hematuria and renal colic. Students felt they had a better understanding of how to insert a Foley catheter and felt comfortable independently inserting a Foley catheter. Importantly, students felt they knew when to consult urology and were also more likely to consider a career in urology. Compared to fourth year students, third year students felt urology was an important component to a family medicine practice and felt they had a better understanding of when to consult urology. The introduction of a mandatory urology rotation for undergraduate medical students leads to a perceived improvement in fundamental urological knowledge and skill set of rotating students. This mandatory rotation provides a valuable experience that validates its inclusion.

  19. 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

  20. Integrated HTA-FMEA/FMECA methodology for the evaluation of robotic system in urology and general surgery.

    Science.gov (United States)

    Frosini, Francesco; Miniati, Roberto; Grillone, Saverio; Dori, Fabrizio; Gentili, Guido Biffi; Belardinelli, Andrea

    2016-11-14

    The following study proposes and tests an integrated methodology involving Health Technology Assessment (HTA) and Failure Modes, Effects and Criticality Analysis (FMECA) for the assessment of specific aspects related to robotic surgery involving safety, process and technology. The integrated methodology consists of the application of specific techniques coming from the HTA joined to the aid of the most typical models from reliability engineering such as FMEA/FMECA. The study has also included in-site data collection and interviews to medical personnel. The total number of robotic procedures included in the analysis was 44: 28 for urology and 16 for general surgery. The main outcomes refer to the comparative evaluation between robotic, laparoscopic and open surgery. Risk analysis and mitigation interventions come from FMECA application. The small sample size available for the study represents an important bias, especially for the clinical outcomes reliability. Despite this, the study seems to confirm the better trend for robotics' surgical times with comparison to the open technique as well as confirming the robotics' clinical benefits in urology. More complex situation is observed for general surgery, where robotics' clinical benefits directly measured are the lowest blood transfusion rate.

  1. 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

  2. Speech and Language Delay

    Science.gov (United States)

    ... OTC Relief for Diarrhea Home Diseases and Conditions Speech and Language Delay Condition Speech and Language Delay Share Print Table of Contents1. ... Treatment6. Everyday Life7. Questions8. Resources What is a speech and language delay? A speech and language delay ...

  3. [Quality and objectifiability of training and advanced training in urology].

    Science.gov (United States)

    Müller, S C; Strunk, T; Alken, P

    2012-08-01

    The attraction to study medicine has not changed, however we are facing a lack of trainees especially in surgical subspecialties like urology. Possible explanations are a 70% proportion of female students and different views on the work-life balance in the future. A high burden of theory and unrealistic multiple choice examinations support those who can learn but there are no objective and reproducible criteria to recognize the competence of a good physician early in the career. This problem continues during residency, especially in surgical subspecialities. The different medical boards in Germany responsible for the training programs have no concepts. Many attempts in other countries to objectively measure surgical skills have so far been ignored. If we do not want to lose our traditionally high competence in medicine we should join those who attempt to improve teaching and to use methods for selecting suitable candidates for surgery as soon and as objectively as possible.

  4. [Usefullness of the Da Vinci robot in urologic surgery].

    Science.gov (United States)

    Iselin, C; Fateri, F; Caviezel, A; Schwartz, J; Hauser, J

    2007-12-05

    A telemanipulator for laparoscopic instruments is now available in the world of surgical robotics. This device has three distincts advantages over traditional laparoscopic surgery: it improves precision because of the many degrees of freedom of its instruments, and it offers 3-D vision so as better ergonomics for the surgeon. These characteristics are most useful for procedures that require delicate suturing in a focused operative field which may be difficult to reach. The Da Vinci robot has found its place in 2 domains of laparoscopic urologic surgery: radical prostatectomy and ureteral surgery. The cost of the robot, so as the price of its maintenance and instruments is high. This increases healthcare costs in comparison to open surgery, however not dramatically since patients stay less time in hospital and go back to work earlier.

  5. Urological cancers of the elderly subject: the role of radiotherapy

    International Nuclear Information System (INIS)

    Hennequin, C.; Quero, L.

    2009-01-01

    Urologic cancers are now usually found in elderly patients and the value of curative treatment is frequently asked. Life expectancy must not be underestimated with its consequence of under-treatment. Geriatric assessment is a good tool to make the right decision. For bladder and prostatic carcinomas, external beam radiation therapy is often the treatment of choice, if a curative option has been choose, because its toxicity is low in this population. In fact, many retrospectives studies have demonstrated that toxicity is equivalent in young and old patients. In prostate cancer, a recent randomised trial demonstrated that combination of irradiation and hormonal treatment increased biochemical control and overall survival over hormonal treatment alone. Hypo-fractionated schedules, more convenient to old patients, have been regularly reported for bladder cancers, but new techniques in radiation therapy seem to allow the use of this type of treatment schedules in prostate carcinomas. (authors)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-02-01

    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.

  7. 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

  8. 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.

  9. Pseudotumoral delayed cerebral radionecrosis

    International Nuclear Information System (INIS)

    Ciaudo-Lacroix, C.; Lapresle, J.

    1985-01-01

    A 60 year-old woman with a scalp epithelioma underwent radiotherapy, the dose being 57 Gray. A first epileptic seizure occurred twenty months later. Neurological examination revealed signs of left hemisphere involvement. γEG, angiography, CT scans, demonstrated a pseudotumoral avascular process. On account of the localisation, the patient being right-handed, no surgical procedure was performed. In spite of corticotherapy and anticonvulsive treatment, seizures recurred and neurological signs slowly progressed. The patient died, 22 months after the first seizure, of an associated disseminated carcinoma with cachexia. Neuropathological examination showed a massive lesion presenting all the features of delayed radionecrosis in the left hemisphere: situated mainly in the white matter; numerous vascular abnormalities; wide-spread demyelination; disappearance of oligoglial cells. The Authors recall the clinical and anatomical aspects of this condition for which the only successful treatment is surgical removal when location and size of the lesion permit. Finally, the mechanisms which have been proposed to explain this delayed cerebral radionecrosis are discussed [fr

  10. Pseudotumoral delayed cerebral radionecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Ciaudo-Lacroix, C; Lapresle, J [Centre Hospitalier de Bicetre, 94 - Le Kremlin-Bicetre (France)

    1985-01-01

    A 60 year-old woman with a scalp epithelioma underwent radiotherapy, the dose being 57 Gray. A first epileptic seizure occurred twenty months later. Neurological examination revealed signs of left hemisphere involvement. ..gamma..EG, angiography, CT scans, demonstrated a pseudotumoral avascular process. On account of the localisation, the patient being right-handed, no surgical procedure was performed. In spite of corticotherapy and anticonvulsive treatment, seizures recurred and neurological signs slowly progressed. The patient died, 22 months after the first seizure, of an associated disseminated carcinoma with cachexia. Neuropathological examination showed a massive lesion presenting all the features of delayed radionecrosis in the left hemisphere: situated mainly in the white matter; numerous vascular abnormalities; wide-spread demyelination; disappearance of oligoglial cells. The Authors recall the clinical and anatomical aspects of this condition for which the only successful treatment is surgical removal when location and size of the lesion permit. Finally, the mechanisms which have been proposed to explain this delayed cerebral radionecrosis are discussed.

  11. Diagnosis and initial management of urological injuries associated with 200 consecutive pelvic fractures.

    Science.gov (United States)

    Palmer, J K; Benson, G S; Corriere, J N

    1983-10-01

    During 26 months 200 consecutive patients with fracture of the bony pelvis were evaluated and treated for urological injury. There was no correlation between the extent of pelvic injury and degree of hematuria but hematuria was present in all patients with a urological injury. All urological injuries occurred with anterior arch fractures. The over-all incidence of injury was 13.5 per cent (bladder 9 per cent, urethra 3.5 per cent and combined 1 per cent). Limited extraperitoneal bladder ruptures were treated successfully by Foley catheter drainage.

  12. 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 

  13. 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.

  14. Variable Delay in port-Hamiltonian Telemanipulation

    NARCIS (Netherlands)

    Secchi, C; Stramigioli, Stefano; Fantuzzi, C.

    2006-01-01

    In several applications involving bilateral telemanipulation, master and slave act at different power scales. In this paper a strategy for passively dealing with variable communication delay in scaled port-Hamiltonian based telemanipulation over packet switched networks is proposed.

  15. 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)

  16. Delayed Single Stage Perineal Posterior Urethroplasty.

    Science.gov (United States)

    Ali, Shahzad; Shahnawaz; Shahzad, Iqbal; Baloch, Muhammad Umar

    2015-06-01

    To determine the delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture/distraction defect. Descriptive case series. Department of Urology, Jinnah Postgraduate Medical Centre, Karachi, from January 2009 to December 2011. 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. 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 patient's age was 26.25 ± 7.9 years. On follow-up, 7 patients (23.3%) experienced recurrent stricture during first 10 months. Five (16.6%) patients were treated successfully with single direct visual internal urethrotomy. Two patients (6.6%) 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% with permissive criteria allowing single direct visual internal urethrotomy and 76.6% with strict criteria allowing no more procedures postoperatively. Posterior anastomotic urethroplasty offers excellent long-term results to patients with posterior urethral trauma and distraction defect even after multiple prior procedures.

  17. HAMLET treatment delays bladder cancer development.

    Science.gov (United States)

    Mossberg, Ann-Kristin; Hou, Yuchuan; Svensson, Majlis; Holmqvist, Bo; Svanborg, Catharina

    2010-04-01

    HAMLET is a protein-lipid complex that kills different types of cancer cells. Recently we observed a rapid reduction in human bladder cancer size after intravesical HAMLET treatment. In this study we evaluated the therapeutic effect of HAMLET in the mouse MB49 bladder carcinoma model. Bladder tumors were established by intravesical injection of MB49 cells into poly L-lysine treated bladders of C57BL/6 mice. Treatment groups received repeat intravesical HAMLET instillations and controls received alpha-lactalbumin or phosphate buffer. Effects of HAMLET on tumor size and putative apoptotic effects were analyzed in bladder tissue sections. Whole body imaging was used to study HAMLET distribution in tumor bearing mice compared to healthy bladder tissue. HAMLET caused a dose dependent decrease in MB49 cell viability in vitro. Five intravesical HAMLET instillations significantly decreased tumor size and delayed development in vivo compared to controls. TUNEL staining revealed selective apoptotic effects in tumor areas but not in adjacent healthy bladder tissue. On in vivo imaging Alexa-HAMLET was retained for more than 24 hours in the bladder of tumor bearing mice but not in tumor-free bladders or in tumor bearing mice that received Alexa-alpha-lactalbumin. Results show that HAMLET is active as a tumoricidal agent and suggest that topical HAMLET administration may delay bladder cancer development. Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    Ghassan A Barayan

    2011-01-01

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

  20. 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.

  1. UAVs and Control Delays

    National Research Council Canada - National Science Library

    de Vries, S. C

    2005-01-01

    .... Delays of about 250-300 ms often lead to unacceptable airplane handling qualities. Techniques such as filtering and predictive displays may extend the range of acceptable delays up to about 400 ms...

  2. Delayed puberty in boys

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007695.htm Delayed puberty in boys To use the sharing features on this page, please enable JavaScript. Delayed puberty in boys is when puberty does not begin ...

  3. Assessing health-related quality of life in urology ? a survey of 4500 German urologists

    OpenAIRE

    Schmick, A.; Juergensen, M.; Rohde, V.; Katalinic, A.; Waldmann, A.

    2017-01-01

    Background Urological diseases and their treatment may negatively influence continence, potency, and health-related quality of life (HRQOL). Although current guidelines recommend HRQOL assessment in clinical urology, specific guidance on how to assess HRQOL is frequently absent. We evaluated whether and how urologists assess HRQOL and how they determine its practicality. Methods A random sample of 4500 (from 5200 identified German urologists) was drawn and invited to participate in a postal s...

  4. 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.

  5. 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.

  6. Surgical simulators in urological training--views of UK Training Programme Directors.

    Science.gov (United States)

    Forster, James A; Browning, Anthony J; Paul, Alan B; Biyani, C Shekhar

    2012-09-01

    What's known on the subject? and What does the study add? The role of surgical simulators is currently being debated in urological and other surgical specialties. Simulators are not presently implemented in the UK urology training curriculum. The availability of simulators and the opinions of Training Programme Directors' (TPD) on their role have not been described. In the present questionnaire-based survey, the trainees of most, but not all, UK TPDs had access to laparoscopic simulators, and that all responding TPDs thought that simulators improved laparoscopic training. We hope that the present study will be a positive step towards making an agreement to formally introduce simulators into the UK urology training curriculum. To discuss the current situation on the use of simulators in surgical training. To determine the views of UK Urology Training Programme Directors (TPDs) on the availability and use of simulators in Urology at present, and to discuss the role that simulators may have in future training. An online-questionnaire survey was distributed to all UK Urology TPDs. In all, 16 of 21 TPDs responded. All 16 thought that laparoscopic simulators improved the quality of laparoscopic training. The trainees of 13 TPDs had access to a laparoscopic simulator (either in their own hospital or another hospital in the deanery). Most TPDs thought that trainees should use simulators in their free time, in quiet time during work hours, or in teaching sessions (rather than incorporated into the weekly timetable). We feel that the current apprentice-style method of training in urological surgery is out-dated. We think that all TPDs and trainees should have access to a simulator, and that a formal competency based simulation training programme should be incorporated into the urology training curriculum, with trainees reaching a minimum proficiency on a simulator before undertaking surgical procedures. © 2012 THE AUTHORS. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.

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

    Science.gov (United States)

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

    2016-05-01

    To elucidate the current portfolio of National Institutes of Health (NIH) funding to departments of urology at U.S. medical schools. The NIH Research Portfolio Online Reporting Tools Expenditures and Results was used to generate a comprehensive analysis of NIH research grants awarded to urology departments during 2014. Costs, mechanisms, and institutes were summarized with descriptive statistics. Demographic data were obtained for principal investigators and project abstracts were categorized by research type and area. Fiscal totals were calculated for 2005-2014 and compared with other surgical departments during 2014. One hundred one investigators at 36 urology departments received $55,564,952 in NIH funding during 2014. NIH-funded investigators were predominately male (79%) and PhD scientists (52%). Funding totals did not vary by terminal degree or sex, but increased with higher academic rank (P < .001). The National Cancer Institute (54.7%) and National Institute of Diabetes and Digestive and Kidney Diseases (32.2%) supported the majority of NIH-funded urologic research. The R01 grant accounted for 41.0% of all costs. The top 3 NIH-funded clinical areas were urologic oncology (62.1%), urinary tract infection (8.8%), and neurourology (7.6%). A minority of costs supported clinical research (12.9%). In 2014, urology had the least number of NIH grants relative to general surgery, ophthalmology, obstetrics & gynecology, otolaryngology, and orthopedic surgery. NIH funding to urology departments lags behind awards to departments of other surgical disciplines. Future interventions may be warranted to increase NIH grant procurement in urology. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Delayed Orgasm and Anorgasmia

    OpenAIRE

    Jenkins, Lawrence C.; Mulhall, John P.

    2015-01-01

    Delayed orgasm/anorgasmia defined as the persistent or recurrent difficulty, delay in, or absence of attaining orgasm after sufficient sexual stimulation, which causes personal distress. Delayed orgasm and anorgasmia are associated with significant sexual dissatisfaction. A focused medical history can shed light on the potential etiologies; which include: medications, penile sensation loss, endocrinopathies, penile hyperstimulation and psychological etiologies, amongst others. Unfortunately, ...

  9. Role of antibiotic prophylaxis in antenatal hydronephrosis: A systematic review from the European Association of Urology/European Society for Paediatric Urology Guidelines Panel.

    Science.gov (United States)

    Silay, Mesrur Selcuk; Undre, Shabnam; Nambiar, Arjun K; Dogan, Hasan Serkan; Kocvara, Radim; Nijman, Rien J M; Stein, Raimund; Tekgul, Serdar; Radmayr, Christian

    2017-06-01

    The benefits and harms of continuous antibiotic prophylaxis (CAP) versus observation in patients with antenatal hydronephrosis (ANH) are controversial. The aim was to determine the effectiveness of CAP for ANH, and if beneficial to determine the best type and regimen of antibiotic and the most harmful to provide guidance for clinical practice. A systematic literature search was performed in databases including Medline, Embase, and Cochrane in June 2015. The protocol was prospectively registered to PROSPERO (CRD42015024775). The search started from 1980, when maternal ultrasound was first introduced into clinical practice. Eligible studies were critically evaluated for risk of bias using Revman software. The outcomes included reduction in urinary tract infections (UTI), drug-related adverse events and kidney functions. Of 797 articles identified, 57 full text articles and six abstracts were eligible for inclusion (2 randomized controlled trials, 11 non-randomized comparative studies, and 50 case series). It remains unclear whether CAP is superior to observation in decreasing UTIs. No conclusion could be drawn for drug-related adverse events and kidney function because of lack of data. Children who were not circumcised, with ureteral dilatation, and high-grade hydronephrosis may be more likely to develop UTI, and CAP may be warranted for these subgroups of patients. A majority of the studies had low-to-moderate quality of evidence and with high risk of bias. The benefits of CAP in a heterogeneous group of children with ANH involving different etiologies remains unproven. However, the evidence in the form of prospective and retrospective observational studies has shown that it reduces febrile UTI in particular subgroups. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  10. Gender trends of urology manuscript authors in the United States: a 35-year progression.

    Science.gov (United States)

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

    2012-01-01

    The presence of women in urology has gradually increased in the last 35 years with an accelerated rate in the last decade. We evaluated manuscript authorship trends by gender. Manuscript authorship is a metric that has been used as a marker of academic productivity. We hypothesized that the number of first and last author publications by women has increased proportionately to the number of women in the field during the last 35 years. We performed a bibliometric study to examine authorship gender in The Journal of Urology® and Urology®. We reviewed all original articles published from American institutions in 1974, 1979, 1984, 1989, 1994, 1999, 2004 and 2009. Of the 8,313 articles reviewed 5,461 were from American institutions, including 97.5% for which we determined author gender. There were 767 articles with female authors, including 440 first and 327 last authors. First and last female authorship increased from 2.7% of all authors in 1979 to 26.5% in 2009 (test for trend p authorship rate surpasses the rate of growth of women in urology, which increased from 0.24% in 1975 to 6.2% in 2008. Based on authorship gender analysis women urologists produce manuscripts at a rate that exceeds their number in the field. Findings show that women in urology are productive, active members of the academic community. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  11. 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

  12. Twitter expands the reach and engagement of a national scientific meeting: the Irish Society of Urology.

    Science.gov (United States)

    Nason, G J; O'Kelly, F; Bouchier-Hayes, D; Quinlan, D M; Manecksha, R P

    2015-09-01

    Social media is the interaction among people in which they create, share or exchange information and ideas in virtual communities and web-based networks. This year, the Irish Society of Urology (ISU) expanded its involvement in social media with a preregistered Twitter hashtag (#ISU14) for the annual meeting. The aim of this study was to highlight the use of Twitter at an annual national meeting held in 2014. The Symplur healthcare analytics website was used to prospectively examine traffic related to the 2014 ISU Annual Meeting. This feature was used to generate statistics for the number of impressions, unique tweets (excluding retweets) and distinct contributors who used the indexing hashtag #ISU14. Individual tweets were assessed using the conference hashtag on the Twitter website. The total number of attendees at the conference was 119, and 99 individuals participated in Twitter using the conference hashtag (#ISU14). 31 % of attendees participated in tweeting at the conference. Over the course of the conference, a total of 798 unique tweets were generated, creating over 665,000 impressions in cyberspace. 590 (73.9 %) tweets were generated from attendees at the conference, while 26.1 % of tweets were from virtual followers. 702 (87.9 %) tweets were from urologists and 439 (55 %) tweets were of scientific nature. Tweet activity peaked during the guest lectures on both days. Twitter use at the ISU has been shown to facilitate interaction between delegates and allows users to follow as well as participate from afar.

  13. [Baron Dominique-Jean Larrey: the founder of urological traumatology].

    Science.gov (United States)

    Hatzinger, M; Ameijenda, C; Lent, V; Sohn, M

    2012-12-01

    Dominique-Jean Larrey (1766-1842) was Surgeon-in-Chief of the Grande Army under Napoleon Bonaparte (1769-1821) and personal physician of the Emperor. Against the opposition of the traditionalists he introduced the "ambulances volantes", the so-called flying ambulances. The aim was the medical treatment of the injured soldiers immediately on the battlefield. This revolutionary treatment led to a benefit not only for the own soldiers, but also for the wounded enemies. His innovation in the field of immediate assistance of wounded persons, together with Larreys' outstanding medical competence, saved thousands of soldiers lives on the battlefield of the Napoleonic wars. His memories concerning the military campaigns, have been even up to the 20th century one of the standard works of modern military surgery. He had as well great interest in urolological injuries of the urinary system and their conservative and operative care. Up to these days, his work shows a surprising actuality and perfect anatomic understanding. In a time without anaesthetics, antibiotics and under primitive circumstances, Larrey and his collegues accomplished surgical feats. Larreys flying ambulances were copied by many different countries. The American Mobile Army Surgical Hospital (M.A.S.H) is clearly based on his thoughts and ideals. In our opinion he is the father of the modern war surgery as well the urological traumatology. Georg Thieme Verlag KG Stuttgart · New York.

  14. 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.

  15. 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.

  16. 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)

  17. [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.

  18. 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)

  19. 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.

  20. 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

  1. The top 100 cited articles on urological emergencies: A bibliometric analysis.

    Science.gov (United States)

    Kazımoğlu, Hatem; Dokur, Mehmet

    2018-05-01

    In this study, we bibliometrically evaluated the top 100 cited articles on urological emergencies published since 1975 with a multidisciplinary and interdisciplinary perspective. We obtained the data for this study from the Thomson Reuters Web of Science and PubMed. We determined 360 articles which were related directly or indirectly to urological emergencies between 1975 and 2017 and analyzed retrospectively the top 100 cited articles among these. The mean citation impact factor of the top 100 cited articles was 25.8±50.1 (range: 4-467) between 1991 and 2014. We determined that classical articles were cited for 2588 times and the total number of self-citations was 23 (0.8%). Highest publication rate per year was in 2006 (n=9). Among the institutions which published ≥2 articles per year University of Texas led the way with 5 articles. The top 100 articles came from 27 countries and 58% of these are from the USA (n=29), the United Kingdom (n=23) and Germany (n=6). For the top 3 journals of the 33 of top 100 articles most frequently cited were published in journals with an impact factor ≥2 namely, Journal of Urology (n=15), British Journal of Urology International (n=13) and Urology (n=5) respectively. The most frequently cited main topics were penile emergencies with 22 articles and acute scrotal problems with 15 articles. Most of the classical articles on urological emergencies were based on clinical researches (n=95) and also we found that the average level of evidence for the top 100 cited articles was 4.16 (range: 1-5). Mostly preferred publishing language was English among this scientific papers (n=90). Although not considered as a completely unbiased and adequate criterion for scientific evaluations, analysis of the top 100 cited articles provides us with important current data on urological emergencies.

  2. 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…

  3. 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

  4. 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 ...

  5. 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

  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. Managed care and its impact on American urology.

    Science.gov (United States)

    Holtgrewe, H L

    1998-05-01

    America's health care is undergoing a revolution. A previous private, fee-for-service, delivery system chiefly centered around hospital specialty care is rapidly being replaced by a commercialized system of managed care, controlled by businessmen whose prime motive is profit. Increasing emphasis of these managed care organizations is upon primary physicians who function as gatekeepers. While this new commercialized method of health care has been attended with reductions in the previous omnipresent health care inflation our country has experienced for the past several decades, its impact on quality of care and patient choice of physician remain a great concern. Especially vulnerable in this new system are our nation's academic centers, which, burdened with responsibility for education and research, are at a disadvantage in the competitive cost-based bidding for managed care contracts. Urology work force issues and the number of urologists in our nation remain another concern for urologists as they compete for access to patients in this new highly competitive environment. In a 1995 survey of a cohort of urologists in seven states, the respondents reported 35.8% of gross income came from managed care contracts, 86% reported the need for preservice approval for many diagnostic and therapeutic undertakings, 87% reported an inability to refer complex cases outside the Managed Care Organization (MCO) network, and 23% reported they were required to retain patients for treatment who they would have otherwise referred to a more qualified urologist. The majority of American urologists are reporting dropping gross revenues and increasing overhead in their dealings with managed care contracts. The advent of managed care is being attended with dropping gross revenues, increasing overhead costs and interference with the practice patterns of American urologists.

  8. 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

  9. IMMUNOLOGICAL REACTIVITY IN PATIENTS WITH UROLOGICAL PROFILE UNDER COMBINED THERAPY

    Directory of Open Access Journals (Sweden)

    A. V. Esipov

    2017-01-01

    Full Text Available Prevention and treatment of postoperative purulent-inflammatory complications in urological practice remains a subject for study and improvement in all medical centers. The principle of evidence must be taken as a basis of effectiveness of therapy. In this study the quality criteria of demonstrated therapy are immunological parameters.The purpose of this study is to identify the effectiveness of using monooxidase (NO containing a gas stream replenishing the deficiency of endogenous NO in a group of patients; and to investigate immunological reactivity in patients under complex therapy included nitrogen monoxide and immunomodulators.Materials and methods. In this experimental study we determined the functioning of the main links of the patient’s immunological system. They were determined on the basis of the levels of general T-lymphocytes (T-total, T-helper (T-h, T-suppressor (T-s, natural killer (NK, B-lymphocyte and immunoglobulin G, M, A, circulating immune complexes (CIC.Results. Based on the obtained data, we concluded that the traditional treatment of patients with postoperative complications was less effective than the one proposed in our study. Immunological picture of patient’s condition come back to normal almost from the first day of treatment, and under traditional treatment it was only on the 7th day. Under using complex treatment with nitrogen monoxide, parameters of humoral immunity corresponded to the norm already on the 7–14th day from the beginning of treatment.Conclusion. NO-containing gas flow application in complex prevention of purulent-inflammatory complications made possible to eliminate wound infection in shorter terms and to shorten the period of patient’s hospitalization. The best results were obtained in terms of immunological reactivity in a clinical trial in patients who received complex therapy included nitrogen monoxide and lymphotropic administration of the immunomodulators.

  10. 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.

  11. 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.

  12. 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.

  13. Delayed orgasm and anorgasmia.

    Science.gov (United States)

    Jenkins, Lawrence C; Mulhall, John P

    2015-11-01

    Delayed orgasm/anorgasmia defined as the persistent or recurrent difficulty, delay in, or absence of attaining orgasm after sufficient sexual stimulation, which causes personal distress. Delayed orgasm and anorgasmia are associated with significant sexual dissatisfaction. A focused medical history can shed light on the potential etiologies, which include medications, penile sensation loss, endocrinopathies, penile hyperstimulation, and psychological etiologies. Unfortunately, there are no excellent pharmacotherapies for delayed orgasm/anorgasmia, and treatment revolves largely around addressing potential causative factors and psychotherapy. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. Status of women in urology: based on a report to the Society of University Urologists.

    Science.gov (United States)

    Lightner, Deborah J; Terris, Martha K; Tsao, Alice K; Naughton, Cathy K; Lohse, Christine M

    2005-02-01

    Written responses from American trained women in urological surgery were obtained to evaluate practice patterns, career choices and workplace satisfaction. A 3-page unblinded questionnaire was mailed in March 2003 to American trained women in urological surgery available through the databases of the Society of Women in Urology with subsequent statistical analysis. The response rate was 60% but inclusive of all women in current academic practice in the United States. A total of 61% reported working 51 or more hours a week whereas 2% have left practice due to retirement or medical infirmity. There were 41% who had completed fellowships including 87% reporting active practice within their subspecialty, whereas 62% of fellowship trained surgeons remained in an academic practice. Among United States women in academic urological practice, academic progression has occurred in a third of this cohort. Threats to successful practice, consistent with other workplace surveys of physicians and professional women including gender based role limitation and inadequate mentoring, were commonly reported. These correctable workplace deficiencies represent an opportunity for American urology to enhance the professional workplace for all urologists regardless of gender.

  15. Readability of American online patient education materials in urologic oncology: a need for simple communication.

    Science.gov (United States)

    Pruthi, Amanda; Nielsen, Matthew E; Raynor, Mathew C; Woods, Michael E; Wallen, Eric M; Smith, Angela B

    2015-02-01

    To determine the readability levels of reputable cancer and urologic Web sites addressing bladder, prostate, kidney, and testicular cancers. Online patient education materials (PEMs) for bladder, prostate, kidney, and testicular malignancies were evaluated from the American Cancer Society, American Society of Clinical Oncology, National Cancer Institute, Urology Care Foundation, Bladder Cancer Advocacy Network, Prostate Cancer Foundation, Kidney Cancer Association, and Testicular Cancer Resource Center. Grade level was determined using several readability indices, and analyses were performed on the basis of cancer type, Web site, and content area (general, causes, risk factors and prevention, diagnosis and staging, treatment, and post-treatment). Estimated grade level of online PEMs ranged from 9.2 to 14.2 with an overall mean of 11.7. Web sites for kidney cancer had the least difficult readability (11.3) and prostate cancer had the most difficult readability (12.1). Among specific Web sites, the most difficult readability levels were noted for the Urology Care Foundation Web site for bladder and prostate cancer and the Kidney Cancer Association and Testicular Cancer Resource Center for kidney and testes cancer. Readability levels within content areas varied on the basis of the disease and Web site. Online PEMs in urologic oncology are written at a level above the average American reader. Simplification of these resources is necessary to improve patient understanding of urologic malignancy. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Can non-urological doctors play a role in early prostate cancer detection?

    Science.gov (United States)

    Yazici, Cenk M; Dogan, Cagri

    2014-05-06

    To evaluate the awareness of non-urological doctors for their role in evaluating prostate cancer (Pca) in scientific manner which may be a possible probability for late diagnosis of Pca. A total of 936 non-urological specialists working in 1 university and 4 education and research hospital who were able to evaluate male patients over 50 years of age were included to the survey. A face to face questionnaire had been administered to all participants. A total of 92 (9.8%) participants were evaluating prostate-specific antigen (PSA) level to all their elderly male patients while 404 (43.2%) participants had never made this evaluation. Among the participants who were evaluating PSA, none was performing an informed decision making consult and even they did not have any idea about the meaning of this strategy. About the criteria for urological consultation, 56 (6%) reported that they consult all their elderly male patients, whereas 880 (94%) answered that they perform consultation if their patients has sought help for any urological symptom. Urologists must remind the non-urological specialists that their approaches to Pca evaluation may change mortality rates of this disease and give them proper information about the scientific evaluation of Pca. This may help us to decrease the mortality rates of Pca.

  17. [Urological emergencies at the Dakar university teaching hospital: epidemiological, clinical and therapeutic features].

    Science.gov (United States)

    Fall, B; Diao, B; Fall, P A; Diallo, Y; Sow, Y; Ondongo, A A M; Diagana, M; Ndoye, A K; Ba, M; Diagne, B A

    2008-11-01

    To present the epidemiological, clinical and therapeutic features of the urological emergencies in Senegal, West Africa. The authors conducted a 20 months retrospective study that analyzed the epidemiological, clinical and therapeutic features of all urological emergencies admitted to the urology department of the university teaching hospital Aristide-Le-Dantec (Dakar). There were 1237 urological emergencies. The mean age of the patients was 58.8 years (range one month-94 years). The sex ratio (M/F) was 20.32. These patients had an age equal to or higher than 60 years in 50.7% of the cases. The most frequent illness was urinary retention (53%) and genitor-urinary system infectious, which represented as a whole 16.4% of the cases. The gangrenes of male external genitalia (Fournier's gangrene) accounted for 4.1% of the cases and the priapism 1.3%. In emergency, 331 surgical operations were performed. The most performed procedures were the installation of a suprapubic catheter (59.8%) and debridement of a gangrene of male external genitalia (15.4%). The most frequent urological emergency in our country was the acute urinary retention. Some serious illness like gangrene of male external genitalia (Fournier's gangrene) and priapism are not rare there.

  18. 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.

  19. 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.

  20. 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.

  1. Nonlinear delay monopoly with bounded rationality

    International Nuclear Information System (INIS)

    Matsumoto, Akio; Szidarovszky, Ferenc

    2012-01-01

    The purpose of this paper is to study the dynamics of a monopolistic firm in a continuous-time framework. The firm is assumed to be boundedly rational and to experience time delays in obtaining and implementing information on output. The dynamic adjustment process is based on the gradient of the expected profit. The paper is divided into three parts: we examine delay effects on dynamics caused by one-time delay and two-time delays in the first two parts. Global dynamics and analytical results on local dynamics are numerically confirmed in the third part. Four main results are demonstrated. First, the stability switch from stability to instability occurs only once in the case of a single delay. Second, the alternation of stability and instability can continue if two time delays are involved. Third, the occurence of Hopf bifurcation is analytically shown if stability is lost. Finally, in a bifurcation process, there are a period-doubling cascade to chaos and a period-halving cascade to the equilibrium point in the case of two time delays if the difference between the two delays is large.

  2. 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

    2018-05-01

    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.

  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...

  4. [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.

  5. 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.

  6. Prevalence of urinary incontinence and other urological problems during pregnancy: a questionnaire based study.

    Science.gov (United States)

    Sharma, J B; Aggarwal, Shena; Singhal, Saurabh; Kumar, S; Roy, K K

    2009-06-01

    To find out the prevalence of various urological symptoms in pregnant women, the status before pregnancy, and their perceived impact. A questionnaire incorporating various urological problems was prepared and used over 240 pregnant women to know their prevalence in different trimesters of pregnancy and compare them with prevalence before pregnancy. Increased urinary frequency (>10/day) (40.8 vs. 3.8%), nocturia (72.9 vs. 50.6%), burning micturition (21.3 vs. 3.8%), UTI (4.6 vs. 1.6%), urinary hesitancy (14.6 vs. 1.6%), urinary incontinence (25.8 vs. 8.2%) and botheration (22.1 vs. 2.7%) were seen during and before pregnancy, respectively. These also show an increment with advancement of gestation. Urinary incontinence was seen more often with advancing age and parity. There is a very high prevalence of urological symptoms during pregnancy as compared to before pregnancy.

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

    Directory of Open Access Journals (Sweden)

    Bruna Marcela Lima de Souza

    Full Text Available ABSTRACT Objective: To describe the creation and implementation of the extension program Advanced Practice Nursing in Pediatric Urology, developed in the outpatient clinic of a teaching hospital in the Federal District. Method: This is an experience report regarding the implementation of an outpatient service aimed at children and adolescents with symptoms of bladder and bowel dysfunction. Results: Because it is an extension program linked to the university, it follows a different model of care, valuing empowerment, informed and shared decision making, which results in a stronger bond between patients, family and the Pediatric Urology nursing team. It has also become a privileged space for the production and use of scientific knowledge, associated with the principles of evidence-based practice. Conclusion: This project shows a different performance of the nurse-specialist-professor-researcher in Pediatric Urology Nursing, and it has become a reference in the Federal District, mainly for undergraduate and graduate nursing students.

  8. 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.

  9. Trends in the Authorship of Peer Reviewed Publications in the Urology Literature.

    Science.gov (United States)

    An, Julie Y; Baiocco, Joseph A; Rais-Bahrami, Soroush

    2018-05-01

    We evaluated the authorship count of all original research and review articles published in prominent Urology journals to trend patterns in authorship over the last decade. Secondarily, we evaluated bibliometric assessments and sought to understand whether authorship count was associated with citation rate and each article's field-normalized measure of impact. Information on authorship count, date of publication, study type, journal of publication, citation rate, and relative citation ratio (RCR) was collected for all original research and review articles published in European Urology, Journal of Urology, Urology , and British Journal of Urology International between 2006 and 2016. We examined trends in authorship count over the past decade, as well as between journals and article types. 21,336 articles were analyzed, of which 19,527 (91.5%) were original research and 1,809 (8.5%) were review articles. Overall, number of authors increased 46.1% from 2006 to 2016. Authorship counts in original research articles increased by an average of 2.45 per manuscript (43.3% increase) over the decade analyzed. More dramatically, authorship counts in review articles increased by an average of 3.14 per manuscript (92.6% increase). Articles with higher authorship counts were associated with more citations and greater RCR (r=0.13, p<0.001). There is a global trend towards more authors per article in urology publications-in both original research publications and review articles, and across each of the individual journals evaluated. An increase in author count has also been associated with increased citations and measures of article impact.

  10. 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.

  11. 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.

  12. Training, Research, and Working Conditions for Urology Residents in Germany: A Contemporary Survey.

    Science.gov (United States)

    Borgmann, Hendrik; Arnold, Hannah K; Meyer, Christian P; Bründl, Johannes; König, Justus; Nestler, Tim; Ruf, Christian; Struck, Julian; Salem, Johannes

    2016-12-16

    Excellent uniform training of urology residents is crucial to secure both high-quality patient care and the future of our specialty. Residency training has come under scrutiny following the demands of subspecialized care, economical aspects, and working hour regulations. To comprehensively assess the surgical training, research opportunities, and working conditions among urology residents in Germany. We sent a 29-item online survey via email to 721 members of the German Society of Residents in Urology. Descriptive analyses were conducted to describe the surveys' four domains: (1) baseline characteristics, (2) surgical training (cumulative completed case volume for all minor-, medium-, and major-complexity surgeries), (3) research opportunities, and (4) working conditions. Four hundred and seventy-two residents completed the online survey (response rate 65%). Surgical training: the median number of cumulative completed cases for postgraduate yr (PGY)-5 residents was 113 (interquartile range: 76-178). Minor surgeries comprised 57% of all surgeries and were performed by residents in all PGYs. Medium-complexity surgeries comprised 39% of all surgeries and were mostly performed by residents in PGYs 2-5. Major surgeries comprised 4% of all surgeries and were occasionally performed by residents in PGYs 3-5. Research opportunities: some 44% have attained a medical thesis (Dr. med.), and 39% are currently pursuing research. Working conditions: psychosocial work-related stress was high and for 82% of residents their effort exceeded their rewards. Some 44% were satisfied, 32% were undecided, and 24% were dissatisfied with their current working situation. Limitations include self-reported survey answers and a lack of validated assessment tools. Surgical exposure among German urology residents is low and comprises minor and medium-complex surgeries. Psychosocial work-related stress is high for the vast majority of residents indicating the need for structural improvements in

  13. Simulators in the urological training armamentarium: A boon or a bane?

    Science.gov (United States)

    Aggarwal, Gaurav; Adhikary, Samiran D

    2017-06-01

    Simulation devices have grasped the attention of almost all industries worldwide and the medical field has not been exempt. With technological advancement, it becomes important to assess whether medical simulators are the way forward as an adjunct or as a replacement to traditional training approaches by assessing their safety, efficacy and cost-effectiveness, and whether they should be made mandatory in the curriculum of urology training. The present review aims to clarify some of these issues, as well as assess their role in urological training and present both the pros and cons of this simulation-based training.

  14. 78 FR 41937 - Joint Meeting of the Gastroenterology-Urology Panel and the Radiological Devices Panel of the...

    Science.gov (United States)

    2013-07-12

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0816] Joint Meeting of the Gastroenterology-Urology Panel and the Radiological Devices Panel of the Medical...: Gastroenterology-Urology Panel and Radiological Devices Panel of the Medical Devices Advisory Committee. General...

  15. Risk factors for urological symptoms in a cohort of users of the HIV protease inhibitor indinavir sulfate - The ATHENA cohort

    NARCIS (Netherlands)

    Dieleman, Jeanne P.; Sturkenboom, Miriam C. J. M.; Jambroes, Marielle; Gyssens, Inge C.; Weverling, Gerrit-Jan; ten Veen, Jacob H.; Schrey, Gerrit; Reiss, Peter; Stricker, Bruno H. Ch

    2002-01-01

    Background: Nephrolithiasis is a well-known complication of indinavir treatment and may result in urological symptoms ranging from renal colic to renal insufficiency. Objective: To obtain further knowledge regarding the incidence and risk factors of urological symptoms associated with indinavir

  16. Publication rates of full-text journal articles converted from abstracts presented during the 22(nd) Turkish National Urology Congress.

    Science.gov (United States)

    Kocaaslan, Ramazan; Kayalı, Yunus; Tok, Adem; Tepeler, Abdulkadir

    2016-03-01

    To analyze the publication rates of full-text journal articles converted from the abstracts presented in the 22(nd) Turkish National Urology Congress in 2012. A total of 576 abstracts accepted for presentation at the 22(nd) Turkish National Urology Association Meeting were identified from the published abstract book. The abstracts were categorized into subsections such as endourology and pediatric urology. The subsequent publication rate for the studies was evaluated by scanning PubMed Medline. Abstracts published before the proceedings were excluded from the study. The abstracts were categorized as being presented orally (n=155), by poster (n=421), or by video (n=78). Of the 28 (18.3%) of 155 oral and 34 (8.15%) of 421 poster presentations, were subsequently published in several journals until March 2015. The publication rates of the abstracts based on urology subsections were as follows: neurology (25%), andrology (18.6%), endourology (17.2%), urolithiasis (15.3%), general urology (12.5%), infectious diseases (7.14%), pediatric urology (6.25%), uro-gynecology (6.06%), reconstructive urology (5.8%), and urooncology (3.8%). The average time to publication was 11.77 (0-33) months. This is the first study assessing the publication rates of abstracts presented at a Turkish National Urology Congress. It reveals that more qualified randomized studies need to be done to improve the rate of publication.

  17. 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.

  18. 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)

  19. Renal oncocytoma: experience of Clinical Urology A, Urology Department, CHU Ibn Sina, Rabat, Morocco and literature review.

    Science.gov (United States)

    Benatiya, Marwane Andaloussi; Rais, Ghizlane; Tahri, Mounir; Barki, Ali; El sayegh, Hachem; Iken, Ali; Nouini, Yassine; Lachkar, Azzouz; Benslimane, Lounis; Errihani, Hassan; Faik, Mohammed

    2012-01-01

    Renal oncocytoma is a rare and benign renal tumor. Only few cases have been reported in Moroccan populations. In the present study, we report our experiences in the diagnosis, management and follow-up of this disease. We report on six cases of renal oncocytoma indentified between 1990 and 2008 in the urology department of "CHU Ibn Sina" in Rabat. These six cases are listed among 130 kidney tumors reported during the study period. We assess the clinical, radiological and therapeutic features of the patients and we review literature. Six cases of renal oncocytoma, representing 4.6% of all primitive kidney tumors treated in our institution during the study period. The mean age was 53 ±9.7 years (range 34 to 61 years). One patient was asymptomatic at presentation, five patients (83%) had flank pain and two (33%) had macroscopic hematuria. The tumor was right sided in 4 cases (66%) and left sided in 2 cases (33%). All patients underwent CT scan which showed, in three cases, a centrally located stellate area of low attenuation. The clinical suspicion of oncocytoma was made preoperatively in only 3 patients by imaging studies, but the suspicion of renal cell carcinoma persist and all patients were treated with radical nephrectomy. Definitive diagnosis was made in all cases postoperatively. All the tumors were well circumscribed but unencapsulated. The mean tumor size was 8,75±2,04 cm. Four patients were classified at stage pT2 and two at stage p T1. Most of the pathological features in our patients were typical of this entity. Predominant cell type was a typical oncocytoma with general low mitotic activity. No extension to peri-nephric fat tissue or lymphovascular invasion was observed. After a mean follow-up of 36 months (range 26-62 months), there was neither recurrence nor death from oncocytoma. Accordingly, the disease-specific survival was 100%. Renal oncocytoma has a benign clinical course with excellent long-term outcomes. In our series, it happened mostly in

  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. Neutron delayed choice experiments

    International Nuclear Information System (INIS)

    Bernstein, H.J.

    1986-01-01

    Delayed choice experiments for neutrons can help extend the interpretation of quantum mechanical phenomena. They may also rule out alternative explanations which static interference experiments allow. A simple example of a feasible neutron test is presented and discussed. (orig.)

  2. Quad nanosecond delay module

    International Nuclear Information System (INIS)

    McDonald, R.J.; Hunter, J.B.; Wozniak, G.J.

    1986-04-01

    Four nanosecond (ns) delay units have been designed to fit in a single-width NIM module. This module is particularly suited for use in conjunction with quad constant fraction timing discriminators (CFTDs) since it has four delay units that can be placed adjacent to the four units of the CFTD. A series of different length cables connected via DIP toggle switches provide delays of 0.60 ns in 4 ns increments. Thus, the CFTD delay can be optimized for pulses of different rise times from approx.10-100 ns. Design work for the PC board and silkscreening of the front panel were done with the MacDraw program on the Apple Mackintosh computer and printed with the Lasewriter printer. 6 refs

  3. Delayed rule following

    OpenAIRE

    Schmitt, David R.

    2001-01-01

    Although the elements of a fully stated rule (discriminative stimulus [SD], some behavior, and a consequence) can occur nearly contemporaneously with the statement of the rule, there is often a delay between the rule statement and the SD. The effects of this delay on rule following have not been studied in behavior analysis, but they have been investigated in rule-like settings in the areas of prospective memory (remembering to do something in the future) and goal pursuit. Discriminative even...

  4. Vernier Delay Unit

    International Nuclear Information System (INIS)

    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

  5. Quad precision delay generator

    International Nuclear Information System (INIS)

    Krishnan, Shanti; Gopalakrishnan, K.R.; Marballi, K.R.

    1997-01-01

    A Quad Precision Delay Generator delays a digital edge by a programmed amount of time, varying from nanoseconds to microseconds. The output of this generator has an amplitude of the order of tens of volts and rise time of the order of nanoseconds. This was specifically designed and developed to meet the stringent requirements of the plasma focus experiments. Plasma focus is a laboratory device for producing and studying nuclear fusion reactions in hot deuterium plasma. 3 figs

  6. 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

  7. [The profile urological emergencies at the Conakry University Teaching Hospital, Guinea].

    Science.gov (United States)

    Bobo Diallo, A; Bah, I; Diallo, T M O; Bah, O R; Amougou, B; Bah, M D; Guirassy, S; Bobo Diallo, M

    2010-03-01

    To stick out the profile urological emergencies at the Conakry University Teaching Hospital, Guinea. This retrospective study, carried out over a period of 3 years (January 2005-December 2007), included 757 urological emergencies admitted to the urology department of the university hospital of Conakry, Guinea. The mean age of patients was 56 years. These patients had an age equal to or higher than 60 years in 58% of the cases. The sex ratio (M/F) was 16.6. According to the social profession, the farmer (40,6%) and workers (21%) were the dominant patients. The most frequent illness was vesical urinary retention (73.9%), hematuria (9.6%) and genito-urinary system trauma (7%). The most performed procedures were the installation of a urethral catheter (55.25%) and the installation of a suprapubic catheter (24.14%). The most frequent urological emergency in our country was vesical urinary retention, the hematuria and genito-urinary system trauma are not rare there. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  8. 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.

  9. Urinary tract infection in children younger than 5 years. Etiology and associated urological anomalies.

    Science.gov (United States)

    Garout, Wallaa A; Kurdi, Hassan S; Shilli, Abdulrahman H; Kari, Jameela A

    2015-04-01

    To investigate the most common underlying organisms, and associated urological anomalies in children presenting with urinary tract infection (UTI). Retrospectively, all children with confirmed UTI between October 2013 and February 2014 were evaluated at King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia. The electronic files of 279 children presenting with UTI, aged less than 5 years were reviewed. A total of 153 patients (85 males) with a mean (SD) age of 15 (19.86) months were included in the study. Recurrent UTI was present in 45.1%. Urine collection in children less than 2 years of age was through trans-urethral catheterization in 69.4%, while midstream urine was the main method in those above 2 years (78.6%). Escherichia coli (E. coli) was the causative organism in 41.2% of first UTI. The second most common organism was Klebsiella Pneumoniae, seen in 19.6%. Urological anomalies were found in 28.1% of the overall study population. Ninety percent of those with single UTI did not have anomalies. However, urological anomalies were reported in 50.7% of those with recurrent episodes of UTI (p less than 0.005). Non-E. coli cases were associated with a higher percentage of abnormal renal ultrasonography results (p=0.006). Escherichia coli was the most common causative organism for UTI, and a single episode of UTI signified normal urological anatomy.

  10. 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

  11. Staff lens doses in interventional urology. A comparison with interventional radiology, cardiology and vascular surgery values

    International Nuclear Information System (INIS)

    Vano, E; Fernandez, J M; Sanchez, R M; Resel, L E; Moreno, J

    2016-01-01

    The purpose of this work is to evaluate radiation doses to the lens of urologists during interventional procedures and to compare them with values measured during interventional radiology, cardiology and vascular surgery. The measurements were carried out in a surgical theatre using a mobile C-arm system and electronic occupational dosimeters (worn over the lead apron). Patient and staff dose measurements were collected in a sample of 34 urology interventions (nephrolithotomies). The same dosimetry system was used in other medical specialties for comparison purposes. Median and 3rd quartile values for urology procedures were: patient doses 30 and 40 Gy cm 2 ; personal dose equivalent Hp(10) over the apron (μSv/procedure): 393 and 848 (for urologists); 21 and 39 (for nurses). Median values of over apron dose per procedure for urologists resulted 18.7 times higher than those measured for radiologists and cardiologists working with proper protection (using ceiling suspended screens) in catheterisation laboratories, and 4.2 times higher than the values measured for vascular surgeons at the same hospital. Comparison with passive dosimeters worn near the eyes suggests that dosimeters worn over the apron could be a reasonable conservative estimate for ocular doses for interventional urology. Authors recommend that at least the main surgeon uses protective eyewear during interventional urology procedures. (paper)

  12. Complications Following Common Inpatient Urological Procedures: Temporal Trend Analysis from 2000 to 2010.

    Science.gov (United States)

    Meyer, Christian P; Hollis, Michael; Cole, Alexander P; Hanske, Julian; O'Leary, James; Gupta, Soham; Löppenberg, Björn; Zavaski, Mike E; Sun, Maxine; Sammon, Jesse D; Kibel, Adam S; Fisch, Margit; Chun, Felix K H; Trinh, Quoc-Dien

    2016-04-01

    Measuring procedure-specific complication-rate trends allows for benchmarking and improvement in quality of care but must be done in a standardized fashion. Using the Nationwide Inpatient Sample, we identified all instances of eight common inpatient urologic procedures performed in the United States between 2000 and 2010. This yielded 327218 cases including both oncologic and benign diseases. Complications were identified by International Classification of Diseases, Ninth Revision codes. Each complication was cross-referenced to the procedure code and graded according to the standardized Clavien system. The Mann-Whitney and chi-square were used to assess the statistical significance of medians and proportions, respectively. We assessed temporal variability in the rates of overall complications (Clavien grade 1-4), length of hospital stay, and in-hospital mortality using the estimated annual percent change (EAPC) linear regression methodology. We observed an overall reduction in length of stay (EAPC: -1.59; ptrends showed a significant increase in complications for inpatient ureterorenoscopy (EAPC: 5.53; ptrends of urologic procedures and their complications. A significant shift toward sicker patients and more complex procedures in the inpatient setting was found, but this did not result in higher mortality. These results are indicators of the high quality of care for urologic procedures in the inpatient setting. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  13. 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.

  14. 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

  15. Training potential in minimally invasive surgery in a tertiary care, paediatric urology centre

    NARCIS (Netherlands)

    Schroeder, R. P. J.; Chrzan, R. J.; Klijn, A. J.; Kuijper, C. F.; Dik, P.; de Jong, T. P. V. M.

    2015-01-01

    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

  16. 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

  17. [Integrate the surgical hand disinfection as a quality indicator in an operating room of urology].

    Science.gov (United States)

    Francois, M; Girard, R; Mauranne, C C; Ruffion, A; Terrier, J E

    2017-12-01

    The surgical hand disinfection by friction (SDF) helps to reduce the risk of surgical site infections. For this purpose and in order to promote good compliance to quality care, the urology service of Centre Hospitalier Lyon Sud achieved a continuous internal audit to improve the quality of the SDF. An internal audit executed by the medical students of urology was established in 2013. The study population was all operators, instrumentalists and operating aids of urology operating room (OR). Each student realized 5-10 random observations, of all types of professionals. The criteria measured by the audit were criteria for friction. The evolution of indicators was positive. Particularly, the increasing duration of the first and second friction was statistically significant during follow-up (P=0.001). The total duration of friction shows a similar trend for all professionals. The surgical hand disinfection by friction in the urology OR of the Centre Hospitalier Lyon Sud has gradually improved over the iterative audits. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  18. 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

  19. A novel robotic system for single-port urologic surgery: first clinical investigation.

    Science.gov (United States)

    Kaouk, Jihad H; Haber, Georges-Pascal; Autorino, Riccardo; Crouzet, Sebastien; Ouzzane, Adil; Flamand, Vincent; Villers, Arnauld

    2014-12-01

    The idea of performing a laparoscopic procedure through a single abdominal incision was conceived with the aim of expediting postoperative recovery. To determine the clinical feasibility and safety of single-port urologic procedures by using a novel robotic surgical system. This was a prospective institutional review board-approved, Innovation, Development, Exploration, Assessment, Long-term Study (IDEAL) phase 1 study. After enrollment, patients underwent a major urologic robotic single-port procedure over a 3-wk period in July 2010. The patients were followed for 3 yr postoperatively. Different types of urologic surgeries were performed using the da Vinci SP Surgical System. This system is intended to provide the same core clinical capabilities as the existing multiport da Vinci system, except that three articulating endoscopic instruments and an articulating endoscopic camera are inserted into the patient through a single robotic port. The main outcomes were the technical feasibility of the procedures (as measured by the rate of conversions) and the safety of the procedures (as measured by the incidence of perioperative complications). Secondary end points consisted of evaluating other key surgical perioperative outcomes as well as midterm functional and oncologic outcomes. A total of 19 patients were enrolled in the study. Eleven of them underwent radical prostatectomy; eight subjects underwent nephrectomy procedures (partial nephrectomy, four; radical nephrectomy, two; and simple nephrectomy, two). There were no conversions to alternative surgical approaches. Overall, two major (Clavien grade 3b) postoperative complications were observed in the radical prostatectomy group and none in the nephrectomy group. At 1-yr follow-up, one radical prostatectomy patient experienced biochemical recurrence, which was successfully treated with salvage radiation therapy. The median warm ischemia time for three of the partial nephrectomies was 38 min. At 3-yr follow-up all

  20. 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.

  1. 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.

  2. 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

  3. [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.

  4. 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

  5. Optimal Joint Expected Delay Forwarding in Delay Tolerant Networks

    OpenAIRE

    Jia Xu; Xin Feng; Wen Jun Yang; Ru Chuan Wang; Bing Qing Han

    2013-01-01

    Multicopy forwarding schemes have been employed in delay tolerant network (DTN) to improve the delivery delay and delivery rate. Much effort has been focused on reducing the routing cost while retaining high performance. This paper aims to provide an optimal joint expected delay forwarding (OJEDF) protocol which minimizes the expected delay while satisfying a certain constant on the number of forwardings per message. We propose a comprehensive forwarding metric called joint expected delay (JE...

  6. Investigation of delayed fission gas release

    International Nuclear Information System (INIS)

    Cayet, Nicolas

    1996-05-01

    The study of the fission gas release process in the high burnup rig IFA-562 has revealed a particular fuel behaviour: a delay in the fission gas release process. It appeared that an important release of gas was measured by the pressure transducers once the power had decreased, whereas, during steady-state operation, the pressure did not increase very much. After examinations, the gap size has been concluded to be the main parameter involving this delay. However the burnup could have been a potential factor, its role is mainly to close the gap by swelling. The observations of low burnup rods have shown the same delayed fission gas release, the gap being small by design and closed essentially by thermal expansion. The study of the kinetics has demonstrated the time-independency of the phenomenon. Thus the proposed mechanism driving this delayed fission gas release would involve three consecutives stages. During steady-state, the gas is released into the interlinkage network of grain boundary bubbles and cracks. Due to the closed gap, the gas is trapped in some void volumes, unable to escape the pellet. During power reduction, the gap and some old/new cracks open, immediately providing a path for the gas to the pressure transducers and explaining this delay in the fission gas release. (author)

  7. 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 ...

  8. Royal College surgical objectives of urologic training: A survey of faculty members from Canadian training programs

    Science.gov (United States)

    Zakaria, Ahmed S.; Haddad, Richard; Dragomir, Alice; Kassouf, Wassim; Andonian, Sero; Aprikian, Armen G.

    2014-01-01

    Introduction: According to the Royal College objectives of training in urology, urologic surgical procedures are divided as category A, B and C. We wanted to determine the level of proficiency required and achieved by urology training faculty for Royal College accreditation. Methods: We conducted a survey that was sent electronically to all Canadian urology training faculty. Questions focused on demographics (i.e., years of practice, geographic location, subspecialty, access to robotic surgery), operating room contact with residents, opinion on the level of proficiency required from a list of 54 surgical procedures, and whether their most recent graduates attained category A proficiency in these procedures. Results: The response rate was 43.7% (95/217). Among respondents, 92.6% were full timers, 21.1% practiced urology for less than 5 years and 3.2% for more than 30 years. Responses from Quebec and Ontario formed 69.4% (34.7% each). Of the respondents, 37.9% were uro-oncologists and 75.7% reported having access to robotic surgery. Sixty percent of faculty members operate with R5 residents between 2 to 5 days per month. When respondents were asked which categories should be listed as category A, only 8 procedures received 100% agreement. Also, results varied significantly when analyzed by sub-specialty. For example, almost 50% or more of uro-oncologists believed that radical cystectomy, anterior pelvic exenteration and extended pelvic lymphadenectomy should not be category A. The following procedures had significant disagreement suggesting the need for re-classification: glanular hypospadias repair, boari flap, entero-vesical and vesicovaginal fistulae repair. Overall, more than 80% of faculty reported that their recent graduating residents had achieved category A proficiency, in a subset of procedures. However, more than 50% of all faculty either disagreed or were ambivalent that all of their graduating residents were Category A proficient in several procedures

  9. 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

  10. Assessing delay discounting in mice

    OpenAIRE

    Mitchell, Suzanne H.

    2014-01-01

    Delay discounting (also intertemporal choice or impulsive choice) is the process by which delayed outcomes, such as delayed food delivery, are valued less than the same outcomes delivered immediately or with a shorter delay. This process is of interest because many psychopathologies, including substance dependence, pathological gambling, attention deficit hyperactivity disorder and conduct disorder, are characterized by heightened levels of delay discounting. Some of these disorders are herit...

  11. [Are therapeutics decisions homogeneous in multidisciplinary onco-urology staff meeting? Comparison of therapeutic options taken in four departments from Paris].

    Science.gov (United States)

    Audenet, F; Lejay, V; Mejean, A; De La Taille, A; Abbou, C-C; Lebret, T; Botto, H; Bitker, M-O; Roupret, M

    2012-06-01

    One of the priorities of the "Plan against the Cancer" in France is to ensure the discussion of all cancer cases in a multidisciplinary meeting staff (RCP). The multidisciplinary collaboration is proposed to guarantee a discussion between specialists in every cases, particularly in complex cases. The aim of this study was to compare the therapeutic decision taken in four RCP in Paris Île-de-France academic centres for three identical cases. Three cases of urological oncology (prostate cancer [PCa], renal cell carcinoma [RCC] and bladder tumour) were selected by a single urologist, not involved in further discussion. These cases were blindly presented in four academic urology department from Paris: Pitié-Salpêtrière Hospital, Mondor Hospital, the Georges-Pompidou European Hospital and Foch Hospital. The four centres met the criteria of quality of RCP in terms of multidisciplinarity, frequency and standardization. The therapeutic suggestions were similar in the RCC cases, there were differences in the surgical approaches and preoperative work-up in the PCa case and, lastly, the proposals were different for the bladder cancer case. The decisions relies on clinical data and preoperative work-up but also on the experience and habits of the centre of excellence. For complex cases that does not fit with current guidelines, the panel discussion can lead to different therapeutic options from a centre to another and is largely influenced by the local organisation of the RCP. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  12. 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.

  13. 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.

  14. Delayed neutrons in ANSTO

    International Nuclear Information System (INIS)

    Wall, T.

    1988-01-01

    Delayed neutron analysis carried out at the Australian Nuclear Scientific and Technology Organization facilities, provides a fast, high sensitivity, low cost, reliable method, particularly suitable for large batches of samples, and for non destructive analysis of a range of materials. While its main use has been in uranium exploration, other applications include archeological investigations, agriculture, oceanography and biology

  15. 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

  16. 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.

  17. [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.

  18. 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

    AIM: We investigated the consequences of applying different imaging guidelines for urological anomalies after first pyelonephritis in children with normal routine antenatal ultrasounds. METHODS: The cohort comprised 472 children treated for their first culture-positive pyelonephritis and investig......AIM: We investigated the consequences of applying different imaging guidelines for urological anomalies after first pyelonephritis in children with normal routine antenatal ultrasounds. METHODS: The cohort comprised 472 children treated for their first culture-positive pyelonephritis...... 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....

  19. [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.

  20. 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.

  1. 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.

  2. 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.

  3. An Analysis of Gender Diversity in Urology in the UK and Ireland.

    Science.gov (United States)

    O'Connor, E M; Nason, G J; Manecksha, R P

    2017-12-18

    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.

  4. Conference report of the Deutsche Gesellschaft fuer Urologie (German Urological Association)

    International Nuclear Information System (INIS)

    Frohmueller, H.; Ackermann, R.

    1987-01-01

    The proceedings contain all lectures and posters presented at the conference in compact form. The main subjects of the meeting were: Lymphnode surgery in the case of urological tumors and diagnosis as well as therapy of carcinomas of the prostate. Besides this, there were posters concerning various free subjects. All 27 lectures and posters dealing with radiological or nuclear medical diagnosis and therapy were indexed separately. With 335 figs., 231 tabs [de

  5. Direct-to-consumer advertising for urological pharmaceuticals: a cross-sectional analysis of print media.

    Science.gov (United States)

    Folsom, Craig; Fesperman, Susan F; Tojuola, Bayo; Sultan, Shahnaz; Dahm, Philipp

    2010-05-01

    To investigate direct-to-consumer advertising (DTCA) of prescription drugs that are relevant to urological conditions. Evidence suggests that DTCA of prescription drugs increase pharmaceutical sales. Concern about such advertising methods has recently increased owing to the market withdrawal of heavily marketed drugs that were found to have serious health risks. Three consecutive issues of 26 popular magazines during a 3-month period were screened for urology-related DTCA. Advertisements were abstracted using a standardized evaluation form that was pilot-tested in a separate sample of nonurological advertisements. Variables analyzed included the type of advertisement, claims of effectiveness, references of research studies, inducements, and use of tables, figures, and pictures. We identified 8 unique DTCA in 4 different magazines (Ladies Home Journal, Golf Digest, Sports Illustrated, and Good Housekeeping). All advertisements were disease-specific and targeted patients with benign prostatic hyperplasia-related symptoms (n = 3), incontinence (n = 3), or erectile dysfunction (n = 2). The median number of claims made per DTCA was 3 (range, 2-6). None of the claims made were supported by research data, as presented in tables or figures, or referenced peer-reviewed publications. The most common types of appeals addressed symptom control (8/8), lifestyle improvement (7/8), effectiveness (4/8), and dependability (3/8), while none addressed drug safety. DTCA of prescription drugs for urological conditions are found in select journals and focus on few highly prevalent conditions. None of the advertisement claims identified in this study were supported by research data. There seems to be significant room for improvement in the quality of information provided by urological advertisements. Copyright 2010 Elsevier Inc. All rights reserved.

  6. The effects of fatigue on robotic surgical skill training in Urology residents.

    Science.gov (United States)

    Mark, James R; Kelly, Douglas C; Trabulsi, Edouard J; Shenot, Patrick J; Lallas, Costas D

    2014-09-01

    This study reports on the effect of fatigue on Urology residents using the daVinci surgical skills simulator (dVSS). Seven Urology residents performed a series of selected exercises on the dVSS while pre-call and post-call. Prior to dVSS performance a survey of subjective fatigue was taken and residents were tested with the Epworth Sleepiness Scale (ESS). Using the metrics available in the dVSS software, the performance of each resident was evaluated. The Urology residents slept an average of 4.07 h (range 2.5-6 h) while on call compared to an average of 5.43 h while not on call (range 3-7 h, p = 0.08). Post-call residents were significantly more likely to be identified as fatigued by the Epworth Sleepiness Score than pre-call residents (p = 0.01). Significant differences were observed in fatigued residents performing the exercises, Tubes and Match Board 2 (p = 0.05, 0.02). Additionally, there were significant differences in the total number of critical errors during the training session (9.29 vs. 3.14, p = 0.04). Fatigue in post-call Urology residents leads to poorer performance on the dVSS simulator. The dVSS may become a useful instrument in the education of fatigued residents and a tool to identify fatigue in trainees.

  7. 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

  8. 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.

  9. Safety and feasibility of platelet rich fibrin matrix injections for treatment of common urologic conditions

    Directory of Open Access Journals (Sweden)

    Ethan L Matz

    2018-01-01

    Full Text Available Purpose: Autologous platelet rich plasma (PRP is used increasingly in a variety of settings. PRP injections have been used for decades to improve angiogenesis and wound healing. They have also been offered commercially in urology with little to no data on safety or efficacy. PRP could theoretically improve multiple urologic conditions, such as erectile dysfunction (ED, Peyronie's disease (PD, and stress urinary incontinence (SUI. A concern with PRP, however, is early washout, a situation potentially avoided by conversion to platelet rich fibrin matrix (PRFM. Before clinical trials can be performed, safety analysis is desirable. We reviewed an initial series of patients receiving PRFM for urologic pathology to assess safety and feasibility. Materials and Methods: Data were reviewed for patients treated with PRFM at our center from November 2012 to July 2017. Patients were observed immediately post-injection and at follow-up for complications and tolerability. Where applicable, International Index of Erectile Function (IIEF-5 scores were reviewed before and after injections for ED and/or PD. Pad use data was collected pre/post injection for SUI. Results: Seventeen patients were identified, with a mean receipt of 2.1 injections per patient. Post-procedural minor adverse events were seen in 3 men, consisting of mild pain at injection site and mild penile bruising. No patients experienced complications at follow-up. No decline was observed in men completing pre/post IIEF-5 evaluations. Conclusions: PRFM appears to be a safe and feasible treatment modality in patients with urologic disease. Further placebo-controlled trials are warranted.

  10. 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.

  11. The Influence of Smoking on the Variations in Carboxyhemoglobin and Methemoglobin During Urologic Surgery.

    Science.gov (United States)

    Gavrilovska-Brzanov, Aleksandra; Shosholcheva, Mirjana; Kuzmanovska, Biljana; Kartalov, Andrijan; Mojsova-Mijovska, Maja; Jovanovski-Srceva, Marija; Taleska, Gordana; Brzanov, Nikola; Simeonov, Risto; Miceska, Maja Slaninka

    2017-06-01

    Surgery is supposed to modulate the production of carbon monoxide by the reduction of heme oxygenase activity or transcriptional regulation of inducible heme oxygenase. On the other hand, the inhalation of tobacco smoke can substantially raise the level of carboxyhemoglobin in the blood. Furthermore, methemoglobin is maintained at a constant level. However, excessive production of methemoglobin relative to total methemoglobin reductase activity results in methemoglobin increase. The aim of our study was to investigate the perioperative variations of carboxyhemoglobin and methemoglobin during urologic surgeries, and at the same time to evaluate the changes in methemoglobin as a possible indicator of nitric oxide generation. Our second aim was to evaluate the effect of preoxygenation on the level of carboxyhemoglobin and methemoglobin and the influence of blood transfusion on their changes. The study included 30 patients scheduled for urologic surgery under general endotracheal anesthesia, aged 18-60 years without any history of respiratory disease, divided into two groups. The study group comprised patients who were smoking cigarettes or tobacco pipe, while the control group included non-smokers. In both groups carboxyhemoglobin (COHb) and methemoglobin (MetHb) levels were determined preoperatively, after preoxygenation, and postoperatively. COHb levels were decreased postoperatively in both groups. The average values of COHb between the two groups were statistically significantly different (p=0.00). MetHb levels increased postoperatively in the group of smokers and decreased in the group of non-smokers. There were no statistically significant differences in the average postoperative MetHb levels between the two groups. Changes in carboxyhemoglobin and methemoglobin concentrations in arterial blood occur during urologic surgery, although these amplitudes are small when compared with carbon monoxide intoxication and methemoglobinemia. It is likely that organ

  12. Use of invisible near infrared light fluorescence with indocyanine green and methylene blue in urology. Part 2.

    Science.gov (United States)

    Polom, Wojciech; Markuszewski, Marcin; Rho, Young Soo; Matuszewski, Marcin

    2014-01-01

    In the second part of this paper, concerning the use of invisible near infrared light (NIR) fluorescence with indocyanine green (ICG) and methylene blue (MB) in urology, other possible uses of this new technique will be presented. In kidney transplantation, this concerns allograft perfusion and real time NIR-guided angiography; moreover, perfusion angiography of tissue flaps, NIRF visualization of ureters, NIR-guided visualization of urinary calcifications, NIRF in male infertility and semen quality assessment. In this part, we have also analysed cancer targeting and imaging fluorophores as well as cost benefits associated with the use of these new techniques. PubMed and Medline databases were searched for ICG and MB use in urological settings, along with data published in abstracts of urological conferences. Although NIR-guided ICG and MB are still in their initial phases, there have been significant developments in a few more major domains of urology, including 1) kidney transplantation: kidney allograft perfusion and vessel reconstruction; 2) angiography perfusion of tissue flaps; 3) visualization of ureters; 4) visualization of urinary calcifications; and 5) NIRF in male infertility and semen quality assessment. Near infrared technology in urology is at its early stages. More studies are needed to assess the true potential and limitations of the technology. Initial studies show that this pioneering tool may influence various aspects of urology.

  13. The History of Nontraditional or Ectopic Placement of Reservoirs in Prosthetic Urology.

    Science.gov (United States)

    Perito, Paul; Wilson, Steven

    2016-04-01

    Reservoir placement during implantation of prosthetic urology devices has been problematic throughout the history of the surgical treatment of erectile dysfunction and urinary incontinence. We thought it would be interesting to review the history of reservoir placement leading up to current surgical techniques. To provide an overview of the past and present techniques for reservoir placement and discuss the evolutionary process leading to safe and effective placement of prosthetic reservoirs. We reviewed data pertaining to inflatable penile prosthesis (IPP) reservoirs and pressure-regulating balloons (PRB) in a chronological fashion, spanning 25 years. Main outcomes included a historical review of techniques for IPP reservoir and PRB placement leading to the subsequent incremental improvements in safety and efficacy when performing penile implants and artificial urinary sphincters. Prosthetic urologic reservoirs have traditionally been placed in the retropubic space. Over the years, urologists have attempted use of alternative spaces including peritoneal, epigastric, "ectopic," posterior to transversalis, and high submuscular. Current advances in prosthetic urologic reservoir placement allow safe and effective abdominal wall placement of reservoirs. These novel approaches appear to be so effective that urologists may now be able to cease using the traditional retropubic space for reservoir placement, even in the case of virgin pelves. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  14. The Knowledge of Radiation and the Attitude Towards Radio-Protection among Urology Residents in India.

    Science.gov (United States)

    Jindal, Tarun

    2015-12-01

    Exposure to radiation is a hazard and precautions are necessary to limit it. This study was done to assess the knowledge of radiation and the attitude towards radio-protection among urology residents in India. A questionnaire was administered to assess the knowledge and attitude of urology residents who came from all over the country to attend a clinical meeting at Apollo Gleneagles Hospital, Kolkata, India. All the respondents agreed to being exposed to radiation, with 78.2% using radiation in more than five cases a week. Only 65.2% always took some steps for radio-protection. Lead aprons and thyroid shields were the most common radiation protection devices used. None of the residents ever used lead gloves or protective eye glasses or dosimeters. An 82.6% felt that they did not have adequate knowledge, 85.4% of residents did not receive any formal classes regarding the risk of radiation, 21.7% either rarely or never moved out of the operating room when the radiation was being used, 42.4% did not know that the SI unit of the equivalent absorbed dose of radiation & 52.1% did not know about the amount of radiation delivered to an adult during a contrast enhanced CT scan of the abdomen. Results of the present study reveal that the urology residents of India lack knowledge about the risks of radiation exposure. Majority of them did not take necessary precautions to limit their exposure to radiation.

  15. Possibilities of fast track surgery principles in the treatment of congenital urological anomalies

    Directory of Open Access Journals (Sweden)

    Bižić Marta R.

    2012-01-01

    Full Text Available Introduction. Urogenital congenital anomalies are among the most common congenital anomalies and very frequent pathology in paediatric urology. Health care systems strive to shorten the duration and reduce the costs of hospitalization, while maintaining treatment effectiveness. Objective. To evaluate the duration of hospital stay of surgically treated patients with congenital urogenital anomalies and estimate the possibility of using fast track surgery principles in paediatric urology in the local settings of a developing country. Methods. Retrospective non-randomized study included 552 patients who had been surgically treated at the Urology Department of the University Children’s Hospital, during 2010. In line with their congenital anomalies, all patients were classified in one of four groups: I - upper urinary tract anomalies (252 patients; II - genital anomalies (164 patients; III - testicular anomalies (76 patients and IV - associated anomalies (60 patients. We analyzed the total duration of stay as well as preand post-operative stay in the hospital. Results. The average duration of hospitalization was 4.7±4.0 days. Patients with testicular anomalies stayed for the shortest period (2.3±1.9 days (p<0.01 and patients with associated anomalies stayed in the hospital the longest (6.5±4.7 days (p<0.01. Conclusion. Modern methods of surgical treatment allow reduction of hospitalization, financial savings to the healthcare system and greater comfort for patients. Our results showed that this is also possible to apply in our environment.

  16. Impact of pharmacist intervention on antibiotic use and prophylactic antibiotic use in urology clean operations.

    Science.gov (United States)

    Zhou, Y; Ma, L-Y; Zhao, X; Tian, S-H; Sun, L-Y; Cui, Y-M

    2015-08-01

    The use of prophylactic antibiotics in clean operations was routine in China before 2011. Along with the appeal for using antibiotics rationally by WHO in 2011, China launched a national special rectification scheme on clinical use of antibiotics from April that year. The scheme, aimed at achieving rational use of antibiotics, made pharmacists part of the responsible medical team. Our objective was to describe the impacts of pharmacist intervention on the use of antibiotics, particularly in urology clean operations. Pharmacists participated in antibiotic stewardship programmes of the hospital and urological clinical work and conducted real-time interventions at the same time from 2011 to 2013. Data on the use of antibiotics between 2010 and 2013 in urology were collected. Comparison of the 2013 data with those of 2010 showed that antibiotic use density [AUD= DDDs*100/(The number of patients who were treated the same period*Average days in hospital). DDDs = Total drug consumption (g)/DDD. DDD is the Defined Daily Dose] decreased by 57·8(58·8%); average antibiotic cost decreased by 246·94 dollars; the cost of antibiotics as a percentage of total drug cost decreased by 27·7%; the rate of use of antibiotics decreased from 100% to 7·3%. The study illustrates how an antibiotic stewardship programme with pharmacist participation including real-time interventions can promote improved antibiotic-prescribing and significantly decrease costs. © 2015 John Wiley & Sons Ltd.

  17. Computer-assisted surgery: virtual- and augmented-reality displays for navigation during urological interventions.

    Science.gov (United States)

    van Oosterom, Matthias N; van der Poel, Henk G; Navab, Nassir; van de Velde, Cornelis J H; van Leeuwen, Fijs W B

    2018-03-01

    To provide an overview of the developments made for virtual- and augmented-reality navigation procedures in urological interventions/surgery. Navigation efforts have demonstrated potential in the field of urology by supporting guidance for various disorders. The navigation approaches differ between the individual indications, but seem interchangeable to a certain extent. An increasing number of pre- and intra-operative imaging modalities has been used to create detailed surgical roadmaps, namely: (cone-beam) computed tomography, MRI, ultrasound, and single-photon emission computed tomography. Registration of these surgical roadmaps with the real-life surgical view has occurred in different forms (e.g. electromagnetic, mechanical, vision, or near-infrared optical-based), whereby the combination of approaches was suggested to provide superior outcome. Soft-tissue deformations demand the use of confirmatory interventional (imaging) modalities. This has resulted in the introduction of new intraoperative modalities such as drop-in US, transurethral US, (drop-in) gamma probes and fluorescence cameras. These noninvasive modalities provide an alternative to invasive technologies that expose the patients to X-ray doses. Whereas some reports have indicated navigation setups provide equal or better results than conventional approaches, most trials have been performed in relatively small patient groups and clear follow-up data are missing. The reported computer-assisted surgery research concepts provide a glimpse in to the future application of navigation technologies in the field of urology.

  18. NOTES performed using multiple ports of entry: Current experience and potential implications for urologic applications.

    Science.gov (United States)

    Lima, Estevao; Rolanda, Carla; Correia-Pinto, Jorge

    2009-05-01

    An isolated transgastric port raises serious limitations in performing natural orifice translumenal endoscopic surgery (NOTES) complex procedures in the urology field. In an attempt to overcome these limitations, several solutions has been advanced, such as the hybrid approach (adding a single abdominal port access) or the pure NOTES combined approach (joining multiple natural orifice ports). To review the current state of experimental and clinical results of multiple ports in NOTES, a literature search of PubMed was performed, seeking publications from January 2002 to 2008 on NOTES. In addition, we looked at pertinent abstracts of annual meetings of the American Urological Association, the European Association of Urology, and the World Congress of Endourology from 2007. Multiple ports of entry seem to be necessary, mainly for moderately complex procedures. Thus, we could find studies using the hybrid approach (combination of transgastric or transvaginal access with a single transabdominal port), or using the pure NOTES combined approach (transgastric and transvesical, transvaginal and transcolonic, or transgastric and transvaginal). There is still limited experience in humans using these approaches, and no comparative studies exist to date. It is predictable that for moderately complex procedures, we will need multiple ports, so the transvaginal-transabdominal (hybrid) approach is the most appealing, whereas in a pure NOTES perspective, the transgastric-transvesical approach seems to be the preferred approach. We are waiting for new equipment and instruments that are more appropriate for these novel techniques.

  19. Extended spectrum beta lactamase (ESBL) producing bacteria urinary tract infections and complex pediatric urology.

    Science.gov (United States)

    Wragg, Ruth; Harris, Anna; Patel, Mitul; Robb, Andrew; Chandran, Harish; McCarthy, Liam

    2017-02-01

    Extended spectrum beta lactamase (ESBL) producing bacteria are resistant to most beta-lactam antibiotics including third-generation cephalosporins, quinolones and aminoglycosides. This resistance is plasmid-borne and can spread between species. Management of ESBL is challenging in children with recurrent urinary tract infections (UTIs) and complex urological abnormalities. We aim to quantify the risk in children and specifically in urological patients. Retrospective review of a microbiology database (April 2014 to November 2015). This identified urine isolates, pyuria, ESBL growth and patient demographics. Data analysis was by Chi square, Mann-Whitney U-test and ANOVA. A P value of 10×10 6 WC/L). 136 urine cultures (n=79 patients) grew purely ESBL. Overall, 5.2% of urine isolates were ESBL and 9.5% isolates with pyuria (>100×10 6 WC/L) had ESBL, whereas only 22/1032 (2.1%) with no pyuria, (Pantibiotics). Over the study period, there was no significant rise of the monthly incidence between 2014 and 2015 (ANOVA P=0.1). This study is the first to document the incidence of ESBL in children (5%), and estimate the frequency of possible plasmid transmission between bacterial species in children. This quantifies the risk of ESBL, especially to urology patients, and mandates better antibiotic stewardship. Level IIc. Copyright © 2017. Published by Elsevier Inc.

  20. 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.

  1. Skeletal-related events in urological cancer patients with bone metastasis. A multicenter study in Japan

    International Nuclear Information System (INIS)

    Yokomizo, Akira; Koga, Hirofumi; Shinohara, Nobuo

    2010-01-01

    The objective of this study was to investigate the incidence of skeletal-related events (SRE) in urological cancer patients with bone metastases in Japan. Five hundred eleven patients with urological cancer and documented bone metastases treated from January 2003 to April 2008 in ten Japanese institutions were included in a retrospective analysis. Type and incidence of SRE (fracture, radiotherapy, spinal cord compression, surgery, hypercalcemia, and bone pain) were determined from patient medical records. The overall incidence of SRE, including 'pain', was 61%. The most common event was radiotherapy for bone metastases, with an incidence of 31%. The overall incidence of events seemed to be similar among Japanese and Western patients with prostate cancer and renal cell carcinoma when comparing data with previously published reports. Nevertheless, a much lower incidence of fracture (19.1%) was observed in Japanese renal cell carcinoma patients. The overall incidence of SRE in Japanese urological cancer patients with bone metastasis was similar to that in Western patients, but the incidence of fracture was lower in Japanese renal cancer patients. (author)

  2. The human immunodeficiency virus protease inhibitor ritonavir is potentially active against urological malignancies

    Directory of Open Access Journals (Sweden)

    Sato A

    2015-04-01

    Full Text Available Akinori Sato Department of Urology, National Defense Medical College, Tokorozawa, Japan Abstract: The human immunodeficiency virus protease inhibitor ritonavir has recently been shown to have antineoplastic activity, and its use in urological malignancies is under investigation with an eye toward drug repositioning. Ritonavir is thought to exert its antineoplastic activity by inhibiting multiple signaling pathways, including the Akt and nuclear factor-kappaB pathways. It can increase the amount of unfolded proteins in the cell by inhibiting both the proteasome and heat shock protein 90. Combinations of ritonavir with agents that increase the amount of unfolded proteins, such as proteasome inhibitors, histone deacetylase inhibitors, or heat shock protein 90 inhibitors, therefore, induce endoplasmic reticulum stress cooperatively and thereby kill cancer cells effectively. Ritonavir is also a potent cytochrome P450 3A4 and P-glycoprotein inhibitor, increasing the intracellular concentration of combined drugs by inhibiting their degradation and efflux from cancer cells and thereby enhancing their antineoplastic activity. Furthermore, riotnavir’s antineoplastic activity includes modulation of immune system activity. Therapies using ritonavir are thus an attractive new approach to cancer treatment and, due to their novel mechanisms of action, are expected to be effective against malignancies that are refractory to current treatment strategies. Further investigations using ritonavir are expected to find new uses for clinically available drugs in the treatment of urological malignancies as well as many other types of cancer. Keywords: drug repositioning, novel treatment

  3. 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

  4. 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

  5. Topological Acoustic Delay Line

    Science.gov (United States)

    Zhang, Zhiwang; Tian, Ye; Cheng, Ying; Wei, Qi; Liu, Xiaojun; Christensen, Johan

    2018-03-01

    Topological protected wave engineering in artificially structured media is at the frontier of ongoing metamaterials research that is inspired by quantum mechanics. Acoustic analogues of electronic topological insulators have recently led to a wealth of new opportunities in manipulating sound propagation with strikingly unconventional acoustic edge modes immune to backscattering. Earlier fabrications of topological insulators are characterized by an unreconfigurable geometry and a very narrow frequency response, which severely hinders the exploration and design of useful devices. Here we establish topologically protected sound in reconfigurable phononic crystals that can be switched on and off simply by rotating its three-legged "atoms" without altering the lattice structure. In particular, we engineer robust phase delay defects that take advantage of the ultrabroadband reflection-free sound propagation. Such topological delay lines serve as a paradigm in compact acoustic devices, interconnects, and electroacoustic integrated circuits.

  6. Delayed traumatic intracranial hematoma

    International Nuclear Information System (INIS)

    Tomita, Hiroki

    1984-01-01

    CT was performed serially within 24 hours after head injury in 64 patients having Glasgow Coma Scale of 14 or less or cranial fracture shown on roentgenogram. Delayed traumatic extradural hematoma was observed within 7-12 hours after head injury in 6 cases (9.4%). This was prominent in the frontal and occipital regions (67%). Good recovery was seen in 83.3%. Delayed traumatic intracerebral hematoma was observed within 6-24 hours after head injury in 17 cases (26.6%). This higher incidence was related to contre coup injury. Conservative treatment was possible in 14 of the 17 patients (82.4%), showing good recovery in 70%. (Namekawa, K.)

  7. 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.

  8. Delayed neutrons in liquid metal spallation targets

    International Nuclear Information System (INIS)

    Ridikas, D.; Bokov, P.; David, J.C.; Dore, D.; Giacri, M.L.; Van Lauwe, A.; Plukiene, R.; Plukis, A.; Ignatiev, S.; Pankratov, D.

    2003-01-01

    The next generation spallation neutron sources, neutrino factories or RIB production facilities currently being designed and constructed around the world will increase the average proton beam power on target by a few orders of magnitude. Increased proton beam power results in target thermal hydraulic issues leading to new target designs, very often based on flowing liquid metal targets such as Hg, Pb, Pb-Bi. Radioactive nuclides produced in liquid metal targets are transported into hot cells, past electronics, into pumps with radiation sensitive components, etc. Besides the considerable amount of photon activity in the irradiated liquid metal, a significant amount of the delayed neutron precursor activity can be accumulated in the target fluid. The transit time from the front of a liquid metal target into areas, where delayed neutrons may be important, can be as short as a few seconds, well within one half-life of many delayed neutron precursors. Therefore, it is necessary to evaluate the total neutron flux (including delayed neutrons) as a function of time and determine if delayed neutrons contribute significantly to the dose rate. In this study the multi-particle transport code MCNPX combined with the material evolution program CINDER'90 will be used to evaluate the delayed neutron flux and spectra. The following scientific issues will be addressed in this paper: - Modeling of a typical geometry of the liquid metal spallation target; - Predictions of the prompt neutron fluxes, fission fragment and spallation product distributions; - Comparison of the above parameters with existing experimental data; - Time-dependent calculations of delayed neutron precursors; - Neutron flux estimates due to the prompt and delayed neutron emission; - Proposal of an experimental program to measure delayed neutron spectra from high energy spallation-fission reactions. The results of this study should be directly applicable in the design study of the European MegaPie (1 MW

  9. Methodological Quality of Systematic Reviews Published in the Urological Literature from 1998 to 2012.

    Science.gov (United States)

    Corbyons, Katherine; Han, Julia; Neuberger, Molly M; Dahm, Philipp

    2015-11-01

    Systematic reviews synthesize the current best evidence to address a clinical question. Given the growing emphasis on evidence-based clinical practice, systematic reviews are being increasingly sought after and published. We previously reported limitations in the methodological quality of 57 individual systematic reviews published from 1998 to 2008. We provide an update to our previous study, adding systematic reviews published from 2009 to 2012. We systematically searched PubMed® and hand searched the table of contents of 4 major urological journals to identify systematic reviews related to questions of prevention and therapy. Two independent reviewers with prior formal evidence-based medicine training assessed the methodological quality using the validated 11-point AMSTAR (A Measurement Tool to Assess Systematic Reviews) instrument. We performed predefined statistical hypothesis testing for differences by publication period (1998 to 2008 vs 2009 to 2012) and journal of publication. We performed statistical testing using SPSS®, version 23.0 with a 2-sided α of 0.05 using the Student t-test, ANOVA and the chi-square test. A total of 113 systematic reviews published from 2009 to 2012 met study inclusion criteria. The most common topics were oncology (44 reviews or 38.9%), voiding dysfunction (26 or 23.0%) and stones/endourology (13 or 11.5%). The largest contributor was European Urology (46 reviews or 40.7%), followed by BJU International (31 or 27.4%) and The Journal of Urology® (22 or 19.5%). The mean ± SD AMSTAR score for the 2009 to 2012 period was 5.3 ± 2.3 compared to 4.8 ± 2.0 for 1998 to 2008 with a mean difference of 0.5 (95% CI 0.2 to 1.2, p = 0.133). While the number of systematic reviews published in the urological literature has increased substantially, the methodological quality of these studies remains suboptimal. Systematic review authors and editors should make every effort to adhere to well established methodological standards to enhance

  10. 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

  11. 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

  12. 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

  13. Delayed child-bearing.

    Science.gov (United States)

    Johnson, Jo-Ann; Tough, Suzanne

    2012-01-01

    To provide an overview of delayed child-bearing and to describe the implications for women and health care providers. Delayed child-bearing, which has increased greatly in recent decades, is associated with an increased risk of infertility, pregnancy complications, and adverse pregnancy outcome. This guideline provides information that will optimize the counselling and care of Canadian women with respect to their reproductive choices. Maternal age is the most important determinant of fertility, and obstetric and perinatal risks increase with maternal age. Many women are unaware of the success rates or limitations of assisted reproductive technology and of the increased medical risks of delayed child-bearing, including multiple births, preterm delivery, stillbirth, and Caesarean section. This guideline provides a framework to address these issues. Studies published between 2000 and August 2010 were retrieved through searches of PubMed and the Cochrane Library using appropriate key words (delayed child-bearing, deferred pregnancy, maternal age, assisted reproductive technology, infertility, and multiple births) and MeSH terms (maternal age, reproductive behaviour, fertility). The Internet was also searched using similar key words, and national and international medical specialty societies were searched for clinical practice guidelines and position statements. Data were extracted based on the aims, sample, authors, year, and results. The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). The Society of Obstetricians and Gynaecologists of Canada. RECOMMENDATIONS 1. Women who delay child-bearing are at increased risk of infertility. Prospective parents, especially women, should know that their fecundity and fertility begin to decline significantly after 32 years of age. Prospective parents should know that assisted reproductive technologies cannot guarantee a live birth or completely

  14. Parental involvement

    Directory of Open Access Journals (Sweden)

    Ezra S Simon

    2005-01-01

    Full Text Available Parent-Teacher Associations and other community groups can play a significant role in helping to establish and run refugee schools; their involvement can also help refugee adults adjust to their changed circumstances.

  15. Delaying information search

    Directory of Open Access Journals (Sweden)

    Yaniv Shani

    2012-11-01

    Full Text Available In three studies, we examined factors that may temporarily attenuate information search. People are generally curious and dislike uncertainty, which typically encourages them to look for relevant information. Despite these strong forces that promote information search, people sometimes deliberately delay obtaining valuable information. We find they may do so when they are concerned that the information might interfere with future pleasurable activities. Interestingly, the decision to search or to postpone searching for information is influenced not only by the value and importance of the information itself but also by well-being maintenance goals related to possible detrimental effects that negative knowledge may have on unrelated future plans.

  16. Positron emission tomography in urological cancer; Positronenemissionstomographie bei urologischen Tumoren

    Energy Technology Data Exchange (ETDEWEB)

    Wit, M. de [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. Onkologie/Haematologie, Medizinische Klinik; Kotzerke, J. [Universitaetsklinikum Ulm (DE). Radiologie III (Nuklearmedizin)

    2000-09-01

    In staging cancer of the urinary bladder, the kidneys and the prostate and of testicular cancer there is a need for detecting tumor involvement of the lymph nodes to avoid surgical exploration. Positron emission tomography (PET) using fluorodeoxyglucose (FDG) can detect tumorous lymph nodes (sensitivity: 70%, specificity: 85%) which is helpful for several patients. In carcinoma of the prostate, other radiotracers than FDG (e.g. C-11-choline) might be more sensitive to detect tumorous lymph nodes. Up to now no diagnostical benefit of PET in germ cell tumors could be demonstrated in the published small series. In principle FDG-PET is useful in diagnosis of recurrence. In germ cell cancer FDG-PET seems to identify effectively persistent vital tumor tissue after chemotherapy. A multicenter study was initiated to demonstrate the potential of FDG-PET in a sufficient number of patients with germ cell tumor. (orig.) [German] Bei Harnblasen-, Nieren-, Prostata- und Hodenkarzinomen besteht aus klinischer Sicht ein Bedarf an verbessertem Lymphknoten-Staging, um die operative Evaluation zu vermeiden. Die Positronenemissionstomographie (PET) mit Fluordeoxyglukose (FDG) kann daher im Einzelfall bei Harnblasen- und Nierenkarzinomen hilfreich sein (bei Sensitivitaet um 70% und Spezifitaet um 85%). Beim Prostatakarzinom koennten sich andere Radiotracer (z.B. C-11-Cholin) bei der Detektion von tumoroesen Lymphknoten ueberlegen erweisen. Bei Keimzelltumoren konnte ein Nutzen der PET im primaeren Staging bei den bisher publizierten kleinen Studien nicht nachgewiesen werden. Fuer die Rezidivdiagnostik ist bei den genannten Tumoren aus grundsaetzlicher Ueberlegung der Einsatz von DFG-PET sinnvoll. Die Erkennung von vitalem malignen Tumorgewebe nach Chemotherapie erscheint bei Keimzelltumoren mit FDG-PET weitgehend sicher zu gelingen. Eine multizentrische Studie wurde begonnen, die hierueber Aufschluss geben wird. (orig.)

  17. 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.

  18. Urological research in sub-Saharan Africa: a retrospective cohort study of abstracts presented at the Nigerian Association of Urological Surgeons conferences.

    Science.gov (United States)

    Bello, Jibril Oyekunle

    2013-11-14

    Nigeria is one of the top three countries in Africa in terms of science research output and Nigerian urologists' biomedical research output contributes to this. Each year, urologists in Nigeria gather to present their recent research at the conference of the Nigerian Association of Urological Surgeons (NAUS). These abstracts are not thoroughly vetted as are full length manuscripts published in peer reviewed journals but the information they disseminate may affect clinical practice of attendees. This study aims to describe the characteristics of abstracts presented at the annual conferences of NAUS, the quality of the abstracts as determined by the subsequent publication of full length manuscripts in peer-review indexed journals and the factors that influence such successful publication. Abstracts presented at the 2007 to 2010 NAUS conferences were identified through conference abstracts books. Using a strict search protocol, publication in peer-reviewed journals was determined. The abstracts characteristics were analyzed and their quality judged by subsequent successful publishing of full length manuscripts. Statistical analysis was performed using SPSS 16.0 software to determine factors predictive of successful publication. Only 75 abstracts were presented at the NAUS 2007 to 2010 conferences; a quarter (24%) of the presented abstracts was subsequently published as full length manuscripts. Median time to publication was 15 months (range 2-40 months). Manuscripts whose result data were analyzed with 'beyond basic' statistics of frequencies and averages were more likely to be published than those with basic or no statistics. Quality of the abstracts and thus subsequent publication success is influenced by the use of 'beyond basic' statistics in analysis of the result data presented. There is a need for improvement in the quality of urological research from Nigeria.

  19. Emergency surgery pre-operative delays - realities and economic impacts.

    Science.gov (United States)

    O'Leary, D P; Beecher, S; McLaughlin, R

    2014-12-01

    A key principle of acute surgical service provision is the establishment of a distinct patient flow process and an emergency theatre. Time-to-theatre (TTT) is a key performance indicator of theatre efficiency. The combined impacts of an aging population, increasing demands and complexity associated with centralisation of emergency and oncology services has placed pressure on emergency theatre access. We examined our institution's experience with running a designated emergency theatre for acute surgical patients. A retrospective review of an electronic prospectively maintained database was performed between 1/1/12 and 31/12/13. A cost analysis was conducted to assess the economic impact of delayed TTT, with every 24hr delay incurring the cost of an additional overnight bed. Delays and the economic effects were assessed only after the first 24 h as an in-patient had elapsed. In total, 7041 procedures were performed. Overall mean TTT was 26 h, 2 min. There were significant differences between different age groups, with those aged under 16 year and over 65 having mean TTT at 6 h, 34 min (95% C.I. 0.51-2.15, p 65 years age group had a mean TTT of 23 h, 41 min which was significantly longer than the overall mean TTT Vascular and urological emergencies are significantly disadvantaged in competition with other services for a shared emergency theatre. The economic impact of delayed TTT was calculated at €7,116,000, or €9880/day of additional costs generated from delayed TTT over a 24 month period. One third of patients waited longer than 24 h for emergency surgery, with the elderly disproportionately represented in this group. Aside from the clinical risks of delayed and out of hours surgery, such practices incur significant additional costs. New strategies must be devised to ensure efficient access to emergency theatres, investment in such services is likely to be financially and clinically beneficial. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier

  20. Delayed rule following.

    Science.gov (United States)

    Schmitt, D R

    2001-01-01

    Although the elements of a fully stated rule (discriminative stimulus [S(D)], some behavior, and a consequence) can occur nearly contemporaneously with the statement of the rule, there is often a delay between the rule statement and the S(D). The effects of this delay on rule following have not been studied in behavior analysis, but they have been investigated in rule-like settings in the areas of prospective memory (remembering to do something in the future) and goal pursuit. Discriminative events for some behavior can be event based (a specific setting stimulus) or time based. The latter are more demanding with respect to intention following and show age-related deficits. Studies suggest that the specificity with which the components of a rule (termed intention) are stated has a substantial effect on intention following, with more detailed specifications increasing following. Reminders of an intention, too, are most effective when they refer specifically to both the behavior and its occasion. Covert review and written notes are two effective strategies for remembering everyday intentions, but people who use notes appear not to be able to switch quickly to covert review. By focusing on aspects of the setting and rule structure, research on prospective memory and goal pursuit expands the agenda for a more complete explanation of rule effects.

  1. Stability and delay sensitivity of neutral fractional-delay systems.

    Science.gov (United States)

    Xu, Qi; Shi, Min; Wang, Zaihua

    2016-08-01

    This paper generalizes the stability test method via integral estimation for integer-order neutral time-delay systems to neutral fractional-delay systems. The key step in stability test is the calculation of the number of unstable characteristic roots that is described by a definite integral over an interval from zero to a sufficient large upper limit. Algorithms for correctly estimating the upper limits of the integral are given in two concise ways, parameter dependent or independent. A special feature of the proposed method is that it judges the stability of fractional-delay systems simply by using rough integral estimation. Meanwhile, the paper shows that for some neutral fractional-delay systems, the stability is extremely sensitive to the change of time delays. Examples are given for demonstrating the proposed method as well as the delay sensitivity.

  2. 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.

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

    Science.gov (United States)

    Martino, Pasquale; Galosi, Andrea Benedetto; Bitelli, Marco; Consonni, Paolo; Fiorini, Fulvio; Granata, Antonio; Gunelli, Roberta; Liguori, Giovanni; Palazzo, Silvano; Pavan, Nicola; Scattoni, Vincenzo; Virgili, Guido

    2014-03-28

    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. 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. 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. 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-observer variability is a well known limitation. These

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. New trends in minimally invasive urological surgery: what is beyond the robot?

    Science.gov (United States)

    Micali, Salvatore; Pini, Giovannalberto; Teber, Dogu; Sighinolfi, Maria Chiara; De Stefani, Stefano; Bianchi, Giampaolo; Rassweiler, Jens

    2013-06-01

    To review the minimal-invasive development of surgical technique in urology focusing on nomenclature, history and outcomes of Laparo-Endoscopic Single-site Surgery (LESS), Natural Orifice Translumenal Endoscopic Surgery (NOTES) and Computer-Assisted Surgery (CAS). A comprehensive literature search was conducted in order to find article related to LESS, NOTES and CAS in urology. The most relevant papers over the last 10 years were selected in base to the experience from the panel of experts, journal, authorship and/or content. Seven hundred and fifty manuscripts were found. Papers on LESS describe feasibility/safety in most of the procedures with a clinical experience of more than 300 cases and five compared results to standard laparoscopy without showing significant differences. NOTES accesses have been proved their feasibility/safety in experimental study. In human, the only procedures performed are on kidney and through a hybrid-Transvaginal route. New robots overcome the main drawbacks of the DaVinci® platform. The use of CAS is increasing its popularity in urology. LESS has been applied in clinical practice, but only ongoing technical and instrumental refinement will define its future role and overall benefit. The transition to a clinical application of NOTES seems at present only possible with multiple NOTES access and transvaginal access. Robot and Soft Tissue Navigation appear to be important to improve surgical skills. We are already witness to the advantages offered by the former even if costs need to be redefined based on pending long-term results. The latter will probably upgrade the quality of surgery in a near future.

  10. 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)

  11. Nonlinear smith-predictor based control strategy for a unicycle mobile robot subject to transport delay

    NARCIS (Netherlands)

    Alvarez Aguirre, A.; Velasco-Villa, M.; Del Muro Cuellar, B.

    2008-01-01

    This paper consider the remote control of an unicycle mobile robot subject to transport delay. The communication delay effects are considered by means of a discrete time approach that allows to solve the path tracking problem in terms of the delayed input. The causality problem involved in the

  12. 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...

  13. Telemedical technologies in urological cancer care: past, present and future applications.

    Science.gov (United States)

    Bogen, Etai M; Aarsæther, Erling; Augestad, Knut M; Lindsetmo, Rolv-Ole; Patel, Hiten Rh

    2013-07-01

    Since the initial development of telegraphy by Sir Charles Wheatstone in 1837 and the telephone by Alexander Graham Bell in 1875, doctors have been able to convey medical information across great distances. The exchange and sharing of medical information has evolved and adapted to suit the vast array of today's medicine. Early adopters of telemedicine within clinical practice have gained significant health economic benefits. The arrival of wireless connections has further enhanced the possibilities for all clinical work with focus on diagnosis, treatment and management of urological cancers, as highlighted in this article.

  14. [The German Museum for the History of Medicine: a museum tour from the perspective of urology].

    Science.gov (United States)

    Ruisinger, M M

    2012-08-01

    In 1973, Germany's first museum of the history of medicine was founded in the former anatomical theatre of Ingolstadt University. Today, the baroque building with its beautiful medical garden is one of the attractions of the old city of Ingolstadt. The paper gives a round tour through the permanent exhibition, the medical technology wing and the herbal garden. The emphasis is put on those objects and plants which have a connection to the history of urology, from a "ladies urinal" to the world's first ESWL apparatus.

  15. Do high-volume hospitals and surgeons provide better care in urologic oncology?

    Science.gov (United States)

    Eastham, James A

    2009-01-01

    Studies focusing primarily on hospital or surgical volume as a surrogate for surgical experience have found substantial variations in outcomes. Increasing surgical experience has been shown to improve outcomes after multiple procedures, including esophagectomy, pancreatectomy, and primary surgery for colon and breast cancer. More recently, evidence has been presented that surgical volume/experience affects quality of life and cancer control outcomes after urologic oncology procedures. Although most of these data pertain to radical prostatectomy, similar conclusions have been reached for radical cystectomy, retroperitoneal lymph node dissection, and management of renal cell carcinoma. This review highlights data indicating that high-volume surgeons and hospitals provide better care for radical prostatectomy.

  16. Serious renal and urological complications in fast-track primary total hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Bjerregaard, Lars S; Jorgensen, Christoffer C; Kehlet, Henrik

    2016-01-01

    of stay > 4 days or 30-day readmissions after fast-track THA and TKA, we conducted a detailed observational study based upon prospectively collected pre-operative data and a complete 30-day follow-up on complications and re-admissions in a unselected cohort of 8,804 consecutive fast-track THAs and TKAs......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...

  17. [German-Japanese scientific exchange in urology in the early 20th century].

    Science.gov (United States)

    Halling, T; Umehara, H; Moll, F

    2014-01-01

    This paper analyzes the importance of the German language and German culture and institutional development of urology in Japan in the early 20th century, starting from the development of the medical school for Japanese in Germany and their function in the process of modernization of the Meiji period (1868-1912). Examples of bi-directional German-Japanese relations in medicine, which also included an integrated knowledge transfer, are shown. The study is based mainly on Japanese and German sources about Japanese physicians in Germany as well as contemporary publications in German and international medical journals. Methodologically, the article combines quantitative analysis with individual biographical aspects.

  18. 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...... reconstruction approaches other than implants should be seriously considered among women who have received radiation therapy....

  19. 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.

  20. [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.

  1. 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.

  2. Current status of natural orifice trans-endoscopic surgery (NOTES and laparoendoscopic single site surgery (LESS in urologic surgery

    Directory of Open Access Journals (Sweden)

    Rafael E. Sanchez-Salas

    2010-08-01

    Full Text Available Laparoendoscopic single site surgery (LESS and natural orifice transluminal endoscopic surgery (NOTES represent novel approaches in urological surgery. To perform a review of the literature in order describe the current status of LESS and NOTES in Urology. References for this manuscript were obtained by performing a review of the available literature in PubMed from 01-01-02 to 15-05-09. Search terms included single port, single site, NOTES, LESS and single incision. A total of 412 manuscripts were initially identified. Out of these, 64 manuscripts were selected based in their urological content. The manuscript features subheadings for experimental and clinical studies, as NOTES-LESS is a new surgical technique and its future evolution will probably rely in initial verified feasibility. A subheading for reviews presents information regarding common language and consensus for the techniques. The issue of complications published in clinical series and the future needs of NOTES-LESS, are also presented.

  3. [The collections of the museum and archives of the German Society of Urology. Reflections on objects in the museum].

    Science.gov (United States)

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

    2012-09-01

    Objects in a museum that were used by urologists are part of the history of urology. If we know how to look at them they can be sources for a better understanding of the history of urology. In a museum visitors are confronted with objects during exhibitions which are the stage on which one possible interpretation of the history of urology is displayed. Objects have become"carriers of symbols" between the past and present (Pomian). Collections from medical societies which are not connected with a university or another public institution cannot be legitimized on the basis of the argument of conserving historical heritage only. The museum itself with its many tasks and as a classical site of scientific communication should be seen as a topic of scientific interest.

  4. 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...

  5. 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.

  6. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Chinmaya; López, José Manuel; Azencott, Robert; Ott, William [Department of Mathematics, University of Houston, Houston, Texas 77004 (United States); Bennett, Matthew R. [Department of Biochemistry and Cell Biology, Rice University, Houston, Texas 77204, USA and Institute of Biosciences and Bioengineering, Rice University, Houston, Texas 77005 (United States); Josić, Krešimir [Department of Mathematics, University of Houston, Houston, Texas 77004 (United States); Department of Biology and Biochemistry, University of Houston, Houston, Texas 77204 (United States)

    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.

  8. 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

  9. 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)

  10. 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.

  11. 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

  12. 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

  13. Outer synchronization of complex networks with internal delay and coupling delay via aperiodically intermittent pinning control

    Science.gov (United States)

    Zhang, Chuan; Wang, Xingyuan; Wang, Chunpeng; Xia, Zhiqiu

    This paper concerns the outer synchronization problem between two complex delayed networks via the method of aperiodically intermittent pinning control. Apart from previous works, internal delay and coupling delay are both involved in this model, and the designed intermittent controllers can be aperiodic. The main work in this paper can be summarized as follows: First, two cases of aperiodically intermittent control with constant gain and adaptive gain are implemented, respectively. The intermittent control and pinning control are combined to reduce consumptions further. Then, based on the Lyapunov stability theory, synchronization protocols are given by strict derivation. Especially, the designed controllers are indeed simple and valid in application of theory to practice. Finally, numerical examples put the proposed control methods to the test.

  14. See, Do, Teach? A Review of Contemporary Literature and Call to Action for Communication Skills Teaching in Urology.

    Science.gov (United States)

    Kieran, Kathleen; Jensen, Norman M; Rosenbaum, Marcy

    2018-04-01

    To assess the current state of published literature on communication skills teaching in urology to inform future directions for research and teaching. Excellent patient-physician communication skills increase understanding of medical conditions, facilitate shared decision-making regarding treatment planning, improve clinical outcomes, and decrease lawsuits. Surgical and procedure-based subspecialties, including urology, have generally been slow to incorporate formal communication skills teaching into curricula for postgraduate trainees. We performed a PubMed literature search using multiple keywords, selecting and reviewing articles published in English, and addressing 1 of 3 domains (curriculum development, teaching methods, and assessment methods) of communication skills teaching. The distribution of articles within the urology-specific literature was compared with that of procedure-based specialties as a whole. Eight articles were found in the urology literature, and 24 articles were found in other procedure-based specialties. Within the urology-specific literature, all 8 articles (100%) acknowledged the need for communication curriculum development, 1 article (12.5%) described how communication skills were taught, and 1 article (12.5%) discussed how communication skills were assessed. Fewer articles in other procedure-based specialties acknowledged the need to develop curricula (29.2%, P = .0007) but were equally likely to discuss communication skills teaching (37.5%, P = .63) and assessment (33.3%, P = .73). Orthopedic surgery is the only surgical subspecialty with ongoing, adaptable, formal training for physicians. Most current publications addressing communication skills in procedure-based specialties are specialty specific and focus on only 1 of the 3 communication domains. Opportunities exist to share information and to create more integrated models to teach communication skills in urology. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. Readability assessment of online patient education materials provided by the European Association of Urology.

    Science.gov (United States)

    Betschart, Patrick; Zumstein, Valentin; Bentivoglio, Maico; Engeler, Daniel; Schmid, Hans-Peter; Abt, Dominik

    2017-12-01

    To assess the readability of the web-based patient education material provided by the European Association of Urology. English patient education materials (PEM) as available in May 2017 were obtained from the EAU website. Each topic was analyzed separately using six well-established readability assessment tools, including Flesch-Kincaid Grade Level (FKGL), SMOG Grade Level (SMOG), Coleman-Liau Index (CLI), Gunning Fog Index (GFI), Flesch Reading Ease Formula (FRE) and Fry Readability Graph (FRG). A total of 17 main topics were identified of which separate basic and in-depth information is provided for 14 topics. Calculation of grade levels (FKGL, SMOG, CLI, GFI) showed readability scores of 7th-13th grade for basic information, 8th-15th grade for in-depth information and 7th-15th grade for single PEM. Median FRE score was 54 points (range 45-65) for basic information and 56 points (41-64) for in-depth information. The FRG as a graphical assessment revealed only 13 valid results with an approximate 8th-17th grade level. The EAU provides carefully worked out PEM for 17 urological topics. Although improved readability compared to similar analyses was found, a simplification of certain chapters might be helpful to facilitate better patient understanding.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. The Impact of Gestational Age at Delivery on Urologic Outcomes for the Fetus with Hydronephrosis.

    Science.gov (United States)

    Benjamin, Tara; Amodeo, Rhiannon R; Patil, Avinash S; Robinson, Barrett K

    2016-01-01

    Compare short-term urologic outcomes with delivery timing in fetuses with severe hydronephrosis. An ultrasound database was queried for severe hydronephrosis. Cases were categorized into late preterm/early term (36 0/7 - 38 6/7 weeks) and full term (39 0/7 weeks or greater) groups. Baseline characteristics were compared using standard statistical methods. Spearman's correlation analysis was performed for grade and severity of hydronephrosis on first postnatal ultrasound with gestational age at delivery. Of 589 cases, 79 (33 late preterm/early term, 46 full term) met criteria. Baseline characteristics were similar between groups. Spearman's correlation coefficients (rs) indicated that increased postnatal Society for Fetal Urology grade, rs= -0.26 (95% CI [-.48, -.002]), and severity of hydronephrosis, rs= -0.39 (95% CI [-.59, -.14]), both correlated with earlier delivery. Late preterm/early term delivery resulted in worse short-term postnatal renal outcomes. Unless otherwise indicated, delivery for fetal hydronephrosis should be deferred until 39 weeks.

  1. 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.

  2. The importance of patient-reported outcome measures in reconstructive urology.

    Science.gov (United States)

    Jackson, Matthew J; N'Dow, James; Pickard, Rob

    2010-11-01

    Patient-reported outcome measures (PROMs) are now recognised as the most appropriate instruments to assess the effectiveness of healthcare interventions from the patient's perspective. The purpose of this review was to identify recent publications describing the use of PROMs following reconstructive urological surgery. A wide systematic search identified only three original articles published in the last 2 years that prospectively assessed effectiveness using a patient-completed condition-specific or generic health-related quality of life (HRQoL) instrument. These publications illustrate the need to administer PROMs at a postoperative interval relevant to the anticipated recovery phase of individual procedures. They also highlight the difference in responsiveness of generic HRQoL instruments to symptomatic improvement between straightforward conditions such as pelviureteric junction obstruction and complex multidimensional conditions such as meningomyelocele. PROMs uptake and awareness is increasing in reconstructive urology but more work is required to demonstrate the effectiveness of surgical procedures for patients and healthcare funders alike. Healthcare policy-makers now rely on these measures to determine whether specific treatments are worth financing and to compare outcomes between institutions.

  3. 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.)

  4. 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.

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

    Science.gov (United States)

    Talamonti, Zita; Cassis, Chiara; Brambilla, Paola G; Scarpa, Paola; Stefanello, Damiano; Cannas, Simona; Minero, Michela; Palestrini, Clara

    2015-01-01

    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.

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

    Science.gov (United States)

    Cai, Tommaso; Mazzoli, Sandra; Lanzafame, Paolo; Caciagli, Patrizio; Malossini, Gianni; Nesi, Gabriella; Wagenlehner, Florian M E; Köves, Bela; Pickard, Robert; Grabe, Magnus; Bjerklund Johansen, Truls E; Bartoletti, Riccardo

    2016-01-05

    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.

  7. “I will not cut, even for the stone”: origins of urology in the hippocratic collection

    Science.gov (United States)

    Poulakou-Rebelakou, E.; Rempelakos, A.; Tsiamis, C.; Dimopoulos, C.

    2015-01-01

    The Hippocratic Collection, including the most of ancient Greek medicine, remains still interesting, despite the recent advances that transformed definitely the urological healing methods. Considering the patient as a unique psycho-somatic entity and avoiding high risk surgical manipulations were the leading principles dictating the everyday practice. Contemporary physicians can still learn from the clinical observations in times of complete absence of laboratory or imaging aid, from the prognostic thoughts, the ethics, and the philosophical concepts, represented by the Hippocratic writings, tracing into them the roots of Rational Medicine in general and Urology in particular. PMID:25928507

  8. 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)

  9. Delayed recovery from anesthesia: A postgraduate educational review

    OpenAIRE

    Misal, Ullhas Sudhakarrao; Joshi, Suchita Annasaheb; Shaikh, Mudassir Mohd

    2016-01-01

    Delayed awakening from anesthesia remains one of the biggest challenges that involve an anesthesiologist. With the general use of fast-acting anesthetic agents, patients usually awaken quickly in the postoperative period. The time to emerge from anesthesia is affected by patient factors, anesthetic factors, duration of surgery, and painful stimulation. The principal factors responsible for delayed awakening following anesthesia are anesthetic agents and medications used in the perioperative p...

  10. 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.

  11. 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.

  12. Factors associated with long diagnostic delay in celiac disease.

    Science.gov (United States)

    Fuchs, Valma; Kurppa, Kalle; Huhtala, Heini; Collin, Pekka; Mäki, Markku; Kaukinen, Katri

    2014-11-01

    Here, we investigated the factors associated with long diagnostic delay in celiac disease and the impact of the national Current Care Guidelines in reducing the delay. This population-based study involved 825 adult celiac disease patients. The diagnosis was considered delayed when the interval between first symptoms and diagnosis was >10 years. The patients were asked about the duration and type of symptoms before diagnosis, time and site (tertiary, secondary, or primary care) of the diagnosis, family history of the disease, and presence of significant comorbidities. Analysis was performed by binary logistic regression. Altogether, 261 (32%) out of 825 participants reported a diagnostic delay of >10 years. Female gender, neurological or musculoskeletal disorders and presence of diarrhea, abdominal pain, and malabsorption were associated with prolonged delay. Male gender, diagnosis after the introduction of the first Current Care Guidelines in 1997, and being detected by serological screening, and family history of celiac disease were associated with a lower risk of delayed diagnosis. Factors not associated with the delay were site of diagnosis, age, and presence of dermatitis herpetiformis, type 1 diabetes, or thyroidal disease. The number of long diagnostic delays in celiac disease has decreased over the past decades. The shift of diagnostics from secondary and tertiary care to primary care has not been detrimental. National guidelines together with increased awareness and active screening in at-risk groups of celiac disease are important in these circumstances.

  13. Delayed Auditory Feedback and Movement

    Science.gov (United States)

    Pfordresher, Peter Q.; Dalla Bella, Simone

    2011-01-01

    It is well known that timing of rhythm production is disrupted by delayed auditory feedback (DAF), and that disruption varies with delay length. We tested the hypothesis that disruption depends on the state of the movement trajectory at the onset of DAF. Participants tapped isochronous rhythms at a rate specified by a metronome while hearing DAF…

  14. #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.    

  15. 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)

  16. 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.

  17. 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).

  18. 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)

  19. 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

    2014-01-01

    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 of reward amount. Previous research has focused on the discounting of delayed and probabilistic rewards separately, with little research examining more complex situations in which rewards are both delayed and probabilistic. In two experiments, participants made choices between smaller rewards that were both immediate and certain and larger rewards that were both delayed and probabilistic. Analyses revealed significant interactions between delay and probability factors inconsistent with an additive model. In contrast, a hyperboloid discounting model in which delay and probability were combined multiplicatively provided an excellent fit to the data. These results suggest that the hyperboloid is a good descriptor of decision making in complicated monetary choice situations like those people encounter in everyday life. PMID:24933696

  20. Use of complementary and alternative medicine before and after organ removal due to urologic cancer

    Directory of Open Access Journals (Sweden)

    Mani J

    2015-10-01

    Full Text Available Jens Mani,1 Eva Juengel,1 Ilhan Arslan,1 Georg Bartsch,1 Natalie Filmann,2 Hanns Ackermann,2 Karen Nelson,3 Axel Haferkamp,1 Tobias Engl,1,* Roman A Blaheta1,* 1Department of Urology, 2Institute of Biostatistics and Mathematical Modeling, 3Department of Vascular and Endovascular Surgery, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany *These authors contributed equally to this work Objective: Many patients use complementary and alternative medicine (CAM as primary treatment or symptom relief for a variety of illnesses. This study was designed to investigate the influence of surgical removal of a tumor-bearing urogenital organ on CAM use.Methods: From 2007 to 2011, 350 patients underwent major urological surgery for kidney, prostate, or bladder cancer at the Goethe-University Hospital, Frankfurt, Germany. Data from 172 patients (49%, who returned a questionnaire, were retrospectively evaluated using the hospital information system along with the questionnaire to objectify CAM use 2 years before and after surgery.Results: From the 172 patients returning questionnaires, 56 (33% used CAM before and/or after surgery and 116 (67% never used CAM. Of the 56 CAM users, 30 (54% used CAM presurgery and 53 (95% used CAM postsurgery, indicating a significant change of mind about CAM use. Patients of German nationality used CAM significantly more than patients of other nationalities. Higher educational status (high-school diploma or higher was a significant factor in favor of CAM use. The most common type of CAM used before/after surgery was an alternative medical system (63/49%, a manipulative and body-based method (50/19%, and a biological-based therapy (37/32%. Information about CAM, either provided by medical professionals or by other sources, was the main reason determining whether patients used CAM or not.Conclusion: The number of patients using CAM almost doubled after surgical removal of a cancer-bearing organ. Better awareness and

  1. Involving women.

    Science.gov (United States)

    Agbo, J

    1994-01-01

    I am a primary health care (PHC) coordinator working with the May Day Rural project, a local NGO involved in integrated approaches and programs with rural communities in the Ga District of the Greater-Accra region in Ghana. When we talk about the community development approach we must first and foremost recognize that we are talking about women, because in the developing world frequent childbirths mean that her burden of mortality is higher than a man's; her workload is extremely heavy--whether in gardening, farming, other household duties, caring for the sick, or the rearing of children; she has a key role in PHC and community development, because men are always looking for greener pastures elsewhere, leaving the women behind. Women's concerns are critical in most health care projects and women and children are their main beneficiaries. Why not include women in the management team, project design, implementation and evaluation processes? That is what the May Day Rural project is practicing, encouraging women's participation and creating a relationship of trust. full text

  2. 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.

  3. High educational impact of a national simulation-based urological curriculum including technical and non-technical skills.

    NARCIS (Netherlands)

    Vries, A.H. de; Schout, B.M.A.; Merriënboer, J.J.G. van; Pelger, R.C.M.; Koldewijn, E.L.; Wagner, C.

    2017-01-01

    Background: Although simulation training is increasingly used to meet modern technology and patient safety demands, its successful integration within surgical curricula is still rare. The Dutch Urological Practical Skills (D-UPS) curriculum provides modular simulation-based training of technical

  4. 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.

  5. 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.

  6. Attosecond Delays in Molecular Photoionization.

    Science.gov (United States)

    Huppert, Martin; Jordan, Inga; Baykusheva, Denitsa; von Conta, Aaron; Wörner, Hans Jakob

    2016-08-26

    We report measurements of energy-dependent photoionization delays between the two outermost valence shells of N_{2}O and H_{2}O. The combination of single-shot signal referencing with the use of different metal foils to filter the attosecond pulse train enables us to extract delays from congested spectra. Remarkably large delays up to 160 as are observed in N_{2}O, whereas the delays in H_{2}O are all smaller than 50 as in the photon-energy range of 20-40 eV. These results are interpreted by developing a theory of molecular photoionization delays. The long delays measured in N_{2}O are shown to reflect the population of molecular shape resonances that trap the photoelectron for a duration of up to ∼110 as. The unstructured continua of H_{2}O result in much smaller delays at the same photon energies. Our experimental and theoretical methods make the study of molecular attosecond photoionization dynamics accessible.

  7. 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.

  8. The potential of 3D printing in urological research and patient care.

    Science.gov (United States)

    Colaco, Marc; Igel, Daniel A; Atala, Anthony

    2018-04-01

    3D printing is an evolving technology that enables the creation of unique organic and inorganic structures with high precision. In urology, the technology has demonstrated potential uses in both patient and clinician education as well as in clinical practice. The four major techniques used for 3D printing are inkjet printing, extrusion printing, laser sintering, and stereolithography. Each of these techniques can be applied to the production of models for education and surgical planning, prosthetic construction, and tissue bioengineering. Bioengineering is potentially the most important application of 3D printing, as the ability to produce functional organic constructs might, in the future, enable urologists to replicate and replace abnormal tissues with neo-organs, improving patient survival and quality of life.

  9. The past, present and future of minimally invasive therapy in urology: a review and speculative outlook.

    Science.gov (United States)

    Rassweiler, Jens; Rassweiler, Marie-Claire; Kenngott, Hannes; Frede, Thomas; Michel, Maurice-Stephan; Alken, Peter; Clayman, Ralph

    2013-08-01

    Twenty-five years of SMIT represents an important date. In this article we want to elaborate the development of minimally invasive surgery in urology during the last three decades and try to look 25 years ahead. As classical scenarios to demonstrate the changes which have revolutionized surgical treatment in urology, we have selected the management of urolithiasis, renal tumour, and localized prostate cancer. This was based on personal experience and a review of the recent literature on MIS in Urology on a MEDLINE/PUBMED research. For the outlook to the future, we have taken the expertise of two senior urologists, middle-aged experts, and upcoming junior fellows, respectively. Management of urolithiasis has been revolutionized with the introduction of non-invasive extracorporeal shock wave lithotripsy (ESWL) and minimally invasive endourology in the mid-eighties of the last century obviating open surgery. This trend has been continued with perfection and miniaturization of endourologic armamentarium rather than significantly improving ESWL. The main goal is now to get rid of the stone in one session rather in multiple non-invasive treatment sessions. Stone treatment 25 years from today will be individualized by genetic screening of stone formers, using improved ESWL-devices for small stones and transuretereal or percutaneous stone retrieval for larger and multiple stones. Management of renal tumours has also changed significantly over the last 25 years. In 1988, open radical nephrectomy was the only therapeutic option for renal masses. Nowadays, tumour size determines the choice of treatment. Tumours >4 cm are usually treated by laparoscopic nephrectomy, smaller tumours, however, can be treated either by open, laparoscopic or robot-assisted partial nephrectomy. For patients with high co-morbidity focal tumour ablation or even active surveillance represents a viable option. In 25 years, imaging of tumours will further support early diagnosis, but will also be able

  10. 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\\

  11. [August Gottlieb Richter: urological aspects of his comprehensive operative and scientific work].

    Science.gov (United States)

    Seifert, D

    2013-06-01

    August Gottlieb Richter (1742-1812) was one of the most distinguished surgeons in the second half of the eighteenth century. In this article his life and scientific career during an age shaken by wars and radical changes are described. Particular attention is paid to his achievements as a doctor, teacher and scientific author. The latter activity finds its foremost expression in the"Chirurgische Bibliothek" ("Surgical library"), a practice-oriented scientific journal, as well as in his later work"Anfangsgründe der Wundarzneykunst" ("Elements of wound surgery"). This article concentrates on the urological aspects of his work and compares these aspects with contemporary publications. Particular emphasis is placed on Richter's dispute about fashionable medical trends typical for that era as well as his culture of criticism and self-criticism.

  12. [The LESS (Laparo-endoscopic Single-Site) procedure in urology. Technical and clinical aspects].

    Science.gov (United States)

    Neri, F; Cindolo, L; Gidaro, S; Schips, L

    2010-01-01

    Minimally invasive urology is rapidly advancing, and single-site laparoscopic surgery is being explored clinically. Such laparoscopic procedures are technically challenging and require an experienced laparoscopic surgeon due to the lack of port placement triangulation and instrument clashing. In the last years several surgeons all over the world have explored the feasibility and safety of LESS using several and different ports, approaches and devices. Hundreds of procedures have been described with overall favorable intraoperative and postoperative outcomes. Our experience consists of more than 30 procedures successfully completed for adrenal, kidney disease and varicocele. To date, LESS could be considered feasible and effective using currently available devices, however it is to be considered as an initial status technique requiring further confirmatory studies and advanced laparoscopic skills.

  13. [Use of PubMed to improve evidence-based medicine in routine urological practice].

    Science.gov (United States)

    Rink, M; Kluth, L A; Shariat, S F; Chun, F K; Fisch, M; Dahm, P

    2013-03-01

    Applying evidence-based medicine in daily clinical practice is the basis of patient-centered medicine and knowledge of accurate literature acquisition skills is necessary for informed clinical decision-making. PubMed is an easy accessible, free bibliographic database comprising over 21 million citations from the medical field, life-science journals and online books. The article summarizes the effective use of PubMed in routine urological clinical practice based on a common case scenario. This article explains the simple use of PubMed to obtain the best search results with the highest evidence. Accurate knowledge about the use of PubMed in routine clinical practice can improve evidence-based medicine and also patient treatment.

  14. 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

    2018-04-01

    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

  15. Saudi Oncology Society and Saudi Urology Association combined clinical management guidelines for prostate cancer 2017.

    Science.gov (United States)

    Aljubran, Ali; Abusamra, Ashraf; Alkhateeb, Sultan; Alotaibi, Mohammed; Rabah, Danny; Bazarbashi, Shouki; Alkushi, Hussain; Al-Mansour, Mubarak; Alharbi, Hulayel; Eltijani, Amin; Alghamdi, Abdullah; Alsharm, Abdullah; Ahmad, Imran; Murshid, Esam

    2018-01-01

    This is an update to the previously published Saudi guidelines for the evaluation and medical and surgical management of patients diagnosed with prostate cancer. Prostate cancer is categorized according to the stage of the disease using the tumor node metastasis staging system 7 th edition. The guidelines are presented with supporting evidence levels based on a comprehensive literature review, several internationally recognized guidelines, and the collective expertise of the guidelines committee members (authors) who were selected by the Saudi Oncology Society and Saudi Urological Association. Local factors, such as availability, logistic feasibility, and familiarity of various treatment modalities, have been taken into consideration. These guidelines should serve as a roadmap for the urologists, oncologists, general physicians, support groups, and health-care policymakers in the management of patients diagnosed with adenocarcinoma of the prostate.

  16. Possible benefits of robot-assisted rectal cancer surgery regarding urological and sexual dysfunction

    DEFF Research Database (Denmark)

    Broholm Andersen, Malene; Pommergaard, H-C; Gögenür, I

    2015-01-01

    AIM: Robot-assisted surgery for rectal cancer may result in lower rates of urogenital dysfunction compared with laparoscopic surgery. A systematic review was conducted of studies reporting urogenital dysfunction after robot-assisted rectal cancer surgery. METHOD: PubMed, Embase and the Cochrane...... Library were systematically searched in February 2014. All studies investigating urogenital function after robot-assisted rectal cancer surgery were identified. The inclusion criteria for meta-analysis studies required comparison of robot-assisted with laparoscopic surgery and the evaluation of urological...... to four including 152 patients in the robotic group and 161 in the laparoscopic group, without heterogeneity. The IPSS score at 3 and 12 months favoured robot-assisted surgery [mean difference (MD) -1.58; 95% CI (-3.1, -0.0), [P = 0.04; and MD -0.90 (-1.81, -0.02), P = 0.05]. IIEF scores at 3 months...

  17. 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.

  18. [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.

  19. Iranian Nephrology and Urology Research Output in the Past Two Decades: A Bibliographic Analysis of Medline Database.

    Science.gov (United States)

    Einollahi, Behzad; Motalebi, Mohsen; Taghipour, Mehrdad; Ebrahimi, Mehrdad

    2015-09-01

    We performed a bibliometric search to evaluate the number of papers published in the field of nephrology and urology by Iranian researchers in the past two decades. We did an online search in abstract/title part of articles with 129 keywords such as kidney, renal, hemodialysis, transplant, nephrology, glomerulonephritis, ureteral, nephrolithiasis, and etc. Endnote software version 7 was used to search articles published in PubMed database from November 1993 to November 2013. Those articles in which Iran was the affiliation of at least one of the authors were selected. These articles in the field of nephrology and urology were analyzed regarding the name of originated institution, field of study, total number of publications, type of study, collaboration rate of Iranian nephrologist and urologists for every year, annual sharing of Iranian articles in five journals with highest impact factor (IF) and journal IF. The total number of publications in the field of nephrology and urology was 3,771 (average of 189 papers per year). Most of the Iranian nephrology and urology papers were from the capital city, Tehran (50.03%). There was an increasing trend in the number of publications over the years. Most papers were about transplantation (44.6%), nephrology (20.9%) and hemodialysis (16.4%). Of all, 53.7% were retrospective articles, whereas the proportion of clinical trials was relatively small (10.8%). Although Iranian publications in the field of nephrology and urology have had a considerable and significant increase in the recent years amongst the Middle Eastern countries, there is a wide distance to be a science exporter country.

  20. Assessing health-related quality of life in urology - a survey of 4500 German urologists.

    Science.gov (United States)

    Schmick, A; Juergensen, M; Rohde, V; Katalinic, A; Waldmann, A

    2017-06-19

    Urological diseases and their treatment may negatively influence continence, potency, and health-related quality of life (HRQOL). Although current guidelines recommend HRQOL assessment in clinical urology, specific guidance on how to assess HRQOL is frequently absent. We evaluated whether and how urologists assess HRQOL and how they determine its practicality. A random sample of 4500 (from 5200 identified German urologists) was drawn and invited to participate in a postal survey (an initial letter followed by one reminder after six weeks). The questionnaire included questions on whether and how HRQOL is assessed, general attitudes towards the concept of HRQOL, and socio-demographics. Due to the exploratory character of the study we produced mainly descriptive statistics. Chi 2 -tests and logistic regression were used for subgroup-analysis. 1557 urologists (85% male, with a mean age of 49 yrs.) participated. Most of them (87%) considered HRQOL assessment as 'important' in daily work, while only 7% reported not assessing HRQOL. Patients with prostate carcinoma, incontinence, pain, and benign prostate hyperplasia were the main target groups for HRQOL assessment. The primary aim of HRQOL assessment was to support treatment decisions, monitor patients, and produce a 'baseline measurement'. Two-thirds of urologists used questionnaires and interviews to evaluate HRQOL and one-quarter assessed HRQOL by asking: 'How are you?'. The main barriers to HRQOL assessment were anticipated questionnaire costs (77%), extensive questionnaire length (52%), and complex analysis (51%). The majority of German urologists assess HRQOL as part of their clinical routine. However, knowledge of HRQOL assessment, analysis, and interpretation seems to be limited in this group. Therefore, urologists may benefit from a targeted education program. The clinical trial was registered with the code VfD_13_003629 at the German Healthcare Research Registry ( www.versorgungsforschung-deutschland.de ).