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Caracterización de la infección urinaria y resistencia antimicrobiana en receptores de trasplante renal de un centro colombiano
Pub Date : 2021-09-01 DOI: 10.1055/s-0041-1730360
D. Castañeda-Millán, Juan Carlos Osorio-Iriarte, J. Alzate-Granados, Daniel Amórtegui-Rodríguez, Juan Sebastián Arbeláez-Teuzaba, María Camila Romero-Sánchez, Karen Flórez-Barbosa, William Fajardo-Cediel
Resumen La infección del tracto urinario (ITU) es una de las principales complicaciones postrasplante renal, los datos a nivel nacional en ese grupo poblacional son limitados. Objetivos caracterizar la microbiología de las ITU presentadas en receptores de trasplante renal (TxR) en un centro colombiano durante el periodo 2017–2019, los factores relacionados con la resistencia antimicrobiana y el impacto de la ITU en la función del injerto renal. Métodos estudio de corte transversal ejecutado mediante el análisis de la base de datos de ingresos hospitalarios por urgencias de pacientes receptores de TxR con sospecha clínica de ITU en una institución de cuarto nivel en Bogotá, Colombia. El análisis de datos se ejecutó en STATA 13.0. Resultados La ITU causó 12,69% de visitas a urgencias en pacientes trasplantados. Los microorganismos aislados fueron: Escherichia coli 52,22%, Klebsiella pneumoniae 16,67%, Pseudomonas aeruginosa 4,44%, Salmonella spp 4,44%, Proteus mirabilis 3,33%, Serratia marcescens 2,22%, Klebsiella oxytoca 2,22%, Citrobacter koseri 1,11%, Enterobacter cloacae 1,11%, otros 2,22%; El urocultivo fue negativo en 10% de los casos. El 28,39% (n:23) de gérmenes aislados fue multisensible mientras que el 71,60% (n:58) expresó algún tipo de patrón de resistencia distribuido así: 68,96% productor de betalactamasa de espectro extendido (BLEE), 15,52% productor de carbapenemasas, 12,06% productor de betalactamasa tipo IRT, 3,45% fue catalogado como multirresistente. 17,78% de los pacientes presentó criterios de urosepsis, no se registró ningún caso de mortalidad asociada a la ITU. La creatinina sérica tuvo un incremento promedio de 0,46 mg/dl durante el episodio de ITU (p: <0,0001) y el antecedente de diabetes mellitus se relacionó con la ITU causada por gérmenes resistentes (p: 0,008). Conclusiones La ITU es una causa frecuente de atención en urgencias para pacientes receptores de TxR; la Escherichia coli es el microorganismo causal más frecuente y cerca del 70% de los gérmenes aislados presentó algún patrón de resistencia antimicrobiana.
在这方面,我们分析了两种不同的方法,一种是通过比较两种方法之间的差异,另一种是通过比较两种方法之间的差异来比较两种方法之间的差异。目的描述2017 - 2019年哥伦比亚某中心肾移植受者(TxR)中uti的微生物学特征、与抗菌素耐药性相关的因素以及uti对肾移植功能的影响。本文的目的是评估在墨西哥国立自治大学(unu)进行的一项研究的结果,该研究的目的是评估在墨西哥国立自治大学(unu)进行的一项研究的结果,该研究的目的是评估在墨西哥国立自治大学(unu)进行的一项研究的结果,该研究的目的是评估在墨西哥国立自治大学(unu)进行的一项研究的结果。使用STATA 13.0进行数据分析。结果:在移植患者中,泌尿道感染占急诊就诊的12.69%。分离的微生物为:大肠杆菌52.22%、肺炎克雷伯菌16.67%、铜绿假单胞菌4.44%、沙门氏菌4.44%、奇异变形杆菌3.33%、粘质沙雷氏菌2.22%、氧化克雷伯菌2.22%、科氏柠檬酸杆菌1.11%、阴沟肠杆菌1.11%、其他2.22%;10%的病例尿路阴性。其中28.39% (n:23)菌株表现出多重敏感,71.60% (n:58)菌株表现出某种抗性分布模式:广谱β -内酰胺酶(BLEE)产生68.96%,碳青霉烯酶产生15.52%,β -内酰胺酶IRT型产生12.06%,多重耐药3.45%。17.78%的患者有尿路败血症的标准,没有与尿路感染相关的死亡病例。在尿路感染期间,血清肌酐平均增加0.46 mg/dl (p: < 0.0001),糖尿病史与耐药细菌引起的尿路感染有关(p: 0.008)。结论尿路感染是TxR患者急诊护理的常见原因;大肠杆菌是最常见的致病微生物,约70%的分离细菌表现出抗菌素耐药性的模式。
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引用次数: 0
Percepción de acoso o discriminación durante la residencia de urología en Colombia 在哥伦比亚泌尿科住院期间的骚扰或歧视
Pub Date : 2021-09-01 DOI: 10.1055/s-0041-1737012
Ana María Ortiz-Zableh, Andres Felipe Quiñones Roa, Bernardo Santamaria Fuerte, Veronica Tobar-Roa
Resumen Objetivos El maltrato laboral (acoso, abuso o discriminación) ejercido de manera persistente contra un individuo genera un ambiente de trabajo hostil y lleva a agotamiento, con un impacto psicológico importante y la posibilidad de aparición de síntomas depresivos. En Colombia, no contamos con publicaciones al respecto. El objetivo de nuestro trabajo es conocer la percepción de los residentes de urología en cuanto a discriminación de género y acoso laboral, verbal y sexual durante su formación. Metodos Estudio observacional, descriptivo, de corte transversal, por medio de encuestas anónimas. Evaluamos las características demográficas, la percepción de acoso, el tipo de acoso, si éste afectó el rendimiento laboral del residente, y por parte de quién lo percibió. Resultados Obtuvimos respuestas de 82/115 (71,3%) residentes, en su mayoría hombres (45 [56%]). En total, 66% (54) reportaron haber experimentado acoso laboral; y 35,4% (29) reportaron haber experimentado discriminación de género, siendo más frecuente en las mujeres (17; 58,6%). El acoso verbal fue reportado por un 64,6% (53), y afectó el trabajo de un 92,5%. La percepción de acoso laboral fue similar entre hombres y mujeres (32 [69.5%] hombres y 21 [61.1%] de mujeres). En total, 7 (19%) mujeres reportaron acoso sexual. Con respecto a la fuente de acoso, 39 (65,8%) fue por profesores, 26 (45%), por otros residentes, y 17 (35.4%), por pacientes. Conclusión La percepción de acoso durante la residencia de urología en Colombia es real, y afecta el trabajo de los residentes. Este acoso es mayor por parte de los hombres, y es principalmente generado por profesores. Consideramos nuestro trabajo el punto de partida para continuar investigando un tema de importancia a nivel nacional y internacional.
客观摘要长期对个人的工作虐待(骚扰、虐待或歧视)会产生敌对的工作环境,导致精疲力竭,对心理产生重大影响,并有可能出现抑郁症状。在哥伦比亚,我们没有这方面的出版物。我们工作的目的是了解泌尿科居民在培训期间对性别歧视以及工作、言语和性骚扰的看法。方法通过匿名调查进行观察、描述性、横断面研究。我们评估了人口特征、对骚扰的看法、骚扰的类型、骚扰是否影响了居民的工作表现,以及谁感知到了骚扰。结果我们得到了82/115(71.3%)居民的答复,其中大多数是男性(45[56%])。共有66%(54)的人报告遭受过工作骚扰;35.4%(29)的人报告遭受了性别歧视,其中女性更常见(17;58.6%)。言语骚扰占64.6%(53),影响工作的占92.5%。男性和女性对工作骚扰的看法相似(男性32[69.5%]和女性21[61.1%])。共有7名(19%)妇女报告了性骚扰。关于骚扰的来源,39人(65.8%)是教师,26人(45%)是其他居民,17人(35.4%)是患者。结论哥伦比亚泌尿外科住院期间对骚扰的看法是真实的,影响了居民的工作。这种骚扰主要是男性的,主要由教师产生。我们认为,我们的工作是继续研究国家和国际两级重要问题的起点。
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引用次数: 1
Prevalence and Demographic Characteristics of Prostate Cancer Patients in Colombia: data from the National Health Registry from 2015 to 2019 哥伦比亚前列腺癌症患者的患病率和人口学特征:2015年至2019年国家卫生注册中心的数据
Pub Date : 2021-09-01 DOI: 10.1055/s-0041-1733844
R. Parra-Medina, J. Barahona-Correa, J. J. Chaves, César Páyan-Gomez, S. Ramírez-Clavijo, Daniel G. Fenández-Ávila, D. Rosselli
Abstract Background and Objective Prostate cancer is a multifactorial disease and is among the top five causes of death in men worldwide. The Colombian Ministry of Health has adopted the Integrated Information System on Social Protection (Sistema Integrado de Información de la Protección Social, SISPRO, by its Spanish acronym) registry to collect comprehensive information from the Colombian health system. The system provides close to universal coverage (around 95%). We aimed to establish the prevalence of prostate cancer in Colombia and to describe its demographics, based on data provided by SISPRO, openly available for scientific analysis. Methods Using the SISPRO data from 2015 through 2019, we analyzed the prevalence and demographic characteristics of patients diagnosed with prostate cancer. Results We identified a total of 43,862 patients with prostate cancer in the 5-year period and estimated a prevalence of 4.54 cases per 1,000 habitants, using as denominator males over 35 years old. We calculated a prevalence of early-onset prostate cancer (i.e., 35–54 years) of 0.14 per 1,000 habitants (791 cases in 5 years). The highest prevalence was observed in patients > 80 years (33.45 per 1,000 habitants). The departments with the highest prevalence were Bogotá, Valle del Cauca, Risaralda, and Boyacá, and the region with the lowest prevalence was Amazonas. Conclusion We describe the prevalence and demographics of prostate cancer in Colombia using the national healthcare system database. We observed that the prevalence has been increasing over time, and the distribution is variable according to regions, which may be related to racial or environmental causes, or access to the urologist. These factors should be addressed in further studies.
摘要背景和目的 前列腺癌症是一种多因素疾病,是全球男性死亡的五大原因之一。哥伦比亚卫生部采用了社会保护综合信息系统(Sistema Integrado de Información de la Protección-Social,SISPRO,西班牙语缩写)登记册,从哥伦比亚卫生系统收集全面信息。该系统提供了接近普遍的覆盖率(约95%)。我们旨在根据SISPRO提供的可公开用于科学分析的数据,确定癌症在哥伦比亚的患病率,并描述其人口统计数据。方法 使用2015年至2019年的SISPRO数据,我们分析了被诊断为前列腺癌症患者的患病率和人口统计学特征。后果 我们在5年内确定了43862名癌症前列腺癌患者,并以35岁以上的男性为分母,估计患病率为每1000名居民4.54例。我们计算了早发性前列腺癌症(即35-54岁)的患病率为0.14/1000居民(5年内791例)。患者的患病率最高 > 80岁(每1000名居民33.45人)。患病率最高的部门是波哥大、考卡山谷、里萨拉尔达和博亚卡,患病率最低的地区是亚马逊。结论 我们使用国家医疗系统数据库描述了哥伦比亚前列腺癌症的患病率和人口统计数据。我们观察到,随着时间的推移,患病率一直在增加,而且分布因地区而异,这可能与种族或环境原因有关,也可能与泌尿科医生有关。这些因素应在进一步研究中加以解决。
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引用次数: 1
El rol de la simulación en la practica y entrenamiento urológico 模拟在泌尿外科实习和训练中的作用
Pub Date : 2021-09-01 DOI: 10.1055/s-0041-1736204
H. García-Perdomo, F. Echeverría-García, Andrés Felipe Gutiérrez Rojas
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引用次数: 0
Liderazgo femenino en medicina y su evolución en el tiempo: 50 años de análisis bibliométrico 女性在医学中的领导地位及其随时间的演变:50年的文献计量分析
Pub Date : 2021-09-01 DOI: 10.1055/s-0041-1724045
C. Mendoza, A. Gómez, Vera Tobar, Luisana Castillo Carvajal, Johanna Vega, L. Jaimes
Resumen Objetivo Realizar un análisis bibliométrico sobre el liderazgo femenino en medicina para conocer el panorama actual y dirigir futuras investigaciones. Métodos Se realizó un análisis bibliométrico descriptivo retrospectivo de la literatura disponible en MEDLINE en relación con el liderazgo de mujeres médicas de 1973 al 2019. Se utilizó Pubmed y FABUMED, y la siguiente estrategia: ("Leadership"[Mesh]) AND "Physicians, Women"[Mesh] (1973:2019[dp]). Se incluyeron artículos originales, de revista, ensayos, informes científicos y reseñas, para analizar toda la literatura indexada relacionada. Para la obtención del factor de impacto (FI), se utilizó el Journal Citation Reports (7)2017/2018 de las revistas encontradas para estimar la calidad de cada una de ellas. Resultados Un total de 310 referencias fueron encontradas en 139 revistas publicadas, el 71,2% fueron artículos originales, el resto revisiones. Hubo un incremento en las publicaciones de 1996 al 2019 en un 11,9%. Las revistas con mayor porcentaje de publicaciones fueron: Academic Medicine y J Womens Health (Larchmt), con 7,7% y 7,1%. Los países con mayores publicaciones fueron Estados Unidos, con 66 (56%) y Reino Unido con 10 (8,6%). América latina tiene cuatro publicaciones y Colombia no cuenta con ninguna publicación indexada. Conclusión El liderazgo femenino en medicina y las publicaciones sobre el tema han aumentado en las últimas décadas en países industrializados. Por su parte, Latinoamérica debe aumentar sus esfuerzos en publicar en revistas con alto factor de impacto para trabajar por la equidad de género.
摘要目的对女性在医学领域的领导地位进行文献计量分析,以了解当前的情况并指导未来的研究。方法对MEDLINE上1973年至2019年关于女医生领导能力的文献进行回顾性描述性文献计量分析。使用了PubMed和Fabumed,以及以下策略:(“Leadership”[Mesh])和“Physicans,Women”[Mesh](1973:2019[DP])。包括原创文章、杂志文章、论文、科学报告和评论,以分析所有相关的索引文献。为了获得影响因子,使用了2017/2018年《引文报告》(7)中发现的期刊来估计每种期刊的质量。结果139种已发表期刊共有310篇参考文献,71.2%为原创文章,其余为综述。从1996年到2019年,出版物增加了11.9%。发表比例最高的杂志是《学术医学》和《妇女健康杂志》,分别为7.7%和7.1%。出版物最多的国家是美国,有66份(56%),英国有10份(8.6%)。拉丁美洲有四份出版物,哥伦比亚没有索引出版物。结论近几十年来,工业化国家女性在医学方面的领导地位和相关出版物有所增加。就其本身而言,拉丁美洲必须加强努力,在影响很大的杂志上发表文章,以促进两性平等。
{"title":"Liderazgo femenino en medicina y su evolución en el tiempo: 50 años de análisis bibliométrico","authors":"C. Mendoza, A. Gómez, Vera Tobar, Luisana Castillo Carvajal, Johanna Vega, L. Jaimes","doi":"10.1055/s-0041-1724045","DOIUrl":"https://doi.org/10.1055/s-0041-1724045","url":null,"abstract":"Resumen Objetivo Realizar un análisis bibliométrico sobre el liderazgo femenino en medicina para conocer el panorama actual y dirigir futuras investigaciones. Métodos Se realizó un análisis bibliométrico descriptivo retrospectivo de la literatura disponible en MEDLINE en relación con el liderazgo de mujeres médicas de 1973 al 2019. Se utilizó Pubmed y FABUMED, y la siguiente estrategia: (\"Leadership\"[Mesh]) AND \"Physicians, Women\"[Mesh] (1973:2019[dp]). Se incluyeron artículos originales, de revista, ensayos, informes científicos y reseñas, para analizar toda la literatura indexada relacionada. Para la obtención del factor de impacto (FI), se utilizó el Journal Citation Reports (7)2017/2018 de las revistas encontradas para estimar la calidad de cada una de ellas. Resultados Un total de 310 referencias fueron encontradas en 139 revistas publicadas, el 71,2% fueron artículos originales, el resto revisiones. Hubo un incremento en las publicaciones de 1996 al 2019 en un 11,9%. Las revistas con mayor porcentaje de publicaciones fueron: Academic Medicine y J Womens Health (Larchmt), con 7,7% y 7,1%. Los países con mayores publicaciones fueron Estados Unidos, con 66 (56%) y Reino Unido con 10 (8,6%). América latina tiene cuatro publicaciones y Colombia no cuenta con ninguna publicación indexada. Conclusión El liderazgo femenino en medicina y las publicaciones sobre el tema han aumentado en las últimas décadas en países industrializados. Por su parte, Latinoamérica debe aumentar sus esfuerzos en publicar en revistas con alto factor de impacto para trabajar por la equidad de género.","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":"30 1","pages":"e171 - e178"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46174748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Effect of Glyphosate on Human Sperm: In Vitro Approximation 草甘膦对人类精子的影响:体外近似
Pub Date : 2021-09-01 DOI: 10.1055/s-0041-1731413
Mateo Morales Velásquez, Valentina Velásquez Rivera, W. C. Cardona Maya
Abstract Introduction Glyphosate is an herbicide used to eradicate illicit crops; however, its use is controversial due to different health problems associated with it. The present study aims to evaluate the effects of glyphosate on human sperm in vitro. Methods Twenty-two semen samples from healthy normozoospermic men were included; 11 semen samples were incubated with Panzer (INVESA S.A., Antiquia, Colombia) and 11 with Roundup (Monsanto Company, MO, USA). The changes in motility and viability were observed. Functional seminal parameters were evaluated as well. Results The samples exposed to glyphosate showed less motility and viability; a decrease in the potential of the mitochondrial membrane was observed, and an increase in the lipoperoxidation of the membrane was evidenced. Conclusion Based on the present results, we concluded that glyphosate has cytotoxic potential for exposed people and may affect their fertility.
草甘膦是一种用于根除非法作物的除草剂;然而,由于与之相关的各种健康问题,它的使用存在争议。本研究旨在评估草甘膦对体外人类精子的影响。方法选取正常精子健康男性精液样本22份;11份精液样本与Panzer (INVESA s.a., Antiquia,哥伦比亚)和Roundup (Monsanto Company, MO, USA)孵育。观察其运动性和活力的变化。并对精液的功能参数进行了评价。结果暴露于草甘膦环境下的小鼠活力和活力下降;观察到线粒体膜电位降低,膜脂质过氧化增加。结论根据目前的结果,我们得出草甘膦对接触者具有细胞毒性的结论,并可能影响其生育能力。
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引用次数: 1
Perception of Harrasment or Discrimination during Urology Residency in Colombia 哥伦比亚泌尿外科住院期间对骚扰或歧视的感知
Pub Date : 2021-09-01 DOI: 10.1055/s-0041-1735787
A. M. Ortiz-Zableh, Andres Felipe Quiñones Roa, Bernardo Santamaría Fuerte, Veronica Tobar-Roa
Abstract Purpose Workplace bullying (harassment, abuse, or discrimination), practiced persistently against an individual, can generate a hostile workplace environment, consequently leading to exhaustion, with poor psychological outcomes, and the onset of symptoms such as loss of confidence, fatigue, depressive thoughts, desertion, and suicidal thoughts. There are no publications regarding this issue in Colombia. Our objective is to describe the residents' perception of gender and workplace discrimination and verbal/sexual harassment during their urological training. Methods Observational, descriptive, cross-sectional study with anonymous surveys. We evaluated the demographic characteristics and the residents' perception of harassment, the type of harassment, how it affected their performance during residency, and from whom it was perceived. Results We were able to obtain answers from 82/115 residents (71.3%), most of them men (45 [56%]). In total, 66% (54) reported workplace harassment; and 35.4% (29) felt gender discrimination, most of them women (17; 58.6%). Verbal abuse was reported by 64.6% (53), and it affected the work of 92.5%. The parception of workplace harassment was similar among both men and women (32 [69.5%] men and 21 [61.1%] women). A total of 7(19%) women reported sexual abuse. Regarding the source of the abuse, 39 (65.8%) was by professors, 26 (45%), by other residents, and 17 (35.4%), by patients. Conclusion The perception of harassment during urology residency in Colombia is real, and it affects the work of residents. This abuse is greater on the part of men, and is mainly perpetrated by professors. We consider our work the starting point to continue researching a topic of national and international importance.
摘要目的 持续针对个人的职场欺凌(骚扰、虐待或歧视)会产生敌对的职场环境,从而导致疲惫、心理后果不佳,并出现丧失信心、疲劳、抑郁、遗弃和自杀等症状。哥伦比亚没有关于这个问题的出版物。我们的目标是描述居民在泌尿外科培训期间对性别和工作场所歧视以及言语/性骚扰的看法。方法 采用匿名调查的观察性、描述性、横断面研究。我们评估了人口统计学特征和居民对骚扰的感知,骚扰的类型,它如何影响他们在住院期间的表现,以及从谁那里感知到的。后果 我们能够从82/115名居民(71.3%)那里获得答案,其中大多数是男性(45[56%])。总的来说,66%(54)的人报告工作场所受到骚扰;35.4%(29)的人感到性别歧视,其中大多数是女性(17;58.6%)。64.6%(53)的人报告了言语虐待,92.5%的人受到了影响。男性和女性对工作场所骚扰的理解相似(32[69.5%]男性和21[61.1%]女性)。共有7名(19%)妇女报告了性虐待。关于虐待的来源,教授39人(65.8%),其他居民26人(45%),患者17人(35.4%)。结论 哥伦比亚泌尿外科住院期间的骚扰是真实存在的,它影响了住院医生的工作。这种虐待行为在男性方面更为严重,主要是由教授实施的。我们认为,我们的工作是继续研究一个具有国家和国际重要性的专题的起点。
{"title":"Perception of Harrasment or Discrimination during Urology Residency in Colombia","authors":"A. M. Ortiz-Zableh, Andres Felipe Quiñones Roa, Bernardo Santamaría Fuerte, Veronica Tobar-Roa","doi":"10.1055/s-0041-1735787","DOIUrl":"https://doi.org/10.1055/s-0041-1735787","url":null,"abstract":"Abstract Purpose Workplace bullying (harassment, abuse, or discrimination), practiced persistently against an individual, can generate a hostile workplace environment, consequently leading to exhaustion, with poor psychological outcomes, and the onset of symptoms such as loss of confidence, fatigue, depressive thoughts, desertion, and suicidal thoughts. There are no publications regarding this issue in Colombia. Our objective is to describe the residents' perception of gender and workplace discrimination and verbal/sexual harassment during their urological training. Methods Observational, descriptive, cross-sectional study with anonymous surveys. We evaluated the demographic characteristics and the residents' perception of harassment, the type of harassment, how it affected their performance during residency, and from whom it was perceived. Results We were able to obtain answers from 82/115 residents (71.3%), most of them men (45 [56%]). In total, 66% (54) reported workplace harassment; and 35.4% (29) felt gender discrimination, most of them women (17; 58.6%). Verbal abuse was reported by 64.6% (53), and it affected the work of 92.5%. The parception of workplace harassment was similar among both men and women (32 [69.5%] men and 21 [61.1%] women). A total of 7(19%) women reported sexual abuse. Regarding the source of the abuse, 39 (65.8%) was by professors, 26 (45%), by other residents, and 17 (35.4%), by patients. Conclusion The perception of harassment during urology residency in Colombia is real, and it affects the work of residents. This abuse is greater on the part of men, and is mainly perpetrated by professors. We consider our work the starting point to continue researching a topic of national and international importance.","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":"30 1","pages":"e184 - e188"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46445679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Geometrical Model of Free Skin Graft for the Optimization of Glans Reconstruction after Partial Penectomy 阴茎部分切除术后最佳阴茎头重建的游离皮移植几何模型
Pub Date : 2021-08-23 DOI: 10.1055/s-0041-1731771
N. Fernández, M. Medina, H. Wessells, Jaime Pérez
Abstract Introduction and Objective The management of penile carcinoma is very disabling and mutilating, bur early treatment can be curative. Our group systematically performs oncological management with immediate penile reconstruction and preservation of the organ (partial penectomy, resurfacing, or glansectomy) when feasible. Due to the low incidence of penile carcinoma, it is difficult to achieve experience in penile reconstruction using free grafts in a standardized and reproducible way. Therefore, we herein present the results of the use of an inanimate model to identify the most efficient geometric way to procure and apply a free skin graft to reconstruct the penis. Methods A preclinical inanimate model of the penis was developed to simulate the surgical reconstruction using a free skin graft. Six different geometric skin-graft models were created and tested. For each of them, we measured graft's surface area as well as the discarded surface after placing the graft on the penis for reconstruction. We also measured the amount of suture lines required for reconstruction. All of these measurements in the six different models were compared. Results Based on the six models, we identified that the longitude of the graft must measure the same as the maximum perimeter of the glans in order to have a square that enables the complete coverage of the penile defect. The total graft area for the first 4 models was of 40 cm2; for models 5 and 6, it was of 60 cm2. The average discarded area of the graft was of 18.135 cm2 (range: 12 cm2 to 30 cm2). Models 4 years 6 were the ones with the least discarded tissue: 12 cm2. The average amount of suture lines to secure the different model grafts was 7.3 (range: 5 to 12). The models that required the least amount of suture lines were number 1 and 4, with a total of 5 suture lines. Conclusions The double trapezoid is the most efficient model to reconstruct the glans after organ-sparing oncological management. Our results contribute to establish a more standardized and predictable technique to reconstruct the penis.
摘要简介和目的 阴茎癌的治疗是非常致残和致残的,但早期治疗是可以治愈的。我们的小组系统地进行肿瘤学治疗,在可行的情况下立即重建阴茎并保存器官(部分阴茎切开术、表面置换术或龟头切除术)。由于阴茎癌的发病率较低,很难以标准化和可重复的方式获得使用游离移植物重建阴茎的经验。因此,我们在本文中介绍了使用无生命模型来确定获取和应用游离皮肤移植物重建阴茎的最有效几何方法的结果。方法 开发了一个阴茎的临床前无生命模型,以模拟使用游离皮肤移植的外科重建。创建并测试了六种不同的几何植皮模型。对于每一个,我们测量了移植物的表面积以及将移植物放置在阴茎上进行重建后丢弃的表面。我们还测量了重建所需的缝合线数量。对六种不同模型中的所有这些测量结果进行了比较。后果 基于这六个模型,我们确定移植物的经度必须与龟头的最大周长相同,才能形成一个能够完全覆盖阴茎缺陷的正方形。前4个模型的总移植物面积为40 cm2;对于型号5和6,它是60 cm2。移植物的平均丢弃面积为18.135 cm2(范围:12 cm2至30 cm2)。4岁至6岁的模型是丢弃组织最少的模型:12 用于固定不同模型移植物的缝合线的平均量为7.3(范围:5-12)。需要最少缝合线的模型为1号和4号,共有5条缝合线。结论 双梯形是保留器官肿瘤治疗后重建龟头最有效的模型。我们的研究结果有助于建立一种更标准化和可预测的阴茎重建技术。
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引用次数: 1
Lean: Introduction of a Quality Improvement Concept into Percutaneous Nephrolithotomy to Improve Efficiency while Maintaining Safety 精益:在经皮肾镜取石术中引入质量改进理念,在保证安全的同时提高效率
Pub Date : 2021-08-13 DOI: 10.1055/s-0041-1733843
N. Fernández, J. Hannick, Rebeca Escobar, Adolfo Serrano
Abstract Introduction and objective Standardization of surgical interventions reduces complications and costs and positively impacts intra and postoperative outcomes. Implementation of the lean concept, initially proposed in the auto industry, now becomes an interesting approach in the surgical setting. We want to present the results of how percutaneous nephrolithotripsy (PCNL) in a high-level center can be positively impacted by implementing the lean concept. Methods We evaluated a total of 140 PCNL procedures. Group 1 included all cases operated prior to implementing the lean concept and group 2 was composed of those operated after implementing the lean concept. We looked for all seven sources of waste to identify and modify our practice to improve efficiency and safety. We then collected intraoperative times and compared the ones prior to those after the implementation. Results After implementing the lean concept, with an average of six PCNL cases per day, a comparison was made to an equivalent number of cases prior to the lean implementation (group 1). The average total operative time for PCNL preintervention was 138 (confidence interval [CI]: 79 to 170) minutes and postlean intervention was 71.1 (CI: 43 to 157) minutes. Surgical time (cystoscopy to skin closure) was 36.1 (CI: 25 to 50) minutes prelean and 50 minutes postlean (CI: 23 to 154). For this last one, bilateral procedures were performed. Operative room turnover time was 27.8 (CI: 21 to 38) minutes prelean and 5.67 (CI: 3.5 to 12) minutes postlean. Induction time was 16.5 (CI: 5 to 55) minutes prelean and 5.4 (CI: 3.5 to 7.5) minutes postlean. Conclusion Implementation of the lean concept enables optimization of the surgical procedure, allowing hospitals to reduce costs and standardization.
摘要:手术干预措施的引入和目的标准化减少了并发症和成本,并对术中和术后的预后产生了积极的影响。精益概念的实施最初是在汽车行业提出的,现在在外科手术环境中成为一种有趣的方法。我们想要呈现的结果是,在高水平中心实施精益理念如何对经皮肾镜碎石(PCNL)产生积极影响。方法对140例PCNL手术进行评价。组1包括实施精益理念之前的所有案例,组2由实施精益理念之后的所有案例组成。我们寻找了所有七个废物来源,以确定和修改我们的做法,以提高效率和安全性。然后我们收集术中时间,并比较实施前和实施后的时间。结果实施精益概念后,平均每天有6例PCNL病例,与精益实施前(1组)的同等数量的病例进行比较。PCNL干预前的平均总手术时间为138分钟(置信区间[CI]: 79至170),精益干预后的平均总手术时间为71.1分钟(CI: 43至157)。手术时间(膀胱镜检查到皮肤闭合)为手术前36.1分钟(CI: 25 ~ 50),手术后50分钟(CI: 23 ~ 154)。最后一例患者行双侧手术。手术前的手术室周转时间为27.8 (CI: 21 ~ 38)分钟,手术后为5.67 (CI: 3.5 ~ 12)分钟。诱导时间为产前16.5 (CI: 5 ~ 55) min,产后5.4 (CI: 3.5 ~ 7.5) min。结论精益理念的实施可以优化外科手术流程,使医院降低成本,实现规范化。
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引用次数: 0
Turning Problems into Opportunities: How to Resume Urological Elective Surgery Using a Scoring System during COVID-19 Outbreak 化问题为机遇:如何在COVID-19爆发期间使用评分系统恢复泌尿外科择期手术
Pub Date : 2021-08-13 DOI: 10.1055/s-0041-1733841
Julián Chavarriaga, H. López-Ramos, J. Prada, N. Fernández
Abstract Objective Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), which is the largest pandemic in the last century and has created a health care crisis worldwide. Contingency plans have led to put on hold all urological elective surgeries. The aim of the present article is to report the adaptation of the Medically Necessary Time-Sensitive (MeNTS) scoring system to triage patients who were awaiting urological elective surgery during the COVID-19 pandemic. Methods The present study was conducted as a part of a necessary transition of care delivery at a tertiary care institution in order to re-establish urological elective surgery. We triaged all urological elective surgeries with the MeNTS instrument and proposed a cutoff value of 45 points to avoid complications in the COVID-19 crisis while resuming elective procedures. Results A total of 91 patients awaiting elective urological surgery pending to be rescheduled were identified. Their median age was 60.5 years old (interquartile range [IQR]: 46–93). Twenty-five patients were American Society of Anesthesiologists (ASA) class I, 51 (56%) were class II, and 12 (13%) were class III. The median MeNTS score was 42 points (IQR: 36–59). Twenty-nine patients had a MeNTS score > 45 and were advised to postpone their surgery. Sixty-two had a score ≤ 45 and were gradually rescheduled. Conclusions The present study may have practical implications regarding the selection of urological elective surgeries in the challenging health care situation caused by the COVID-19 pandemic. Our real-life data showed us that 32% of our procedures must be postponed, and 68% could be carefully considered and gradually rescheduled for surgery.
摘要目的由SARS-CoV-2引起的冠状病毒病2019 (COVID-19)是上个世纪最大的流行病,在全球范围内造成了卫生保健危机。应急计划导致所有泌尿外科选择性手术暂停。本文的目的是报道适应医学必要的时间敏感(MeNTS)评分系统在COVID-19大流行期间等待泌尿外科选择性手术的患者。方法本研究是作为三级医疗机构护理交付的必要过渡的一部分,以重建泌尿外科选择性手术。我们对所有使用MeNTS仪器的泌尿外科选择性手术进行了分类,并提出了45分的临界值,以避免在COVID-19危机中出现并发症,同时恢复选择性手术。结果共有91例患者等待择期泌尿外科手术。年龄中位数为60.5岁(四分位数差[IQR]: 46-93)。25例患者为美国麻醉医师协会(ASA) I级,51例(56%)为II级,12例(13%)为III级。MeNTS评分中位数为42分(IQR: 36-59)。29例患者的MeNTS评分为bb45,建议推迟手术。62例评分≤45分,逐渐改期。结论本研究对新冠肺炎疫情下泌尿外科择期手术的选择具有一定的现实意义。我们的真实数据表明,32%的手术必须推迟,68%的手术可以仔细考虑并逐步重新安排手术时间。
{"title":"Turning Problems into Opportunities: How to Resume Urological Elective Surgery Using a Scoring System during COVID-19 Outbreak","authors":"Julián Chavarriaga, H. López-Ramos, J. Prada, N. Fernández","doi":"10.1055/s-0041-1733841","DOIUrl":"https://doi.org/10.1055/s-0041-1733841","url":null,"abstract":"Abstract Objective Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), which is the largest pandemic in the last century and has created a health care crisis worldwide. Contingency plans have led to put on hold all urological elective surgeries. The aim of the present article is to report the adaptation of the Medically Necessary Time-Sensitive (MeNTS) scoring system to triage patients who were awaiting urological elective surgery during the COVID-19 pandemic. Methods The present study was conducted as a part of a necessary transition of care delivery at a tertiary care institution in order to re-establish urological elective surgery. We triaged all urological elective surgeries with the MeNTS instrument and proposed a cutoff value of 45 points to avoid complications in the COVID-19 crisis while resuming elective procedures. Results A total of 91 patients awaiting elective urological surgery pending to be rescheduled were identified. Their median age was 60.5 years old (interquartile range [IQR]: 46–93). Twenty-five patients were American Society of Anesthesiologists (ASA) class I, 51 (56%) were class II, and 12 (13%) were class III. The median MeNTS score was 42 points (IQR: 36–59). Twenty-nine patients had a MeNTS score > 45 and were advised to postpone their surgery. Sixty-two had a score ≤ 45 and were gradually rescheduled. Conclusions The present study may have practical implications regarding the selection of urological elective surgeries in the challenging health care situation caused by the COVID-19 pandemic. Our real-life data showed us that 32% of our procedures must be postponed, and 68% could be carefully considered and gradually rescheduled for surgery.","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41590241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Urologia Colombiana
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