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.
{"title":"Caracterización de la infección urinaria y resistencia antimicrobiana en receptores de trasplante renal de un centro colombiano","authors":"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","doi":"10.1055/s-0041-1730360","DOIUrl":"https://doi.org/10.1055/s-0041-1730360","url":null,"abstract":"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.","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44187204","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}
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.
{"title":"Percepción de acoso o discriminación durante la residencia de urología en Colombia","authors":"Ana María Ortiz-Zableh, Andres Felipe Quiñones Roa, Bernardo Santamaria Fuerte, Veronica Tobar-Roa","doi":"10.1055/s-0041-1737012","DOIUrl":"https://doi.org/10.1055/s-0041-1737012","url":null,"abstract":"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.","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41330083","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}
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。
{"title":"Prevalence and Demographic Characteristics of Prostate Cancer Patients in Colombia: data from the National Health Registry from 2015 to 2019","authors":"R. Parra-Medina, J. Barahona-Correa, J. J. Chaves, César Páyan-Gomez, S. Ramírez-Clavijo, Daniel G. Fenández-Ávila, D. Rosselli","doi":"10.1055/s-0041-1733844","DOIUrl":"https://doi.org/10.1055/s-0041-1733844","url":null,"abstract":"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.","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49276687","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}
H. García-Perdomo, F. Echeverría-García, Andrés Felipe Gutiérrez Rojas
{"title":"El rol de la simulación en la practica y entrenamiento urológico","authors":"H. García-Perdomo, F. Echeverría-García, Andrés Felipe Gutiérrez Rojas","doi":"10.1055/s-0041-1736204","DOIUrl":"https://doi.org/10.1055/s-0041-1736204","url":null,"abstract":"","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44850123","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}
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.
{"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":null,"pages":null},"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}
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.
{"title":"The Effect of Glyphosate on Human Sperm: In Vitro Approximation","authors":"Mateo Morales Velásquez, Valentina Velásquez Rivera, W. C. Cardona Maya","doi":"10.1055/s-0041-1731413","DOIUrl":"https://doi.org/10.1055/s-0041-1731413","url":null,"abstract":"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.","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83594621","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}
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.
{"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":null,"pages":null},"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}
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.
{"title":"Geometrical Model of Free Skin Graft for the Optimization of Glans Reconstruction after Partial Penectomy","authors":"N. Fernández, M. Medina, H. Wessells, Jaime Pérez","doi":"10.1055/s-0041-1731771","DOIUrl":"https://doi.org/10.1055/s-0041-1731771","url":null,"abstract":"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.","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46693645","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}
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.
{"title":"Lean: Introduction of a Quality Improvement Concept into Percutaneous Nephrolithotomy to Improve Efficiency while Maintaining Safety","authors":"N. Fernández, J. Hannick, Rebeca Escobar, Adolfo Serrano","doi":"10.1055/s-0041-1733843","DOIUrl":"https://doi.org/10.1055/s-0041-1733843","url":null,"abstract":"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.","PeriodicalId":38070,"journal":{"name":"Urologia Colombiana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43425804","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}
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.
{"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":null,"pages":null},"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}
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