Actas urologicas espanolas最新文献_第8页

Establishment of a rabbit model of different degrees of testicular torsion 建立不同程度睾丸扭转的兔子模型

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuroe.2024.05.017

Introduction and objectives

Different degrees of testicular torsion result in varying degrees of testicular damage, which influences treatment options and outcomes. Therefore, establishing a testicular torsion model with different degrees is necessary for clinical diagnosis.

Materials and methods

Rabbits were randomly divided into four groups and their spermatic cords were twisted at 0 °, 180 °, 360 °, and 720 °, respectively. Color Doppler flow imaging (CDFI) were performed to evaluate the blood supply in testicles. The twisted testicles were surgically removed at six hours post-operation and were evaluated by morphological observation and Hematoxylin and Eosin staining.

Results

CDFI signals were gradually decreased as the degree of testicular torsion increased, and scores of CDFI in the 360 ° and 720 ° groups were significantly decreased at postoperative six hours compared to pre-surgery. Compared to the sham, the testicle in the 180 ° group exhibited slight congestion, whereas the testicles in the 360 ° and 720 ° groups were dark red in color and had severe congestion and unrecognizable vessels. Hematoxylin and Eosin staining showed mild spermatogenic cell reduction and testicular interstitial hemorrhage in the 180 ° group. In the 360 ° and 720 ° groups, disordered seminiferous tubules, shed spermatogenic cells in tubules, inflammatory cell infiltration, and severe hemorrhage were found. In comparison with the sham, interstitial hemorrhage scores in the 360 ° and 720 ° groups were significantly higher, and scores of germinal epithelial cell thickness in the three testicular torsion groups were significantly decreased.

Conclusions

Collectively, we successfully constructed a testicular torsion model with different degrees in rabbits.

简介和目的不同程度的睾丸扭转会导致不同程度的睾丸损伤，从而影响治疗方案和效果。因此，建立不同程度的睾丸扭转模型对临床诊断十分必要。材料和方法将兔子随机分为四组，分别将其精索扭转 0°、180°、360° 和 720°。进行彩色多普勒血流成像（CDFI）以评估睾丸的血液供应情况。结果随着睾丸扭转程度的增加，CDFI信号逐渐减弱，360°和720°组的CDFI评分在术后6小时明显低于术前。与假体相比，180°组的睾丸表现出轻微充血，而360°和720°组的睾丸呈暗红色，充血严重，血管无法辨认。血色素和伊红染色显示 180 °组有轻微的生精细胞减少和睾丸间质出血。在 360 ° 和 720 ° 组中，发现曲细精管紊乱、精管内生精细胞脱落、炎性细胞浸润和严重出血。与假体相比，360 °组和 720 °组的间质出血评分明显升高，三个睾丸扭转组的生精上皮细胞厚度评分明显降低。

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引用次数: 0

State of art of robotic prostatectomy: the way we do it in Catalonia, Spain 机器人前列腺切除术的最新进展：西班牙加泰罗尼亚地区的情况如何？

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuroe.2024.05.006

Introduction and objective

Robotic-assisted laparoscopic prostatectomy (PLAR) seems to improve functional outcomes, however there is not a consensus of a standard procedure. The aim of this study was to identify the PLAR “state of art” in Catalonia, Spain.

Material and methods

This was a cross-sectional survey-based study conducted among urologists across Catalonia, Spain. The survey was distributed through online platforms and the professional urology society. All statistical analyses were performed using Stata software, v20.

Results

59 urologists completed the survey, revealing PLAR as the most commonly used technique (79.7%). Most urologist (70%) create the pneumoperitoneum using a controlled incision with direct access and 78.3% use the Airseal technology. The intraperitoneal approach is performed in >90% of cases. Endopelvic fascia preservation is not routinely performed. 34.5% of the survey not perform the dorsal vein complex suture. All preserves the bladder neck when oncologically safe. Nerve-vascular bundles bleeding control is performed using standard coagulation or suturing. 34% performed posterior reconstruction. Only use hemostatic devices when evident bleeding and 70% does not routinely left a drainage.

Multivariable analysis showed that center volume had a significant independent association with dorsal venous complex suturing (OR 0.073, 95%CI 0.07−0.826), nerve-vascular bundles suturing hemostasis (OR 11.67, 95%CI 1.07−127.60) and endopelvic fascia preservation (OR 13.64, 95%CI 1.087–201.27), but there was no correlation with time the bladder catheter or days hospitalized.

Conclusions

The study provides an overview of the state of PLAR in Catalonia, Spain, showing significant variability and reflecting a commitment to advancing surgical technology and patient care.

简介和目的：机器人辅助腹腔镜前列腺切除术（PLAR）似乎能改善功能性结果，但目前尚未就标准手术达成共识。本研究旨在确定西班牙加泰罗尼亚地区前列腺切除术的 "技术水平"：这是一项以横断面调查为基础的研究，调查对象为西班牙加泰罗尼亚地区的泌尿科医生。调查通过在线平台和专业泌尿外科学会进行。所有统计分析均使用 Stata 软件 v20 进行：59 名泌尿科医生完成了调查，结果显示 PLAR 是最常用的技术（79.7%）。大多数泌尿科医生（70%）使用直接进入的可控切口创建腹腔积气，78.3%的医生使用 Airseal 技术。超过90%的病例采用腹腔内方法。骨盆内筋膜保留不是常规做法。34.5%的调查未进行背静脉复合缝合。在肿瘤学安全的情况下，全部保留膀胱颈。使用标准凝固或缝合术控制神经血管束出血。34%进行后方重建。只有在明显出血时才使用止血装置，70%的患者不会常规留置引流管。多变量分析显示，中心容积与背静脉复合缝合（OR 0.073，95%CI 0.07-0.826）、神经血管束缝合止血（OR 11.67，95%CI 1.07-127.60）和骨盆内筋膜保留（OR 13.64，95%CI 1.087-201.27）有显著的独立关联，但与膀胱导尿时间或住院天数没有相关性：本研究概述了西班牙加泰罗尼亚地区 PLAR 的现状，显示出显著的差异性，并反映了该地区致力于提高手术技术和患者护理水平的决心。

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引用次数: 0

Rising testicular cancer incidence in Spain despite declining mortality: an age-period-cohort analysis 西班牙睾丸癌发病率上升而死亡率下降：年龄-时期-队列分析》。

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuroe.2024.05.003

Background

Testicular cancer, primarily affecting young men, has seen an alarming rise globally. This study delves into incidence and mortality trends in Spain from 1990 to 2019 using the Global Burden of Disease (GBD) database and the Age-Period-Cohort (A-P-C) model.

Methods

We analyzed GBD data on testicular cancer cases and deaths in Spain, calculating age-standardized rates (ASIR and ASMR) and employing Joinpoint regression to identify significant shifts. The A-P-C model further dissected the effects of age, period, and birth cohort on these trends.

Results

A striking doubling in testicular cancer incidence was observed, from 3.09 to 5.40 per 100,000 men (1.9% annual increase), while mortality rates remained stable and even decreased in younger age groups (0.34 to 0.26 per 100,000, 0.8% annual decrease). Joinpoint analysis revealed four distinct periods of increasing incidence, with a recent slowdown. The A-P-C model highlighted a consistent rise in incidence risk with each successive generation born after 1935, contrasting with a progressive decline in mortality risk across cohorts, particularly marked for those born since the 1960s.

Conclusion

While mortality rates are encouraging, Spain reflects the global trend of escalating testicular cancer incidence. The A-P-C analysis suggests a generational influence, but the underlying causes remain elusive. Further research is crucial to understand these trends and implement effective prevention strategies to combat this growing health concern.

背景：睾丸癌主要影响年轻男性，其发病率在全球范围内呈惊人上升趋势。本研究利用全球疾病负担（GBD）数据库和年龄-时期-队列（A-P-C）模型，深入研究了1990年至2019年西班牙的发病率和死亡率趋势：我们分析了西班牙睾丸癌病例和死亡的 GBD 数据，计算了年龄标准化比率（ASIR 和 ASMR），并采用 Joinpoint 回归法确定了显著的变化。A-P-C模型进一步剖析了年龄、时期和出生队列对这些趋势的影响：结果：观察到睾丸癌发病率翻了一番，从每 10 万名男性中 3.09 例增加到 5.40 例（年增长率为 1.9%），而死亡率保持稳定，年轻年龄组的死亡率甚至有所下降（每 10 万名男性中 0.34 例下降到 0.26 例，年下降率为 0.8%）。结合点分析显示，发病率有四个不同的上升期，最近有所放缓。A-P-C模型突出表明，1935年后出生的每一代人的发病风险都在持续上升，与此形成鲜明对比的是，各年龄组的死亡率风险在逐步下降，这在20世纪60年代后出生的人群中尤为明显：结论：西班牙的死亡率令人鼓舞，但也反映了全球睾丸癌发病率不断上升的趋势。A-P-C分析表明，睾丸癌的发病率与世代因素有关，但其根本原因仍难以捉摸。要了解这些趋势并实施有效的预防策略来应对这一日益严重的健康问题，进一步的研究至关重要。

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引用次数: 0

Does success in percutaneous nephrolithotomy depend only on stone size? Analysis of the predictive capacity for success and complications of the current nephrolithometry scoring systems and their relationship with the stone surface 经皮肾镜取石术的成功与否仅取决于结石大小吗？分析当前肾镜碎石评分系统对成功率和并发症的预测能力及其与结石表面的关系。

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuroe.2024.05.010

Objective

To analyze the predictive capacity of the nephrolithometry scoring systems (GSS, STONE, CROES and S-ReSC) and stone surface regarding success and complications following percutaneous nephrolithotomy (PCNL).

Methods

We studied 392 patients who had undergone PCNL in our center. Only patients with a non-contrast CT (n = 240) were finally included for analysis. The predictive capacities for success and complications of the different scoring systems were evaluated using ROC curves and their area under the curve (AUC).

Results

Regarding success, the S-ReSC system had the highest predictive capacity with an AUC of 0.681 (95% CI 0.610−0.751), followed by the CROES with 0.667 (95% CI 0.595−0.738), the STONE with 0.654 (95% CI 0.579−0.728) and finally the GSS with 0.626 (95% CI 0.555−0.698). The stone surface as a single variable had an AUC of 0.641 (95% CI 0.565−0.718). As for complications, the S-ReSC had the highest AUC with 0.664 (95% CI 0.57−0.758), followed by STONE with 0.663 (95% CI 0.572−0.755), GSS with 0.626 (95% CI 0.555).−0.698) and CROES with 0.614 (95% CI 0.518−0.7). The stone surface alone had an AUC of 0.616 (95% CI 0.522−0.715).

Conclusion

The nephrolithometry scales analyzed show a moderate predictive capacity for success and complications in patients undergoing PCNL in our center. Moreover, stone surface as an independent variable demonstrates moderate predictive capacity for both outcomes.

目的分析肾石测量评分系统（GSS、STONE、CROES 和 S-ReSC）和结石表面对经皮肾镜取石术（PCNL）成功率和并发症的预测能力：我们对本中心接受 PCNL 的 392 例患者进行了研究。方法：我们对本中心接受 PCNL 的 392 例患者进行了研究，最终只分析了接受非对比 CT 检查的患者（240 例）。使用 ROC 曲线及其曲线下面积（AUC）评估了不同评分系统对成功率和并发症的预测能力：在成功率方面，S-ReSC 系统的预测能力最高，其 AUC 为 0.681（95% CI 0.610 - 0.751），其次是 CROES，为 0.667（95% CI 0.595 - 0.738），STONE 为 0.654（95% CI 0.579 - 0.728），最后是 GSS，为 0.626（95% CI 0.555 - 0.698）。结石表面作为单一变量的 AUC 为 0.641（95% CI 0.565 - 0.718）。在并发症方面，S-ReSC 的 AUC 最高，为 0.664 (95% CI 0.57 - 0.758)，其次是 STONE，为 0.663 (95% CI 0.572 - 0.755)，GSS 为 0.626 (95% CI 0.555).- 0.698），CROES 为 0.614（95% CI 0.518 - 0.7）。结石表面单独的 AUC 为 0.616（95% CI 0.522 - 0.715）：结论：所分析的肾石量表对在本中心接受 PCNL 治疗的患者的成功率和并发症具有一定的预测能力。此外，结石表面作为一个独立变量，对这两种结果也有一定的预测能力。

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引用次数: 0

Coinfection of monkeypox, COVID-19 and syphilis in a PrEP using MSM: a case report from Barcelona 在使用 PrEP 的男男性行为者中同时感染猴痘、COVID-19 和梅毒：来自巴塞罗那的病例报告。

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuroe.2024.05.011

引用次数: 0

Gender trends at the annual Spanish Urologic Association (AEU) meeting: A review of AEU programmes over a 10-year period (2012–2022) 西班牙泌尿协会（AEU）年会的性别趋势：西班牙泌尿外科协会（AEU）年会的性别趋势：西班牙泌尿外科协会十年计划回顾（2012-2022 年）。

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuroe.2024.05.005

Introduction

Gender equity in urological meetings is pivotal for fostering diversity and inclusivity in the field. This study aims to evaluate the representation of Spanish urologist and regional disparities, and to assess its alignment with the demographic composition of the urological community.

Materials and methods

All urology meetings organized by the AEU between January 2012 and December 2022 were reviewed, including meeting information and details of the faculty. Additionally, we analysed geographic distribution of speakers across 17 different regions. Gender demographics were obtained disaggregating data by sex and year from the Organización Médica Colegial de España (OMC) and from those urologists affiliated to the AEU.

Results

Analysing 52 AEU congresses held from 2012 to 2022, encompassing 3,407 speakers, the study found that 95.25% of speakers were from Spain and 89.6% were male speakers. Over the years, there was a positive trend in female speaker representation, increasing by 1.1% annually, slightly lagging the 1.8% annual rise in the number of female urologists in Spain. In specific subfields like functional, transplantation, and oncology sessions, the study revealed a higher representation of women, indicating focused efforts in these areas. Geographically, Madrid, Catalonia and Andalusia exhibited the highest representation.

Conclusions

Although there was a positive trend towards an increased participation of female urologists in Spanish urological meetings, it fails to accurately reflect the proportional increase in the number of women entering the urology profession in recent years. This study underscores the importance of ongoing efforts to ensure diverse and balanced representation in urological forum.

导言：泌尿外科会议中的性别平等对于促进该领域的多样性和包容性至关重要。本研究旨在评估西班牙泌尿外科医生的代表性和地区差异，并评估其与泌尿外科界人口构成的一致性：我们回顾了 2012 年 1 月至 2022 年 12 月间由 AEU 组织的所有泌尿外科会议，包括会议信息和教师详情。此外，我们还分析了发言人在 17 个不同地区的地理分布情况。我们还从Organización Médica Colegial de España (OMC)和隶属于AEU的泌尿科医生那里获得了按性别和年份分列的性别人口统计数据：研究分析了2012年至2022年期间举行的52次AEU大会，共有3407人发言，发现95.25%的发言者来自西班牙，89.6%的发言者为男性。多年来，女性发言人的比例呈上升趋势，每年增加1.1%，略低于西班牙泌尿科女医生人数每年1.8%的增幅。研究显示，在功能、移植和肿瘤等特定子领域的会议上，女性代表的比例较高，这表明这些领域的工作重点是女性。从地域上看，马德里、加泰罗尼亚和安达卢西亚的女性比例最高：尽管西班牙泌尿外科会议中女性泌尿科医生的参与率呈上升趋势，但这并不能准确反映近年来进入泌尿外科行业的女性人数的增长比例。这项研究强调了持续努力确保泌尿外科论坛的多元化和均衡代表性的重要性。

{"title":"Gender trends at the annual Spanish Urologic Association (AEU) meeting: A review of AEU programmes over a 10-year period (2012–2022)","authors":"","doi":"10.1016/j.acuroe.2024.05.005","DOIUrl":"10.1016/j.acuroe.2024.05.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Gender equity in urological meetings is pivotal for fostering diversity and inclusivity in the field. This study aims to evaluate the representation of Spanish urologist and regional disparities, and to assess its alignment with the demographic composition of the urological community.</div></div><div><h3>Materials and methods</h3><div>All urology meetings organized by the AEU between January 2012 and December 2022 were reviewed, including meeting information and details of the faculty. Additionally, we analysed geographic distribution of speakers across 17 different regions. Gender demographics were obtained disaggregating data by sex and year from the Organización Médica Colegial de España (OMC) and from those urologists affiliated to the AEU.</div></div><div><h3>Results</h3><div>Analysing 52 AEU congresses held from 2012 to 2022, encompassing 3,407 speakers, the study found that 95.25% of speakers were from Spain and 89.6% were male speakers. Over the years, there was a positive trend in female speaker representation, increasing by 1.1% annually, slightly lagging the 1.8% annual rise in the number of female urologists in Spain. In specific subfields like functional, transplantation, and oncology sessions, the study revealed a higher representation of women, indicating focused efforts in these areas. Geographically, Madrid, Catalonia and Andalusia exhibited the highest representation.</div></div><div><h3>Conclusions</h3><div>Although there was a positive trend towards an increased participation of female urologists in Spanish urological meetings, it fails to accurately reflect the proportional increase in the number of women entering the urology profession in recent years. This study underscores the importance of ongoing efforts to ensure diverse and balanced representation in urological forum.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 574-580"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913639","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

Prevalence of DNA-Repair Gene mutations in Mexican men with prostate cancer 墨西哥男性前列腺癌患者 DNA 修复基因突变的发生率。

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuroe.2024.05.009

Introduction and objective

Mexico reported 26,742 new cases of prostate cancer in 2020. Different risk factors have been identified in the pathogenesis of prostate cancer. Among them, genetic factors and alterations or mutations in specific genes have been described in different ethnic groups worldwide. The aim of our study is to report the prevalence of germline DNA-repair gene mutations in Mexican patients with prostate cancer.

Material and method

We performed germline genetic testing in 50 patients with localized prostate cancer and 50 patients with metastatic prostate cancer. Demographic, clinical, and histopathological data were collected.

Results

Thirty-seven germline mutations were identified in 32 patients. The most commonly affected genes were ATM in 6%, followed by FANCA (5%), and ATR (4%). BRCA2 mutations were identified in 3%. The frequency of mutations was higher in the metastatic group.

Discussion and conclusion

The results of our study show different mutations from those reported in different populations or regions. The use of PARP inhibitors is indicated in patients with germline mutations, specifically BRCA2, showing improvement in overall survival and progression free survival. To our knowledge, this is the first study reporting the prevalence of mutations in DNA-repair genes in Mexican patients with prostate cancer.

导言和目标：据报告，2020 年墨西哥新增前列腺癌病例 26 742 例。在前列腺癌的发病机制中发现了不同的风险因素。其中，遗传因素和特定基因的改变或突变已在全球不同种族群体中得到描述。我们的研究旨在报告墨西哥前列腺癌患者种系 DNA 修复基因突变的发生率：我们对 50 名局部前列腺癌患者和 50 名转移性前列腺癌患者进行了种系基因检测。收集了人口统计学、临床和组织病理学数据：结果：在 32 名患者中发现了 37 个基因突变。最常受影响的基因是ATM，占6%，其次是FANCA（5%）和ATR（4%）。BRCA2基因突变占3%。在转移组中，基因突变的频率更高：我们的研究结果显示，不同人群或地区的突变情况有所不同。PARP抑制剂适用于有基因突变（尤其是BRCA2）的患者，可改善总生存期和无进展生存期。据我们所知，这是第一项报告墨西哥前列腺癌患者 DNA 修复基因突变发生率的研究。

{"title":"Prevalence of DNA-Repair Gene mutations in Mexican men with prostate cancer","authors":"","doi":"10.1016/j.acuroe.2024.05.009","DOIUrl":"10.1016/j.acuroe.2024.05.009","url":null,"abstract":"<div><h3>Introduction and objective</h3><div><span>Mexico reported 26,742 new cases of prostate cancer<span><span> in 2020. Different risk factors have been identified in the pathogenesis of prostate cancer. Among them, </span>genetic factors and alterations or mutations in specific genes have been described in different ethnic groups worldwide. The aim of our study is to report the prevalence of </span></span>germline DNA-repair gene mutations in Mexican patients with prostate cancer.</div></div><div><h3>Material and method</h3><div>We performed germline genetic testing in 50 patients with localized prostate cancer and 50 patients with metastatic prostate cancer. Demographic, clinical, and histopathological data were collected.</div></div><div><h3>Results</h3><div><span>Thirty-seven germline mutations were identified in 32 patients. The most commonly affected genes were </span><em>ATM</em> in 6%, followed by <span><em>FANCA</em></span> (5%), and <em>ATR</em> (4%). <span><span>BRCA2</span></span> mutations were identified in 3%. The frequency of mutations was higher in the metastatic group.</div></div><div><h3>Discussion and conclusion</h3><div><span>The results of our study show different mutations from those reported in different populations or regions. The use of PARP inhibitors<span> is indicated in patients with germline mutations, specifically BRCA2, showing improvement in </span></span>overall survival<span> and progression free survival. To our knowledge, this is the first study reporting the prevalence of mutations in DNA-repair genes in Mexican patients with prostate cancer.</span></div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 8","pages":"Pages 588-595"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913626","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 journey of determining PD-L1 expression in muscle-invasive urothelial carcinoma 确定浸润性尿路上皮癌中 PD-L1 的表达：西班牙解剖病理学会的建议。

Actas urologicas espanolas

Pub Date : 2024-10-01 DOI: 10.1016/j.acuroe.2024.05.015

引用次数: 0

Why do patients with urinary diversions have an increased risk of bone fracture? A systematic review on risk factors for osteoporosis and bone mineral density loss in this group of patients 为什么尿路改道患者发生骨折的风险会增加？关于该类患者骨质疏松症和骨矿物质密度损失风险因素的系统综述。

Actas urologicas espanolas

Pub Date : 2024-09-01 DOI: 10.1016/j.acuroe.2023.11.009

Introduction

Patients undergoing radical cystectomy with urinary diversions (UD) are at increased risk of bone fractures compared to the general population. Although a loss of bone mineral density (BMD) has been described in patients with UD, we still do not know with certainty why these patients follow this tendency.

Objective

We performed a systematic review of the available literature to analyze the prevalence of osteoporosis and bone alterations in patients with ileal UD and the possible associated risk factors.

Evidence acquisition

We systematically searched PubMed® and Cochrane Library for original articles published before December 2022 according to PRISMA guidelines.

Evidence synthesis

A total of 394 publications were identified. We selected 12 studies that met the inclusion criteria with 496 patients included. Six of the twelve studies showed decreased BMD values. Prevalence of osteoporosis was specified in three articles, with values ranging from 0% to 36%. Risk factors such as age, sex, body mass index, metabolic acidosis and renal function appear to have an impact on bone tissue reduction, while type of UD, follow-up, 25-hydroxyvitamin D and parathormone had less evidence or contradictory data. The heterogeneity of the studies analyzed could led to interpretation bias.

Conclusions

UD are associated with multiple risk factors for osteoporosis and bone fractures. Identifying patients at highest risk and establishing diagnostic protocols in routine clinical practice are essential to reduce the risk of fractures and the resulting complications.

简介：与普通人群相比，接受根治性膀胱切除术和尿路改道手术（UDs）的患者发生骨折的风险更高。虽然已有文献描述尿路转流术患者的骨矿物质密度（BMD）会下降，但我们仍不清楚这些患者为何会出现这种趋势：我们对现有文献进行了系统回顾，以分析回肠 UD 患者骨质疏松症和骨质改变的患病率以及可能的相关风险因素：根据 PRISMA 指南，我们系统检索了 PubMed® 和 Cochrane 图书馆中 2022 年 12 月之前发表的原创文章：共发现 394 篇文献。我们选择了符合纳入标准的 12 项研究，共纳入 496 名患者。12 项研究中有 6 项显示 BMD 值下降。有三篇文章明确指出了骨质疏松症的患病率，数值从 0% 到 36% 不等。年龄、性别、体重指数、代谢性酸中毒和肾功能等风险因素似乎对骨组织减少有影响，而尿失禁类型、随访、25-羟维生素 D 和副肾激素的证据较少或数据相互矛盾。所分析研究的异质性可能会导致解释偏差：UD与骨质疏松症和骨折的多种风险因素相关。识别高危患者并在常规临床实践中制定诊断方案对于降低骨折风险及由此引发的并发症至关重要。

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引用次数: 0

Why is it necessary to produce a BCG strain in Spain? 为什么必须在西班牙生产卡介苗菌株？

Actas urologicas espanolas

Pub Date : 2024-09-01 DOI: 10.1016/j.acuroe.2024.04.003

引用次数: 0