Evaluation of uro-oncological surgical treatment during the Sars-CoV-2 pandemic in a Brazilian tertiary oncology institution, the new world epicenter

ABSTRACT Introduction: The rapid spread of coronavirus disease 2019 (COVID-19) has dramatic effects on individuals and health care systems. In our institute, a tertiary oncologic public hospital with high surgical volume, we prioritize maintaining cancer treatment as well as possible. The aim of this study is to evaluate if uro-oncological surgeries at pandemic are safe. Materials and Methods: We evaluated patients who underwent uro-oncological procedures. Epidemiological data, information on COVID-19 infection related to surgery and clinical characteristics of non-survival operative patients with COVID-19 infections were analyzed. Results: From 213 patients analyzed, Covid-19 symptoms were noticed in 8 patients at preoperative process or at hospital admission postponing operation; 161 patients were submitted to elective surgery and 44 to emergency surgery. From patients submitted to elective surgeries, we had 1 patient with laboratory confirmation of COVID-19 (0,6%), with mild symptoms and quick discharge. From the urgencies group, we had 6(13%) patients tested positive; 5 were taken to ICU with 4 deaths. Conclusion: Elective uro-oncological procedures at the COVID-19 epidemic period in a COVID-19-free Institute are safe, and patients who need urgent procedures, with a long period of hospitalization, need special care to avoid COVID-19 infection and its outcomes.

Impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists

ABSTRACT Objectives To evaluate the impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists during the month of April 2020. Materials and Methods A 39-question, web-based survey was sent to all urologist members of the Brazilian Society of Urology. We assessed socio-demographic, professional, health and behavior parameters. The primary goal was to evaluate changes in urologists' clinical practice and income after two months of COVID-19. We also looked at geographical differences based on the incidence rates of COVID-19 in different states. Results Among 766 urologists who completed the survey, a reduction ≥ 50% of patient visits, elective and emergency surgeries was reported by 83.2%, 89.6% and 54.8%, respectively. An income reduction of ≥ 50% was reported by 54.3%. Measures to reduce costs were implemented by most. Video consultations were performed by 38.7%. Modifications in health and lifestyle included weight gain (32.9%), reduced physical activity (60.0%), increased alcoholic intake (39.9%) and reduced sexual activity (34.9%). Finally, 13.5% of Brazilian urologists were infected with SARS-CoV-2 and about one third required hospitalization. Urologists from the highest COVID-19 incidence states were at a higher risk to have a reduction of patient visits and non-essential surgeries (OR=2.95, 95% CI 1.86 - 4.75; p< 0.0001) and of being infected with SARS-CoV-2 (OR=4.36 95%CI 1.74-10.54, p=0.012). Conclusions COVID-19 produced massive disturbances in Brazilian urologists' practice, with major reductions in patient visits and surgical procedures. Distressing consequences were also observed on physicians' income, health and personal lives. These findings are probably applicable to other medical specialties.

Factors associated with the Journal Impact Factor (JIF) for Urology and Nephrology Journals

Purpose: The Journal Impact Factor (JIF) is an index used to compare a journal's quality among academic journals and it is commonly used as a proxy for journal quality. We sought to examine the JIF in order to elucidate the main predictors of the index while generating awareness among scientific community regarding need to modify the index calculation in the attempt to turn it more accurate. Materials and Methods: Under the Urology and Nephrology category in the Journal Citations Report Website, the top 17 Journals by JIF in 2011 were chosen for the study. All manuscripts’ abstracts published from 2009-2010 were reviewed; each article was categorized based on its research design (Retrospective, Review, etc). T and correlation tests were performed for categorical and continuous variables respectively. The JIF was the dependent variable. All variables were then included in a multivariate model. Results: 23,012 articles from seventeen journals were evaluated with a median of 1,048 (range=78-6,342) articles per journal. Journals with a society affiliation were associated with a higher JIF (p=0.05). Self-citations (rho=0.57, p=0.02), citations for citable articles (rho=0.73, p=0.001), citations to non-citable articles (rho=0.65, p=0.0046), and retrospective studies (rho=-0.51, p=0.03) showed a strong correlation. Slight modifications to include the non-citable articles in the denominator yield drastic changes in the JIF and the ranking of the journals. Conclusion: The JIF appears to be closely associated with the number of citable articles published. A change in the formula for calculating JIF to include all types of published articles in the denominator would result in a more accurate representation.

Brazilian Abstracts Presented at the American Urological Association Annual Meetings: Contribution, Publication Rates, and Comparison with Oncology Abstracts

Purpose Scientific research originating from Brazil appears to be rising in several medical fields. Research results are often presented at scientific meetings before publication in peer-reviewed journals. We investigated the publication rate of Brazilian studies presented in American Urological Association (AUA) meetings and compared with the rate of publication of Brazilian oncological studies presented at the American Society of Clinical Oncology (ASCO) meetings. Materials and Methods a hand search of 12,454 abstracts presented at aua meetings 2001-2007 was conducted. abstracts for which at least two-thirds of institutions were from brazil were considered as brazilian. final publication was searched in pubmed and lilacs databases. oncological abstracts were also hand searched in the asco meetings proceedings in the same years. Results There was no significant temporal trend in the proportion of AUA studies originating from Brazil along those 7 years. A total of 195 abstracts (1.57%) were from Brazil. One hundred (51.3%) abstracts were published in full, and the estimated 5-year publication rate was 48.2%. There was a progressive increase in publication rates for studies categorized as video, poster, and podium presentations. Considering abstracts presented in years 2001-2005, urologic publication rate was significantly higher than for abstracts presented at the ASCO meeting. Conclusions Our results suggest that the Brazilian contribution to AUA meetings is at a plateau and that the Brazilian literature contribution is greater in urology than in oncology. Efforts must be invested towards raising this plateau and understanding qualitative aspects of the urology scientific output from Brazil. .

Report of the Korean Journal of Urology Editorial Board Meeting 2014

No abstract available.

Diferenças de gênero no campo da sexologia: novos contextos e velhas definições / Gender differences in the field of sexology: new contexts and old definitions / Diferencias de género en el campo de la sexología: nuevos contextos y viejas definiciones

OBJETIVO: Analisar concepções de gênero e sexualidade presentes no campo de intervenções terapêuticas em torno do sexo. PROCEDIMENTOS METODOLÓGICOS: Observação etnográfica, complementada por análise documental de material impresso referente ao X Congresso Brasileiro de Sexualidade Humana, promovido pela Sociedade Brasileira de Estudos em Sexualidade Humana, e ao VIII Congresso Brasileiro sobre Inadequações Sexuais, promovido pela Associação Brasileira para o Estudo das Inadequações Sexuais, realizados em 2005. A análise privilegiou a interação entre a perspectiva quantitativa no processamento das variáveis profissão e gênero dos participantes e temas das palestras, e perspectiva qualitativa na análise e interpretação do conjunto mais geral de dados. RESULTADOS: Os temas das sessões e o enfoque das apresentações sugerem que o campo é definido pelo contraste entre duas especialidades médicas: a ginecologia e a urologia, a primeira voltada para disfunções femininas e do casal e a segunda para as disfunções masculinas. CONCLUSÕES: A sexualidade masculina é abordada por perspectiva predominantemente biomédica, centrada na fisiologia da ereção e na prescrição de medicamentos, enquanto a sexualidade feminina é apresentada como condicionada por problemas relacionais, mais adequados à intervenção psicológica.

OBJECTIVE: To analyze concepts of gender and sexuality present in the field of sex therapeutic interventions. METHODOLOGICAL PROCEDURES: An ethnographic observation was conducted, and it was completed with the analysis of printed material originated from the X Congresso Brasileiro de Sexualidade Humana (10th Brazilian Congress on Human Sexuality), promoted by the Sociedade Brasileira de Estudos em Sexualidade Humana (Brazilian Society of Human Sexuality Studies), and the VIII Congresso Brasileiro sobre Inadequações Sexuais (8th Brazilian Congress on Sexual Inadequacies), promoted by the Associação Brasileira para o Estudo das Inadequações Sexuais (Brazilian Association of Sexual Inadequacy Studies), both held in 2005. The analysis emphasized the interaction between the quantitative perspective in the processing of the variables (participants' gender and profession and lecture topics) and the qualitative perspective in the analysis and interpretation of the more general set of data. RESULTS: The topics of sessions and focus of presentations suggest that the field is divided by the contrast between two medical specialties: gynecology and urology, the former is aimed at female and couple dysfunctions, while the latter is aimed at male dysfunctions. CONCLUSIONS: Male sexuality is approached from the predominantly biomedical perspective, centered on the physiology of erection and drug prescription, whereas female sexuality is considered to be conditioned by relationship problems, when psychological intervention is more adequate.

OBJETIVO: Analizar concepciones de género y sexualidad presentes en el campo de intervenciones terapéuticas en torno al sexo. PROCEDIMIENTOS METODOLÓGICOS: Observación etnográfica, complementada por análisis documental de material impreso referentes al X Congreso Brasileño de Sexualidad Humana, promovido por la Sociedad Brasileña de Estudios en Sexualidad Humana y el VIII Congreso Brasileño sobre Inadecuaciones Sexuales, promovido por la Asociación Brasileña para el Estudio de las Inadecuaciones Sexuales, realizados en 2005. El análisis privilegió la interacción entre la perspectiva cuantitativa en el procesamiento de las variables profesión y género de los participantes y temas de las palestras y cualitativa en el análisis e interpretación del conjunto más general de datos. RESULTADOS: Los temas de las sesiones y el enfoque de las presentaciones sugieren que el campo es definido por el contraste entre dos especialidades médicas: la ginecología y la urología, la primera dirigida a disfunciones femeninas y de la pareja y la segunda a las disfunciones masculinas. CONCLUSIONES: La sexualidad masculina es abordada por perspectiva predominantemente biomédica, centrada en la fisiología de la erección y en la prescripción de medicamentos, mientras que la sexualidad femenina es presentada como condicionada por problemas de relación, más adecuados a la intervención psicológica.

Patient positioning during digital rectal examination of the prostate: preferences, tolerability, and results

PURPOSE: To evaluate the preferred position used by Brazilian Urologists to perform DRE, the position that Brazilian patients prefer or think it is less embarrassing to have a DRE, and to evaluate the results of DRE with patients in left lateral decubitus, modified lithotomy, standing-up, or the physician will have them place their elbows on the table and squat down slightly. MATERIALS AND METHODS: Brazilian Urologists were contacted by e-mail, and 200 patients answered a questionnaire while undergoing prostate cancer screening. RESULTS: The preferred position was modified lithotomy position reported by 63.4 percent of Urologists, and left lateral position reported by 42.7 percent of the patients. Total DRE time was lower in the standing-up position. Pain and urinary urgency scores were similar regardless of the position used, and bowel urgency score was higher in patients squatting down. Patients were similar in terms of age and PSA level, but there was a significant difference between the standard deviations of estimated prostate weight in left lateral position. There were no differences in prostate asymmetry, positive DRE, or incomplete palpation of the prostate rates among different examination positions. CONCLUSIONS: Despite individual subjective preferences, a faster examination time in the standing-up position, and higher bowel urgency scores in patients with their elbows placed on the table and squatting down slightly, there were similar rates of prostate asymmetry, positive DRE, and incomplete palpation of the prostate, and comparable patient tolerability among different examination techniques.

Korean Urologist's View of Practice Patterns in Diagnosis and Management of Benign Prostatic Hyperplasia: A Nationwide Survey

PURPOSE: In Korea, there was no specific guidelines for the management of benign prostatic hyperplasia (BPH). We reviewed the practice patterns of Korean urologists in the management of BPH and aimed to describe the need to develop specific guidelines. MATERIALS AND METHODS: A probability sample was taken from the Korean Urological Association Registry of Physicians, and a structured questionnaire, that explored practice patterns in the management of BPH, was mailed to a random sample of 251 Korean urologists. RESULTS: For the initial evaluation of BPH, most urologists routinely performed prostatic specific antigen (PSA) (96.4%), digital rectal exam (94.4%), international prostate symptom score (IPSS) (83.2%) and transrectal ultrasound (79.2%). Symptom assessment (36.4%) followed by transrectal ultrasound of prostate (TRUS) (20.0%) was considered as the most important diagnostic examination affecting the decision about individual treatment options. Almost all urologists (92.2%) chose medical treatment as the first-line treatment option for uncomplicated BPH with moderate symptoms. Of the respondents, 57.2% had prescribed alpha blocker and 41.6% alpha blocker plus 5-alpha reductase inhibitors as the medical treatment option for BPH. The prescription of 5-ARIs was dependent on the size of the prostate and the severity of symptoms. CONCLUSION: The results of our current survey provide useful insight into variations in the clinical practice of Korean urologists. They also indicate the need to develop further practical guidelines based on solid clinical data and to ensure that these guidelines are widely promoted and accepted by the urological community.

The publication rate of abstracts presented at the 2003 urological brazilian meeting

OBJECTIVE: To determine the publication rate of orally-presented abstracts from the 2003 Urological Brazilian Meeting, as well as the factors determining this publication rate. MATERIALS AND METHODS: The publication rate of the 313 orally-presented abstracts at the 2003 Urological Brazilian Meeting was evaluated by scanning the Lilacs, Scielo and Medline databases. The time between presentation and publication, the state and country of the abstract, the research methodology (cross-sectional, case-control, retrospective case series, prospective case series or clinical trial), whether drugs were utilized and the topic of the study were all characterized. RESULTS: Thirty-nine percent of the abstracts were published after a median time of 14 months (range: 1 to 51 months). There were high publication rates for cross-sectional abstracts (75 percent), drug utilization studies (51.3 percent), clinical trials (50 percent) and prospective case series' (48.1 percent). However, there was only a moderate statistical trend towards a higher publication rate in the prospective case series (p=0.07), while the retrospective case series' showed statistically lower publication rates than the other groups (33.7 percent, p=0.04). Abstracts on laparoscopic surgery had the highest publication rate (61.9 percent, p=0.03) compared to others topics. In 57 percent of the unpublished abstracts, there was no interest in or attempt to publish, and rejection was responsible for the lack of publication of only 4 percent of the abstracts. CONCLUSION: The publication rate of the orally-presented abstracts from the 2003 Urological Brazilian Meeting was comparable to that of international congresses. The subsequent publication of presented abstracts and the selection of prospective studies with stronger evidence should be encouraged and may improve the scientific quality of the meeting.

Infecciones intrahospitalarias: conceptos actuales de prevención y control / Intrahospitalary Infections: update prevention concepts and control

Los avances tecnológicos que han incorporado nuevas herramientas diagnósticas y terapéuticas, muchas de ellas invasivas, y los cambios en las características demográficas de la población con tendencia al envejecimiento, mayor prevalencia de patologías crónicas y de pacientes inmunosuprimidos, han hecho cada vez más compleja la atención hospitalaria y con mayores riesgos potenciales de infecciones intrahospitalarias (IIH).Actualmente las IIH son consideradas como uno de los mejores indicadores de calidad de la atención debido a su frecuencia, la gravedad que conllevan, el aumento significativo de los costos que implica su ocurrencia y porque reflejan el resultado de acciones del equipo de salud, susceptibles de ser modificadas de acuerdo a los estándares vigentes. Se estima que un tercio de ellas pueden prevenirse con un programa adecuado de control de infecciones1 y de los casos médicos que generan acciones legales, hasta 25 por ciento puede corresponder a IIH2.El objetivo de este artículo es revisar los conceptos más importantes de prevención y control de IIH, orientado a su conocimiento y aplicación por especialistas en urología.

An audit of the surgical work-load in a urology unit.

OBJECTIVES: To assess the surgical work-load on a urology unit; to define the difference between case-load and work-load; and to assess the work-load in relation to surgical staffing levels. DESIGN: Prospective audit of all surgical procedures carried out on patients, excluding extracorporeal shockwave lithotripsy (ESWL), during a one year period, classified according to the British United Provident Association (BUPA) schedule of procedures. SETTING: One of the two urology units at the National Hospital of Sri Lanka, Colombo (NHSL). PATIENTS: Inpatients having surgical procedures in one year. MAIN OUTCOME MEASURES: The number of surgical procedures, according to their complexity, with particular reference to the level of surgical staffing; difference between case-load and the actual work-load computed using the Intermediate Equivalent (IE) system of Jones and Collins (1). RESULTS: The annual surgical work-load on the urology firm was 1900 IEs. In our unit BUPA complex major, major plus and major operations comprised 27.2% of the case-load but accounted for about 47% of the work-load. The BUPA intermediate and minor procedures comprising the remaining 72.8% of the case-load accounted for only 53% of the work-load. Endoscopic urological procedures made up 71% of the work-load. The specialist surgeon and the senior registrar have contributed to 51.4% (977 IEs) and 40.2% (765 IEs) of the total work-load respectively. CONCLUSION: Case-load is a poor performance indicator of surgical activity. IE weighted work-load has been shown to reflect surgical activity more appropriately than case-load. A well trained senior registrar's contribution to the total surgical work-load is appreciable.

Feocromocitoma de la vejiga urinaria: presentación de un caso clínico / Feocromacitoma of the bladder urinaria: presentation of a clinical case

Presentamos un paciente con diagnóstico de feocromocitoma de la vejiga urinaria a quien se le realizó cistectomía parcial con linfadenectomía regional, evolucionando satisfactoriamente. Se revisa la literatura, encontrandose que la escisión quirúrgica completa es el único tratamiento de elección

Nuevos conseptos en espermiologia / New concepts in spermatology

Se establecen paràmetros, tècnicas y fòrmulas para una valoraciòn exacta del estudio animal y concomitantemente la forma de valorar de fertilidad masculina. Dicha mètadologia es la usada por el autor laboratorio del I.G.H.