Practice and Experience of Clinical Pharmacist in Participating in the Anti-infective Treatment of Severe Patients in Urology Department / 中国药师

Objective: To investigate the role of clinical pharmacist in the treatment of patients with severe infections in urology department.Methods: An objective analysis of the important roles of clinical pharmacists was carried out by making and adjusting the anti-infective treatment plan of two patients in urology department.Results: During the participation in the treatment of two patients with severe infections in urology department, clinical pharmacists played important roles in the treatment of the diseases through observing the clinical symptoms,analyzing the conditions of the patients and giving the pharmaceutical opinions and suggestions, and finally the infections were controlled successfully.Conclusion: Clinical pharmacists should participate in the therapy strategy adjustment in urology department using their professional knowledge to play important roles in the management of anti-infection strategy for severe patients.

Risk factors for infection following percutaneous nephrolithotomy / 中国感染控制杂志

Objective To explore the risk factors for infection following percutaneous nephrolithotomy(PCNL), and provide the basis for prevention of postoperative infection.Methods 96 patients who were performed PCNL in a hospital between August 2010 and August 2013 were chosen,clinical data of patients were retrospectively analyzed, the occurrence of postoperative infection,risk factors and isolated pathogens were analyzed.Results 35 patients (36.46%[35/96])developed infection following PCNL.Univariate analysis revealed that risk factors for postopera-tive infection were the size and shape of stone,duration of operation,and intraoperative perfusion (all P <0.05). 96 patients before operation and 18 patients after operation were performed bacterial culture for urine,a total of 39 strains were isolated,the main isolated pathogens was Escherichia coli (n=12),followed by Pseudomonas aerugi-nosa (n=8),Streptococcus viridans (n =5 ),Klebsiella pneumoniae (n =4)and Enterobacter cloacae (n =3 ). Conclusion Infection rate following PCNL is high,duration of operation and intraoperative perfusion should be re-duced,antimicrobial agents should be used rationally.

Suspensión retropúbica en mujeres con incontinencia urinaria de esfuerzo / Retropubic suspension in women with forced urinary incontinence

Se efectuó un estudio descriptivo y transversal de 60 pacientes con incontinencia urinaria de esfuerzo, atendidas en la consulta de Urología del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, de enero del 2003 a igual mes del 2012, con vistas a evaluar la aplicación de la técnica quirúrgica de suspensión retropúbica en ellas. Entre los resultados relevantes de la serie figuraron: edad promedio de 50 años, incontinencia urinaria de esfuerzo de grados III (48,0 %) y II (28,0 %) y un elevado porcentaje de continencia posoperatoria inmediata (95,3). A los 3 meses de practicada la intervención, la continencia fue de 92,2 %, mientras que luego de 6 y 9 meses, se obtuvo una continencia de 87,5 %. Se concluyó que la suspensión retropúbica es un procedimiento de elevada efectividad para tratar pacientes con incontinencia urinaria de esfuerzo e incontinencia urinaria mixta, debido a su simple realización y las escasas complicaciones que se producen, lo cual incide favorablemente en la estadía hospitalaria.

A descriptive and cross sectional study of 60 patients with forced urinary incontinence, assisted in the Urology Department of "Saturnino Lora Torres" Teaching Provincial Clinical surgical Hospital in Santiago de Cuba, from January, 2003 to same month of 2012, with the aim of evaluating the use of the surgical technique of retropubic suspension in them. Among the relevant results of the series there were: average age 50 years, forced urinary incontinence degree III (48.0%) and II (28.0%) and a high percentage of immediate postoperative continence (95.3). After 3 months of practicing the intervention the continence was 92.2%, while after 6 and 9 months a continence of 87.5% was obtained. It was concluded that the retropubic suspension is a procedure of high effectiveness to treat patients with forced urinary incontinence and mixed urinary, incontinence due to its simple realization and the scarce complications which take place, what influences favorably in the hospital stay.

Por que os pacientes são encaminhados ao urologista?: análise crítica dos encaminhamentos no município de São Bernardo do Campo / Why are patients referred to urological consultation?: critical analysis of referrals in São Bernardo do Campo

Introdução: A elevada demanda por atendimento urológico em São Bernardo do Campo gera uma espera para que pacientes sejam atendidos pelo urologista, após terem sido encaminhados pelo clínico. Objetivos: Avaliar condições associadas a encaminhamentos aos ambulatórios de Urologia da Faculdade de Medicina do ABC, no município. Métodos: Foram avaliados 106 relatórios de encaminhamento de pacientes para consulta urológica em São Bernardo do Campo, entre dezembro de 2009 e março de 2010, e sua correlação com os dados obtidos em consulta urológica. Resultados: Os principais motivos para encaminhamento urológico foram o exame da próstata (29,2%) e a urolitíase (22,6%). Houve concordância entre o motivo referido e o diagnóstico após consulta urológica em 55,7% dos casos, discordância em 20,8% e ausência de menção do motivo da consulta em 23,6%. Observouse que 56,6% dos pacientes não levaram os exames mínimos necessários à consulta com o especialista. Dos encaminhamentos por disfunções sexuais, 17% referiam o real motivo para consulta. Houve concordância em 100% dos encaminhamentos de pacientes oncológicos. Médicos formados há mais de 30 anos encaminharam pacientes mais precisamente. Conclusão: A imprecisão no encaminhamento aos ambulatórios de Urologia e a inexistência de protocolos para tal contribuem para a morosidade do sistema. Propõe-se o uso de protocolos para solicitar exames, previamente ao encaminhamento ao urologista, e o reforço quanto à importância da precisão do encaminhamento junto aos médicos responsáveis pela atenção primária.

Introduction: High demand to urological care in São Bernardo do Campo leads to a delay from the primary care physician referral until urologist?sconsultation. Objetives: To evaluate conditions associated with referrals to the Urology outpatient clinic from Faculdade de Medicina do ABC in thismunicipality. Methods: We analyzed 106 urological referral reports of patients in São Bernardo do Campo, from December 2009 to March 2010, and compared to data obtained after urologic consultation. Results: The main reasons for urological referral were prostatic check-up (29.2%) and urolithiasis (22.6%). There was similarity between referral report and diagnoses after urological consultation in 55.7% of the cases, discordance in 20.8%, while no reason was informed in 23.6% of referral reports; 56.6% of the pacients did not bring their exams to specialist?s consultation. Referrals for sexual disfunction held the real reason for consultation in 17% of the cases, while concordance was found in every referral for oncologyc disease. Moreover, doctors graduated for more than 30 years usually referred pacients more precisely. Conclusion: The lack of accuracy in patient's referral to urological clinics and the absence of referral protocols contribute to the delay in the health care system. We recommend the adoption of guidelines to aid requesting subsidiary exams before referring patients to the urologist as well as the reinforcement towards the need of a proper referral by primary care physicians.

Evaluation of the significance of psychological intervention on elderly patients in urology department of primary hospital / 中国实用护理杂志

Objective To evaluate the significance of psychological intervention on elderly patients in urology department of primary hospital. Methods 60 patients in urology department of our hospital were selected from January to December, 2009, and were randomly divided into the observation group and control group with 30 patients in each group. The control group was given conventional treatment and care, the observation group received psychological interventions based on conventional care. Scores of self-rating anxiety scale(SAS), self-rating depression scale (SDS), the amount of Likert questionnaire score of the two groups underwent comparison. Results After treatment, anxiety and depression condition was much better in the observation group than the control group, the overall satisfaction rate in the observation group was 83.33%, much higher than the control group, 50.00%. Concluslons Psychological intervention is effective in treatment of the elderly patients in urology department,which should be applied in clinical practice.