Pandemia COVID-19: impacto y reacción rápida de la Urología COVID-19 Pandemic: Impact and rapid reaction of Urology

La pandemia COVID-19 causada por el virus SARS-CoV-2 ha ocasionado decenas de miles de muertos en España y logrado colapsar los hospitales de la red sanitaria en la Comunidad de Madrid, debido en gran parte a su particular tendencia a causar neumonías graves con necesidad de soporte ventilatorio. Este hecho ha ocasionado el colapso de nuestro centro, llegando a tener una ocupación del 130% de sus camas por enfermos COVID-19, y causando por tanto el cese absoluto de actividad del servicio de urología, la práctica desaparición de la docencia de los residentes y la incorporación de buena parte de la plantilla de urología al grupo de personal médico que atiende a estos pacientes. Para la recuperación de esta elevada cantidad de actividad suspendida será necesaria una priorización de la patología en base a criterios puramente clínicos, para la cual se proponen tablas que recogen la relevancia de cada patología dentro de cada área de la urología. Herramientas brindadas por la tecnología como la formación online o los simuladores quirúrgicos podrán ser útiles para la necesaria restitución de la formación de residentes.

Five-Fraction Radiotherapy for Breast Cancer: Which are the Most Suitable Patients?

FAST-Forward trial reported that five-fraction radiotherapy (5fx-RT) schedule with 26 Gy in adjuvant setting after breast-conserving surgery for early-breast cancer (BC) was non-inferior to the standard hypo-fx (SHfx) schedule with 40 Gy in 15fx in terms of local tumor control. Since the COVID-19 pandemic started RT expert groups encouraged professionals to implement hypo-fx schedules in order to decrease visits of patients to hospitals. The aim of this study is to help radiation oncologists choose the most suitable patients for 5fx-RT schedule according to anatomical features. Between March 2020 and December 2021, 239 patients suitable for 5fx-RT schedule were referred to our department. Prescribed RT dose was 26 Gy in 5fx to the whole breast plus a simultaneously integrated boost (SIB) up to 29 Gy to tumor bed if indicated. Patients were divided into 3 groups: Group A: Patients treated with 5fx-RT schedule that met all the FAST-Forward constraints for normal tissues;Group B: Patients treated with 5fx-RT schedule that slightly did not meet all constraints, Group C: Patients switched to SHfx schedule as they did not meet constraints in an acceptable way. For each patient, we draw an imaginary straight line connecting the medial and lateral borders of PTV in the axial slice of simulation CT where the longest anteroposterior diameter was found. From midpoint of this line, we measured the tangent distance to PTV margin and collected the data as medial-to-lateral tangent (MELT). Data was analyzed using statistical software. 150 patients were included in group A, 75 in group B and 14 in group C. The median MELT distance was: 1.91cm, 2.48cm and 3cm respectively. We found that the increase in MELT distance was significantly associated with a poorer compliance of normal tissue constraints (p<0.0001). Patient´s distribution among 3 groups for MELT distance intervals are shown in table 1. Median V8 for ipsilateral lung was: 13.1, 15.46 and 20.49% for groups A, B and C respectively. For the heart, median mean dose was: 1.06, 1.8 and 2.25 Gy for left breast cancer patients and 0.28, 0.33 and 0.48 Gy for right breast cancer patients for groups A, B and C respectively. We found a moderate positive correlation between MELT distance and dosimetric parameters assessed above (r=0.545, 0.475 and 0.418 respectively). According to laterality, for a higher MELT distance the % of left BC patients increased significantly (p=0.039). MELT distance is an easy tool that helps radiation oncologists predict which BC patients are the most suitable for 5fx-RT before RT planning begins. This could avoid delays in starting RT for patients with a high MELT distance directly planning them with the SHfx schedule. [ FROM AUTHOR] Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The impact of the COVID-19 lockdown on human psychology and physical activity;a space analogue research perspective

Introduction Astronauts will encounter isolated, confined and extreme (ICE) conditions during future missions, and will have to be able to adapt. Until recently, however, few places on Earth could serve as acceptable space analogues (i.e., submarine and polar regions). The coronavirus disease-2019 (COVID-19)-related lockdowns around the globe provided a good opportunity to obtain more comprehensive datasets on the impact of prolonged isolation on human functioning in a very large sample. Methods Seven hundred forty-eight individuals (Belgium 442, Spain 183, Germany 50, Italy 50, US 23;Mean age +/- SD: 41 +/- 14 years, with an age range of 18-83 years;66% women) filled out an online survey assessing the impact of the COVID-lockdown on psychological, exercise and general health variables a first time near the beginning of the initial lockdown (hereafter 'T1';24 +/- 13 days after the start of the first lockdown;i.e., 3 weeks after the start of the first lockdown) and a second time a couple of weeks thereafter (hereafter 'T2';17 +/- 5 days after the first online survey;i.e., 6 weeks after the start of the first lockdown). Results From T1 to T2 an improvement of subjective sleep quality was observed (P = 0.003), that was related to an increase in subjective sleep efficiency and a decrease in sleep latency and disturbance (P <= 0.013). Weekly sitting time decreased, and the weekly amount of moderate and vigorous physical activity increased from T1 to T2 (P <= 0.049). No differences from T1 to T2 were observed in terms of mood, loneliness and state anxiety. A lower amount of sitting time was significantly correlated with improved subjective sleep quality (r = 0.096, P = 0.035) and with an increased amount of moderate (r = -0.126, P = 0.005) and vigorous (r = -0.110, P = 0.015) physical activity. Conclusion Compared to 3 weeks into the first COVID-imposed lockdown, 6-weeks after the start of the first COVID-imposed lockdown, physical activity and subjective sleep scores were positively impacted. The present, large sample size study further confirms exercise as a worthwhile countermeasure to psycho-physiological deconditioning during confinement.

Impacto de la pandemia COVID-19 en el servicio de urología de un centro de referencia en la Comunidad de Madrid

La pandemia COVID-19 causada por el virus SARS-CoV-2 ha causado decenas de miles de muertos en España y logrado colapsar los hospitales de la red sanitaria en la Comunidad de Madrid, debido en gran parte a su particular tendencia a causar neumonías graves con necesidad de soporte ventilatorio. Este hecho ha ocasionado el colapso de nuestro centro, llegando a tener una ocupación del 130% de sus camas por enfermos COVID-19, y causando por tanto el cese absoluto de actividad del servicio de urología, la práctica desaparición de la docencia de los residentes y la incorporación de buena parte de la plantilla de urología al grupo de personal médico que atiende a estos pacientes. Para la recuperación de esta elevada cantidad de actividad suspendida será necesaria una priorización de la patología en base a criterios puramente clínicos, para la cual se proponen tablas que recogen la relevancia de cada patología dentro de cada área de la urología. Herramientas brindadas por la tecnología como la formación online o los simuladores quirúrgicos podrán ser útiles para la necesaria restitución de la formación de residentes The COVID-19 pandemic caused by the SARS-CoV-2 virus has caused tens of thousands of deaths in Spain and has managed to breakdown the healthcare system hospitals in the Community of Madrid, largely due to its tendency to cause severe pneumonia, requiring ventilatory support. This fact has caused our center to collapse, with 130% of its beds occupied by COVID-19 patients, thus causing the absolute cessation of activity of the urology service, the practical disappearance of resident training programs, and the incorporation of a good part of the urology staff into the group of medical personnel attending these patients. In order to recover from this extraordinary level of suspended activity, we will be obliged to prioritize pathologies based on purely clinical criteria, for which tables including the relevance of each pathology within each area of urology are being proposed. Technology tools such as online training courses or surgical simulators may be convenient for the necessary reestablishment of resident education

[COVID-19 Pandemic: Impact and rapid reaction of Urology]. / Pandemia COVID-19: impacto y reacción rápida de la Urología.

The COVID-19 pandemic caused by the SARS-CoV-2 virus has caused tens of thousands of deaths in Spain and has managed to breakdown the healthcare system hospitals in the Community of Madrid, largely due to its tendency to cause severe pneumonia, requiring ventilatory support. This fact has caused our center to collapse, with 130% of its beds occupied by COVID-19 patients, thus causing the absolute cessation of activity of the urology service, the practical disappearance of resident training programs, and the incorporation of a good part of the urology staff into the group of medical personnel attending these patients. In order to recover from this extraordinary level of suspended activity, we will be obliged to prioritize pathologies based on purely clinical criteria, for which tables including the relevance of each pathology within each area of urology are being proposed. Technology tools such as online training courses or surgical simulators may be convenient for the necessary reestablishment of resident education.

COVID-19 pandemic: Impact and rapid reaction of urology

The COVID-19 pandemic caused by the SARS-CoV-2 virus has caused tens of thousands of deaths in Spain and has managed to breakdown the healthcare system hospitals in the Community of Madrid, largely due to its tendency to cause severe pneumonia, requiring ventilatory support. This fact has caused our center to collapse, with 130% of its beds occupied by COVID-19 patients, thus causing the absolute cessation of activity of the urology service, the practical disappearance of resident training programs, and the incorporation of a good part of the urology staff into the group of medical personnel attending these patients. In order to recover from this extraordinary level of suspended activity, we will be obliged to prioritize pathologies based on purely clinical criteria, for which tables including the relevance of each pathology within each area of urology are being proposed. Technology tools such as online training courses or surgical simulators may be convenient for the necessary reestablishment of resident education. Resumen La pandemia COVID-19 causada por el virus SARS-CoV-2 ha ocasionado decenas de miles de muertos en España y logrado colapsar los hospitales de la red sanitaria en la Comunidad de Madrid, debido en gran parte a su particular tendencia a causar neumonías graves con necesidad de soporte ventilatorio. Este hecho ha ocasionado el colapso de nuestro centro, llegando a tener una ocupación del 130% de sus camas por enfermos COVID-19, y causando por tanto el cese absoluto de actividad del servicio de urología, la práctica desaparición de la docencia de los residentes y la incorporación de buena parte de la plantilla de urología al grupo de personal médico que atiende a estos pacientes. Para la recuperación de esta elevada cantidad de actividad suspendida será necesaria una priorización de la patología en base a criterios puramente clínicos, para la cual se proponen tablas que recogen la relevancia de cada patología dentro de cada área de la urología. Herramientas brindadas por la tecnología como la formación online o los simuladores quirúrgicos podrán ser útiles para la necesaria restitución de la formación de residentes.