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The Coronavirus (COVID-19) pandemic, typified as such in March 2020 by the World Health Organization (WHO), has exceeded the capacity of health systems to aid victims, and triggered a radical change in medical research, and in the monitoring of the enrollment for clinical trials in urologic fields around the world. Last year, almost 90% of clinical sites closed patient enrollment, while at the same time, researchers around the world initiated almost 1000 COVID-19 clinical trials. This catastrophic pandemic has allowed us to expand our medical knowledge exponentially. The global urological community has created and published an infinity of scientific articles: establishing guideline reactions for diagnosis, treatment, and follow-up of the different urologic conditions across all areas of the field, reporting the experiences at urology services, and putting forward new strategies. The Confederacion Americana de Urologia (CAU) has promoted international collaborative projects that have led to gaining insight into how the Latin American Urology Services faced the pandemic, including the challenges, strengths, and the areas of opportunity for urologic care. It also allowed us to increase the number and quality of publications. Also, we have created new virtual platforms and international networks to exchange our knowledge. We have as well transformed this social, economic and health crisis brought upon us by COVID-19, into a source of opportunities for the growth and promotion of research in Latin America. Urologic patients, require researchers to work on favoring their goals. A collaborative network, the established and coordinated protocols, the safety of patients and researchers, assertive and constant communication, and effective technology use, are the essential tools to resume institutional investigation under these critical conditions. Copyright © 2022 Sociedad Mexicana de Urologia. Colegio de Profesionistas A.C.. All rights reserved.
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Introduction: Metastatic kidney cancer continues to be a therapeutic challenge for urologies and oncologies. With the new systemic therapies, the indication for initial cytoreductive nephrectomy is becoming increasingly controversial. The treatment of the primary tumor at a stage with systemic involvement continues to be a controversial issue. Material(s) and Method(s): By conducting a survey of Latin American hospitals, this publication aims to evaluate the indication for cytoreductive nephrectomy, the preferred surgical technique and the results obtained, estimating regional therapeutic lines. Online survey was made, based on the most important topics of discussion on cytoreductive nephrectomy and metastatic kidney cancer. Result(s): A total of 20 centers participated on the survey, al of them affirmatively about the realization of cytoreductive nephrectomy. Most of them also offer systemic treatment. Regarding the surgical technique used, most used minimally invasive techniques. Discussion(s): The international evidence about the role of cytoreductive nephrectomy in this context is varied and subject to permanent change. Individualized treatment, multidisciplinary team are fundamental for the approach of these patients. Conclusion(s): The subgroup of patients with metastatic kidney cancer is conceptually heterogeneous. Cytoreductive nephrectomy continues to play an important role, sometimes leading role, in the management of selected patients. Copyright © 2022 Sociedad Mexicana de Urologia. Colegio de Profesionistas A.C.. All rights reserved.
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The COVID-19 pandemic has led to the saturation of public health services worldwide. In this scenario, the early diagnosis of SARS-Cov-2 infections can help to stop or slow the spread of the virus and to manage the demand upon health services. This is especially important when resources are also being stretched by heightened demand linked to other seasonal diseases, such as the flu. In this context, the organisers of the DiCOVA 2021 challenge have collected a database with the aim of diagnosing COVID-19 through the use of coughing audio samples. This work presents the details of the automatic system for COVID-19 detection from cough recordings presented by team PANACEA. This team consists of researchers from two European academic institutions and one company: EURECOM (France), University of Granada (Spain), and Biometric Vox S.L. (Spain). We developed several systems based on established signal processing and machine learning methods. Our best system employs a Teager energy operator cepstral coefficients (TECCs) based frontend and Light gradient boosting machine (LightGBM) backend. The AUC obtained by this system on the test set is 76.31% which corresponds to a 10% improvement over the official baseline.
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Introduction & Objectives: In the last two decades, several therapeutic schemes have been proposed for erectile rehabilitation (ER) after radical prostatectomy (RP), but none has been standardized or validated due to the lack of high-level evidence in the Literature. We performed an international Survey focused on the current worldwide approach to ER, highlighting the contact and divergent aspects. Materials & Methods: We purposed an online Survey between July and December 2020 using email lists and Twitter, aiming to evaluate the ER protocols after RP performed by urologists and andrologists in daily practice. The following sections were investigated: 1) Demographics;2) Number and type of RP performed;3) Type and schedule, timing and duration of ER erectile programs;4) Standard treatment protocol. The specialists were contacted with the support of Confederación Americana de Urología (CAU), Urological SOcial MEdia (UroSoMe) Working Group, Functional Urology- Techno Urology- Research (FUTURe) Group and by a dedicated uro-andrologists spaces on Twitter platform of iTRUE Group. Results: The Survey was completed by 518 responders from 52 worldwide countries. The main criteria to candidate patients for ER were nerve sparing surgery (72.8%), lack of significant comorbidities (66.4%), patient’s request (55.4%), valid pre-operative EF (55%), age (48.1%), and partner’s willing (19.1%). Surgical techniques reported were: 38.9% open RP, 22.9% video laparoscopic RP, 38.2% robot- assisted RP. There were no significant differences (p>0.05) among the main surgical techniques and the time of EF recovery beginning, protocol and duration. The use of specific ER protocols was reported by 61.4%. The beginning of ER was reported by 33% of responders at catheter removal, after one month from surgery by 22%, and before RP by 15%. PDE5i were more frequently used as first line treatment (99.4%). Tadalafil 20 mg was the most prescribed in monotherapy, prescribed daily (48.2%) or 2-3 times/week (46%). PGE1 intra-cavernosal injection (67.9%) was the second more common prescription in monotherapy, followed by the association of PDE5i and vacuum device (29.6%). A minority of specialists 44/518 (8.5%) recommended low intensity shock wave therapy, while 63/518 (12.2%) proposed this in association to other therapies. The duration of ER was: in 16.2% <6 months, in 39% between 6 and 11 months;in 31.9% between 12 and 18 months;in 9.2% between 19-24 months, and in 3.7% >24 months. In case of first-line failure, the majority of the responders shifted to another treatment after at least 3 months (71%). During COVID-19 outbreak, the 37.4% of responders did not perform EF recovery consultations, while 26.8% had normal consultations, and 35.7% used telemedicine. Conclusions: This Survey showed an inhomogeneous approach to ER, reflecting the lack of high-level evidence on this topic. A worldwide accepted guideline on ER is therefore needed.
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Coronavirus disease 2019 (COVID-19) is an emerging human infectious disease caused by severe acute respiratory syndrome 2 (SARS-CoV-2, initially called novel coronavirus 2019-nCoV) virus. Thus, an accurate and specific diagnosis of COVID-19 is urgently needed for effective point-of-care detection and disease management. The reported promise of two-dimensional (2D) transition-metal carbides (Ti3C2Tx MXene) for biosensing owing to a very high surface area, high electrical conductivity, and hydrophilicity informed their selection for inclusion in functional electrodes for SARS-CoV-2 detection. Here, we demonstrate a new and facile functionalization strategy for Ti3C2Tx with probe DNA molecules through noncovalent adsorption, which eliminates expensive labeling steps and achieves sequence-specific recognition. The 2D Ti3C2Tx functionalized with complementary DNA probes shows a sensitive and selective detection of nucleocapsid (N) gene from SARS-CoV-2 through nucleic acid hybridization and chemoresistive transduction. The fabricated sensors are able to detect the SARS-CoV-2 N gene with sensitive and rapid response, a detection limit below 10(5) copies/mL in saliva, and high specificity when tested against SARS-CoV-1 and MERS. We hypothesize that the MXenes' interlayer spacing can serve as molecular sieving channels for hosting organic molecules and ions, which is a key advantage to their use in biomolecular sensing.
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The intense governmental effort to achieve Sustainable Development Goals (SDG), allowed project development accomplishment within this framework and, hand in hand with globalization, has connected Colombian territories with large cities by technological interfaces. The population and territorial view of the SDG has promoted trends that bring near consumers and territories of goods producers or consumer services;one of these trends are short commercial systems (SCS). This research has proved that Colombian SCS aid commercial exchange equity, promote sustainable and conscious consumption, produce new social and commercial links, contribute to reducing packaging use and solid waste production, product freshness, traditions and knowledge exchange, supply chain actors autonomy and integration of actors involved;this was also potentialized by the Covid-19 sanitary crisis. Evidence showed that SCS is performed by families or farming associations that lack technics to certify quality process and that effectively apply continuous improvement process, making uncompetitive operations faced to other commercial models;however, traceability as a quality strategy for perishable products has shown to adapt, allowing continuous quality improvement according to the supply chain actor requirements and the appropriate architecture that allows to model according to the requirements of each of the participant actors. The need to build a technological architecture that allows establishing the best commercialization and distribution model for each actor involved in the supply chain, ensuring guidelines for development and success of this technological answer is concluded from the four phases of this research. The architecture involved in this research allows adaptability in different rural families in the same economical sector, potentializing competitiveness, and clear information flow, minimizing risks, time, and allowing decision making facing possible risks. © IEOM Society Inweternational.
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Introduction: The global pandemic due to Covid-19 has constituded a challenge in the follow up and monitoring of cardiac rehabilitation's programs. The State of alarm declared last year in Spain, led to strict home confinement that could have had an impact in the progress of patients Aim: To analyze the effect of home confinement on the managment of cardiovascular risk factors (CVRF) in patients included in phase III of a cardiac rehabilitation program (CRP) and also to evaluate the self-care education received during CRP. Methods and materials: Descriptive, comparative and retrospective analysis of patients in phase III of a CRP. The sample was divided into two groups: Post-Covid group (consecutive CRP patients with follow up one year after the cardiac event from 6/21/2020 [date of end of home confinement in Spain] to 12/31/2020) and Group Pre-Covid (consecutive CRP patients with follow up one year after the cardiac event from 6/21/2019 to 12/31/2019). Demographic and CVRF data from end of phase II consultation were compared with those from the phase III consultation (one year after the event) for both groups. The SPSS statistics v23 program was used for statistical analysis. Results: 283 patients, 137 patients from the pre-Covid group and 146 patients from the post-Covid group. No statistically significant differences were found between the two populations (Table 1). No statistically significant differences were found in the achievement of the CVRF target values: systolic blood pressure <140mmHg (94 vs 107;p=0.216), diastolic blood pressure <90mmHg (121 vs 130, p=0.276), LDL-c <70 mg/dl (86 (71.7%) vs 89 (73.6%);p=0.743), LDL-c <55 mg/dl (41 (34.2%) Vs 47 (38.8%);p=0.451), HbA1c figure <7% (106 vs 111;p=0.478), baseline fasting blood glucose <110 mg/dl (103 vs 107;p=0.970). Regarding the variation of the CVRF figures between the final consultation of phase III and that of phase II, no statistically significant differences were found between the two groups: difference in LDL-c figure for phase III consultation with respect to phase II (-0.5±20.3 mg/dl in pre- Covid group vs -5.3±24.4 mg/dl in post-Covid group;p=0.102), difference in HDL-c (4.6±26.1 mg/dl pre-Covid group vs -0.6±24.9 mg/dl post-Covid group;p=0.113), difference in total cholesterol level (4.6±26.1 mg/dl vs -0.6±24.9 mg/dl;p=0.113), difference in HbA1c (0.1±0.3% in pre-Covid group vs 0.1±0.6% in group post-Covid), Table 2. Conclusions: Home confinement has not contribute to a worsening in CVRF control in patients in a phase III of a CRP, in our study. The education given in a CRP concerning to the management of CVRF is the essential factor that grant an adequate patient control in extraordinary circumstances. (Figure Presented).
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Introduction: SARS-CoV-2 has affected the whole world as a global health pandemic in 2020. A nationwide home confinement was declared in our country by beginning of March. Cardiac rehabilitation programs (CRP) had to adapt to new health requirements and the impact of these changes is unknown. Purpose: To analyse the impact of COVID-19 pandemic in improvement of cardiopulmonary exercise test (CPET) with maximal oxygen consumption uptake (VO2max) and control of cardiovascular risk factors in patients with cardiovascular established disease (coronary heart disease, heart failure or cardiac surgery) included in the phase II of our centre CRP. Methods: 510 consecutive patients were evaluated. A maximal CPET was performed for each patient from the beginning and at the end of phase II of CRP. Enrolled patients were divided in two groups: from March 2019 to March 2020 (before Covid pandemic) and second one, from the beginning of the pandemic in March 2020 until February 2021. Results: 296 patients were studied in preCovid group and 214 patients were studied in Covid group. There were no statistically significant differences between these two groups in reference to cardiovascular risk factors and medical treatment (Figure 1). 82.7% of patients completed a hospital-based program in preCovid group vs 36% in Covid (p=0.001). Comparing the percentage of patients that accomplished the risk factors control targets between pre- and Covid group, statistically significant differences have been seen referring to systolic BP <140mmHg (85.1 vs 95.4%, p=0.001) and cLDL <70 mg/dl (67.2 vs 77.7%, p=0.003). However, in terms of glucose control (fasting blood glucose <110 mg/dl: 78.4 vs 82.2%, p=0.612;HbA1c <7%: 90.7 vs 92.7%, p=0.464) and weight control (BMI: 27.8±4.69 kg/m2 vs 27.3±4.07 kg/m2, p=0.299) this could not be established. There were no differences in psychological attention demand (27 vs 23.3%, p=0.695). Statistical differences between two groups were found in terms of VO2max at the beginning phase II CPET (22.7±7 vs 20±5 ml/min/kg, p=0.006) and ending phase II CPET (24±7 vs 21±6, p=0.001). Nevertheless, no differences were found in the final phase II CPET improvement between both groups (1.4±4.1 ml/kg/min vs 0.81±2.9 ml/kg/min;p=0.221) (Figure 2). Conclusions: SARS-CoV-2 changed our practice from an in-hospital based phase II CRP to a home-based phase II CRP. COVID-19 pandemic had no negative impact in the control of risk factors in our phase II patients. In our experience, despite preCovid phase II patients have a better functional capacity in terms of VO2max, the improvement in VO2max after phase II CRP persists in the SARS-CoV-2 era. This might show that an accurate structure of home-based program could also have great results. (Figure Presented).
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While we are waiting for the "best good news" of a vaccine that allows us to control the SARS-CoV-2 virus that causes COVID-19, we have to find a solution to reduce the adverse effects of the disease on people's health. The situation is not hopeful. According to the World Health Organization, 4278180 people have been infected, of whom 292376 have died (May 13, 2020), many in their productive age who surely were out of the economic upheavals due to the measures adopted to anticipating the pandemic will also have a negative impact on the world economy.
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The SARS-CoV 2 outbreak is one of the most important events of public health around the world;this disease has affected millions of people, has killed over 430.000 people and has increased the needed of intensive care unit beds around the world. During the pandemic the world has seen a decline in the organ donation and transplantation activities, Colombian transplant model has been affected too. This paper wants to show the current situation of organ donation and transplantation during SARS-CoV 2 pandemic and explore some dilemmas around organ donation and transplantation for emerging countries.