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2.
Minerva Urol Nefrol ; 72(3): 376-383, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-616576

ABSTRACT

The public health emergency caused by the Coronavirus Disease 2019 (COVID-19) pandemic has resulted in a significant reallocation of health resources with a consequent reorganization of the clinical activities also in several urological centers. A panel of Italian urologists has agreed on a set of recommendations on pathways of pre-, intra- and post-operative care for urological patients undergoing urgent procedures or non-deferrable oncological interventions during the COVID-19 pandemic. Simplification of the diagnostic and staging pathway has to be prioritized in order to reduce hospital visits and consequently the risk of contagion. In absence of strict uniform regulations that impose the implementation of nasopharyngeal swabs, we recommend that an accurate triage for COVID-19 symptoms be performed both by telephone at home before hospitalization and at the time of hospitalization. We recommend that during hospital stay patients should be provided with as many instructions as possible to facilitate their return to, and stay at, home. Patients should be discharged under stable good conditions in order to minimize the risk of readmission. It is advisable to reduce or reschedule post-discharge controls and implement an adequate system of communication for telemonitoring discharged patients.


Subject(s)
Coronavirus Infections , Critical Pathways/statistics & numerical data , Pandemics , Pneumonia, Viral , Urologic Diseases/surgery , Urology , Elective Surgical Procedures , Female , Humans , Italy , Male , Perioperative Care , Public Health , Triage , Urologic Neoplasms/surgery , Urologic Surgical Procedures , Urologists
3.
Curr Opin Urol ; 30(4): 610-616, 2020 07.
Article in English | MEDLINE | ID: covidwho-605599

ABSTRACT

PURPOSE OF REVIEW: The novel coronavirus-2019 disease (COVID-19) pandemic has had devastating consequences on healthcare systems globally. The effect this has on urologists and the patients they care for is not fully understood and presents the challenge of prioritizing the most urgent cases. We aim to review the impact on urology services and evaluate strategies to minimize disruption. RECENT FINDINGS: Various healthcare systems have been forced to postpone treatment for many urological conditions as resources are dedicated to the treatment of COVID-19. Training has been postponed as staff are reallocated to areas of need. Face-to-face contact is largely minimized and innovative, virtual communication methods are used in the outpatient setting and multidisciplinary team meetings. Surgical practice is changing because of the risks posed by COVID-19 and procedures can be prioritized in a nonurgent, low priority, high priority or emergency category. SUMMARY: Although the COVID-19 pandemic will inevitably affect urological services, steps can be taken to mitigate the impact and prioritize the patients most in need of urgent care. Similarly, in future; simulation, e-learning and webinars will allow interaction to share, discuss and debate focused training and education.


Subject(s)
Coronavirus Infections/complications , Coronavirus , Pneumonia, Viral/complications , Urologists , Betacoronavirus , Coronavirus Infections/epidemiology , Humans , Pandemics , Pneumonia, Viral/epidemiology , Urology
4.
Urologiia ; (3): 5-9, 2020 Jun.
Article in Russian | MEDLINE | ID: covidwho-619833

ABSTRACT

The aim of this study was to analyze the symptoms of depression, anxiety, and stress in urologists during the COVID-19 pandemic. MATERIALS AND METHODS: 90 urologists aged 25 to 60 years (M=37.27, S.D.=9.53), 93% of them were men, participated in the online survey. They answered questions about their attitude to their job as doctors and the impact of COVID-19. They filled out the Depression, Anxiety and Stress Scales (DASS-21), the Ten Item Personality Inventory (TIPI) and answered questions assessing their sense of control. RESULTS: The greatest concern among urologists is the risk of getting infected with COVID-19 (for 30% of the doctors). 43% of urologists state that their profession interesting. A positive attitude to work, as well as the Big Five traits (Conscientiousness, Emotional Stability and Agreeableness) are associated with lower levels of depression, anxiety, stress and lack of control. Working with COVID-19 patients reduces stress and increases the sense of control. Age and high levels of Emotional Stability predicted lower levels of anxiety, depression and stress. DISCUSSION: Working with COVID-19 patients allows doctors to feel more control over what is happening. A sense of control, in turn, and a positive attitude towards work are associated with a lower levels of depression, anxiety and stresssymptoms. CONCLUSION: The results of this study can be used in selection of therapeutic targets for psychotherapy, administered to doctors; in prevention of symptoms of anxiety, stress and depression among doctors; and in professional selection of doctors for working in crisis situations.


Subject(s)
Anxiety/epidemiology , Coronavirus Infections/epidemiology , Depression/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Stress, Psychological/epidemiology , Urologists/psychology , Adult , Coronavirus Infections/therapy , Female , Humans , Male , Middle Aged , Pneumonia, Viral/therapy , Surveys and Questionnaires , Urologists/statistics & numerical data
6.
Curr Opin Urol ; 30(4): 610-616, 2020 07.
Article in English | MEDLINE | ID: covidwho-330143

ABSTRACT

PURPOSE OF REVIEW: The novel coronavirus-2019 disease (COVID-19) pandemic has had devastating consequences on healthcare systems globally. The effect this has on urologists and the patients they care for is not fully understood and presents the challenge of prioritizing the most urgent cases. We aim to review the impact on urology services and evaluate strategies to minimize disruption. RECENT FINDINGS: Various healthcare systems have been forced to postpone treatment for many urological conditions as resources are dedicated to the treatment of COVID-19. Training has been postponed as staff are reallocated to areas of need. Face-to-face contact is largely minimized and innovative, virtual communication methods are used in the outpatient setting and multidisciplinary team meetings. Surgical practice is changing because of the risks posed by COVID-19 and procedures can be prioritized in a nonurgent, low priority, high priority or emergency category. SUMMARY: Although the COVID-19 pandemic will inevitably affect urological services, steps can be taken to mitigate the impact and prioritize the patients most in need of urgent care. Similarly, in future; simulation, e-learning and webinars will allow interaction to share, discuss and debate focused training and education.


Subject(s)
Coronavirus Infections/complications , Coronavirus , Pneumonia, Viral/complications , Urologists , Betacoronavirus , Coronavirus Infections/epidemiology , Humans , Pandemics , Pneumonia, Viral/epidemiology , Urology
7.
Prog Urol ; 30(8-9): 448-455, 2020.
Article in English | MEDLINE | ID: covidwho-220683

ABSTRACT

INTRODUCTION: The COVID-19 outbreak in France is disturbing our health system. Urologists in training who are already known to have burnout, are in the front line to face this disease. The aim of our study was to assess the psychological impact of COVID-19 pandemic on young French urologists in training. MATERIAL AND METHODS: A self-administered anonymous questionnaire evaluating the pandemic added stress, and its negative impact on work and training quality, was e-mailed to the members of the French Association of Urologists in Training (AFUF). The association includes all French junior and senior residents. The survey lasted 3 days. Multivariable analyses using logistic regression was performed to identify the predictive factors. RESULTS: Two hundred and seventy-five (55.5%) of the 495 AFUF members responded to the questionnaire. More than 90% of responders felt more stressed by the pandemic. Fellows and senior residents were more likely to feel that the crisis had an important impact on their work quality (OR=1.76, IC95=[1.01-3.13]), even more when COVID 19 patients were present in their department (OR=2.31, IC95=[1.20-4.65]). Past medical history of respiratory disease (OR=2.57, IC95=[1.31-5.98]) and taking in charge COVID19 patients (OR=1.85, IC95=[0.98-3.59]) were additional risk factors. CONCLUSION: COVID19 pandemic has a negative impact on young French urologists in training and on their work and training quality. Managing their psychosocial well-being during this time is as important as managing their physical health. LEVEL OF EVIDENCE: 3.


Subject(s)
Anxiety/epidemiology , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Urologists/psychology , Urology/education , Adult , Female , France/epidemiology , Humans , Internship and Residency , Male , Medical Staff, Hospital/psychology , Pandemics , Risk Factors , Surveys and Questionnaires
11.
Int Braz J Urol ; 46(4): 501-510, 2020.
Article in English | MEDLINE | ID: covidwho-47682

ABSTRACT

This letter to the Editor aims to provide suggestions and recommendations for the management of urological conditions in times of COVID-19 crisis in Brazil and other low- and middle-income countries. It is important to highlight that one of the main characteristics of this pandemic is the oversaturation of the health system capacity, mostly due to a high demand for personal protective equipment (PPE), Hospital/ICU beds, as well as ventilators. In places with limited resources and where the health care systems are already saturated, such consideration is even more worrisome. Therefore, most worldwide authorities are recommending to avoid, as much as possible, patient's elective visits to hospitals, as well as a judicious use of the operating room in order to mitigate the strain put on the health system. While efforts should be directed to the care of COVID-19 patients, other conditions (especially urgencies and oncological cases) must continue to be assisted. Thus, through a panel of experts, we have prepared a practical guide for Thus, through a panel of experts, we have prepared a practical guide for urologists based on the recommendations from the main Urologic Associations, as well as data from the literature to support the suggested management. We will try to follow the standard guideline recommendations from the American Urological Association (AUA) and European Association of Urology (EAU), with the aim of pursuing the best outcomes possible. However, some recommendations were based on the consensus of the panel, taking into consideration the reality of developing countries and the unprecedented situation caused by the COVID-19 crisis. Most importantly, all recommendations on this manuscript are based on the expectancy of a maximum 3-month duration of the crisis. If this period shall extended, these recommendations will be revised and updated.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Practice Patterns, Physicians'/standards , Urologists/standards , Brazil/epidemiology , Humans , Pandemics , Personal Protective Equipment/standards , Surveys and Questionnaires
12.
Prog Urol ; 30(5): 221-231, 2020 Apr.
Article in French | MEDLINE | ID: covidwho-25921

ABSTRACT

AIM: The French population is facing the COVID-19 pandemic and the health system have been reoriented in emergency for the care of patients with coronavirus. The management of cancers of the urinary and male genital tracts must be adapted to this context. MATERIAL AND METHOD: An expert opinion documented by a literature review was formulated by the Cancerology Committee of the French Association of Urology (CCAFU). RESULTS: The medical and surgical management of patients with any cancers of the urinary and male genital tracts must be adapted by modifying the consultation methods, by prioritizing interventions according to the intrinsic prognosis of cancers, taking into account the patient's comorbidities. The protection of urologists from COVID-19 must be considered. CONCLUSION: The CCAFU issues an expert opinion on the measure to be taken to adapt the management of cancers of the male urinary and genital tract to the context of pandemic by COVID-19.


Subject(s)
Coronavirus Infections , Disease Management , Infection Control , Pandemics , Pneumonia, Viral , Urogenital Neoplasms/surgery , Betacoronavirus , Coronavirus Infections/epidemiology , Decision Making , Epidemics , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Male , Pneumonia, Viral/epidemiology , Societies, Medical , Urologists
13.
Prog Urol ; 30(5): 221-231, 2020 Apr.
Article in French | MEDLINE | ID: covidwho-23918

ABSTRACT

AIM: The French population is facing the COVID-19 pandemic and the health system have been reoriented in emergency for the care of patients with coronavirus. The management of cancers of the urinary and male genital tracts must be adapted to this context. MATERIAL AND METHOD: An expert opinion documented by a literature review was formulated by the Cancerology Committee of the French Association of Urology (CCAFU). RESULTS: The medical and surgical management of patients with any cancers of the urinary and male genital tracts must be adapted by modifying the consultation methods, by prioritizing interventions according to the intrinsic prognosis of cancers, taking into account the patient's comorbidities. The protection of urologists from COVID-19 must be considered. CONCLUSION: The CCAFU issues an expert opinion on the measure to be taken to adapt the management of cancers of the male urinary and genital tract to the context of pandemic by COVID-19.


Subject(s)
Coronavirus Infections , Disease Management , Infection Control , Pandemics , Pneumonia, Viral , Urogenital Neoplasms/surgery , Betacoronavirus , Coronavirus Infections/epidemiology , Decision Making , Epidemics , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Male , Pneumonia, Viral/epidemiology , Societies, Medical , Urologists
14.
Minerva Urol Nefrol ; 72(3): 376-383, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-20797

ABSTRACT

The public health emergency caused by the Coronavirus Disease 2019 (COVID-19) pandemic has resulted in a significant reallocation of health resources with a consequent reorganization of the clinical activities also in several urological centers. A panel of Italian urologists has agreed on a set of recommendations on pathways of pre-, intra- and post-operative care for urological patients undergoing urgent procedures or non-deferrable oncological interventions during the COVID-19 pandemic. Simplification of the diagnostic and staging pathway has to be prioritized in order to reduce hospital visits and consequently the risk of contagion. In absence of strict uniform regulations that impose the implementation of nasopharyngeal swabs, we recommend that an accurate triage for COVID-19 symptoms be performed both by telephone at home before hospitalization and at the time of hospitalization. We recommend that during hospital stay patients should be provided with as many instructions as possible to facilitate their return to, and stay at, home. Patients should be discharged under stable good conditions in order to minimize the risk of readmission. It is advisable to reduce or reschedule post-discharge controls and implement an adequate system of communication for telemonitoring discharged patients.


Subject(s)
Coronavirus Infections , Critical Pathways/statistics & numerical data , Pandemics , Pneumonia, Viral , Urologic Diseases/surgery , Urology , Elective Surgical Procedures , Female , Humans , Italy , Male , Perioperative Care , Public Health , Triage , Urologic Neoplasms/surgery , Urologic Surgical Procedures , Urologists
15.
Prog Urol ; 30(5): 221-231, 2020 Apr.
Article in French | MEDLINE | ID: covidwho-19537

ABSTRACT

AIM: The French population is facing the COVID-19 pandemic and the health system have been reoriented in emergency for the care of patients with coronavirus. The management of cancers of the urinary and male genital tracts must be adapted to this context. MATERIAL AND METHOD: An expert opinion documented by a literature review was formulated by the Cancerology Committee of the French Association of Urology (CCAFU). RESULTS: The medical and surgical management of patients with any cancers of the urinary and male genital tracts must be adapted by modifying the consultation methods, by prioritizing interventions according to the intrinsic prognosis of cancers, taking into account the patient's comorbidities. The protection of urologists from COVID-19 must be considered. CONCLUSION: The CCAFU issues an expert opinion on the measure to be taken to adapt the management of cancers of the male urinary and genital tract to the context of pandemic by COVID-19.


Subject(s)
Coronavirus Infections , Disease Management , Infection Control , Pandemics , Pneumonia, Viral , Urogenital Neoplasms/surgery , Betacoronavirus , Coronavirus Infections/epidemiology , Decision Making , Epidemics , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Male , Pneumonia, Viral/epidemiology , Societies, Medical , Urologists
17.
Minerva Urol Nefrol ; 72(3): 369-375, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-13924

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 and the disease it causes, coronavirus disease 2019 (COVID-19) is generating a rapid and tragic health emergency in Italy due to the need to provide assistance to an overwhelming number of infected patients and, at the same time, treat all the non-deferrable oncological and benign conditions. A panel of Italian urologists has agreed on possible strategies for the reorganization of urological routine practice and on a set of recommendations that should facilitate the process of rescheduling both surgical and outpatient activities during the COVID-19 pandemic and in the subsequent phases. This document could be a valid tool to be used in routine clinical practice and, possibly, a cornerstone for further discussion on the topic also considering the further evolution of the COVID-19 pandemic. It also may provide useful recommendations for national and international urological societies in a condition of emergency.


Subject(s)
Coronavirus Infections , Pandemics , Pneumonia, Viral , Urologic Surgical Procedures/statistics & numerical data , Anesthesiology , Hospitalization/statistics & numerical data , Hospitals , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Italy , Patient Care Team , Patient Safety , Urologic Surgical Procedures/adverse effects , Urologists , Urology
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