Preparedness of the community in facing disasters like earthquakes (Case: Cisarua, Indonesia).

The potential for disaster in an area is based on the geographical characteristics of a place and the living factors of the surrounding community. Community preparedness must be implemented to minimise the impact of an earthquake. This study aimed to determine the level of community preparedness in facing earthquakes in Cisarua District, Indonesia, based on the results of earthquake hazard mapping. The research used the quantitative Analytical Hierarchy Process (AHP) for earthquake hazard mapping and disaster preparedness using questionnaires. The AHP parameters include earthquake acceleration, distance from the Lembang fault, rock type, soil type, land use, slope and population density. The sample for this study comprised 80 respondents from six villages with a relatively high level of vulnerability, namely the villages of Jambupida, Padaasih, Pasirhalang, Pasirlangu, Kertawangi and Tugumukti. Data collection was carried out through interviews and site surveys based on a questionnaire consisting of variables like knowledge and attitudes, policies, emergency response plans, disaster warning systems and resource mobilisation with a total of 80 respondents. The study results concluded that community preparedness was included in the unprepared category with a total score of 211. Aspects of kinship and kinship relations between residents greatly influenced community preparedness, and knowledge and attitudes were considered sufficient with a weight of 4.4. Increased public awareness of the potential for earthquake disasters must routinely be carried out through disaster emergency response outreach and training activities in addition to improving residents' emergency response facilities. Contribution: The study findings highlight the village community's earthquake disaster preparedness with the support of integrated spatial mapping of disaster vulnerability. The lack of awareness of the village community in earthquake disaster mitigation increases the level of disaster risk in their area.

Aspectos urodinámicos de la incontinencia urinaria femenina tratada con cabestrillos / Urodynamic Aspects of Feminine Urinary Incontinence Treated with Slings

Objetivos: El tratamiento de la incontinencia urinaria de esfuerzo (IUE) femenina con cabestrillos pretende suplir la función de los ligamentos dañados, favoreciendo la transmisión correcta de las tensiones. Nuestro objetivo es determinar qué variables preoperatorias pueden predecir el resultado del tratamiento quirúrgico de la IUE y estudiar los cambios urodinámicos que produce la cirugía. Material y métodos: 139 mujeres (edad =61,7; σ =10,88) intervenidas por IUE fueron estudiadas retrospectivamente. En 118 casos (84,8%) se utilizaron técnicas de cabestrillo (TVT, TOT, TVT-Safyre, REEMEX). Se realizó evaluación clínica y vídeo-urodinámica completa preoperatoria y a los tres meses de cirugía. Se realizó tratamiento estadístico (test de Fisher, Wilcoxon, Friedman, «t» de Student y χ2 Pearson) y análisis de regresión logística multivariante mediante método de eliminación por pasos. Resultados: Postoperatoriamente disminuyó la IUE (p=0,000) y el síndrome de hiperactividad vesical (p=0,001). Los porcentajes de éxito (ausencia urodinámica de IUE) para cada técnica fueron: TVT-Safyre (75%), TOT (73%), TVT (60%) y REEMEX (57%), sin diferencias significativas. La edad (punto de corte ROC 61 años) fue factor pronóstico de éxito (p=0,024). El flujo máximo (Qmáx) preoperatorio (16ml/s) constituyó el único parámetro urodinámico con valor predictivo (p=0,026) para éxito. Un cuello vesical abierto fue factor de riesgo para la persistencia de IUE postoperatoria (RR=2,78). Se comprobó disminución significativa de Qmáx postquirúrgico (p=0,017), sin aumento del residuo posmiccional ni de Wmáx. También se observó aumento de resistencia uretral (URA) poscirugía (p=0,004). Conclusiones: El Qmáx preoperatorio es el parámetro urodinámico pronóstico más importante en la cirugía de la IUE femenina, asociándose su normalidad a una mayor posibilidad de cura de la incontinencia. En los casos de flujo preoperatorio disminuido se desaconsejan los cabestrillos que más incrementan la resistencia uretral (REEMEX). La hiperactividad del detrusor preoperatoria no modifica significativamente los resultados de la cirugía de la IUE (AU)

Objectives: Treatment of feminine stress urinary incontinence (SUI) with slings aims to supplement the function of the damaged ligaments, favoring the correct transmission of the tensions. Our objective is to determine which preoperative variables could predict the outcome of surgical treatment of SUI and to study the urodynamic changes produced by the surgery. Material and methods: 139 women (age =61.7; σ=10.88) operated on due to SUI were studied retrospectively. In 118 cases (84.8%), sling techniques (TVT, TOT, TVT-Safyre, REEMEX) were used. Clinical evaluation and complete preoperative video -urodynamics were made pre-operatively and at 3 months of surgery. A statistical study (Fisher's test, Wilcoxon, Friedman, Student's T and Pearson's χ2) and analysis of multivariant logistic regression analysis by step elimination method were performed. Results: Post-operatively, the SUI (p=0.000) and bladder hyperactivity syndrome decreased. The success percentages (urodynamic absence of SUI) for each technique were: TVT-Safyre (75%), TOT (73%), TVT (60%) and REEMEX (57%), without significant differences. Age (ROC cut-off: 61 years) was a prognostic factor of success (p=0.024). Preoperative maximum flow (Qmax) (16ml/s) constituted the only urodynamic parameter with a predictive value for success (p=0.026). An open bladder neck was a risk factor for persistence of postoperative SUI (RR=2.78). A significant decrease of the postsurgical Qmax (p=0.017) was verified, without increase of the post micturation residue or of the Wmax. An increase of the postsurgical urethral resistance (UR) was also observed (p=0.004). Conclusions: The pre-operative Qmax is the most important urodynamic prognostic parameter in feminine SUI surgery, its normality being associated to a greater probability of cure of the incontinence. In the cases of decreased preoperative flow, use of slings that increase urethral resistance more (REEMEX) is not recommended. Hyperactivity of the preoperative detrusor does not significantly modify the results of surgery of the SUI (AU)

[Urodynamic aspects of feminine urinary incontinence treated with slings]. / Aspectos urodinámicos de la incontinencia urinaria femenina tratada con cabestrillos.

OBJECTIVES: Treatment of feminine stress urinary incontinence (SUI) with slings aims to supplement the function of the damaged ligaments, favoring the correct transmission of the tensions. Our objective is to determine which preoperative variables could predict the outcome of surgical treatment of SUI and to study the urodynamic changes produced by the surgery. MATERIAL AND METHODS: 139 women (age X =61.7; σ=10.88) operated on due to SUI were studied retrospectively. In 118 cases (84.8%), sling techniques (TVT, TOT, TVT-Safyre, REEMEX) were used. Clinical evaluation and complete preoperative video -urodynamics were made pre-operatively and at 3 months of surgery. A statistical study (Fisher's test, Wilcoxon, Friedman, Student's T and Pearson's χ(2)) and analysis of multivariant logistic regression analysis by step elimination method were performed. RESULTS: Post-operatively, the SUI (p=0.000) and bladder hyperactivity syndrome decreased. The success percentages (urodynamic absence of SUI) for each technique were: TVT-Safyre (75%), TOT (73%), TVT (60%) and REEMEX (57%), without significant differences. Age (ROC cut-off: 61 years) was a prognostic factor of success (p=0.024). Preoperative maximum flow (Qmax) (16 ml/s) constituted the only urodynamic parameter with a predictive value for success (p=0.026). An open bladder neck was a risk factor for persistence of postoperative SUI (RR=2.78). A significant decrease of the postsurgical Qmax (p=0.017) was verified, without increase of the post micturation residue or of the Wmax. An increase of the postsurgical urethral resistance (UR) was also observed (p=0.004). CONCLUSIONS: The pre-operative Qmax is the most important urodynamic prognostic parameter in feminine SUI surgery, its normality being associated to a greater probability of cure of the incontinence. In the cases of decreased preoperative flow, use of slings that increase urethral resistance more (REEMEX) is not recommended. Hyperactivity of the preoperative detrusor does not significantly modify the results of surgery of the SUI.

[Carcinoma of the penis. Our experience with 22 cases]. / Carcinoma de pene. Nuestra experiencia en 22 casos.

The penis carcinoma is a neoplasia representing 0.7% of all male neoplasias, with an annual incidence between 1 and 2 cases per 100,000 inhabitants/year. The present study compiles the authors' experience in treating 22 patients presenting this neoplasia in the period between 1977-90. The procedures carried out included local resection, partial amputation, radical penectomy with lymphadenectomy plus radiotherapy, and palliative surgery plus radiotherapy all based on staging made following TNM grading. Therapy complications, follow-up, and survival results are explained. There were 5 occasions of spinocellular carcinoma co-existing with other neoplasias: 1 colon adenocarcinoma, 1 prostate carcinoma, 1 cleaved small cell centrocytic diffuse lymphoma, and 2 skin epithelioma in other sites, and relevant literature was reviewed. A background of psoriasis treated with psoralens plus UV was present in 4 cases, and caution was advised towards genital protection in patients undergoing UV radiations whether for therapeutic, recreational or cosmetic reasons.

[Uncoordinated urination syndrome]. / Síndrome de micción no coordinada.

Fourteen male and female patients aged 8 to 21 (mean 12.57 years) underwent clinical and urodynamic evaluation. These patients had different lower urinary tract symptoms, and flow changes and increased perineal muscle activity during voiding were demonstrated urodynamically. The urodynamic work up consisted of flowmetry, cystomanometry, detrusor pressure-flow test, videocystourethrography and electromyography of the periurethral sphincter. The urinary symptoms were nocturnal enuresis in 6 cases (42.85%), urinary infection in 6 (42.85%), difficulty in voiding in 4 (28.57%), urgency incontinence in 4 (28.57%), voiding urgency in 2 (14.28%) and diurnal urgency and frequency in 1 case (7.18%). The following 3 voiding bladder behaviour patterns were observed; 1) involuntary micturition from bladder instability (7 cases, 50%), 2) micturition from voluntary bladder contraction (2 cases, 14.28%) and 3) absence of bladder contractile activity with voiding achieved using the abdominal muscles (5 cases, 35.71%). Decompensated voiding was observed in 21% of the overall group. Of these, 75% belonged to the group that used the abdominal muscles to void. Dilatation of the proximal or prostatic urethra was frequently accompanied by bladder instability (57%). The urodynamic data may be useful in determining the outcome of treatment.

[Technique of simplified retropubic colpourethrocervicopexy in the treatment of genuine urinary stress incontinence in women]. / Técnica de colpouretrocervicopexia retropúbica simplificada en el tratamiento de la genuina incontinencia urinaria de esfuerzo femenina.

A surgical technique is described for the treatment of genuine urinary exercise incontinence (U.E.I.) in the female, consisting in the performance of simplified retropubic colpouretrocerico- pexia which allows to obtain a 89.2% urinary incontinence recovery rate and 97% cystocele reduction (n=40 cases).

[Xanthogranulomatous pyelonephritis. Retrospective study]. / Pielonefritis xantogranulomatosa (PXG). Estudio retrospectivo.

The incidence of PGX in our setting is low (0.67%). Middle-aged women comprise most of our cases. This disease process is usually unilateral; 53.2% of the present series had right-sided renal involvement. Over the past 17 years, 135 cases of histopathologically-documented XGP have been recorded at our hospital. Sixty-three cases were studied retrospectively. Patient history, symptoms and signs, and data gleaned from physical examination are presented. Similarly, patient outstanding pathogenetic features are described. Preoperative diagnosis of XGP is difficult. The availability of high resolution imaging techniques has enhanced diagnostic accuracy. Urinary cytology permits preoperative diagnosis with an accuracy rate of 80%. The postoperative prognosis is excellent.

[Dysfunction of the contractile capacity of the detrusor muscle in post-prostatectomy urinary retention]. / La afectación de la capacidad de contracción del detrusor en la retención urinaria posprostatectomía.

We report on 23 consecutive patients with urinary retention following prostatectomy for benign prostatic hypertrophy. The patients were clinically and urodynamically evaluated. Urodynamic work-up included flowmetry, cystomanometry, detrusor pressure-micturition flow test, and videocystography. The involvement of detrusor contractility in urinary retention was observed in 60.87% of the cases and was ascribable to lower urinary tract obstruction in 39.19%. These data permitted instituting correct treatment.

[Participation of bladder dysfunction in urinary incontinence after prostatectomy]. / Participación de la disfunción vesical en la incontinencia urinaria postprostatectomía.

Twenty-four patients with post-prostatectomy urinary incontinence were submitted to clinical and urodynamic evaluation. The clinical evaluation analyzed urinary symptoms and included rectal examination of the prostate lodge, neurourologic examination (perineal sensitivity, anal tone, bulbocavernous reflex, voluntary control of anal sphincter). The urodynamic study consisted of flowmetry, cystomanometry, detrusor pressure/micturition flow test and videocystography. An unstable bladder was demonstrated in 62.5% of the cases. Bladder dysfunction was recognized in 75% of the cases. Involvement of the striated periurethral sphincter was demonstrated in no patient. The clinical data did not provide orientation. No relation was observed between the urodynamic data, type of surgery, and amount of prostate removed. The urodynamic data appear to have a prognostic significance.

Hepatic acetylator phenotype in bladder cancer patients.

We determined the hepatic acetylator phenotype in 130 patients with transitional-cell carcinoma (urothelioma) of the bladder and, previously in 157 normal control subjects. Eighty-three patients (63.8%) and 90 control subjects (57.4%) were slow acetylators (p greater than 0.05). Patients of both phenotypes did not differ in the consumption of tobacco and coffee. Seventy-five patients were not exposed to occupational risk for bladder cancer and the distribution of acetylator phenotype in them was similar to that of the control group. The other 55 patients had been employed in jobs with an elevated risk for urotheliomas; 41 (74.5%) were slow acetylators, which represented a significant excess over the incidence of slow acetylators in the control group (57.4%) (p less than 0.05); 15 of these patients had worked in jobs with carcinogenic arylamines proven in the workplace environment (11 were slow acetylators). Our results suggest that the slow acetylator phenotype can facilitate the development of urothelioma in individuals with occupational risk.

Giant fibrous polyp of a calyx.

A case of a giant fibrous polyp of the pyelocaliceal system producing hydronephrosis is described. The presentation of the findings in this case as well as brief review of the literature are included.

[Retroperitoneal malignant xanthogranuloma. 1 case and a literature review]. / Xanthogranulome malin rétro-péritonéal. Présentation d'un cas et revue de la littérature.

A case is reported, the 33rd to be published in the literature, of malignant retroperitoneal xanthogranuloma. The tumor involved 2 cm of the right ureter at the junction between the middle and upper thirds. The middle third of the ureter was removed and ureteral continuity established by end to end ureteral anastomosis. The patient died fourteen months later probably from metastases, though the presence of these was not confirmed.