Temporary work disability following trapezial resection and suspension arthroplasty for thumb carpometacarpal osteoarthritis. / Incapacidad laboral temporal tras cirugía de rizartrosis mediante trapecectomía y artroplastia de suspensión con sutura de alta resistencia.

PURPOSE: The aim of this study is to assess the time to return to work (TRW) in patients undergoing trapezial resection using the Mini TightRope® system at our center and to investigate factors that might delay return to work following this surgery. MATERIAL AND METHODS: A retrospective study was conducted on patients who underwent Trapezial resection and suspensionplasty using the Mini TightRope® system between 2015 and 2016, with a minimum one-year follow-up. Telephone interviews were conducted along with a review of medical records and radiology reports, as well as temporary work disability documents, collecting epidemiological and occupational data. Groups were compared based on age, gender, dominant hand, biomechanical occupational requirements of the patients, and whether they had experienced prior temporary work disability. RESULTS: A total of 36 patients (29 women and 7 men) with an average age of 55.7 years were included. The median time to return to work was 126 days. Self-employed workers re-entered the workforce 72 days earlier on average; workers who had experienced prior temporary work disability had a greater total temporary work disability duration and took 91 days longer to return to work compared to those who had not. CONCLUSIONS: Patients employed by others and those who had experienced prior temporary work disability before the surgery had longer temporary work disability periods. In our study, no differences were observed based on gender, dominant hand, or biomechanical work demands of the intervened patients.

Evolución de las derivaciones de atención primaria a urología. Impacto de un protocolo en enfermedad prostática y de formación continuada / Evolution of primary care referrals to urology. Impact of a protocol on prostate disease and continuing education

Objetivo: Analizar la evolución de las derivaciones desde atención primaria (AP) a urología tras implantar un protocolo conjunto en enfermedad prostática y un programa de formación continuada en nuestra área sanitaria. Material y métodos: En enero de 2011 iniciamos un protocolo de actuación en enfermedad prostática, que se complementó con sesiones formativas y con un sistema de consultas vía correo electrónico. Analizamos las derivaciones desde AP a urología entre 2011 y 2013, determinando el motivo de consulta y la adecuación a los criterios establecidos en enfermedad prostática. Obtuvimos los datos del programa «Solicitud de cita en atención especializada» de la Comunidad de Madrid. Calculamos el tamaño muestral con un nivel de confianza del 95% y heterogeneidad del 50%. Resultados: Se produjeron 19.048 derivaciones. El motivo de consulta más frecuente fue STUI asociado a HBP, con una reducción del 27% y una adecuación que pasó del 46 al 67%. Las consultas por PSA, aunque aumentaron un 40%, también mejoraron su adecuación (del 55 al 72%), siendo la principal consulta por sospecha de malignidad (30%). Destacan además la incontinencia femenina, que ha duplicado su número, y el descenso del 41% en disfunción eréctil, que pueden justificarse por la formación impartida a AP. Conclusiones: La colaboración entre urología y AP consigue mejorar la adecuación de las derivaciones en enfermedad prostática y modificar la tendencia de derivación del resto de enfermedades incluidas en el proyecto

Objective: To analyze the evolution of primary care referrals to the Urology Department after the implementation of a joint protocol on prostate disease and a continuing education program in our healthcare area. Material and methods: In January 2011, we launched an action protocol on prostate disease, which was complemented by training sessions and an e-mail-based consultation system. We analyzed primary care referrals to the Urology Department between 2011 and 2013 and determined the reasons for the consultations and the compliance with the established criteria on prostate disease. We obtained data from the "Request for Appointment in Specialized Care" program of the Community of Madrid. We calculated the sample size with a 95% confidence level and a 50% heterogeneity. Results: A total of 19,048 referrals were conducted. The most common reason for the referrals was lower urinary tract symptoms associated with benign prostate hyperplasia, with a 27% reduction and a compliance that went from 46% at 67%. Although prostate-specific antigen consultations increased by 40%, they improved their appropriateness (from 55% to 72%). This was the main type of consultation for suspicion of malignancy (30%). Also worth mentioning were female incontinence, which doubled in number, and a 41% reduction in erectile dysfunction, which could be due to the primary care training. Conclusions: The collaboration between the Department of Urology and primary care succeeded in improving the appropriateness of prostate disease referrals and modified the tendency to refer the rest of the diseases included in the project

Evolution of primary care referrals to urology. Impact of a protocol on prostate disease and continuing education.

OBJECTIVE: To analyze the evolution of primary care referrals to the Urology Department after the implementation of a joint protocol on prostate disease and a continuing education program in our healthcare area. MATERIAL AND METHODS: In January 2011, we launched an action protocol on prostate disease, which was complemented by training sessions and an e-mail-based consultation system. We analyzed primary care referrals to the Urology Department between 2011 and 2013 and determined the reasons for the consultations and the compliance with the established criteria on prostate disease. We obtained data from the "Request for Appointment in Specialized Care" program of the Community of Madrid. We calculated the sample size with a 95% confidence level and a 50% heterogeneity. RESULTS: A total of 19,048 referrals were conducted. The most common reason for the referrals was lower urinary tract symptoms associated with benign prostate hyperplasia, with a 27% reduction and a compliance that went from 46% at 67%. Although prostate-specific antigen consultations increased by 40%, they improved their appropriateness (from 55% to 72%). This was the main type of consultation for suspicion of malignancy (30%). Also worth mentioning were female incontinence, which doubled in number, and a 41% reduction in erectile dysfunction, which could be due to the primary care training. CONCLUSIONS: The collaboration between the Department of Urology and primary care succeeded in improving the appropriateness of prostate disease referrals and modified the tendency to refer the rest of the diseases included in the project.