In March 2020, the Italian Government introduced measures to reduce the spread of COVID-19 infection. Between 8th April and 2nd May 2020 we investigated levels and correlates of sexual activity and ...depression during COVID-19 lockdown in a sample of hospital workers and their acquaintances by an online survey on SurveyMonkey. Socio-demographic data, International Index of Erectile Function, Female Sexual Function Index, and Beck Depression Inventory were recorded. Multivariable logistic regression analysis (MLRA) was used to test predictors of depressive symptoms and low sexual desire and satisfaction. A statistically significant difference in age, change in working habit, sexual satisfaction, sexual desire, and depressive symptoms was found between males and females. A statistically significant higher proportion of health care workers had low sexual desire (65.3% vs 56.8%, p = 0.042). At MLRA, age, being female, being a health care worker, having children at home, living with the partner, and having low sexual satisfaction were predictors of low level of sexual desire. To our knowledge, this is one of the few studies using validated questionnaires for both males and females to assess sexual well-being and psychometric alterations during COVID quarantine.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Purpose
To determine the current status of surgical training amongst European Urology Residents, including their satisfaction with training and their confidence in performing procedures.
Methods
A ...23-item survey was distributed to the 15th European Urology Residents Education Programme (EUREP) 2017 participants. An analysis of demographics, workload, training resources, surgical exposure, surgical caseload, satisfaction and confidence in performing each procedure was performed.
Results
A total of 152/350 participants completed the survey (response rate 43%), of which 14% think they perform enough surgeries during their training, and 83% would like to continue training with a fellowship. Confidence in performing procedures without supervision and satisfaction with training was associated with higher surgical caseloads. Confidence in all laparoscopic/robotic procedures (except for laparoscopic/robotic partial nephrectomy) was associated with laparoscopic and robotics training, participation in practical courses and having training resources in hospitals. Satisfaction with surgical training was statistically associated with working ≤ 50 h per week, laparoscopic training and having laparoscopic training boxes.
Conclusions
Surgical exposure of European Urology residents for major/minimally invasive procedures, confidence in performing these procedures, and overall satisfaction with training is low. A higher volume of cases, as well as resources for training are associated with higher individual confidence and satisfaction with training.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
To the Editor,
Good surgical training is essential for the formation of excellent surgeons, consequently providing the best possible care for our patients in the future. Considering the increase in ...surgeon shortage over the last two decades (estimated between 14,300 and 23,400 by the year 2032 only in the US), it is important for filling the national health system's needs as well ....
To the Editor, Bladder cancer (BCa) is the second most common cancer in urological clinical practice, after prostate adenocarcinoma. Usually occurs in patients between 60 and 70 years old, three ...times more frequently in men than women. About 75% of bladder cancer are pTa or pT1, even more frequently considering a population younger than 40 years old. Early detection is of paramount importance since allows to find tumors when they are still superficial and therefore with a better prognosis.
Renal infarction in a COVID-19 patient Mantica, Guglielmo; De Rose, Aldo Franco
The Pan African medical journal,
2020, Volume:
37, Issue:
182
Journal Article
Peer reviewed
Open access
A 67-year-old female patient, who underwent a recent right lobectomy for pT2a N2 lung adenocarcinoma and adjuvant chemotherapy with Vinorelbine and Cisplatin, was admitted in April 2020 to the ...emergency department for nausea and abdominal pain. The clinical evaluation revealed a slightly positive right costovertebral angle tenderness and signs suspicious of right lower leg deep vein thrombosis. The blood tests revealed a white cell count of 26.07 X 109/L; hemoglobin 13.8 g/dl; INR 1.17; C-reactive protein 170 mg/L and creatinine 1.0 mg/dl. The Figure 1A shows an axial frame of the arterial phase of contrasted CT-scan in which is clearly visible the hypoperfusion of the right kidney compared to the left. Only few sporadic areas of the right parenchyma pick up contrast, differently from the left kidney parenchyma which appears totally contrasted. Similarly, Figure 1B shows a coronal image of the abdomen in which is visible the hypoperfusion of the right kidney, especially in the upper pole. The patient was started on Fondaparinux 5 mg/day and Piperacillin/Tazobactam 4.5 g x 3/day. Few days after the admission the patient developed fever (38.9°C), dyspnea (Sp02 90%) and tested positive for SARS-CoV-2. She died due to COVID-19. Although respiratory failure is the main characteristic of COVID-19, some authors indicate an increased risk for acute kidney injury (AKI). The pathophysiologic mechanisms leading to AKI in patients affected by SARS-CoV-2 are not completely clear but may include direct cytopathic effects of the virus on kidney tubular and endothelial cells or indirect damage caused by virus-induced cytokine release. Furthermore, thromboembolic events in COVID-19 patients are proven. Data suggest that the differential diagnosis of acute kidney injury in patients with COVID-19 infection should include kidney infarction. In this era of fear, patients and doctors should be aware of the fact that medical consultation should not be avoided or delayed in the absence of respiratory symptoms.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Introduction and objectives: Radical cystectomy (RC) continues to be standard of care for muscle-invasive bladder cancer and recurrent or refractory nonmuscle invasive bladder cancer. Unfortunately, ...it has high rates of perioperative morbidity and mortality. One of the most important predictors of postoperative outcomes is frailty, while the majority of complications are diversion related. The aim of our study was to evaluate safety of extraperitoneal cystectomy with ureterocutaneostomy in patients considered as frail. Materials and methods: We retrospectively collected data of frail patients who underwent extraperitoneal cystectomy with ureterocutaneostomy from October 2018 to August 2020 in a single center. We evaluated frailty by assessing patients' age, body mass index (BMI), nutritional status by Malnutrition Universal Screening Tool, overall health by RAI (Risk Analysis Index) and ASA (American Society of Anaesthesiologists) score, and laboratory analyses. We observed intraoperative outcomes and rates of perioperative (within 30 days) and early postoperative (within 90 days) complications (Clavien-Dindo classification). We defined extraperitoneal cystectomy with ureterocutaneostomy as safe if patients did not develop Clavien Dindo IIIb, or worse, complication. Results: A total of 34 patients, 3 female and 31 male, were analyzed. The median age was 77, BMI 26, RAI 28, ASA 3 and the majority had preexisting renal insufficiency. Blood analyses revealed presence of severe preoperative hypoalbuminemia and anemia in half of our cohort. Intraoperative median blood loss was 250 cc, whilst operative time 245 min. During perioperative period 60% of our cohort developed Clavien Dindo II complication and during early postoperative period 32% of patients required readmission. One death occurred during early postoperative period (2.9%). After 12 months of follow-up, we observed stability of the renal function for most patients. Conclusions: We believe that extraperitoneal cystectomy with ureterocutaneostomy could be considered as a treatment option for elderly and/or frail patients.
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