The COVID-19 pandemic has brought about changes in the management of urology patients, especially those with prostate cancer.
The aim of this work is to show the changes in the ambulatory care ...practices by individualized telematic care for each patient profile.
Articles published from March 2020 to January 2021 were reviewed. We selected those that provided the highest levels of evidence regarding risk in different aspects: screening, diagnosis, treatment and follow-up of prostate cancer.
We developed a classification system based on priorities, at different stages of the disease (screening, diagnosis, treatment and follow-up) to which the type of care given, in-person or telephone visits, was adapted. We established 4 options, as follows: in priority A or low, care will be given by telephone in all cases; in priority B or intermediate, if patients are considered subsidiary of an in-person visit after telephone consultation, they will be scheduled within 3 months; in priority C or high, patients will be seen in person within a margin from 1 to 3 months and in priority D or very high, patients must always be seen in person within a margin of up to 48 h and considered very preferential.
Telematic care in prostate cancer offers an opportunity to develop new performance and follow-up protocols, which should be thoroughly analyzed in future studies, in order to create a safe environment and guarantee oncologic outcomes for patients.
La pandemia por COVID-19 ha supuesto un cambio en la atención a pacientes en el ámbito urológico, especialmente con cáncer de próstata.
El objetivo de este trabajo es mostrar los cambios en el manejo a nivel ambulatorio individualizando para cada perfil de paciente la atención telemática.
Se han revisado artículos publicados desde marzo del 2020 hasta enero del 2021. Se han seleccionado aquellos que aportaban los mayores niveles de evidencia en cuanto al riesgo en distintos aspectos: cribado, diagnóstico, tratamiento y seguimiento del cáncer de próstata.
Desarrollamos una clasificación según prioridades, en diferentes etapas de la enfermedad (cribado, diagnóstico, tratamiento y seguimiento) adaptando a esta el tipo de control: presencial o telefónico. Establecemos 4 opciones: prioridad A o baja, en la que la atención será telefónica en todos los casos; prioridad B o intermedia, en la que si el paciente valorado telefónicamente se considera subsidiario de visita presencial, esta se citará dentro de los 3 meses posteriores; prioridad C o alta, el paciente será visto presencial con un margen para la visita de 1 a 3 meses, y prioridad D o muy alta, la visita deberá ser siempre presencial con un margen de hasta 48 h y considerada muy preferente.
La atención telemática en cáncer de próstata representa una oportunidad para desarrollar nuevos protocolos de actuación y seguimiento que deberán ser analizados exhaustivamente en futuros trabajos con el fin de conformar un entorno seguro y garantizar resultados oncológicos para los pacientes.
The prevalence of menopausal women with confirmed vulvovaginal atrophy (VVA) oscillates between 67–98%.
To assess the prevalence of postmenopausal women with VVA confirmed by gynecologic clinical ...assessment among all women attending menopause centers in Spain, as well as to describe the impact of VVA on quality of life and sexual functioning.
Women aged 45–75 years old with the last menstrual period >12 months before were included in a cross-sectional study.
Women with ≥1 VVA symptoms filled out a number of questionnaires, including EuroQoL, Day-to-Day Impact of Vaginal Aging, Female Sexual Function Index, and Female Sexual Distress Scale-revised. A gynecologic examination was performed to confirm diagnosis.
1,177 evaluable patients were included. VVA was confirmed in 87.3% of the patients. Almost 80% of women who acknowledged being sexually active (n = 717) presented pain during intercourse. As compared with patients without confirmed VVA (n = 66), patients with confirmed VVA (n = 1,028) were significantly older (P < .0001), had lower rates of sexual activity (P < .05), and used more VVA treatments (P < .05). Severe vaginal atrophy and severe vulvar atrophy were more prevalent in VVA-confirmed women (P < .0001, in both cases). No differences regarding the confirmation of VVA were observed for EuroQoL and Day-to-Day Impact of Vaginal Aging quality-of-life questionnaires. Sexual function measured through the Female Sexual Function Index score was significantly reduced in sexually-active patients with confirmed VVA (P < .05).
VVA signs and symptoms are highly prevalent in Spanish postmenopausal women. Confirmation of VVA diagnosis was associated with impaired sexual function. The early recognition of VVA symptoms should be actively promoted in medical practice, instead of waiting until signs appear to exclude other reasons for VVA and to manage treatment effectively.
Palacios S, González SP, Fernández-Abellán M, et al. Impact of Vulvovaginal Atrophy of Menopause in Spanish Women: Prevalence and Symptoms According to the EVES Study. Sex Med 2019;7:207–216.
Peripheral cell responses against
Leishmania infantum and serology by IFAT and WB were determined in 87 untreated dogs from an endemic area (Madrid, Spain) and in 15 treated dogs (antimonials, ...allopurinol). All untreated symptomatic dogs (nine) did not show any lymphoproliferative response, whereas 21 out of 78 untreated asymptomatic dogs had a positive cellular response. Serum IgG
2 from dogs with clinical signs of patent leishmaniosis reacted with a variety of peptides (26, 29, 34–35.4, 42, 45, 50–57 and 67 kDa), but IgG
1 response was mainly directed against a 67-kDa peptide. Successfully treated dogs displayed a low immunoreactivity of both IgG
1 and IgG
2, particularly against 67 kDa, thus indicating the potential prognostic value of this region. Positive cellular response of dogs treated with good clinical progress was only observed up to 5–12 months post treatment. Untreated asymptomatic dogs with positive cell response showed a clear recognition by IgG
2 of ≈67 and 45 kDa antigens, whereas IgG
1 did not recognise any antigen.
Flexible polymer-based magnetoelectric (ME) materials are developed based on novel CoFe2O4(CoFO) nanoellipsoids and polyvinylidenefluoride-co-trifluoroethylene P(VDF-TrFE). The synthesized ...noncytotoxic CoFO nanoellipsoids (270 nm × 50 nm) show high magnetization, ≈170 emu·g–1, high magnetostriction, ≈300 ppm, and magnetic anisotropy that, coupled to the piezoelectric response of P(VDF-TrFE), |d 33| = 21 ± 1 pC·N–1, lead to an interfacial ME coupling (α) of 1.50 mV·cm–1·Oe–1. Further, nanoellipsoid orientation within the polymer matrix allows an anisotropic ME response of the CoFO/P(VDF-TrFE) composite. Such a response is dependent on the angle between the dc magnetic field direction and the nanoellipsoids length direction. The proposed mechanism for the anisotropic behavior allows the tailoring of the ME response to contactless sensing applications.
Imposing essential boundary conditions is a key issue in mesh-free methods. The mesh-free interpolation does not verify the Kronecker delta property and, therefore, the imposition of prescribed ...values is not as straightforward as for the finite element method. The aim of this paper is to present a general overview on the existing techniques to enforce essential boundary conditions in Galerkin based mesh-free methods. Special attention is paid to the mesh-free coupling with finite elements for the imposition of prescribed values and to methods based on a modification of the Galerkin weak form. Particular examples are used to analyze and compare their performance in different situations.
Free-standing flexible magnetoelectric 0–3 composite films comprising CoFe
2
O
4
non-spherical ferromagnetic nanoparticles with strong magnetic anisotropy in soft polyvinylidene fluoride matrices ...with significant void ratios have been prepared at low temperatures by solvent casting, melt crystallization and mechanical stretching. Magnetoelectric voltage coefficients increase linearly with applied dc magnetic field bias up to 5 kOe. At this field, a maximum magnetoelectric voltage coefficient of 11.2 mV cm
−1
Oe
−1
was obtained for samples with 10 wt% ferrite at ~50-kHz resonance. The observed linear magnetoelectric response is attributed to a linear gradient of magnetostriction with respect to magnetic field for
H
≤ 5 kOe.
To analyse the characteristics and predictors of death in hospitalized patients with coronavirus disease 2019 (COVID-19) in Spain.
A retrospective observational study was performed of the first ...consecutive patients hospitalized with COVID-19 confirmed by real-time PCR assay in 127 Spanish centres until 17 March 2020. The follow-up censoring date was 17 April 2020. We collected demographic, clinical, laboratory, treatment and complications data. The primary endpoint was all-cause mortality. Univariable and multivariable Cox regression analyses were performed to identify factors associated with death.
Of the 4035 patients, male subjects accounted for 2433 (61.0%) of 3987, the median age was 70 years and 2539 (73.8%) of 3439 had one or more comorbidity. The most common symptoms were a history of fever, cough, malaise and dyspnoea. During hospitalization, 1255 (31.5%) of 3979 patients developed acute respiratory distress syndrome, 736 (18.5%) of 3988 were admitted to intensive care units and 619 (15.5%) of 3992 underwent mechanical ventilation. Virus- or host-targeted medications included lopinavir/ritonavir (2820/4005, 70.4%), hydroxychloroquine (2618/3995, 65.5%), interferon beta (1153/3950, 29.2%), corticosteroids (1109/3965, 28.0%) and tocilizumab (373/3951, 9.4%). Overall, 1131 (28%) of 4035 patients died. Mortality increased with age (85.6% occurring in older than 65 years). Seventeen factors were independently associated with an increased hazard of death, the strongest among them including advanced age, liver cirrhosis, low age-adjusted oxygen saturation, higher concentrations of C-reactive protein and lower estimated glomerular filtration rate.
Our findings provide comprehensive information about characteristics and complications of severe COVID-19, and may help clinicians identify patients at a higher risk of death.
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