scholarly journals Management of complex renal cysts in Canada: Results of a survey study

2020 ◽  
Author(s):  
Félix Couture ◽  
Antonio Finelli ◽  
Amélie Tétu ◽  
Bimal Bhindi ◽  
Rodney H. Breault ◽  
...  

Abstract Background Bosniak III and IV cysts have a high risk of malignancy and have traditionally been managed surgically. However, growing evidence suggests that many can be managed by active surveillance. The main objective of this study was to characterize the use of surveillance in the management of complex renal cysts. Methods A web-based survey was sent to all registered, active members of the Canadian Urological Association (N=583) in October 2018. Results The survey response rate was 24.7%. Management of Bosniak III cysts varied considerably. A large proportion of respondents (33.1%) offered active surveillance in >50% of cases. Only 13.7% of respondents reported never or rarely (<5% of cases) offering surveillance. In contrast, for Bosniak IV cysts, 60.1% of urologists never or rarely offered surveillance, while only 10.1% offer it in >50% of cases. A significantly greater proportion of academic urologists, compared to non-academic urologists, viewed surveillance as a management option for patients with a Bosniak III or IV cyst. The most commonly reported barriers to a greater adoption of surveillance were concerns regarding its oncologic safety, the lack of data to support surveillance in this population, and the lack of triggers for discontinuation of active surveillance and intervention. Conclusions Despite active surveillance being included as a management option in guidelines, many Canadian urologists are reluctant to offer surveillance to patients with Bosniak III or IV cysts. Practice patterns are heterogeneous among those offering surveillance. High-quality studies are required to better define the benefits and risks of cystic renal mass surveillance.

2020 ◽  
Author(s):  
Félix Couture ◽  
Antonio Finelli ◽  
Amélie Tétu ◽  
Bimal Bhindi ◽  
Rodney H. Breault ◽  
...  

Abstract Background Bosniak III and IV cysts have a high risk of malignancy and have traditionally been managed surgically. However, growing evidence suggests that many can be managed by active surveillance. The main objective of this study was to characterize the use of surveillance in the management of complex renal cysts. Methods A web-based survey was sent to all registered, active members of the Canadian Urological Association (N=583) in October 2018. Results The survey response rate was 24.7%. Management of Bosniak III cysts varied considerably. A large proportion of respondents (33.1%) offered active surveillance in >50% of cases. Only 13.7% of respondents reported never or rarely (<5% of cases) offering surveillance. In contrast, for Bosniak IV cysts, 60.1% of urologists never or rarely offered surveillance, while only 10.1% offer it in >50% of cases. A significantly greater proportion of academic urologists, compared to non-academic urologists, viewed surveillance as a management option for patients with a Bosniak III or IV cyst. The most commonly reported barriers to a greater adoption of surveillance were concerns regarding its oncologic safety, the lack of data to support surveillance in this population, and the lack of triggers for discontinuation of active surveillance and intervention. Conclusions Despite active surveillance being included as a management option in guidelines, many Canadian urologists are reluctant to offer surveillance to patients with Bosniak III or IV cysts. Practice patterns are heterogeneous among those offering surveillance. High-quality studies are required to better define the benefits and risks of cystic renal mass surveillance.


2021 ◽  
Vol 21 (2) ◽  
pp. 136-141
Author(s):  
Wesam Saleh A. Al Attar ◽  
Nawaf Al Masoudi ◽  
Ali Al Zubeadi ◽  
Ahmed Qasem

Purpose. The Oslo Sports Trauma Research Center (OSTRC) handball injury prevention exercise is an evidence-based injury prevention exercise designed to prevent handball injury. This study aimed to assess the implementation of the OSTRC handball injury prevention exercises among professional handball players in the Gulf Cooperation Council (GCC) countries. Materials and methods. A web-based survey to acquire information regarding the implementation of OSTRC handball injury prevention exercises was distributed to 267 professional handball players in six GCC countries.  Results. A total of 250 handball players from the GCC countries responded to the survey (response rate 93.6%). The mean (±SD (Standard Deviation)) of the total implementation score was 13 (±2.558), with no statistically significant difference between the GCC countries, with a P-value of 0.123. The highest mean score was shown from Bahrain at 13.60 (±2.614), while the lowest was from Qatar at 12.10 (±2.427). Conclusions. A low implementation level of the OSTRC handball prevention exercises among the handball players in the GCC countries was reported in the current study.


Author(s):  
Keren Armoni Domany ◽  
Israel Amirav ◽  
Efraim Sadot ◽  
Nir Diamant ◽  
Dror Mandel ◽  
...  

Objective Long-term diuretic treatment in patients with bronchopulmonary dysplasia (BPD) is common despite lack of data that support its use. We aimed to characterize the commonly used diuretics weaning strategies for outpatient clinically stable preterm infants with BPD. Study Design We conducted a cross-sectional web-based survey among all pediatric pulmonologists and neonatologists in Israel. Questionnaire included data regarding practitioners' different diuretics-weaning practice in this population. Results The response rate for pulmonologists and neonatologists were 35/50 (70%) and 36/120 (30%), respectively. When both oxygen and diuretics are used, 59% wean oxygen first and 32% wean diuretics first. If patients are solely on diuretics, 27% discontinue instantly, 34% decrease the dosage gradually, and 34% outgrow the discharge dosage. Significantly more pulmonologists decrease the dosage gradually, while more neonatologists discontinue at once (p < 0.001). Most participants (94%) reported being unsatisfied with the existing data and guidelines regarding these issues. Conclusion Our results showed a wide range of practice patterns in the weaning strategy of diuretics in outpatient preterm infants with BPD. Pulmonologists and neonatologists differ significantly in their weaning strategy. A prospective larger controlled study to explore the outcome of gradual tapering versus discontinuation without weaning is warranted. Key Points


2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Tamarinde Haven ◽  
Joeri Tijdink ◽  
Brian Martinson ◽  
Lex Bouter ◽  
Frans Oort

Abstract Background Concerns about research misbehavior in academic science have sparked interest in the factors that may explain research misbehavior. Often three clusters of factors are distinguished: individual factors, climate factors and publication factors. Our research question was: to what extent can individual, climate and publication factors explain the variance in frequently perceived research misbehaviors? Methods From May 2017 until July 2017, we conducted a survey study among academic researchers in Amsterdam. The survey included three measurement instruments that we previously reported individual results of and here we integrate these findings. Results One thousand two hundred ninety-eight researchers completed the survey (response rate: 17%). Results showed that individual, climate and publication factors combined explained 34% of variance in perceived frequency of research misbehavior. Individual factors explained 7%, climate factors explained 22% and publication factors 16%. Conclusions Our results suggest that the perceptions of the research climate play a substantial role in explaining variance in research misbehavior. This suggests that efforts to improve departmental norms might have a salutary effect on behavior.


2011 ◽  
Vol 145 (5) ◽  
pp. 753-754 ◽  
Author(s):  
Jeremy D. Prager ◽  
Charles M. Myer ◽  
Charles M. Myer

Attrition is a disruptive problem in residency training programs. Resident attrition has been more thoroughly investigated and reported in other medical fields with limited data specific to otolaryngology. Using a Web-based survey of otolaryngology residency program directors, information regarding a 5-year cohort of residents was collected. The survey response rate was 61% (59 of 97 programs), representing 779 of 1239 training positions (63%). Forty-two percent of responding programs (25 of 59) lost a total of 47 residents (range, 1-7; mode 1). The overall attrition rate was 6% for the 5-year cohort (47 of 779) or 1.2% annually. Involuntary attrition affected 6 residents. Eighteen residents voluntarily left for other medical programs. Four left medicine entirely. The remaining 19 residents’ career paths were not described. Attrition within otolaryngology occurs with less frequency than general surgery and is likely comparable to other surgical subspecialties.


Pharmacy ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 23
Author(s):  
Hanna Justad ◽  
Ylva Askfors ◽  
Tero Shemeikka ◽  
Marine L. Andersson ◽  
Tora Hammar

Janusmed interactions is a drug-drug interactions (DDI) database available online for healthcare professionals (HCP) at all levels of the healthcare system including pharmacies. The database is aimed at HCP but is also open to the public for free, for those individuals who register for a personal account. The aim of this study was to investigate why and how patients use the database Janusmed interactions, how they perceive content and usability, and how they would react if they found an interaction. A web-based questionnaire was sent by email to all users who had registered for Janusmed interactions as a “patient” (n = 3219). A total of 406 patients completed the survey (response rate 12.6%). The study shows that there is an interest among patients to use a DDI database to check their own or a relative’s medication. The respondents found the database easy to use and perceive they understand the information aimed at HCP. Most patients stated they would talk to their HCP if they found an interaction and not adjust their treatment by themselves. However, the respondents in this study are actively searching for information and seem to have high health literacy. Thus, the findings are not generalizable for the general population.


CJEM ◽  
2016 ◽  
Vol 19 (3) ◽  
pp. 186-197
Author(s):  
Robert S. Green ◽  
Dean A. Fergusson ◽  
Alexis F. Turgeon ◽  
Lauralyn A. McIntyre ◽  
George J. Kovacs ◽  
...  

AbstractObjectivesVarious medications and devices are available for facilitation of emergent endotracheal intubations (EETIs). The objective of this study was to survey which medications and devices are being utilized for intubation by Canadian physicians.MethodsA clinical scenario-based survey was developed to determine which medications physicians would administer to facilitate EETI, their first choice of intubation device, and backup strategy should their first choice fail. The survey was distributed to Canadian emergency medicine (EM) and intensive care unit (ICU) physicians using web-based and postal methods. Physicians were asked questions based on three scenarios (trauma; pneumonia; heart failure) and responded using a 5-point scale ranging from “always” to “never” to capture usual practice.ResultsThe survey response rate was 50.2% (882/1,758). Most physicians indicated a Macintosh blade with direct laryngoscopy would “always/often” be their first choice of intubation device in the three scenarios (mean 85% [79%-89%]) followed by video laryngoscopy (mean 37% [30%-49%]). The most common backup device chosen was an extraglottic device (mean 59% [56%-60%]). The medications most physicians would “always/often” administer were fentanyl (mean 45% [42%-51%]) and etomidate (mean 38% [25%-50%]). EM physicians were more likely than ICU physicians to paralyze patients for EETI (adjusted odds ratio 3.40; 95% CI 2.90-4.00).ConclusionsMost EM and ICU physicians utilize direct laryngoscopy with a Macintosh blade as a primary device for EETI and an extraglottic device as a backup strategy. This survey highlights variation in Canadian practice patterns for some aspects of intubation in critically ill patients.


2016 ◽  
Vol 27 (4) ◽  
pp. 722-730 ◽  
Author(s):  
Nadine A. Kasparian ◽  
Nathan Lieu ◽  
David S. Winlaw ◽  
Andrew Cole ◽  
Edwin Kirk ◽  
...  

AbstractIntroductionThis study aimed to (a) examine eHealth literacy, beliefs, and behaviours in parents of children with complex CHD, and (b) identify parents’ preferences for the content, format, features, and functions of eHealth resources for CHD.Materials and methodsFamilies (n=198) of children born between 2008 and 2011 and diagnosed with CHD requiring surgery were mailed a survey assessing a range of variables including eHealth literacy, beliefs, and behaviours as well as preferences for the format, functions, features, and content of eHealth resources for CHD.ResultsA total of 132 parents (83 mothers, 49 fathers) completed the survey (response rate: 50%). Mothers (96%) were more likely to access eHealth resources than fathers (83%, χ2=6.74, p=0.009). Despite high eHealth resource use, eHealth literacy was relatively low, with results demonstrating considerable and widespread gaps in awareness of, access to, and communication about eHealth resources. Over 50% of parents reported that decisions regarding their child’s healthcare were influenced, to some extent, by web-based resources. Barriers to doctor–patient communication about eHealth included limited consultation time and concern about doctors’ disapproval. Participants demonstrated a strong desire for “eHealth prescriptions” from their child’s healthcare team, and perceived a wide range of eHealth topics as highly important, including treatment-related complications as well as physical, cognitive, and emotional development in children with CHD.DiscussionResults suggest a need for stronger, more proactive partnerships between clinicians, researchers, educators, technologists, and patients and families to bring about meaningful innovations in the development and implementation of eHealth interventions in paediatric cardiology.


Author(s):  
Yeoungjee Cho ◽  
Aminu K. Bello ◽  
Adeera Levin ◽  
Meaghan Lunney ◽  
Mohamed A. Osman ◽  
...  

2020 ◽  
Author(s):  
Ignacio Garitano ◽  
Manuel Linares ◽  
Laura Santos ◽  
Ruth Gil ◽  
Elena Lapuente ◽  
...  

UNSTRUCTURED On 28th February a case of COVID-19 was declared in Araba-Álava province, Spain. In Spain, a confinement and movement restrictions were established by Spanish Government at 14th March 2020. We implemented a web-based tool to estimate number of cases during the pandemic. We present the results in Áraba-Álava province. We reached a response rate of 10,3% out a 331.549 population. We found that 22,4 % fulfilled the case definition. This tool rendered useful to inform public health action.


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