scholarly journals Urological Pathologies and Their Incidence Rates Determined in Cases Applied to the Health Board

2021 ◽  
Author(s):  
Deniz Noyan Özlü ◽  
Ekrem Güner
Keyword(s):  
Incidence Rates ◽  
Stone Disease ◽  
Health Board ◽  
Urogenital System ◽  
Occupational Groups ◽  
Age Assessment ◽  
Health Report ◽  
Number Of Patients ◽  
Urinary Tract Stones

Objective: Applications are made to health boards for age assessment, gender determination, employment in some occupational groups and detection of disability. The aim of our study is to determine the defined urological pathologies and their incidence rates in the patients who applied to the health board of our hospital. Materials and Methods: Our study included patients who applied to the urology outpatient clinic of the health board between January 2015 and December 2020 for the purpose of employment in some occupational groups, determination of age, gender, disabilities and obtaining a general health report. Patients were investigated in two different groups, according to their indications for their applications as detection of disabilities and other indications, and the diagnoses were classified under the subheadings of stone diseases, malignancies, neurourology-incontinence, andrology and benign prostatic hyperplasia (BPH). Results: A total of 1453 cases were included in the study. Hundred and fifty-one (10.4%) patients applied for the detection of disability. A total of 206 (17%) patients, including 70 (46.3%) cases in the disability detection group and 136 (10.4%) in the other group had a urological diagnosis. The most common pathology was malignancies with 65 (4.4%) cases, in order of frequency; testicular cancer (n=25: 38.4%), bladder cancer (n=15: 23%), prostate cancer (n=13: 20%), kidney cancer (n=11: 16.9%) and penile cancer (n=1: 1,5%). The second most frequently seen diagnostic group was the stone disease group (n=55: 3.7%), and 17 (30.9%) of them required further investigation after diagnosis. Consequently ESWL (n=6: 10.9%), and surgical intervention (n=4: 7.3%) were planned for the indicated number of patients. Conclusion: Urogenital system malignancies and urinary tract stones have been identified as the most common pathologies in patients who applied to the health board. The fact that some diseases, especially urolithiasis were followed by further examination and treatment, shows the contribution of the health board examinations to the treatment as well as the health status determination feature.

Use of non-contrast computed tomography determined urinary stone fragility in predicting the outcome of extracorporeal shockwave lithotripsy treatment: a single-center study

2020 ◽  
Vol 14 (2) ◽  
pp. 59-63
Author(s):  
Athar Hameed ◽  
Khazir Hayyat Gondal
Keyword(s):  
Shock Waves ◽  
Renal Stone ◽  
Plain Film ◽  
Renal Stones ◽  
Renal Calculus ◽  
Urinary Stone ◽  
Stone Disease ◽  
Urinary Stones ◽  
Fisher Exact Test

Background: Renal stones represent a common urological pathology where standard treatment advised is ESWL in current practice. However, NCCT based determination of stone fragility may help to predict the outcome of ESWL treatment, hence optimizing its clinical use. Therefore, this study evaluated the role of NCCT determined urinary stone fragility in predicting the outcome of ESWL treatment in local clinical settings. Patients and methods: One hundred patients with single renal calculus of 0.6-2 cm in size were included. NCCT based determination of stone fragility in HU units was done for all patients. Patients were then subjected to ESWL, with a maximum of 3000 shock waves given per ESWL session. Plain film and/or ultrasonography was used to monitor ESWL treatment progress with a final NCCT evaluation at 12 weeks to determine the clearance of the calculi for each patient. Association of NCCT based stone fragility and outcome of ESWL was statistically analyzed using Fisher exact test. Results: The mean age of the patients was 37.7 ± 10.9 years with 54% being male. Decreasing stone fragility on NCCT (high = <500HU, moderate = 500-1000HU, and high = 1000HU) required more number and intensity of ESWL sessions (1-2 visits and 3000-6000 shock waves for high stone fragility group, 3-5 visits and 7000-18000 shock waves for the moderate group, and 6 visits and >18000 shock waves for low fragility group, respectively) necessary for clearance of urinary stones (p<0.001). In 98% of patients, the clearance of urinary stones was excellent. Conclusion: Renal stone patients with NCCT determined high and moderate stone fragility show an optimal response after ESWL treatment, whereas, for low fragility renal stones attenuative treatment like percutaneous nephrolithotomy and/or ureteroscopy should be considered instead of ESWL. This approach can enable patient stratification before ESWL therapy ensuring better clinical management of the renal stone disease.

scholarly journals Diabetes mellitus was not associated with lower amputation-free survival after open revascularization for chronic limb-threatening ischemia – A nationwide propensity score adjusted analysis

2021 ◽  
pp. 1358863X2110082
Author(s):  
Erika Lilja ◽  
Anders Gottsäter ◽  
Mervete Miftaraj ◽  
Jan Ekelund ◽  
Björn Eliasson ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Propensity Score ◽  
Vascular Surgery ◽  
Incidence Rate ◽  
Cox Regression ◽  
Major Amputation ◽  
Incidence Rates ◽  
Major Adverse Cardiovascular Events ◽  
Cox Regression Analysis ◽  
Number Of Patients

The risk of major amputation is higher after urgently planned endovascular therapy for chronic limb-threatening ischemia (CLTI) in patients with diabetes mellitus (DM). The aim of this nationwide cohort study was to compare outcomes between patients with and without DM following urgently planned open revascularization for CLTI from 2010 to 2014. Out of 1537 individuals registered in the Swedish Vascular Registry, 569 were registered in the National Diabetes Register. A propensity score adjusted Cox regression analysis was conducted to compare outcome between the groups with and without DM. Median follow-up was 4.3 years and 4.5 years for patients with and without DM, respectively. Patients with DM more often had foot ulcers ( p = 0.034) and had undergone more previous amputations ( p = 0.001) at baseline. No differences in mortality, cardiovascular death, major adverse cardiovascular events (MACE), or major amputation were observed between groups. The incidence rate of stroke was 70% higher (95% CI: 1.11–2.59; p = 0.0137) and the incidence rate of acute myocardial infarction (AMI) 39% higher (95% CI: 1.00–1.92; p = 0.0472) among patients with DM in comparison to those without. Open vascular surgery remains a first-line option for a substantial number of patients with CLTI, especially for limb salvage in patients with DM. The higher incidence rates of stroke and AMI among patients with DM following open vascular surgery for infrainguinal CLTI require specific consideration preoperatively with the aim of optimizing medical treatment to improve cardiovascular outcome postoperatively.

scholarly journals Impact of COVID-19 pandemic on non-COVID patient’s management in urology: a public hospital experience in Mumbai

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Nikhilesh A. Jibhakate ◽  
Sujata K. Patwardhan ◽  
Ajit S. Sawant ◽  
Hemant R. Pathak ◽  
Bhushan P. Patil ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Stone Disease ◽  
Outpatient Clinics ◽  
Percentage Decrease ◽  
Emergency Procedures ◽  
Number Of Patients ◽  
Long Term Impact ◽  
Tertiary Care Hospitals ◽  
The Impact ◽  
Near Future

Abstract Background To evaluate the impact of COVID-19 lockdown on non-COVID urological patient’s management in tertiary care urology centres. Methods This is an observational study in which data of patients visiting the urology department of all the MCGM run tertiary care hospitals were recorded for the duration of 1 April 2020 to 31 July 2020 and were compared to data of pre-COVID-19 period of similar duration. Results There was a decrease of 93.86% in indoor admissions of urology patients during the COVID-19 lockdown. Indoor admissions for stone disease, haematuria, malignancy accounted for 53.65%, 15.85%, 9.75%, respectively. Elective surgeries had the highest percentage decrease followed by emergency and semi-emergency procedures. There was a reduction of more than 80% in patients attending outpatient clinics. Stone disease and its consequences were the main reasons for visiting outdoor clinics (39%). A substantial number of patients presented with flank and abdominal pain (14.8%) and benign enlargement of the prostate (10.23%). Malignancy accounted for a very small number of patients visiting outdoor clinics (1.58%). Conclusions COVID-19 pandemic has a profound impact on patient care and education in Urology. There was more than ninety percent reduction in indoor admissions, operative procedures, and outpatient clinics attendance. Once the pandemic is controlled, there will be a large number of patients seeking consultation and management for urological conditions and we should be prepared for it. Surgical training of urology residents needs to be compensated in near future. Long-term impact on urological patient outcome remains to be defined.

Inhibitor development in haemophilia according to concentrate

2015 ◽  
Vol 113 (05) ◽  
pp. 968-975 ◽  
Author(s):  
Riita Lassila ◽  
Flora Peyvandi ◽  
Gabriele Calizzani ◽  
Alex Gatt ◽  
Thierry Lambert ◽  
...  
Keyword(s):  
Calculated Data ◽  
Incidence Rates ◽  
Clotting Factor ◽  
Haemophilia A ◽  
Severe Haemophilia ◽  
Inhibitor Development ◽  
Haemophilia B ◽  
Number Of Patients ◽  
Recombinant Fviii ◽  
Set Up

SummaryInhibitor development represents the most serious side effect of haemophilia treatment. Any difference in risk of inhibitor formation depending on the product used might be of clinical relevance. It was this study’s objective to assess inhibitor development according to clotting factor concentrate in severe haemophilia A and B. The European Haemophilia Safety Surveillance (EUHASS) was set up as a study monitoring adverse events overall and according to concentrate. Since October 2008, inhibitors were reported at least quarterly. Number of treated patients was reported annually, specifying the number of patients completing 50 exposure days (Previously Untreated Patients, PUPs) without inhibitor development. Cumulative incidence, incidence rates and 95 % confidence intervals (CI) were calculated. Data from October 1, 2008 to December 31, 2012 were analysed for 68 centres that validated their data. Inhibitors developed in 108/417 (26 %; CI 22–30 %) PUPs with severe haemophilia A and 5/72 (7 %; CI 2–16%) PUPs with severe haemophilia B. For Previously Treated Patients (PTPs), 26 inhibitors developed in 17,667 treatment years [0.15/100 treatment years; CI 0.10–0.22) for severe haemophilia A and 1/2836 (0.04/100; (CI 0.00–0.20) for severe haemophilia B. Differences between plasma-derived and recombinant concentrates, or among the different recombinant FVIII concentrates were investigated. In conclusion, while confirming the expected rates of inhibitors in PUPs and PTPs, no class or brand related differences were observed.

scholarly journals Melatonin prescribing practices and the provision of sleep hygiene/parent-led sleep behavioural Interventions in S-CAMHS, Aneurin Bevan University Health Board (ABUHB)- Service evaluation as part of quality improvement project

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S351-S352
Author(s):  
Kathryn Speedy ◽  
Lokesh Nukalapati ◽  
Kathryn Speedy ◽  
Megan Davies-Kabir
Keyword(s):  
Mood Disorder ◽  
Management Practices ◽  
Sleep Hygiene ◽  
Evidence Base ◽  
Health Board ◽  
Prescribing Practices ◽  
Sleep Habits ◽  
Improvement Project ◽  
Behavioural Interventions ◽  
Number Of Patients

AimsTo identify the number of patients currently on melatoninTo determine the average duration of use of melatonin in patients under the care of S-CAMHS in ABUHBTo investigate whether behaviour interventions were tried and reinforced from time to timeTo identify any areas of improvementMethodData were collected at St. Cadoc's hospital, in January, 2021. S-CAMHS database was used. Out of total 346 patient currently being managed with pharmacological therapies, 115 (33.2%) are currently on melatonin. 57/115 were randomly selected as a sample for this this project. Patient notes and EPEX software were also used to collect information regarding the sleep management practices.ResultDuring analysis, it was noticed that within the sample, only 46 patients were actively on melatonin. Melatonin is prescribed for sleep related issues in ASD (8/46), ADHD (15/46), ASD and ADHD (10/46), ADHD and mood disorder (0/46), ASD and mood disorder (6/46), ADHD and behaviour difficulties (2/46), ASD with behaviour difficulties (1/46), mood disorder (4/46).39/46 patients are currently on melatonin for more than a year (85%). These patients also include 10 patients who have been using melatonin for 5 years or more.35 patients (76%) reported improved sleep or some benefit from melatonin.Evidence for implementation of parent-led sleep behavioural interventions:Prior to commencing melatonin- Clear evidence available for 35 patients only (76%). These interventions were however not deemed helpful by most of the service users.While prescribing melatonin- Clear evidence available for 39(85%) patients. Evidence base for melatonin was also discussed during this visit.During last follow-up visit- Evidence available for 31 patients only (67%).ConclusionMajority of patients under S-CAMHS ABUHB remain on melatonin therapy for longer than one year. Most of these patients have reported benefit from this therapy and preferred to remain on it despite being informed about evidence base for melatonin. Also, there is evidence for implementation of sleep behavioural interventions prior to prescribing melatonin, however their benefit remains unclear.Recommendations:The quality of education on sleep hygiene offered should be assessed and improved if neededFormal group sessions/workshops on sleep hygiene/parent-led sleep behavioural interventions at regular intervals might be useful in reducing the chances of long term polypharmacy or unlicensed drugsUse of outcome measures such as Child Sleep Habits Questionnaire at intervals can be helpful in identifying any improvement from educational/pharmacological interventionsS-CAMHS database (for patients actively on medications) needs a review and update

scholarly journals Diagnosis and management of interstitial lung disease of systemic sclerosis in challenging health conditions

2019 ◽  
pp. 18-20
Author(s):  
Daniel Rivas-Vargas
Keyword(s):  
Systemic Sclerosis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Vital Capacity ◽  
Screening Method ◽  
Skin Fibrosis ◽  
Number Of Patients ◽  
History Of ◽  
Salt And Pepper

A 51-year-old woman presented with swelling in both hands and a 3-months history of triphasic Raynaud phenomenon. She denied cough and dyspnea. The physical examination was notable for swollen hands, facial telangiectasia and salt and pepper lesions. She had no skin fibrosis. The determination of antinuclear antibodies and antitopoisomerase were positive. A spirometry demonstrated a forced vital capacity of 86% of the predicted. High resolution chest computed tomography revealed bilateral, basal and subpleural ground glass opacities. These findings were consistent with the diagnosis of Scleroderma-Related Interstitial Lung Disease. Moreover, due to the absence of skin fibrosis, a diagnosis of systemic sclerosis sine scleroderma was made. Infusions of endovenous cyclophosphamide were indicated at 4-week intervals, followed by oral azathioprine. This case showed that using PFT as the single screening method for SSc-ILD may cause clinicians to miss a significant number of patients and that the absence of pulmonary symptoms does not exclude lung disease in patients with normal FVC.

Recent epidemiological trends in extrapulmonary TB in Galicia, Spain

2021 ◽  
Vol 25 (5) ◽  
pp. 373-381
Author(s):  
L. Ferreiro ◽  
A. Ruano-Raviña ◽  
R. Otero-Mallo ◽  
C. Pou-Álvarez ◽  
V. Riveiro-Blanco ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Prevention And Control ◽  
Extrapulmonary Tuberculosis ◽  
Absolute Number ◽  
Incidence Rates ◽  
Age Group ◽  
Number Of Patients ◽  
Epidemiological Trends ◽  
And Control ◽  
Epidemiological Characteristics

OBJECTIVE: To describe the epidemiological trends and characteristics of extrapulmonary tuberculosis (EPTB) in Galicia, Spain, from 2000 to 2019.METHODS: This was a retrospective cohort study based on data from the Galician TB information system.RESULTS: Of the total number of TB cases (n = 15,871), 5,428 (34.2%) had EPTB. The absolute number of cases and incidence of EPTB decreased dramatically (from 480 cases and 17.8 cases/100,000 in 2000, to 172 and 6.4 cases/100,000 in 2019, respectively), with a mean annual decrease of respectively 64% and 4.7% for absolute cases and incidence rates. The risk for EPTB was higher in men than in women (RR 3.86, 95% CI 3.66–4.07). The most frequent age group was 15–44 years (2,234 patients, 41.2%); overall reductions per age group were 82% (0–14 years), 75% (15–44 years), 44% (45–64 years) and 63% (≥65 years), with statistically significant differences. The most frequently locations were the pleura (1,916 cases; 35.3%) and the lymph nodes (1,504; 27.7%).CONCLUSION: The incidence of EPTB in Galicia has decreased significantly in the last 20 years. The epidemiological characteristics have not changed, except for the number of patients with risk factors. This improvement of EPTB epidemiological trends coincides with the implementation of the programme for the prevention and control of TB, which suggests that it has been very effective in the control of the EPTB.

scholarly journals Polymeric Matrix Membrane Sensors for Stability-Indicating Potentiometric Determination of Oxybutynin Hydrochloride and Flavoxate Hydrochloride Urogenital System Drugs

2008 ◽  
Vol 91 (6) ◽  
pp. 1318-1330 ◽  
Author(s):  
Mohamed Heba ◽  
Nesrin Ramadan ◽  
Moustafa El-Laithy
Keyword(s):  
Degradation Products ◽  
Pharmaceutical Formulations ◽  
Official Method ◽  
Urogenital System ◽  
Electroactive Materials ◽  
Significant Difference ◽  
Ph Range ◽  
Oxybutynin Hydrochloride ◽  
Flavoxate Hydrochloride

Abstract Four polyvinyl chloride (PVC) matrix membrane electrodes responsive to 2 drugs affecting the urogenital systemoxybutynin hydrochloride (OX) and flavoxate hydrochloride (FX)were developed, described, and characterized. A precipitation-based technique with tungstophosphate (TP) and ammonium reineckate (R) anions as electroactive materials in a PVC matrix with an OX cation was used for electrode 1 and 2 fabrication, respectively. Electrode 3 and 4 fabrication was based on use of the precipitation technique of FX cation with tetrakis (4-chlorophenyl) borate and R anions as electroactive materials. Fast and stable Nernstian responses in the range 1 1021 106 M for the 2 drugs over the pH range 58 revealed the performance characteristics of these electrodes, which were evaluated according to International Union of Pure and Applied Chemistry recommendations. The method was applied to FX and OX in their pharmaceutical formulations and in human plasma samples. The 4 proposed sensors were found to be specific for the drugs in the presence of up to 60 of their degradation products. Validation of the method according to the quality assurance standards showed suitability of the proposed electrodes for use in the quality control assessment of these drugs. The recoveries for determination of the drugs by the 4 proposed selective electrodes were 99.5 0.5, 100.0 0.4, 99.9 0.4, and 100.1 0.4 for sensors 14, respectively. Statistical comparison between the results obtained by this method and the official method of the drugs was done, and no significant difference found.

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