Sawyermcbride2141

The utility and importance of the 3-day Bladder Diary (3dBD) for the diagnosis and management of patients with Bladder Pain Syndrome (BPS) was analyzed.

Epidemiological, observational, longitudinal and multicentric study, carried out under usual conditions of clinical practice. 37 Functional Urology and Urodynamics units included 329 women with BPS according to the criteria of the International Society for the Study of Bladder Pain Syndrome (ESSIC). Of all patients included, 319 were evaluable (79 with new diagnosis and 240 in follow-up). Sociodemographic and clinical variables were collected together with variables related to cystoscopy, biopsy and physical examination and BPS diagnostic tests. Patients completed the "Bladder Pain/Interstitial Cystitis - Symptom Score"(BPIC-SS), "Patient Global Impression of Severity" (PGI-S) and "EuroQoL-5D-5L" (EQ-5D-5L) questionnaires besides of the 3dBD. Results of the 3dBD were described according to urinary symptoms and the symptoms reported through questionnaires,e micturition pattern and for the differential diagnosis of the symptoms of BPS patients. It also allows to obtain complete and objective information about the symptoms. Although it is necessary to incorporate other tools that complete the clinical characterization of these patients.

Perform a review on the diagnosis and treatment of pheochromocytomas and malignant paragangliomas.MATERIAL AND METHOD A search was conducted in PubMed and Google Scholar of articles or clinical guides that referred to the diagnosis and treatment of these tumors.RESULTS For the diagnosis of malignancy, a histological confirmation of a pheochromocytoma or paraganglioma should be provided, plus the presence of metastasis confirmed by images. Methanephrines are recommended over other biochemical determinations. For staging, PET-CT with 18F-FDG or 18F-DOPA is preferred because of its greater sensitivity than conventional images. The 123I-MIBG scan should be requested when radiotherapy with 131I-MIBG is planned.For treatment, control of adrenergic symptoms through the use of α-blockers is recommended. Active surveillance was an option in selected patients with slowly progressive tumors. Surgical treatment improved OS (148 months vs 36 months p=<0.01). Therapy with131I-MIBG was indicated in patients with positi and quality of life of these patients.The ERAS (Enhanced Recovery After Surgery) protocol, originated in the 1990s when two groups of researchers presented different proposals to improve the postoperative evolution of patients undergoing elective surgery. In 2001, the ERAS group was organized, consisting of different surgery units from northern Europe (Scotland, Sweden, Denmark, Norway, and the Netherlands). This group made a consensus that they called the ERAS project, characterized by a multimodal rehabilitation program for surgically operated patients on ascheduled basis. MDL-28170 The protocol includes a combination of preoperative, intraoperative, and postoperative strategies based on scientific evidence. That improves the recovery and functionality of patients after the surgical event minimizes the response to surgical stress. Besides, this action on factors involved in the biological response to aggression impacts postoperative complications and decreases hospital stay and hospitalization costs. The professionals in charge of the patient are responsible for three key elements that affect the outcome after surgery the first is the control of stress reactions to surgery, the second is fluid therapy, and the third is analgesia. The trimodal approach leads to improving the results in urological surgery, such as radical cystectomy.

Perform a detailed anatomopathological analysis of consecutive surgical specimens in men with clinically very low risk prostate cancer according to National Comprehensive Cancer Network (NCCN) criteria.MATERIALS ANDMETHODS The study included 799 prostate cancer patients who under went radical prostatectomy between January 2005 and December 2013. We identified 81 consecutive patients with clinically very low risk prostate cancer. The slides of the patients who fulfilled the inclusion criteria were re-reviewed. The parameters studied were pathological stage, histological grade by Gleason score (GSS), margins involvement, tumor percentage (PT), and number of apparently independent tumor foci (FT).RESULTS The patients had organ-confined tumors in almost all of them (pT2 97.5%). Most of the cancers studied were bilateral (pT2c 67.9%), multifocal (FT≥288.8%), with a low tumor percentage (PTand with a low Gleason Score (GSS≤6 91,3%). Non-confined disease 2.5%, all cases extra-prostatic extension (pT3a). GSS>6 8,6%, all cases GSS7 (3+4).CONCLUSIONS The NCCN criteria for very low risk prostate cancer help to make a good selection of non-aggressive tumors and are a useful tool for including patients in an active surveillance program.

6 8,6%, all cases GSS7 (3+4). CONCLUSIONS The NCCN criteria for very low risk prostate cancer help to make a good selection of non-aggressive tumors and are a useful tool for including patients in an active surveillance program.

To determine the prevalence of Urinary Incontinence (UI) in a hospitalization unit.METHODS Descriptive cross-sectional study, with patients in a hospitalization unit in Ferrol. The prevalence, the type of UI, the UI assessment and the impact of UI on daily life were estimated with the questionnaires IU-4 (by sex), the severity tool ICIQ-SF and the IIQ.RESULTS 302 patients participated in the study. The prevalence of UI was 41.4%. Regarding the type of incontinence, 35% suffer stress UI, 27% urge UI, 14.6% mixed UI, 8.8% functional UI and 2.2% Reflex UI. We can affirm that being a woman is a risk factor for UI[p<0.001; OR 5.0-95% CI (2.8-8.9)] . On the otherhand, medium physical activity is objectified as a protective factor to suffer UI (p=0.003).CONCLUSION The impact on the quality of life of the UI is high. Establishing more real data of predictive factors may help to identify patients. Using standardized methods of study such as validated questionnaires when assessing our patients is also of interest.ife of the UI is high. Establishing more real data of predictive factors may help to identify patients. Using standardized methods of study such as validated questionnaires when assessing our patients is also of interest. The need to manage UI should be reinforced as a priority for nursing professionals, not only during hospital admissions, but also at the community level or in emergencies, due to the high prevalence described.

In the Spanish health system, General Practitioners (GPs) play a key role in regulating the flow of patients to hospital care. Most of patients with BPH can be managed through out the evolution of the disease exclusively by the GPs.METHODS A pre-experimental study was carried outin two periods, before (pre-test) and after (post-test) of the dissemination of a management protocol for patients with BPH. The protocol was trialled in the health area of Villarrobledo and included all referrals to the urology clinic for BPH from Primary Care. We analyzed the appropriate referrals according with the criteria set for thin the protocol and compared the complementary tests through statistical study (descriptive, a bivariate, multivariate analysis and rate calculation) using version 21of the SPSS.

Referral rate decreased after the application of the protocol but did not increase the rate of appropriated referrals. Patients referred after setting forth protocol by GPs that assisted to the education program were younger. There were referred less patients with elevated PSA and more patients with clinical progression. These GPs used less test to achieve diagnosis. The GPs whodid not attend were significantly younger, mainly women, with no previous specific training in BPH and without a full time GP position.

The implementation of a protocol has reduced the referral rate, but it has not improved the appropriate referrals. More research is required to understand the determinants of inequalities in referral from primary care.

The implementation of a protocol has reduced the referral rate, but it has not improved the appropriate referrals. More research is required to understand the determinants of inequalities in referral from primary care.

Overcrowding in the emergency departments has become an increasingly significant problem. Patient triage strategies are acknowledged to help clinicians manage patient flow and reduce patients' waiting time. However, electronic patient triage systems are not developed so that they comply with clinicians' workflow.

This case study presents the development of a patient prioritization tool (PPT) and of the related patient prioritization algorithm (PPA) for a pediatric emergency department (PED), relying on a human-centered design process.

We followed a human-centered design process, wherein we (1) performed a work system analysis through observations and interviews in an academic hospital's PED; (2) deduced design specifications; (3) designed a mock PPT and the related PPA; and (4) performed user testing to assess the intuitiveness of the icons, the effectiveness in communicating patient priority, the fit between the prioritization model implemented and the participants' prioritization rules, and the particStudies are carried out to evaluate the use and impact of this tool on clinicians' situation awareness and prioritization-related cognitive load, prioritization of patients, waiting time, and patients' experience.

The results of the user tests have led to modifications to improve the usability and usefulness of the PPT and its PPA. We discuss the value of integrating human factors into the design process for a PPT for PED. The PPT/PPA has been developed and installed in Lille University Hospital's PED. Studies are carried out to evaluate the use and impact of this tool on clinicians' situation awareness and prioritization-related cognitive load, prioritization of patients, waiting time, and patients' experience.

Atrial fibrillation (AF) is a common arrhythmia that adversely affects health-related quality of life (HRQoL). We conducted a pilot trial of individuals with AF using a smartphone to provide a relational agent as well as rhythm monitoring. We employed our pilot to measure acceptability and adherence and to assess its effectiveness in improving HRQoL and adherence.

This study aims to measure acceptability and adherence and to assess its effectiveness to improve HRQoL and adherence.

Participants were recruited from ambulatory clinics and randomized to a 30-day intervention or usual care. We collected baseline characteristics and conducted baseline and 30-day assessments of HRQoL using the Atrial Fibrillation Effect on Quality of Life (AFEQT) measure and self-reported adherence to anticoagulation. The intervention consisted of a smartphone-based relational agent, which simulates face-to-face counseling and delivered content on AF education, adherence, and symptom monitoring with prompted rhythm monitoring.and trustworthy.

Individuals randomized to a 30-day smartphone intervention with a relational agent and rhythm monitoring showed significant improvement in HRQoL and adherence. Participants had favorable acceptability of the intervention with both objective use and qualitative assessments of acceptability.

Individuals randomized to a 30-day smartphone intervention with a relational agent and rhythm monitoring showed significant improvement in HRQoL and adherence. Participants had favorable acceptability of the intervention with both objective use and qualitative assessments of acceptability.