Abernathyrasmussen3018

Severe patients with COVID-19 are characterized by persistent lung damage, causing respiratory failure, secondary circulatory changes and multiple organ dysfunction after virus invasion. Because of its dynamic, real-time, non-invasive, repeatable and other advantages, critical ultrasonography can be widely used in the diagnosis, assessment and guidance of treatment for severe patients. Based on the recommendations of critical care experts from all over the country who fight against the epidemic in Wuhan, this article summarizes the guidelines for the treatment of COVID-19 based on critical ultrasonography, hoping to provide help for the treatment of severe patients. The recommendations mainly cover the following aspects (1) lung ultrasound in patients with COVID-19 is mainly manifested by thickened and irregular pleural lines, different types of B-lines, shred signs, and other consolidation like dynamic air bronchogram; (2) Echocardiography may show right heart dysfunction, diffuse cardiac function enhancemeny can help to improve the safety and quality of nursing; (9) When performing critical ultrasonography for patients with COVID-19, it needs to implement three-level protection standard, pay attention to disinfect the machine and strictly obey the rules from nosocomial infection. (10) Telemedicine and artificial intelligence centered on critical ultrasonography may help to improve the efficiency of treatment for the patients with COVID-19.In the face of the global spread of the epidemic, all we can do is to share experience, build a defense line, We hope this recommendations can help COVID-19patients therapy.Neijing Tu(, Chart of Inner Landscape), collected by the Museum of Chinese Medical History, is a colored drawing which is used to guide Taoist internal alchemy training pattern. It belongs to the inheritance of the immortals in the Tao Yin(physical and breathing exercise) of traditional Chinese medicine in folk. It is the essence for nurturing vitality of the traditional Chinese medicine. Its core tenet is that one practices with both Shen(spirit) and Qi(pneuma) and makes both to fuse in perfect harmony way. The specific practice process includes four phases refining Jing and converting it into Qi, refining Qi and converting it into Shen, extracting and then restoring Xu(void)from Shen, purifying Xu to fit Dao. This process contains the contents of the Secret Alchemy such as sub-Meridian Circle Vessel, overcoming the roadblock and entering Primary Meridian Circle Vessel, getting Yangshen (highest level spirit) and harmonizing the body and spirit. Its important value lies in being able to treat the disease which has not yet completely developed and the disease developed already.Objective This study aims to design a novel semirigid ureterorenoscope with irrigation and vacuum suction system and a modified ureteral access sheath (UAS) named Sotn ureterorenoscope® (Sotn=ShuoTong Medical Company) to overcome the deficiencies of the current procedure and to improve the efficiency and safety of using Sotn ureterorenoscope® for treatment of upper urinary calculi. Materials and methods Fifty-eight patients, comprising 31 males and 27 females, were evaluated. The medical records of 58 patients with upper urinary calculi treated with Sotn ureterorenoscope® from March 2015 to June 2017 were retrospectively reviewed at the Second Affiliate Hospital of Guangzhou University of Chinese Medicine in China. The primary outcome was stone-free rate (SFR) assessed by computed tomography on the 1st day and one month after treatment. The secondary outcome was postoperative complication rate. Results The mean and SD of operative duration was 78.5 (30.4) min, and the mean and SD of stone size was 15.6 (5.6) mm. The primary overall SFR was 89.7% (52/58) and 100% at 1 month follow-up. Complication, which was Clavien I (minor fever managed by antipyretic therapy), was detected in 1.7% (1/58) of the patients. Conclusions Sotn ureterorenoscope® is technically feasible, efficacious and safe for treatment of upper urinary calculi because of its advantages of high SFR and low complication rates.Purpose We aimed to investigate the effects of menopause on long-term outcomes of transobturator tape (TOT) surgery. Materials and methods Patients who underwent TOT surgery were evaluated under two groups as postmenopausal and premenopausal. The International Consultation on Incontinence short-form questionnaire (ICIQ-SF), Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory-Short Form (UDI-6) questionnaires were completed by the patients at the 1st and 5th-year follow-up sessions. Patients with a postoperative UDI-6 and IIQ-7 score of less then 10 were considered as cured, those with lower postoperative scores compared to the preoperative period were regarded as improved, and the cases that had higher postoperative scores than preoperative values were interpreted as TOT failure. The TOT success rates were compared between the results obtained from UDI-6 and IIQ-7. Results A total of 109 patients were included in the study (53 postmenopausal and 56 premenopausal). We contacted with 90remenopausal group at 5th year follow-up (p=0.045). There were no significant differences between the premenopausal and postmenopausal patients in terms of TOT success rates at 1st and 5th year control, evaluated with UDI-6 (1st year p=0.198 and 5th year p=0.687) and IIQ-7 (1st year p=0.489 and 5th year p=0.608) questionnaires. Conclusions Transobturator tape surgery is an effective and reliable method according to the long-term outcomes reported in this paper. CPT-11 In the current study, we determined that the TOT success rates were not affected by the presence of menopause.Objectives To evaluate the impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists during the month of April 2020. Materials and methods A 39-question, web-based survey was sent to all urologist members of the Brazilian Society of Urology. We assessed socio-demographic, professional, health and behavior parameters. The primary goal was to evaluate changes in urologists' clinical practice and income after two months of COVID-19. We also looked at geographical differences based on the incidence rates of COVID-19 in different states. Results Among 766 urologists who completed the survey, a reduction ≥ 50% of patient visits, elective and emergency surgeries was reported by 83.2%, 89.6% and 54.8%, respectively. An income reduction of ≥ 50% was reported by 54.3%. Measures to reduce costs were implemented by most. Video consultations were performed by 38.7%. link2 Modifications in health and lifestyle included weight gain (32.9%), reduced physical activity (60.0%), increased alcoholic intake (39.9%) and reduced sexual activity (34.9%). Finally, 13.5% of Brazilian urologists were infected with SARS-CoV-2 and about one third required hospitalization. Urologists from the highest COVID-19 incidence states were at a higher risk to have a reduction of patient visits and non-essential surgeries (OR=2.95, 95% CI 1.86 - 4.75; p.Purpose To investigate the association between preoperative retrograde pyelography (RGP), conducted to evaluate upper tract urothelial carcinoma (UTUC), and intravesical recurrence (IVR) after radical nephroureterectomy (RNU). Materials and methods Of 114 patients that underwent RNU, 72 patients without preoperative ureteroscopy and a history of bladder tumor were selectively enrolled. Variables associated with IVR were identified. Results RGP was performed at a mean duration of 24.9 days prior to RNU in 41 (56.1%) of study subjects. During the mean follow-up period of 64.5 months, IVRs were identified in 32 (44.4%) patients at 22.3±18.8 (mean±SD) months after RNU. Despite similar tumor characteristics in the RGP and non-RGP groups, the incidence of IVR was considerably higher in the RGP group (63.4%) than in the non-RGP group (19.4%, p pT2; 53.1% vs. 17.5%), preoperative hemoglobin (12.8±1.36 vs. 13.9±1.65), preoperative creatinine (1.29±0.32 vs. 1.11±0.22), and preoperative RGP (81.3% vs. 37.5%), respectively. Multivariate Cox regression model showed that tumor location (p=0.020, HR=2.742), preoperative creatinine level (p=0.004, HR=6.351), and preoperative RGP (p=0.045, HR=3.134) independently predicted IVR. Conclusion Given the limitations of retrospective single-center series, performance of RGP before RNU was shown to have a negative effect on IVR after surgery.Purpose To develop and validate a new test of specific technical skills required for microsurgical varicocelectomy. Materials and methods An electronic questionnaire was sent to 558 members of the Brazilian Society of Urology for the validation of the task-specific checklist (TSC) for assessment of microsurgical varicocelectomy. Participants who had experience in this procedure were selected as judges. For construct validation, 12 participants including attending urologists and urological residents in training were recruited for voluntary participation. We formed a group of three experts and a group of nine novices, who had to perform the steps of microsurgical varicocelectomy on a simulation model using human placenta. Each participant was filmed and two blinded raters would then evaluate their performance using the TSC of microsurgical varicocelectomy. Results 14 judges were recruited. The assessment tool was reformulated, according to the judges suggestions and had the content validity achieved. The final version of the TSC was comprised of the task-specific score, a series of 4 items scored in a binary fashion designed for microscopic sub-inguinal varicocelectomy. The differences between the performance of participants with different levels of experience reflected the construct validity. The reliability between the raters was high. The mean time required to complete the training of microsurgical varicocelectomy in simulation model was significantly shorter for experts compared to novices (201 vs. link3 496 seconds, p=0.01). Conclusions This preliminary study suggests that the task-specific checklist of microsurgical varicocelectomy is reliable and valid in assessing microsurgical skills.Purpose We aimed to determine pre-operative and post-operative sexual function scores of patients who underwent four-arm polypropylene mesh implantation surgery to treat urinary incontinence and pelvic organ prolapse. Materials and methods A prospective study from January 2011 to November 2015 including patients (n 72) submitted to surgical mesh implantation (four-arm anterior mesh implant (Betamix POP4R, Betatech Medical, Turkey) questioned the patients with Female Sexual Function Index evaluation form. The questionnaire was applied to all patients at pre-operative, post-operative 3rd month and post-operative 1st year periods. Results The mean age of the patients was 47.2±7.1 years. The mean Body Mass Index (kg/m2) was 28.7±3.7. The average of incontinence duration (year) was 4.6±2.6 and the average for operation time (min) was 35.7±2.1. After the urinary incontinence and pelvic organ prolapse surgery, it was observed that incontinence complaints of patients reduced. Furthermore, there was a positive change in quality of life and sexual function of patients at the post-operative period.