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be administered a greater number of sessions.

Penile metastasis is a very rare clinical entity. The primary origin is usually genitourinar y followed by the gastrointestinal.MATERIAL AND METHODS Review of the available literature on a case of penile metastasis of urothelial bladder carcinoma.

Penile metastasis is an exceptional entity despite the rich vascularization of this organ. Less than 500 cases have been described. Most cases manifestas exophytic or nodular lesions. Its association with disseminated disease conditions its palliative management in a large part of the cases, as well as an unfavorable prognosis. In selected cases, surgical treatment can be chosen.CONCLUSIONS Since its clinical presentation is variable, clinical suspicion is important in the presence of a skin lesion of torpid evolution taking into account the patient's oncological history.

Penile metastasis is an exceptional entity despite the rich vascularization of this organ. Less than 500 cases have been described. read more Most cases manifestas exophytic or nodular lesions. Its association with disseminated disease conditions its palliative management in a large part of the cases, as well as an unfavorable prognosis. In selected cases, surgical treatment can be chosen. CONCLUSIONS Since its clinical presentation is variable, clinical suspicion is important in the presence of a skin lesion of torpid evolution taking into account the patient's oncological history.

Adequate empirical treatment should be established for treatment urinary tract infections, considering the prevalence of the most frequent microorganisms in each geographic area and their susceptibility to different antibiotics. The objective of the study is to analyze the epidemiology of UTIs in our Health Area as well as to understand the antibiotic susceptibility of the most prevalent isolated microorganisms to guide empirical treatment. The objective was to establish a reasoned system for recommending ITU empirical therapy, based on the microorganisms causing episodes assisted in a Regional Hospital, knowing their antibiotic susceptibility.PATIENTS AND METHODS A descriptive-retrospective study was carried out based on the results of 12,204 urine cultures of the year 2018. The overall empirical activity of the antibiotics tested was calculated, differentiating between episodes of the community and of in patients, adults and children.RESULTS Escherichia coli was the most frequently isolated microorganism adults and 89.09-94.04% in children; and for cefotaxime of 53.28-54.76% in adults and 68.73-74.77% in children. CONCLUSIONS Fosfomycin, piperacillin-tazobactam or imipenem were the best option for empirical treatment without covering all episodes in adults. Each Center must establish a reasoned profile of empirical treatment of the infection, which should also take into account risk factors for a microorganism and clinical severity.

There are 61 (9%) female urologist enrolled at Sociedad Colombiana de Urología. 41 (40%) of urology residentes in Colombia are women. The aim of this study is to demonstrate the work tendencies of female urologist, female residents and patient's preferences regarding the gender of their urologist.MATERIALS AND METHODS Descriptive observational sectional study with anonymous surveys carried out to practicing female urologists, female residents, and patients. The questions evaluated the demographic characteristics of the surveyed individuals; the questions for female urologists evaluated their work tendencies; for the residents we evaluated their plans as urologists; and the patients were asked about their preferences to be evaluated in medical consultation and to have a surgery performed by either a male or female urologist.RESULTS The survey was answered by 53 female urologists. The average age was 37 years, the majority (54%) worked in Bogotá. 34% have subspecialized, the majority in andrology (16%) endour). Most of them (73.6%) perform surgery between 5-20 hours weekly, and the most performed surgery was varicocelectomy. 34% referred to have been harassed in their work environment based on their gender.Thirty-six female residents answered the survey. Th eaverage age was 28 years. The average number of academic publications was 3. 80% wish to achieve a sub-specialization, of which 24% would do it in endourology. 41% referred to have been harassed. 188 patients answered the survey, 96 men and 87 women; 44.1% preferred to be attended in medical consultation by a female urologist, and 49.2% preferred to be operated by a male urologist. CONCLUSIONS The number of female urologists has exponentially increased, just as the percentage of female residents. Female residents wish to subspecialize in diverse areas. Patients prefer to be attended by a female urologist in medical consultation but prefer to have surgery performed by a male urologist.OBJETIVOS 1. Saber que ha sido de los requerimientos judiciales por presunta mala praxis, en relación a casos de torsión testicular (TT). 2. Comentar lo ajustable a protocolo y guía clínica, en referencia a los "escrotos agudos - EA" y en concreto a lo que refiere a las TT. 3. Buscar vías que eviten los procedimientos judiciales en los EA y en concreto en las TT. 4. Conocer las conductas de riesgo e implantar las ajustadas a la normo praxis asistencial.Over the last couple of months physicians world wide are struggling to prevent the novel coronavirus (COVID-19) spread all over the world. It has become obvious that our health care systems should under go modifications in order to successfully confront similar pandemics, since this is considered the century of pandemics, due to the high incidence of new virus attacks with expressly high virulence (Hong Kong flu in 1968, AIDS, SARS in 2002, H1N1 pandemic in 2009, MERS in 2012 and COVID-19 in 2020) (1).In this narrative review, we provide an overview of the role of physical activity as part of differing exposomes (our combined non-genetic exposures from conception onwards) and environmental influences on metabolic health. We discuss 'beneficial' exposomes (green/natural outdoor spaces, sun exposure, healthy diets and features of built environments) that could synergise with physical activity to prevent metabolic dysfunction, particularly that related to lifestyle diseases of obesity, type 2 diabetes and metabolic syndrome. Physical activity may also reduce the capacity of some adverse exposomes, specifically those with significant levels of air pollution, to contribute towards metabolic dysfunction. Other exposomes, such as those experienced during pandemics (including COVID-19), potentially limit opportunities for physical activity, and there may be unexpected combined effects of physical activity with other infections (e.g. adenovirus-36) on metabolic health. Finally, we discuss how environments could be better optimised to create exposomes that promote the health benefits of physical activity and likely future directions of this research field.

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