A Panorama of the Urological Diseases at the Former Military Teaching Hospital of Cotonou

Background: Urological care has been advancing quickly over the last ten years in Benin. In order to conveniently support that trend towards better urological care standards, decision-makers need sound data on urological diseases in the country. Objective: To determine the prevalence of urological diseases in the former Military Teaching Hospital of Cotonou. Patients and Method: We retrospectively collected the urological diseases that the institution had managed from January 2012 to December 2020. We used Excel© 2010 and SPSS© to analyze the collected data. Results: 4244 patients, i.e. 3717 males (87.58%) and 527 females (12.42%) were managed during the study period. The main diseases diagnosed were benign prostatic hyperplasia (32.61%, n = 1384), erectile dysfunction (10.44%, n = 443), chronic prostatitis (5.94%, n = 252), prostate cancer (4.03%, n = 171), and ejaculatory disorders (3.44%, n = 146). In patients ≤ 15 years, predominant diseases were peritoneal vaginal canal (15.9%, n = 43), circumcision (15.6%, n = 42), testicular dystopia (10.7%, n = 29), hydrocele (7.8%, n = 21), and hypospadias (5.6%, n = 15). Wilms tumor (1.9%, n = 5) was the first cancer, testicular (0.4%, n = 1) and para-testicular (0.4%, n = 1) tumors were the next. In patients > 15 and ≤40 years, the main diseases were infertility (14.1%, n = 189), chronic prostatitis (12.9%, n = 173), erectile dysfunction (10.1%, n = 135), ejaculatory disorders (6.2%, n = 83), genital infections (6.2%, n = 83) and urinary stone (4.9%, n = 66). The first cancer was kidney cancer (0.97%, n = 13) followed by bladder cancer (0.3%, n = 4) and testicular tumor (0.3%, n = 4). In patients >40 years, the most prevalent diseases were BPH (52.0%, n = 1370), erectile dysfunction (11.7%, n = 308), prostate cancer (6.5%, n = 171), inguinal hernia (5.1%, n = 134), and urinary stone (3.9%, n = 102). Prostate cancer is the first cancer;the next were bladder (0.95%, n = 25) and kidney (0.68%, n = 18) cancers. Conclusion: Benign prostatic hyperplasia and urological cancers (prostate, bladder and kidney cancers) were the main urological diseases at the former Military Teaching Hospital of Cotonou. Urological malformations and Wilms tumor were the main diseases in the children.

Clinical Application of Percutaneous Nephrostomy in Some Urologic Diseases

Percutaneous nephrostomy was applied in some other urologic diseases and the efficacy was evaluated. Percutaneous nephrostomy for percutaneous nephrolithotomy （PNL） was performed in patients with various renal, perinephric and bladder diseases （n=79）. The tract establishment, operation duration and complications were observed and the efficacy was assessed. The results showed that the tracts were successfully established in 79 cases. The operation lasted 4–20 min. 12F–16F single tract was established in nephrohydrop patients and 16F–20F single or multiple tracts were established in patients with pyonephrosis, renal cortical abscess, renal cyst and perinephric abscess. During dilation, no leakage of liquor puris was noted. Establishment of 18F single tract was achieved in one urinoma patient. In two patients with foreign body in kidney, the foreign bodies were removed via established 14F single tract. 18F tracts were established in 2 patients with bladder contracture, which was followed by the placement of 16F balloon urethral catheter for drainage. No complications, such as massive bleeding, intestinal injury and spreading of infection took place in our series. All the patients were followed up for 2–12 months. No long-term complications such as dropping of drainage tube occurred. It is concluded that as a minimally invasive technique, percutaneous nephrostomy has the advantages of convenience, simplicity and causing less complications and can be used for various urologic diseases.

Epidemiological Aspects of Female Urological Diseases, at the National University Teaching Hospital H. K. Maga of Cotonou from 2008 to 2017

Most urological conditions are represented by male disorders. Analyzing certain epidemiological aspects of female urological disorders at the National University Teaching Hospital of Cotnou, will allow us objectively to have reliable data to optimize the urological management of women. Patients and Methods: This was a retrospective, analytical and descriptive study that was conducted at the CNHU-HKM over a 10-year period from January 2008 to December 2017 on the epidemiological aspects of female urological diseases from the study of patient records. The variable studied was: the age, the profession, the year of admission, the organ affected, and the type of pathology. The confidentiality of the data has been ensured. Results: Female urological disorders over 10 years accounted for 9.62% of all patients received in Urology Department. The age group greater than 50 years was the most common at 31.34%. Traders and housewives were the most numerous (39.93% and 14.55%). Bladder diseases were the most frequent (51.50), dominated by vesico-vaginal fistulas (29.85%). In addition to fistulas, tumoral affections were most prevalent at 27.99% followed by infectious diseases at 8.21%. The lithiasic affections were infrequent at 6.72%. Conclusion: Female urological conditions are infrequent but not negligible, dominated by vesico-vaginal fistulas and tumors in the context of developing countries. The specific evaluation of each pathology group can help optimize management.

Daily activities and training experiences of urology residents during the coronavirus disease 2019 pandemic in Indonesia: A nationwide survey

Objective:To explore the impact of the coronavirus disease 2019(COVID-19)pandemic on the training experiences of urology residents in Indonesia.Methods:A cross-sectional study using a web-based questionnaire(SurveyMonkey)involved all registered urology residents in Indonesia.The questionnaire was structured in Bahasa Indonesia,composed of 28 questions,and divided into three sections:demographic characteristics,current daily activities,and opinions regarding training experiences during the COVID-19 outbreak.The survey was distributed to all respondents via chief of residents in each urology center from May 26,2020 to Jun 2,2020.Results:Of the total 247 registered urology residents,243 were eligible for the study.The response and completeness rate for this study were 243/243(100%).The median age of respondents was 30(range:24e38)years old,and 92.2%of them were male.Among them,6(2.5%)respondents were confirmed as COVID-19 positive.A decrease in residents’involvement in clinical and surgical activities was distinguishable in endourological and open procedures.Most educational activities were switched to web-based video conferences,while others opted for the in-person method.Smart learning methods,such as joining a national or international speaker webinar or watching a recorded video,were used by 93.8%and 80.7%of the respondents,respectively.The respondents thought that educational activities using web-based video conferences and smart learning methods were effective methods of learning.Overall,the respondents felt unsure whether training experiences during the COVID-19 pandemic were comparable to the respective period before.Conclusion:The COVID-19 pandemic negatively affected urology residents’training experiences.However,it also opened up new possibilities for incorporating new learning methodologies in the future.

Microbiological and Physico-Chemical Analysis of the Waters of the “Mamouwol” Stream in the Urban District of Mamou (Republic of Guinea)

Water is essential to life and to the sustainable socio-economic development of a nation, It is therefore interesting to have a better knowledge of the quality of this water. The aim was to determine the degree of microbiological and physico-chemical pollution of the water of the “Mamouwol” river in the town of Mamou. To do this, we chose four (4) sampling sites spread throughout the town of Mamou. During the month of March (2024), 4 water samples were analyzed to monitor the water quality of this river. The average values of the flora analyzed show that these water are heavily contaminated with bacteria indicative of fecal and metal pollution. This study showed that sites: Mam4;Mam2 and Mam1 contain the highest loads, with Total Coliform counts ranging from 1534 CFU/100 ml to 2100 CFU/100 ml, the number of faecal coliforms varies between 526 and 1240 CFU/100 ml, and that of faecal streptococci between 526 and 841 CFU/100 ml. Metal content, BOD5 and COD all comply with the laboratory’s analysis criteria, although they vary from point to point.

The impact of the cor on avirus disease 2019 Checkfol pandemic on elective urological procedures in Australia

Objective:To investigate the changes in elective private urological procedures in Australia during the coronavirus disease 2019 pandemic.Methods:Data were extracted from publicly available datasets from Medicare Ben efits Schedule using item nu mbers assig ned to each comm only performed urological interve ntion.These procedures were divided into three groups:Oncological therapeutic,diagnostic,and non-oncological therapeutic procedures.A smoothing model,based on the historic procedure numbers from 2017 to 2019,was used to forecast monthly number of procedures performed in each category between January 2020 and June 2020.These forecasted models were compared with reported figures.Results:A total of 108169 procedures were performed between January 2020 and June 2020 based on the Medicare Ben efits Schedule item nu mbers listed.There was a sign ifica nt reducti on(perce nt-age cha nge)in total procedures performed in April 2020(22.6%,95%con fide nee in terval[CI]:-28.7%to-15.4%)and May 2020(-33.2%,95%CI:-37.5%to 28.3%).There was a significant reduction in oncological therapeutic,non-oncological therapeutic,and diagnostic procedures performed in April 2020 and May 2020(p<0.05).These nu mbers did not in elude procedures performed in public sector.Conclusion:There was a significant reduction in total urological procedures(including diagnostic,oncological,and non-on cological)performed in mon ths of April 2020 and May 2020 during time of federal restrictions.Both public and private healthcare sectors need to be supported in the up-comi ng mon ths to preve nt further delays in treatme nt and poorer clinical outcomes.

Microbiological Quality of Drinking Water and Prevalence of Waterborne Diseases in the Gaza Strip, Palestine: A Narrative Review

Water quality and occurrence of water-borne diseases in the Gaza strip are vivid examples for most developing societies. In recent years, the quality and quantity of groundwater, the only source of waters in the Gaza strip, have deteriorated markedly. A general rundown of the infrastructure and water distribution networks, in particular, the spread of cesspools, excessive use of pesticides and fertilizers, and improper treatment and disposal of wastewater remain major contributing factors to the continued deterioration in the water status in the Gaza strip. Without a doubt, the (Israeli)-Palestinian conflict had a clear negative impact on the water sector in the Gaza strip. Apparently, there is a dire need to adopt the WHO’s water safety plan in the management of Gaza’s water supply systems from catchment to consumer’s tap in order to maintain the sustainability and quality of water resources and prevent outbreaks of waterborne diseases. Therefore, this review has been prepared to highlight the overall picture of the water dilemma in the Gaza strip in the last years and in addition, to identify the sources, sorts, levels, and health risks of consequence to microbial contamination of water. The impact of political conflicts on the water sector in the Gaza strip also was reviewed. Furthermore, recommendations were formulated in order to assist and guide future researchers, stakeholders, and policymakers to avoid the more exacerbation of water contamination as well as to protect public health.

Microbiological Assessment and Antimicrobials’ Use in an Infectious Diseases Department in Mali

The use of antimicrobials without microbiological proof is frequent and contributes to the emergence of resistance. The aim was to identify the organisms isolated during laboratory examinations and the type of antimicrobials consumed by patients hospitalized to Infectious Diseases’ Clinic. This is a cross-sectional and analytical study, carried out from January 1 to December 31, 2017 in the Infectious Diseases Department of Point “G” Teaching Hospital in Mali. All biological specimens from patients during the study period were analyzed. In total, 322 patients benefited from microbiological test, with a mean age of 40.9 ± 12.2 years (range 15 and 74 years) with a sex ratio of 0.93. Only 5.6% of patients were HIV negative. In all participants, a total of 658 microbiological specimen were taken, 224 (34.0%) identified at least one pathogen including bacteria in more than a half of the cases (58.5%). On the report of bacteriological analysis, the most frequently identified organisms were Mycobacterium tuberculosis (42.2%) mainly in sputum;Escherichia coli (24.2%) and Klebsiella pneumoniae (7.8%) commonly in urine and Gardnerella vaginalis (7.0%) exclusively in vaginal secretions. Candida albicans (5/8) and Cryptococcus neoformans (3/8) were the most common fungi while Plasmodium falciparum (96.4%) represented the parasite frequently found in blood. From a therapeutic standpoint, 1143 antimicrobials were prescribed to 322 admitted patients, i.e. 3.55 anti-infectives per patient. Antibiotics (excluding tuberculosis drugs), antiparasitics and antifungals represented respectively 46.2%;18.8% and 15.1% of anti-infectives. Antibiotic therapy was effective in 274 (85.1%) patients and among them, only 76 (27.7%) cases were based on microbiological evidence. Antibiotics are the most widely used antimicrobials in an infectious disease department. Empiric treatments are common but must be minimized by the search for microbiological evidence.

Urological manifestations and treatment of the primary systemic vasculitides

The primary systemic vasculitides(PSV) are a group of rare inflammatory disorders affecting blood vessels of varying size and multiple organs. Urological manifestations of PSV are uncommon. Testicular vasculitis is the most commonly reported finding and is associated with Polyarteritis Nodosa(PAN), Henoch-Sch?nleinPurpura(HSP), anti-neutrophil cytoplasm antibody associated Vasculitides(AAV), Giant Cell Arteritis(GCA) and Kawasaki disease. Prostatic vasculitis has been reported in association with GCA and AAV. Ureteric involvement has been noted in PAN, HSP and AAV. Other urogenital manifestations of PSV include genital ulceration and bladder dysfunction in Beh?ets Disease and haematuria which is commonly seen in many of the PSV. Finally, therapies used to treat the PSV, especially cyclophosphamide, are associated with urological sideeffects including haemorrhagic cystitis and urothelial malignancy. The aim of this review is to examine how the urological system is involved in the PSV. Each PSV is examined in turn, with a brief clinical description of the disease followed by a description of the urological manifestations and management. Identification of urological manifestations of PSV is important as in many cases symptoms may improve with immunosuppressive therapy, avoiding the need for invasive surgery. Additionally, patients who present with isolated urogenital PSV are at higher risk of developing subsequent systemic vasculitis and will need to be followed up closely.

Changes in the gut mycobiome in pediatric patients in relation to the clinical activity of Crohn's disease

BACKGROUND Numerous studies have shown that in Crohn’s disease(CD),the gut microbiota is of great importance in the induction and maintenance of inflammation in the gastrointestinal tract.Until recently,studies have focused almost exclusively on bacteria in the gut.Lately,more attention has been paid to the role of intestinal fungi.AIM To study the gut mycobiome analysis of pediatric patients with CD(in different stages of disease activity)compared to healthy children.METHODS Fecal samples were collected from patients:With active,newly diagnosed CD(n=50);active but previously diagnosed and treated CD(n=16);non-active CD and who were in clinical remission(n=39)and from healthy volunteers(n=40).Fungal DNA was isolated from the samples.Next,next generation sequencing(MiSeq,Illumina)was performed.The composition of mycobiota was correlated with clinical and blood parameters.RESULTS Candida spp.were overrepresented in CD patients,while in the control group,the most abundant genus was Saccharomyces.In CD patients,the percentage of Malassezia was almost twice that of the control(P<0.05).In active CD patients,we documented a higher abundance of Debaryomyces hansenii(D.hansenii)compared to the non-active CD and control(P<0.05)groups.Moreover,statistically significant changes in the abundance of Mycosphaerella,Rhodotorula,and Microidium were observed.The analyses at the species level and linear discriminant analysis showed that in each group it was possible to distinguish a specific species characteristic of a given patient population.Moreover,we have documented statistically significant correlations between:D.hansenii and patient age(negative);C.zeylanoides and patient age(positive);C.dubliniensis and calprotectin(positive);C.sake and calprotectin(positive);and C.tropicalis and pediatric CD activity index(PCDAI)(positive).CONCLUSION Mycobiome changes in CD patients,and the positive correlation of some species with calprotectin or PCDAI,give strong evidence that fungi may be of key importance in the development of CD.

基于微信公众平台开展医学微生物学课程思政与健康融合教育的实践意义

研究表明微信公众平台能显著提高大学生健康教育和课程思政教育的效果。通过医学微生物学课程思政与健康融合教育微信公众平台,将课程思政与校园健康教育有机统一起来,以提高医学生的健康、人文素养和医学微生物学课程的学习效果。微信公众平台作为校园思政、健康与课程融合教育创新模式,对完善课程思政与健康的融合、协同式教育的长效机制,形成人人都积极参与建设“健康中国”的校园和社会合力,共同促进新时代医学教育事业的改革与创新,建设中国特色社会主义和实现中华民族伟大复兴的目标等都具有重要实践意义。

网络CBL-PBL教学在泌尿外科教学中的应用

探索基于网络平台的CBL-PBL教学模式在“泌尿外科疾病”教学中的应用效果,选取同一学期内的苏州大学苏州医学院临床医学专业学生62名,随机分为两组,分别接受基于网络平台的CBL-PBL教学模式(38名学生)和传统教学模式(24名学生),比较分析两种教学模式在“泌尿外科疾病”教学中的教学效果差异。在对教师满意度评分、病情分析、治疗节点鉴别、个体化方案选择能力等方面接受CBL-PBL模式教学的学生均显著优于接受传统教学模式的学生(p<0.05)。此外,教师对接受CBLPBL模式教学的学生的满意度也优于接受传统教学模式的学生(p<0.05)。基于网络平台的CBL-PBL教学模式在“泌尿外科疾病”教学中的教学效果优于传统教学模式,适宜推广和应用。

Gastrointestinal tuberculosis:Diagnostic approaches for this uncommon pathology

A case report entitled“Primary gastroduodenal tuberculosis presenting as gastric outlet obstruction”recently published in the World Journal of Clinical Cases presented a rare cause of gastric outlet obstruction and highlighted the atypical manner in which gastrointestinal tuberculosis(TB)can present.The literature with regards to this rare pathology is limited to case reports and case series with the largest being published using data from between 2003 and 2013.However,since then the diagnostic tools available have significantly changed with more modern and increasingly accurate tests now available.This editorial reviews the current state of the art with regards to diagnosis in gastrointestinal TB.

持续质量改进对疾控中心微生物检验管理水平的提升评价

目的探究疾控中心微生物检验中采取持续质量改进的效果。方法选取2020年1—12月青岛市崂山区疾病预防控制中心相关管理人员20名为研究对象。2020年1—6月为对照组(实施常规管理),2020年7—12月为观察组(实施持续质量改进)。比较两组标本达标率、管理质量、工作人员满意度。结果观察组标本达标率高于对照组,差异有统计学意义(P均<0.05)。观察组管理质量评分高于对照组,差异有统计学意义(P均<0.05)。观察组的满意度(100.00%)高于对照组(75.00%),差异有统计学意义(χ^(2)=5.714,P<0.05)。结论疾控中心微生物检验中采取持续质量改进效果显著,可提高检验标本达标率,提升管理质量,提高满意度。

尿游离DNA的液体活检有望成为泌尿系疾病诊治的重要方向

尿液由泌尿系统直接产生,其中的游离DNA(cfDNA)携带了来源于泌尿系的基因组DNA,并且尿液样本具有非侵入性、数量不受限及获取方便等优点,因此尿cfDNA是诊治泌尿系疾病的一种很有潜力的生物标志物,对尿cfDNA进行液体活检在泌尿系疾病的诊治中具有重要的临床应用价值。本文就尿cfDNA在泌尿系疾病临床诊治中的应用研究作一综述。

微生物检验在感染性疾病患者预防和诊断治疗中的临床价值分析

目的分析微生物检验在感染性疾病患者预防和诊断治疗中的临床价值。方法选取110例尿路感染患者作为研究对象,随机分为传统组与新式组,各55例。传统组仅凭借医生的经验选择治疗药物,不采用任何检验方法。新式组为避免产生对治疗感染无效的耐药菌株,根据所接受微生物检验的药敏试验结果合理选择临床用药。对比两组患者治疗后的感染程度。结果传统组治疗后,轻度感染18例(32.73%)、中度感染23例(41.82%)、重度感染14例(25.45%);新式组治疗后,轻度感染36例(65.45%)、中度感染13例(23.64%)、重度感染6例(10.91%)。相较于传统组,新式组感染程度更低,差异有统计学意义(P<0.05)。结论在院内开展感染控制工作中,实施微生物检验能起到相当重要的作用,该法应用价值很高。其于测定病原菌、预测传播途径方面能够取得突出的效果。因而值得进一步在临床内推广和应用。

微生物检验在感染性疾病患者预防及诊断治疗中的应用研究

目的分析微生物检验在感染性疾病患者中的应用价值。方法选取晋江市医院晋南分院在2022年4月至2023年3月收治的134例感染性疾病患者为研究对象,随机分为观察组(n=67)和对照组(n=67),对照组行常规性抗生素治疗,观察组先进行微生物检测,然后依照检测结果进行抗生素治疗。分析134例病原菌类型,对比两组感染率、治疗总有效率及复发情况。结果134例患者中共分离出病原菌128株,其中G^(+)菌46株(35.94%),G^(-)菌43株(33.59%),真菌39株(30.47%);观察组总感染率、复发率均较对照组更低(P<0.05);观察组治疗总有效率较对照组更高(P<0.05)。结论微生物检验在感染性疾病可以准确诊断病原菌类型,提高治疗总有效率,降低感染复发。

中青年泌尿外科癌症病人生育忧虑现状及影响因素分析

目的:了解中青年泌尿外科癌症病人生育忧虑现状及影响因素,为提升病人生活质量提供理论依据。方法:采用便利抽样的方法,选取2022年6月-2023年6月住院治疗的118例中青年泌尿外科癌症病人作为研究对象,应用病人一般资料调查表、中文版生育忧虑问卷、疾病感知问卷简化版、癌症病人生活质量量表对其进行横断面调查。结果:中青年泌尿外科癌症病人生育忧虑问卷条目均分为(1.82±0.53)分,与疾病感知问卷简化版总分呈显著正相关关系,与癌症病人生活质量量表总分呈显著负相关关系,多元线性回归分析结果显示,性别、疾病分期、疾病感知以及生活质量水平为影响中青年泌尿外科癌症病人生育忧虑的主要因素(P<0.05)。结论:中青年泌尿外科癌症病人生育忧虑处于中等水平,医护人员要重点关注女性、疾病分期较高、疾病感知水平较高以及生活质量水平较低的病人,采取针对性的干预措施减轻病人的心理痛苦,降低其生育忧虑水平。

质量控制与管理措施在疾病预防控制机构微生物检验中的应用效果

目的探讨质量控制与管理措施在疾病预防控制机构微生物检验中的应用效果。方法选取2022年8月至2023年7月枣庄市辖区内疾病预防控制机构的70例微生物检验样本和70名医务人员作为研究对象,按照随机数字表法分为参照组(n=35)和研究组(n=35)。参照组采用传统管理措施,研究组采用微生物检验质量以及控制管理措施。比较两组不良事件(环境问题、试剂问题、样本问题、仪器问题、人为问题)总发生率、工作质量(工作态度评分、操作技能评分、标准符合评分以及检测结果准确性评分)、管理总满意度。结果研究组不良事件总发生率、工作质量和管理总满意度均高于参照组,差异有统计学意义(P<0.05)。结论疾病预防控制机构在进行微生物检验质量控制期间,合理运用微生物检验质量以及控制管理措施,可以提升工作态度、操作技能、标准符合以及检测结果准确性等工作质量,能够减少环境问题、试剂问题、样本问题、仪器问题、人为问题等系列不良事件,提高管理满意度。

持续质量改进在疾控中心微生物检验中的应用效果及对管理质量的影响

目的探讨持续质量改进在疾控中心微生物检验中的应用效果及对管理质量的影响。方法选取2021年7月—2023年8月宜都市疾病预防控制中心的10名微生物实验室工作人员作为研究对象。于2021年7月—2022年7月实施常规管理模式,为常规组。于2022年8月—2023年8月实施持续质量改进管理,为研究组。对比管理前后标本规范采集达标率、人员应对突发公共卫生事件能力、管理满意度情况。结果研究组样品采集合格率、医院用品表面微生物达标率、工作人员手卫生检验达标率、应对突发公共卫生事件能力评分均高于常规组,差异有统计学意义(P均<0.05)。研究组满意度为100.00%(10/10),高于常规组的80.00%(8/10),差异有统计学意义(P<0.05)。结论疾控中心微生物检验中实施持续质量改进管理能够有效提高管理质量。