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1.
PLoS One ; 19(5): e0300530, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38709721

RESUMEN

BACKGROUND: Over several years of recent efforts to make sense and detect online hate speech, we still know relatively little about how hateful expressions enter online platforms and whether there are patterns and features characterizing the corpus of hateful speech. OBJECTIVE: In this research, we introduce a new conceptual framework suitable for better capturing the overall scope and dynamics of the current forms of online hateful speech. METHODS: We adopt several Python-based crawlers to collect a comprehensive data set covering a variety of subjects from a multiplicity of online communities in South Korea. We apply the notions of marginalization and polarization in identifying patterns and dynamics of online hateful speech. RESULTS: Our analyses suggest that polarization driven by political orientation and age difference predominates in the hateful speech in most communities, while marginalization of social minority groups is also salient in other communities. Furthermore, we identify a temporal shift in the trends of online hate from gender to age based, reflecting the changing sociopolitical conditions within the polarization dynamics in South Korea. CONCLUSION: By expanding our understanding of how hatred shifts and evolves in online communities, our study provides theoretical and practical implications for both researchers and policy-makers.


Asunto(s)
Internet , República de Corea , Humanos , Masculino , Femenino , Adulto , Política , Adulto Joven , Persona de Mediana Edad
2.
JMIR Form Res ; 8: e52157, 2024 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-38206652

RESUMEN

BACKGROUND: Individuals with autism often experience heightened anxiety in workplace environments because of challenges in communication and sensory overload. As these experiences can result in negative self-image, promoting their self-efficacy in the workplace is crucial. Virtual reality (VR) systems have emerged as promising tools for enhancing the self-efficacy of individuals with autism in navigating social scenarios, aiding in the identification of anxiety-inducing situations, and preparing for real-world interactions. However, there is limited research exploring the potential of VR to enhance self-efficacy by facilitating an understanding of emotional and physiological states during social skills practice. OBJECTIVE: This study aims to develop and evaluate a VR system that enabled users to experience simulated work-related social scenarios and reflect on their behavioral and physiological data through data visualizations. We intended to investigate how these data, combined with the simulations, can support individuals with autism in building their self-efficacy in social skills. METHODS: We developed WorkplaceVR, a comprehensive VR system designed for engagement in simulated work-related social scenarios, supplemented with data-driven reflections of users' behavioral and physiological responses. A within-subject deployment study was subsequently conducted with 14 young adults with autism to examine WorkplaceVR's feasibility. A mixed methods approach was used, compassing pre- and postsystem use assessments of participants' self-efficacy perceptions. RESULTS: The study results revealed WorkplaceVR's effectiveness in enhancing social skills and self-efficacy among individuals with autism. First, participants exhibited a statistically significant increase in perceived self-efficacy following their engagement with the VR system (P=.02). Second, thematic analysis of the interview data confirmed that the VR system and reflections on the data fostered increased self-awareness among participants about social situations that trigger their anxiety, as well as the behaviors they exhibit during anxious moments. This increased self-awareness prompted the participants to recollect their related experiences in the real world and articulate anxiety management strategies. Furthermore, the insights uncovered motivated participants to engage in self-advocacy, as they wanted to share the insights with others. CONCLUSIONS: This study highlights the potential of VR simulations enriched with physiological and behavioral sensing as a valuable tool for augmenting self-efficacy in workplace social interactions for individuals with autism. Data reflection facilitated by physiological sensors helped participants with autism become more self-aware of their emotions and behaviors, advocate for their characteristics, and develop positive self-beliefs.

3.
PLoS One ; 17(12): e0278970, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36580442

RESUMEN

Research has shown that sensor data generated by a user during a VR experience is closely related to the user's behavior or state, meaning that the VR user can be quantitatively understood and modeled. Eye-tracking as a sensor signal has been studied in prior research, but its usefulness in a VR context has been less examined, and most extant studies have dealt with eye-tracking within a single environment. Our goal is to expand the understanding of the relationship between eye-tracking data and user modeling in VR. In this paper, we examined the role and influence of eye-tracking data in predicting a level of cybersickness and types of locomotion. We developed and applied the same structure of a deep learning model to the multi-sensory data collected from two different studies (cybersickness and locomotion) with a total of 50 participants. The experiment results highlight not only a high applicability of our model to sensor data in a VR context, but also a significant relevance of eye-tracking data as a potential supplement to improving the model's performance and the importance of eye-tracking data in learning processes overall. We conclude by discussing the relevance of these results to potential future studies on this topic.


Asunto(s)
Tecnología de Seguimiento Ocular , Realidad Virtual , Humanos
4.
PLoS One ; 16(12): e0260080, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34882703

RESUMEN

BACKGROUND: Although fake news creation and consumption are mutually related and can be changed to one another, our review indicates that a significant amount of research has primarily focused on news creation. To mitigate this research gap, we present a comprehensive survey of fake news research, conducted in the fields of computer and social sciences, through the lens of news creation and consumption with internal and external factors. METHODS: We collect 2,277 fake news-related literature searching six primary publishers (ACM, IEEE, arXiv, APA, ELSEVIER, and Wiley) from July to September 2020. These articles are screened according to specific inclusion criteria (see Fig 1). Eligible literature are categorized, and temporal trends of fake news research are examined. RESULTS: As a way to acquire more comprehensive understandings of fake news and identify effective countermeasures, our review suggests (1) developing a computational model that considers the characteristics of news consumption environments leveraging insights from social science, (2) understanding the diversity of news consumers through mental models, and (3) increasing consumers' awareness of the characteristics and impacts of fake news through the support of transparent information access and education. CONCLUSION: We discuss the importance and direction of supporting one's "digital media literacy" in various news generation and consumption environments through the convergence of computational and social science research.


Asunto(s)
Desinformación , Difusión de la Información/métodos , Inteligencia Artificial , Minería de Datos , Humanos , Internet , Modelos Teóricos , Medios de Comunicación Sociales , Ciencias Sociales
5.
Sensors (Basel) ; 21(21)2021 Oct 29.
Artículo en Inglés | MEDLINE | ID: mdl-34770500

RESUMEN

A virtual reality (VR) controller plays a key role in supporting interactions between users and the virtual environment. This paper investigates the relationship between the user experience and VR control device modality. We developed a VR firefighting training system integrated with four control devices adapted from real firefighting tools. We iteratively improved the controllers and VR system through a pilot study with six participants and conducted a user study with 30 participants to assess two salient human factor constructs-perceived presence and cognitive load-with three device modality conditions (two standard VR controllers, four real tools, and a hybrid of one real tool and one standard VR controller). We found that having more realistic devices that simulate real tools does not necessarily guarantee a higher level of user experience, highlighting a strategic approach to the development and utilization of VR control devices. Our study gives empirical insights on establishing appropriate combinations of VR control device modality in the context of field-based VR simulation and training.


Asunto(s)
Bomberos , Realidad Virtual , Simulación por Computador , Humanos , Proyectos Piloto , Interfaz Usuario-Computador
6.
PLoS One ; 16(5): e0251140, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33979368

RESUMEN

This paper presents a year-long study of our project, aiming at (1) understanding the work practices of clinical staff in trauma intensive care units (TICUs) at a trauma center, with respect to their usage of clinical data interface systems, and (2) developing and evaluating an intuitive and user-centered clinical data interface system for their TICU environments. Based on a long-term field study in an urban trauma center that involved observation-, interview-, and survey-based studies to understand our target users and their working environment, we designed and implemented MediSenseView as a working prototype. MediSenseView is a clinical-data interface system, which was developed through the identification of three core challenges of existing interface system use in a trauma care unit-device separation, usage inefficiency, and system immobility-from the perspectives of three staff groups in our target environment (i.e., doctors, clinical nurses and research nurses), and through an iterative design study. The results from our pilot deployment of MediSenseView and a user study performed with 28 trauma center staff members highlight their work efficiency and satisfaction with MediSenseView compared to existing clinical data interface systems in the hospital.


Asunto(s)
Medicina Clínica/métodos , Centros Traumatológicos/tendencias , Interfaz Usuario-Computador , Toma de Decisiones Asistida por Computador , Eficiencia , Personal de Salud/psicología , Humanos , Unidades de Cuidados Intensivos/tendencias , Programas Informáticos , Participación de los Interesados , Encuestas y Cuestionarios
7.
PLoS One ; 15(9): e0237966, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32911501

RESUMEN

Primary symptoms of adults with autism spectrum disorder (ASD), such as pervasive social deficits in social interaction and communication, cause adults with ASD to adopt a sedentary lifestyle. Meanwhile, gamified and behavioral theory-based interventions have been shown to improve physical activity in a fun and unobtrusive way. In this paper, we describe the iterative design inquiry process of PuzzleWalk, a gamified, physical activity-promoting mobile app designed for adults with ASD. We report the design rationales and lessons learned across four user-centered design phases with ASD experts and adults with ASD, including user requirement gathering, iterative participatory design, usability evaluation, and field deployment. The design insights generated from this work could inform future research focusing on designing sociotechnical systems, games, and interventions for people with ASD.


Asunto(s)
Trastorno del Espectro Autista/psicología , Trastorno del Espectro Autista/terapia , Terapia por Ejercicio , Aplicaciones Móviles/estadística & datos numéricos , Modelos Teóricos , Proyectos de Investigación/normas , Juegos de Video/estadística & datos numéricos , Adolescente , Adulto , Comunicación , Femenino , Humanos , Relaciones Interpersonales , Masculino , Juegos de Video/psicología , Adulto Joven
8.
Health Informatics J ; 26(4): 2992-3008, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32951500

RESUMEN

The purpose of this study was to conduct the first usability inquiry of a gamified, behavior change theory-guided mobile app PuzzleWalk for increasing physical activity and reducing sedentary behavior in adults with and without autism spectrum disorder (ASD). Eighteen adults with and without ASD participated in a mixed-methods study that consisted of cognitive walkthrough, system usability assessment, and qualitative interviews. The results of the system usability testing indicated satisfactory quality of the PuzzleWalk system that can be readily applicable to both adults with and without ASD. Several notable issues were identified from the qualitative interviews that address critical insights into unique health and social needs in adults with ASD. Future work is warranted to examine the long-term effects of the PuzzleWalk system on increasing physical activity and reducing sedentary behavior in adults with and without ASD in real-world settings.


Asunto(s)
Trastorno del Espectro Autista , Aplicaciones Móviles , Adulto , Trastorno del Espectro Autista/complicaciones , Trastorno del Espectro Autista/terapia , Ejercicio Físico , Humanos , Conducta Sedentaria , Interfaz Usuario-Computador
9.
IEEE Trans Vis Comput Graph ; 26(3): 1577-1591, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-30334799

RESUMEN

Geographical maps encoded with rainbow color scales are widely used by climate scientists. Despite a plethora of evidence from the visualization and vision sciences literature about the shortcomings of the rainbow color scale, they continue to be preferred over perceptually optimal alternatives. To study and analyze this mismatch between theory and practice, we present a web-based user study that compares the effect of color scales on performance accuracy for climate-modeling tasks. In this study, we used pairs of continuous geographical maps generated using climatological metrics for quantifying pairwise magnitude difference and spatial similarity. For each pair of maps, 39 scientist-observers judged: i) the magnitude of their difference, ii) their degree of spatial similarity, and iii) the region of greatest dissimilarity between them. Besides the rainbow color scale, two other continuous color scales were chosen such that all three of them covaried two dimensions (luminance monotonicity and hue banding), hypothesized to have an impact on task performance. We also analyzed subjective performance measures, such as user confidence, perceived accuracy, preference, and familiarity in using the different color scales. We found that monotonic luminance scales produced significantly more accurate judgments of magnitude difference but were not superior in spatial comparison tasks, and that hue banding had differential effects based on the task and conditions. Scientists expressed the highest preference and perceived confidence and accuracy with the rainbow, despite its poor performance on the magnitude comparison tasks. We also report on interesting interactions among stimulus conditions, tasks, and color scales, that lead to open research questions.


Asunto(s)
Percepción de Color/fisiología , Gráficos por Computador , Análisis de Datos , Mapas como Asunto , Adulto , Anciano , Cambio Climático , Color , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis y Desempeño de Tareas , Adulto Joven
10.
PLoS One ; 13(10): e0204938, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30289937

RESUMEN

Because using social media has become a major part of people's daily lives, many of their personal characteristics are often implicitly or explicitly reflected in the content they share. We present a study of two personal characteristics-age and gender-related to user engagement on Instagram that can be determined through the characterization of images and tags. We demonstrate the strong influence of age and gender on Instagram use in terms of topical and content differences. We then build age and gender classification models that yield F1 scores of up to 88% and 74% in the detection of age and gender, respectively, and that better characterize users by images than by tags. We further demonstrate the robustness of our models using a new set of test data, with which the models exhibit greater overall performance than human raters. Our study highlights that future research should look to exploit images to a greater degree because they complement text and there are many unexamined images with no embedded text available.


Asunto(s)
Medios de Comunicación Sociales/estadística & datos numéricos , Adolescente , Factores de Edad , Femenino , Humanos , Aprendizaje Automático , Masculino , Modelos Teóricos , Factores Sexuales , Encuestas y Cuestionarios
11.
PLoS One ; 13(6): e0197050, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29944656

RESUMEN

With the growing dependence on smartphones for everyday activities, a large number of pedestrians nowadays are constantly fixated on their smartphone screens, and hence are susceptible to walking off pavements or colliding with other pedestrians. Reduced attention and situational awareness can render smartphone-occupied users, or smombies, oblivious to potential risks when using their smartphones while walking or driving. In this paper, we introduce a smartphone application, called Smombie Guardian, that detects obstacles and alerts smombies as they walk while viewing their smartphone screens to prevent potential collisions. Based on a user study with 74 participants who used Smombie Guardian in a real-life scenario, we highlight the effectiveness, usefulness, and unobtrusiveness of the algorithm and Smombie Guardian in helping users to avoid potential obstacles.


Asunto(s)
Aplicaciones Móviles , Teléfono Inteligente , Adulto , Femenino , Humanos , Masculino
12.
PLoS One ; 13(2): e0192061, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29389979

RESUMEN

In this study, we leverage human evaluations, content analysis, and computational modeling to generate a comprehensive analysis of readers' evaluations of authors' communication quality in social media with respect to four factors: author credibility, interpersonal attraction, communication competence, and intent to interact. We review previous research on the human evaluation process and highlight its limitations in providing sufficient information for readers to assess authors' communication quality. From our analysis of the evaluations of 1,000 Twitter authors' communication quality from 300 human evaluators, we provide empirical evidence of the impact of the characteristics of the reader (demographic, social media experience, and personality), author (profile and social media engagement), and content (linguistic, syntactic, similarity, and sentiment) on the evaluation of an author's communication quality. In addition, based on the author and message characteristics, we demonstrate the potential for building accurate models that can indicate an author's communication quality.


Asunto(s)
Autoria , Comunicación , Medios de Comunicación Sociales , Humanos
13.
J Endourol ; 31(4): 374-379, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25353326

RESUMEN

PURPOSE: To evaluate the validity of hand-assisted laparoscopic partial nephrectomy (HALPN) for small renal masses, patients who underwent HALPN, robot-assisted laparoscopic partial nephrectomy (RALPN), or open partial nephrectomy (OPN) at a single medical institution were compared in terms of perioperative outcomes. PATIENTS AND METHODS: In this retrospective cohort study, all 590 consecutive patients who underwent HALPN (n=89), RALPN (n=147), or OPN (n=354) between July 2011 and April 2014 in a single institute were compared in terms of perioperative outcomes, including the mean operative time, warm ischemia time (WIT), length of the hospital stay, change in the estimated glomerulofiltration rate (eGFR), duration of analgesic use, surgical margins, and adverse events. The patient groups were compared by a multivariate regression model, in which adjustments were made for differences in baseline demographic and tumor characteristics. RESULTS: OPN associated with a significantly longer mean operative time (187 minutes) than RALPN (162 minutes; p<0.001) or HALPN (172 minutes; p=0.013), a longer hospital stay (7.3, 5.3, and 5.9 days, respectively; p<0.001 and <0.001, respectively), and a longer duration of analgesic use (6.6, 4.6, and 5.4 days, respectively; p<0.001 and <0.001, respectively). HALPN and RALPN were equivalent in terms of operative time. RALPN had a significantly longer WIT than HALPN and OPN (p<0.001 and <0.001, respectively). HALPN had a significantly longer hospital stay than RALPN (p=0.026). The three methods differed in terms of eGFR change (p=0.028), but multivariate analysis found that the surgical method was not a significant factor for eGFR. The three methods did not differ in terms of complication rates. CONCLUSIONS: HALPN associated with shorter operative and convalescence times compared with OPN. HALPN was generally not inferior to RALPN in terms of perioperative outcomes, although it associated with a longer convalescence.


Asunto(s)
Carcinoma de Células Renales/cirugía , Laparoscópía Mano-Asistida/métodos , Neoplasias Renales/cirugía , Nefrectomía/métodos , Procedimientos Quirúrgicos Robotizados/métodos , Adulto , Anciano , Carcinoma de Células Renales/patología , Dipirona/uso terapéutico , Femenino , Tasa de Filtración Glomerular , Humanos , Neoplasias Renales/patología , Laparoscopía/métodos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Análisis Multivariante , Estadificación de Neoplasias , Tempo Operativo , Dolor Postoperatorio/tratamiento farmacológico , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Factores de Tiempo , Isquemia Tibia
14.
Ann Surg Oncol ; 23(5): 1646-52, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-26714938

RESUMEN

BACKGROUND: This study reviewed the outcomes for patients who underwent simultaneous bladder and ureter reconstructive surgery using the ileum after radical treatment for cervical cancer. METHODS: The medical records of seven patients who underwent augmentation ileocystoplasty with ileal ureter replacement between September 2006 and May 2013 were reviewed. Data on indications for surgery, underlying urologic comorbidities, type of ureteral replacement, postoperative complications, and changes in renal function were obtained. RESULTS: The median age of the patients was 56 years. The primary tumor was cervical cancer in all the patients, and the majority of the patients (4/7, 57.1 %) were previously treated with radical hysterectomy plus radiotherapy. Ileal ureter replacement was performed on 11 renal units, and bilateral ileal ureter substitution was performed for four patients, with the largest ureteral defect being 15 cm. The median length of the ileum used for augmentation and ureter substitution was 30 cm (range 15-40 cm), and the median hospital stay was 23 days (range 18-47 days). The overall rate of major complications (grade ≥3) was 57.1 % (4 of 7 patients). The median preoperative and immediate postoperative serum creatinine levels were respectively 1.2 mg/dL and 0.9 mg/dL. During a mean follow-up duration of 38 months, none of the patients experienced deterioration of renal function after surgery. CONCLUSION: Ileal ureter substitution combined with augmentation ileocystoplasty is a useful surgical technique for bridging long ureteral defects caused by ureteric stenosis from surgery, radiotherapy, or both for pelvic tumors in contracted low-compliance bladders.


Asunto(s)
Íleon/cirugía , Procedimientos de Cirugía Plástica/métodos , Complicaciones Posoperatorias , Uréter/cirugía , Procedimientos Quirúrgicos Urológicos/métodos , Neoplasias del Cuello Uterino/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Anastomosis Quirúrgica , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Estudios Retrospectivos , Neoplasias del Cuello Uterino/patología
15.
J Laparoendosc Adv Surg Tech A ; 25(10): 814-20, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26397733

RESUMEN

OBJECTIVE: To assess whether pubovesical complex (PVC) reconstruction (termed Kim's stitch) improves urinary continence following robot-assisted laparoscopic prostatectomy (RALP). PATIENTS AND METHODS: The cohort consisted of 130 consecutive patients who underwent RALP in a tertiary-care hospital between July 2012 and June 2013. The first 70 patients did not undergo PVC reconstruction with Kim's stitch and formed the control group. The subsequent 60 patients underwent Kim's stitch and formed the intervention (Kim's stitch) group. The primary outcome measure was degree of urinary continence assessed 1, 3, and 6 months after surgery using the Expanded Prostate Cancer Index Composite Questionnaire. Continence was compared between the two groups using propensity scores and inverse-probability weighting to adjust for treatment selection bias. To evaluate adverse treatment effects, all patients underwent uroflowmetry before and 1 month after surgery. RESULTS: The prevalence of continence at 1, 3, and 6 months was 23.9%, 57.7%, and 77.6%, respectively, in the control group and 25.9%, 60.0%, and 89.7%, respectively, in the Kim's stitch group. After adjustment, the 6-month continence was different between the two groups (odds ratio = 2.25; 95% confidence interval, 0.91-5.55; P = .08). The 1- and 3-month continence rates and postoperative maximal urinary flow rate were similar between the two groups (Kim's stitch group, 21.5 ± 9.5; control group, 22.1 ± 8.6; P = .72). CONCLUSIONS: A PVC reconstruction (Kim's stitch) with posterior reconstruction during RALP has a beneficial effect on continence recovery without producing additional adverse effects.


Asunto(s)
Ligamentos/cirugía , Prostatectomía/métodos , Neoplasias de la Próstata/cirugía , Procedimientos Quirúrgicos Robotizados/métodos , Incontinencia Urinaria/prevención & control , Anciano , Humanos , Laparoscopía/efectos adversos , Laparoscopía/métodos , Masculino , Persona de Mediana Edad , Prostatectomía/efectos adversos , Recuperación de la Función , Procedimientos Quirúrgicos Robotizados/efectos adversos , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Factores de Tiempo , Incontinencia Urinaria/etiología
16.
J Korean Med Sci ; 30(3): 252-8, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25729246

RESUMEN

The objective of this study was to evaluate the risk of recurrence in patients with intermediate-risk non-muscle-invasive bladder cancer (NMIBC) after intravesical instillation with chemotherapeutic agents or Bacillus Calmette-Guérin (BCG) therapy. A cohort of 746 patients with intermediate-risk NMIBC comprised the study group. The primary outcome was time to first recurrence. The recurrence rates of the transurethral resection (TUR) alone, chemotherapy, and BCG groups were determined using Kaplan-Meier analysis. Risk factors for recurrence were identified using Cox regression analysis. In total, 507 patients (68.1%), 78 patients (10.5%), and 160 (21.4%) underwent TUR, TUR+BCG, or TUR+chemotherapy, respectively. After a median follow-up period of 51.7 months (interquartile range=33.1-77.8 months), 286 patients (38.5%) developed tumor recurrence. The 5-yr recurrence rates for the TUR, chemotherapy, and BCG groups were 53.6%±2.7%, 30.8%±5.7%, and 33.6%±4.7%, respectively (P<0.001). Chemotherapy and BCG treatment were found to be predictors of reduced recurrence. Cox-regression analysis showed that TUR+BCG did not differ from TUR+chemotherapy in terms of recurrence risk. Adjuvant intravesical instillation is an effective prophylactic that prevents tumor recurrence in intermediate-risk NMIBC patients following TUR. In addition, both chemotherapeutic agents and BCG demonstrate comparable efficacies for preventing recurrence.


Asunto(s)
Adyuvantes Inmunológicos/uso terapéutico , Antineoplásicos/uso terapéutico , Vacuna BCG/uso terapéutico , Recurrencia Local de Neoplasia/patología , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Administración Intravesical , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Riesgo , Resultado del Tratamiento , Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/cirugía
17.
World J Urol ; 33(10): 1459-65, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25617236

RESUMEN

PURPOSE: The aim of this study was to report our technique of hand-assisted laparoscopic bladder cuff excision through the same hand port as that used for nephroureterectomy and evaluate its benefits and short-term oncologic outcomes. MATERIALS AND METHODS: We included 67 consecutive patients treated by a single surgeon between June 2011 and November 2014 with hand-assisted laparoscopic bladder cuff excision through the same hand port as that used for nephroureterectomy. We retrospectively analyzed procedure-related clinical data and short-term oncologic outcomes. RESULTS: The mean patient age was 66.2 ± 10.6 years. The mean follow-up period was 17.6 months (range 1-37 months). The mean operation time was 243.5 ± 60.4 min. There were no major accidents or open conversions. Forty-two patients (63 %) underwent immediate mitomycin C instillation without complications. There was one high-grade complication (prolonged lymphatic leakage) that required reoperation and multiple hospitalizations. Thirty patients (45 %) underwent regional lymph node dissection. The pathological stages included CIS in 2 (3 %), Ta/T1 in 32 (48 %), T2 in 6 (9 %), T3 in 27 (40 %), and N+ in 4 (6 %) cases. G1, G2, and G3 were seen in 3 (5 %), 21 (31 %), and 43 (64 %) patients, respectively. Eighteen patients (26 %) underwent postoperative adjuvant chemotherapy. Two patients died during the study period, and nine patients (13 %) had bladder recurrences. CONCLUSIONS: HAL bladder cuff excision through the same hand port used for nephroureterectomy is a feasible technique that is both amenable to oncologic principles and can reproduce the open surgical technique.


Asunto(s)
Cistectomía/métodos , Laparoscópía Mano-Asistida/instrumentación , Laparoscopios , Nefrectomía/métodos , Uréter/cirugía , Neoplasias de la Vejiga Urinaria/cirugía , Vejiga Urinaria/cirugía , Anciano , Carcinoma de Células Transicionales/cirugía , Diseño de Equipo , Femenino , Estudios de Seguimiento , Humanos , Masculino , Tempo Operativo , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento
18.
J Endourol ; 29(4): 485-9, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25215545

RESUMEN

PURPOSE: To report complications, including three types of fistula, intractable hematuria, and pain, which can develop after polymeric ureteral stent (PUS) or metallic ureteral stent placements and to evaluate the risk factors for these adverse events. PATIENTS AND METHODS: We reviewed seven patients referred to our trauma and reconstructive subdivision for complications that presented after placement of a PUS (two patients), double-layered, coated, self-expandable, mesh metallic stent (three patients), Memokath stent (one patient), or Resonance stent (one patient). We retrospectively reviewed their medical records and accessed the predisposing factors, mechanism of injury, diagnosis, and interventional and surgical management. RESULTS: The two patients with PUS presented with ureteroarterial fistula (UAF). Among patients with a self-expandable metallic mesh stents, UAF developed UAF in one patient, ureteroenteral fistula (UEF) developed in one patient, and ureterovaginal fistula (UVF) developed in one patient. There were five patients with fistula who had a history of pelvic surgery, radiation therapy, long-term ureteral stent, or high-pressure balloon dilation. Surgical procedures were needed to manage these problems, including nephrectomy in two patients and bypass surgery with ureter ligation in two patients. UAF was seen with massive gross hematuria that necessitated angiography. UEF required small bowel resection. The patient with UVF underwent multiple surgeries for recurrent fistula. Patients with a Memokath or Resonance stent presented with intractable flank pain and hematuria. These persons required a surgical or other procedure to remove the stents. CONCLUSIONS: UAF should be highly suspected in patients with long-term ureteral stents, especially if gross hematuria develops. The placement of a metallic ureteral stent using a high-pressure balloon should be performed cautiously, especially in patients with a history of pelvic surgery or radiation.


Asunto(s)
Fístula Intestinal/epidemiología , Complicaciones Posoperatorias/epidemiología , Stents , Obstrucción Ureteral/cirugía , Ureteroscopía , Fístula Urinaria/epidemiología , Fístula Vaginal/epidemiología , Fístula Vascular/epidemiología , Adulto , Anciano , Angiografía , Femenino , Fístula/epidemiología , Hematuria/etiología , Humanos , Masculino , Metales , Persona de Mediana Edad , Polímeros , Estudios Retrospectivos , Enfermedades Ureterales/complicaciones , Enfermedades Ureterales/epidemiología , Fístula Urinaria/complicaciones , Fístula Vascular/complicaciones
19.
Int J Urol ; 21(11): 1106-12, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25039565

RESUMEN

OBJECTIVES: To investigate the association between body mass index and clinicopathological features of bladder cancer, and to assess the prognostic value of body mass index in patients undergoing radical cystectomy for bladder cancer. METHODS: The medical records of 714 patients who underwent radical cystectomy for bladder cancer were reviewed. The association of body mass index at surgery with clinicopathological features was examined, and the prognostic value of body mass index for recurrence-free survival and cancer-specific survival was analyzed using the Kaplan-Meier method and Cox regression models. Additional survival analyses were carried out in a subgroup of 534 patients with N0M0 disease. RESULTS: Of 714 patients, 304 (42.6%), 184 (25.8%) and 226 (31.7%) had a body mass index of <23 (normal), 23-25 (overweight), and ≥25 (obese) kg/m(2) , respectively. Patients with high body mass index had a lower pathological T stage, fewer lymph node metastases and a lower frequency of lymphovascular invasion than those with low body mass index (P < 0.05). Multivariable analysis showed that obese status was an independent predictor of recurrence-free survival (obese vs normal: P < 0.001; overweight vs normal: P = 0.008) and cancer-specific survival (obese vs normal: P < 0.001; overweight vs normal: P = 0.019), along with pathological T stage, lymph node metastasis, and lymphovascular invasion. In addition, obesity was significantly associated with recurrence-free survival (P = 0.018) and cancer-specific survival (P = 0.019) in patients with N0M0 status. CONCLUSIONS: The present findings suggest that overweight and obesity are associated with favorable pathological features and prognosis in patients with bladder cancer undergoing radical cystectomy.


Asunto(s)
Carcinoma/complicaciones , Obesidad/complicaciones , Neoplasias de la Vejiga Urinaria/complicaciones , Anciano , Índice de Masa Corporal , Carcinoma/patología , Carcinoma/cirugía , Cistectomía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/cirugía
20.
Neurourol Urodyn ; 29(3): 387-90, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-19229954

RESUMEN

AIMS: The aim of this study is to compare the urodynamic parameters in ischemic and hemorrhagic stroke patients with bladder dysfunction. MATERIALS AND METHODS: We retrospectively reviewed medical records such as computed tomography (CT) or magnetic resonance imaging (MRI) and urodynamic study and identified 84 cases among 150 stroke patients underwent urodynamic test due to lower urinary tract symptoms (LUTS) from June 2003 to May 2008. Exclusion criteria are diabetes mellitus (DM) cystopathy, previous pelvic surgery, spinal cord injury, benign prostate hyperplasia (BPH), and other neurologic etiology. RESULTS: Among analyzed variables of urodynamic study, total bladder capacity, postvoid residual urine volume and bladder compliance have a significant value between ischemic and hemorrhagic stroke group (P = 0.004, P = 0.017, P = 0.007). Ischemic group have detrusor overactivity (DO) (70.7%), detrusor underactivity (DU) (29.3%), and hemorrhagic group have DO (34.6%), DU (65.4%). (P = 0.003). CONCLUSIONS: Evaluation of the stroke type may be helpful in the determination of the type of urinary dysfunction and in deciding the appropriate bladder management. The urodynamic study, however, is essential to manage LUTS in stroke patients.


Asunto(s)
Accidente Cerebrovascular/complicaciones , Trastornos Urinarios/etiología , Trastornos Urinarios/fisiopatología , Urodinámica , Adulto , Anciano , Anciano de 80 o más Años , Isquemia Encefálica/complicaciones , Femenino , Humanos , Hemorragias Intracraneales/complicaciones , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Accidente Cerebrovascular/clasificación , Trastornos Urinarios/clasificación , Adulto Joven
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