Triple neurectomía transperitoneal laparoscópica y con asistencia robótica para el tratamiento del dolor inguinal crónico: descripción de la técnica, nuestra experiencia y resultados preliminares / Robot-assisted laparoscopic triple neurectomy for chronic inguinal pain: Description of the technique, our experience and preliminary results

Introducción. El dolor inguinal crónico o inguinodinia posthernioplastia es una complicación relativamente común y que puede llegar a ser muy incapacitante. El tratamiento quirúrgico mediante triple neurectomía es una opción terapéutica ante el fracaso de tratamientos previos (terapia oral, local o neuromodulación).ObjetivoDescripción retrospectiva de la técnica quirúrgica y resultados de la triple neurectomía laparoscópica y con asistencia robótica en el tratamiento de la inguinodinia crónica.Material y métodosSe describen los criterios de inclusión/exclusión, así como la técnica quirúrgica empleada en 7 pacientes intervenidos en el Complejo Asistencial Universitario de León (Servicio de Urología) tras no responder a otras alternativas terapéuticas.ResultadosLos pacientes presentaban dolor crónico inguinal reportando una valoración en la escala EVA del dolor prequirúrgica de 7,43 sobre 10. Tras la cirugía, dicha valoración se redujo a 3,71 al primer día postoperatorio y a 4,2 puntos al año de la intervención. El alta hospitalaria se produjo a las 24h de la cirugía y no se reportaron complicaciones relevantes.ConclusionesLa triple neurectomía laparoscópica o con asistencia robótica es una técnica segura, reproducible y eficaz en el tratamiento del dolor inguinal crónico refractario a otros tratamientos. (AU)

Introduction. Chronic inguinal pain or inguinodynia following hernioplasty is a relatively common complication that can be very incapacitating. Surgical treatment by triple neurectomy is a therapeutic option when previous treatments (oral/local therapy or neuromodulation) have failed.ObjectiveRetrospective description of the surgical technique and results of laparoscopic and robot-assisted triple neurectomy for chronic inguinodynia.Material and methodsWe describe the inclusion/exclusion criteria as well as the surgical technique applied in 7 patients operated on at the University Health Care Complex of León (Urology Department) after failure of other treatment options.ResultsThe patients presented chronic groin pain, reporting a preoperative pain VAS of 7.43 out of 10. After surgery, this score was reduced to 3.71 on the first postoperative day and to 4.2 points one year after surgery. Hospital discharge occurred 24hours after surgery with no relevant complications being reported.ConclusionsLaparoscopic or robot-assisted triple neurectomy is a safe, reproducible, and effective technique for the treatment of chronic groin pain refractory to other treatments. (AU)

Robot-assisted laparoscopic triple neurectomy for chronic inguinal pain: Description of the technique, our experience and preliminary results.

INTRODUCTION: Chronic inguinal pain or inguinodynia following hernioplasty is a relatively common complication that can be very incapacitating. Surgical treatment by triple neurectomy is a therapeutic option when previous treatments (oral/local therapy or neuromodulation) have failed. OBJECTIVE: Retrospective description of the surgical technique and results of laparoscopic and robot-assisted triple neurectomy for chronic inguinodynia. MATERIAL AND METHODS: We describe the inclusion/exclusion criteria as well as the surgical technique applied in 7 patients operated on at the University Health Care Complex of León (Urology Department) after failure of other treatment options. RESULTS: The patients presented chronic groin pain, reporting a preoperative pain VAS of 7.43 out of 10. After surgery, this score was reduced to 3.71 on the first postoperative day and to 4.2 points one year after surgery. Hospital discharge occurred 24 h after surgery with no relevant complications being reported. CONCLUSIONS: Laparoscopic or robot-assisted triple neurectomy is a safe, reproducible, and effective technique for the treatment of chronic groin pain refractory to other treatments.

Estado actual de la actividad y formación académica de residentes y urólogos jóvenes en España. Resultados de una encuesta nacional / Current status of young urologists and residents' activity and academic training in Spain. National survey results

Objetivo: Conocer el estado actual de la actividad y formación académica de los residentes y urólogos jóvenes en España. Material y métodos: Se diseñó una encuesta anónima de 32 preguntas, desde el Grupo de Trabajo de Residentes y Jóvenes Urólogos de la Asociación Española de Urología (RAEU), dirigida a evaluar la actividad académica de los residentes, definida por: número de comunicaciones a congresos, publicaciones en revistas nacionales e internacionales, rotaciones clínicas dentro de España y en el extranjero, realización de máster, doctorado (PhD), aplicaciones para presentar el examen de la European Board of Urology y competencias en idiomas de residentes. La encuesta fue enviada vía email y difundida vía redes sociales. Resultados: Se obtuvieron 91 respondedores; el 66% afirmaron no tener publicaciones en revistas científicas, el 67% no han realizado rotaciones en el extranjero. Solo el 21% afirmaron presentarse al examen EBU. Solo el 2% de los respondedores han realizado un fellowship, aunque la mayoría (82%) no lo han realizado, pero sí estarían interesados. Sin embargo, el 67% de los respondedores opinan que la relevancia de la actividad académica/investigadora es alta a muy elevada. Conclusiones: Los resultados indican que la actividad académica, la producción científica y la publicación de artículos de los residentes y urólogos jóvenes en España es baja. Así también, la participación en el examen EBU, así como la realización de máster, PhD, rotaciones y fellowship, son bajas. Sin embargo, la valoración de la actividad científica es considerada como muy relevante

Objective: To study the current status of the activity and academic training of residents and young urologists in Spain. Material and methods: From the working group of residents and young urologists of the Spanish Association of Urology (AEU), an anonymous survey of 32 questions was designed. Its aim was to evaluate the academic activity of residents, defined by: number of communications to congresses, publications in national and international journals, clinical rotations within Spain and abroad, master's degree, Doctorate (PhD), applications to the European Board of Urology exam and language competences. The survey was sent via email and disseminated through social networks. Results: Ninety-one respondents were obtained; 66% affirmed not having publications in scientific journals, 67% did not perform rotations abroad. Only 21% claimed to have taken the EBU exam. Only 2% of the respondents had completed a Fellowship. Although most of them (82%) had not done so, they would be interested. However, 67% of respondents believed that the relevance of academic/research activity is from high to very high. Conclusions: Our results indicate that academic activity, scientific production and publication of articles of the residents and young urologists in Spain is low. Moreover, participation in the EBU exam, the completion of a master's degree, PhD, rotations and fellowship is low. In contrast, the assessment of scientific activity is considered to be very relevant

Current status of young urologists and residents' activity and academic training in Spain. National survey results. / Estado actual de la actividad y formación académica de residentes y urólogos jóvenes en España. Resultados de una encuesta nacional.

OBJECTIVE: To study the current status of the activity and academic training of residents and young urologists in Spain. MATERIAL AND METHODS: From the working group of residents and young urologists of the Spanish Association of Urology (AEU), an anonymous survey of 32 questions was designed. Its aim was to evaluate the academic activity of residents, defined by: number of communications to congresses, publications in national and international journals, clinical rotations within Spain and abroad, master's degree, Doctorate (PhD), applications to the European Board of Urology exam and language competences. The survey was sent via email and disseminated through social networks. RESULTS: Ninety-one respondents were obtained; 66% affirmed not having publications in scientific journals, 67% did not perform rotations abroad. Only 21% claimed to have taken the EBU exam. Only 2% of the respondents had completed a Fellowship. Although most of them (82%) had not done so, they would be interested. However, 67% of respondents believed that the relevance of academic/research activity is from high to very high. CONCLUSIONS: Our results indicate that academic activity, scientific production and publication of articles of the residents and young urologists in Spain is low. Moreover, participation in the EBU exam, the completion of a master's degree, PhD, rotations and fellowship is low. In contrast, the assessment of scientific activity is considered to be very relevant.

Asthma exacerbations: risk factors for hospital readmissions.

OBJECTIVE: The aim of our study is to analyse hospital readmissions due to asthma, as well as the factors associated with their increase. STUDY DESIGN: We carried out a retrospective study including all admissions of patients over 18 years old due to exacerbation of asthma occurring in our hospital between the years 2000 and 2010. METHODS: The data were gathered by two members of the research team, by reviewing the clinical records. The first hospital admission of each patient was included for this study. An early readmission (ER) was defined as that which occurred in the following 15 days after hospital discharge and late readmission (LR) to that occurring from 16 days after discharge. RESULTS: This study included 2166 hospital admissions and 1316 patients, with a mean age of 62.6 years. Of the 1316 patients analysed, 36 (2.7%) had one ER and 313 (23.8%) one LR. The only factor independently associated with a higher probability of an ER was poor lung function. A higher probability of LR was associated with a greater severity of the asthma (OR: 17.8, for severe asthma versus intermittent asthma), to have had any hospital admission in the previous year (OR: 3.5) and the use of a combination of ICS-LABA as maintenance treatment. CONCLUSIONS: About 25% of the patients in our area admitted to hospital due to asthma exacerbation had repeat episodes of hospitalisation.

Actividad médico-quirúrgica y estado actual de la formación de los residentes de urología en España: Resultados de una encuesta nacional / Medical-surgical activity and the current state of training of urology residents in Spain: Results of a national survey

Objetivos: Conocer el estado actual de la actividad médico-quirúrgica y de la formación de los residentes de urología en España. Material y método: Se diseñaron 2 encuestas anónimas y fueron cargadas en la herramienta Google Docs© para ser contestadas vía online. El periodo de recolección online fue de septiembre de 2015-enero de 2016. Los datos recolectados fueron procesados utilizando el programa estadístico IBM SPSS para Windows, Versión 21.0 y el programa R versión 3.2.3. Resultados: El número de total de respondedores fue de 163. En referencia al número de guardias de presencia física la mayoría de los residentes realizan entre 4 y 6 guardias al mes. Ochenta y cuatro de los encuestados refieren estar menos de 20 horas semanales en quirófano y 43 de estos incluso menos de 10 horas. El 30% de los encuestados no ha realizado ninguna resección transuretral, la mayoría ha realizado al menos una adenomectomía prostática, pero a su vez no ha realizado ningún procedimiento oncológico mayor, ya sea por vía laparoscópica o abierta. En las preguntas destinadas a entrenamiento y cursos de formación encontramos que la mayoría de los residentes entrena laparoscopia en el hospital o en casa. La satisfacción global de la residencia fue valorada en 2,6. En este sentido podría considerarse la satisfacción global como moderada. Conclusiones: Se deberían orientar esfuerzos para estandarizar la adquisición de habilidades quirúrgicas y no quirúrgicas, garantizar el acceso a cursos de formación, establecer un mínimo de intervenciones requeridas por año y lograr una evaluación objetiva de la especialidad

Objectives: To determine the actual state of medical-surgical activity and training for urology residents in Spain. Material and method: We designed 2 anonymous surveys, which were uploaded with the Google Docs© tool so that the respondents could answer the surveys online. The online collection period was September 2015 to January 2016. The collected data were processing using the statistical programme IBM SPSS for Windows, Version 21.0 and the programme R version 3.2.3. Results: The total number of responders was 163. In reference to the number of physically present on-call residents, the majority conducted between 4 and 6 shifts a month. Eighty-four of those surveyed indicated that they were in the operating room less than 20hours a week, and 43 of these even less than 10hours. Thirty percent of those surveyed had not performed any transurethral resection. The majority had performed at least one prostatic adenomectomy, but had not performed any major oncologic procedure, either laparoscopically or openly. In the questions concerning training and training courses, we found that most of the residents trained in laparoscopy at the hospital or at home. The overall satisfaction for the residence was assessed at 2.6. Based on this score, the overall satisfaction could be considered moderate. Conclusions: Efforts should be directed towards standardising the acquisition of surgical and nonsurgical skills, ensuring access to training courses, establishing a minimum of required operations per year and achieving an objective assessment of the specialty

Influencia de las redes sociales en congresos de sociedades y asociaciones urológicas: Resultados del 81° Congreso Nacional de la Asociación Española de Urología / Influence of social networks on congresses of urological societies and associations: Results of the 81th National Congress of the Spanish Urological Association

Objetivo: Medir la actividad en las RRSS durante el 81.° Congreso Nacional de la Asociación Española de Urología (AEU) y compararla con la actividad durante otros congresos de asociaciones urológicas nacionales e internacionales. Materiales y métodos: Se designó y registro el hashtag oficial #AEU16 para el 81.° Congreso Nacional de la AEU en el sitio web Symplur. Se recogieron las siguientes mediciones: número de participantes, número de tweets, tweets por participante, tweets por hora e impresiones. Resultados: El número de participantes en la actividad en RRSS durante el congreso fue de 207. Las mediciones de la actividad en Twitter fueron un total de 1.866 tweets, una media de 16 tweets/hora, 9 tweets por participante y 1.511.142 impresiones. La actividad durante los congresos internacionales seria: AUA annual congress 2016 (impresiones: 28.052.558), EAU annual congress 2016 (impresiones: 13.915.994), USANZ 2016 (impresiones: 4.757.453), SIU annual congress 2015 (impresiones: 1.023.038). La actividad durante los congresos nacionales quedaría registrada de la siguiente manera: Annual Conference of The British Association of Urological Surgeons 2016 (impresiones: 2.518.880), 81.° Congreso Nacional de la AEU (impresiones: 1.511.142), 109e Congrès de l’Association Française d’Urologie (impresiones: 662.828), 67th German Congress of Urology (impresiones: 167.347). Se encontraron 10 publicaciones en Facebook y 2 transmisiones vía Periscope TV relacionadas con #AEU16. Conclusiones: La actividad en RRSS durante el 81.° Congreso Nacional de la AEU ha sido notable según los resultados de este estudio. El uso de las RRSS se ha expandido entre asociaciones, congresos y reuniones científicas urológicas, otorgándoles un carácter global

Objective: To measure social network activity during the 81th National Congress of the Spanish Urological Association (AEU) and to compare it with the activity during other congresses of national and international urological associations. Material and methods: We designed and registered the official hashtag #AEU16 for the 81th National Congress of the AEU on the Symplur website. The following measurements were recorded: number of participants, number of tweets, tweets by participant, tweets per hour and views. Results: The number of participants in the social network activity during the congress was 207. The measurements of activity in Twitter consisted of a total of 1866 tweets, a mean rate of 16 tweets/h, 9 tweets per participant and 1,511,142 views. The activity during the international congresses is as follows: 2016 American Urological Association annual congress (views: 28,052,558), 2016 European Association of Urology annual congress (views: 13,915,994), 2016 Urological Society of Australia and New Zealand (views: 4,757,453), 2015 Société Internationale d’Urologie annual congress (views: 1,023,038). The activity during the national congresses was recorded as follows: 2016 Annual Conference of The British Association of Urological Surgeons (views: 2,518,880), 81th National Congress of the AEU (views: 1,511,142), 109th Congress of l’Association Française d’Urologie (views: 662,828), 67th German Congress of Urology (views: 167,347). We found 10 posts in Facebook and 2 communications via Periscope TV related to #AEU16. Conclusions: The social network activity during the 81th National Congress of the AEU was notable given the results of this study. The use of social networks has expanded among urological associations, congresses and meetings, giving them a global character

Medical-surgical activity and the current state of training of urology residents in Spain: Results of a national survey. / Actividad médico-quirúrgica y estado actual de la formación de los residentes de urología en España: Resultados de una encuesta nacional.

OBJECTIVES: To determine the actual state of medical-surgical activity and training for urology residents in Spain. MATERIAL AND METHOD: We designed 2 anonymous surveys, which were uploaded with the Google Docs© tool so that the respondents could answer the surveys online. The online collection period was September 2015 to January 2016. The collected data were processing using the statistical programme IBM SPSS for Windows, Version 21.0 and the programme R version 3.2.3. RESULTS: The total number of responders was 163. In reference to the number of physically present on-call residents, the majority conducted between 4 and 6 shifts a month. Eighty-four of those surveyed indicated that they were in the operating room less than 20hours a week, and 43 of these even less than 10hours. Thirty percent of those surveyed had not performed any transurethral resection. The majority had performed at least one prostatic adenomectomy, but had not performed any major oncologic procedure, either laparoscopically or openly. In the questions concerning training and training courses, we found that most of the residents trained in laparoscopy at the hospital or at home. The overall satisfaction for the residence was assessed at 2.6. Based on this score, the overall satisfaction could be considered moderate. CONCLUSIONS: Efforts should be directed towards standardising the acquisition of surgical and nonsurgical skills, ensuring access to training courses, establishing a minimum of required operations per year and achieving an objective assessment of the specialty.

Influence of social networks on congresses of urological societies and associations: Results of the 81th National Congress of the Spanish Urological Association. / Influencia de las redes sociales en congresos de sociedades y asociaciones urológicas: Resultados del 81.° Congreso Nacional de la Asociación Española de Urología.

OBJECTIVE: To measure social network activity during the 81th National Congress of the Spanish Urological Association (AEU) and to compare it with the activity during other congresses of national and international urological associations. MATERIAL AND METHODS: We designed and registered the official hashtag #AEU16 for the 81th National Congress of the AEU on the Symplur website. The following measurements were recorded: number of participants, number of tweets, tweets by participant, tweets per hour and views. RESULTS: The number of participants in the social network activity during the congress was 207. The measurements of activity in Twitter consisted of a total of 1866 tweets, a mean rate of 16 tweets/h, 9 tweets per participant and 1,511,142 views. The activity during the international congresses is as follows: 2016 American Urological Association annual congress (views: 28,052,558), 2016 European Association of Urology annual congress (views: 13,915,994), 2016 Urological Society of Australia and New Zealand (views: 4,757,453), 2015 Société Internationale d'Urologie annual congress (views: 1,023,038). The activity during the national congresses was recorded as follows: 2016 Annual Conference of The British Association of Urological Surgeons (views: 2,518,880), 81th National Congress of the AEU (views: 1,511,142), 109th Congress of l'Association Française d'Urologie (views: 662,828), 67th German Congress of Urology (views: 167,347). We found 10 posts in Facebook and 2 communications via Periscope TV related to #AEU16. CONCLUSIONS: The social network activity during the 81th National Congress of the AEU was notable given the results of this study. The use of social networks has expanded among urological associations, congresses and meetings, giving them a global character.

Factors associated with the incidence of serious adverse events in patients admitted with COPD acute exacerbation.

BACKGROUND: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common cause of hospitalization. Patient outcome and prognosis following AECOPD are variable. The aim of this study is to identify the factors associated with the incidence of serious adverse events (SAE), defined as need for ICU admission, noninvasive ventilation, death during hospitalization or early readmission, in those patients admitted with AECOPD. METHODS: We conducted a retrospective study by reviewing the medical records of all patients admitted with AECOPD in the University Hospital Complex of Santiago de Compostela in 2007 and 2008. To identify variables independently associated with SAE incidence, we conducted a logistic regression including those variables which proved to be significant in the univariate analysis. RESULTS: 757 patients were assessed (mean age 74.8 years, SD 11.26), 77.2 % male, and 186 (24.6 %) of the patients assessed experienced an SAE. Factors associated with SAE in multivariate analysis were anticholinergic therapy (OR 3.19; CI 95 %: 1.16; 8.82), oxygen therapy at home (OR 3.72; CI 95 %: 1.62; 8.57), oxygen saturation at admission (OR 0.93; CI 95 %: 0.88; 0.99) and serum albumin (OR 0.26; CI 95 %: 0.1; 0.66). CONCLUSION: Oxygen therapy at home, anticholinergic therapy as baseline treatment, lower oxygen saturation at admission and lower serum albumin level seem to be associated with higher incidence of SAE in patients with AECOPD.

Adaptación al español de las recomendaciones para el uso apropiado de las redes sociales en Urología de la European Association of Urology (EAU) / Spanish adaptation of the recommendations for the appropriate use of social networks in urology of the European Association of Urology

Objetivo: Adaptar a nuestro idioma las recomendaciones para el uso apropiado de las redes sociales (RRSS) en el ámbito urológico elaboradas por la European Association of Urology (EAU). Adquisición de la evidencia: El uso de las RRSS se ha hecho bastante popular en la comunidad urológica internacional. Sin embargo, debido a la naturaleza del contenido médico que se comparte entre profesionales de la salud a través de RRSS, existe el riesgo de ocasionar perjuicios de carácter médico-legal. Por este motivo, diversas asociaciones urológicas internacionales como la American Urological Association, la British Association of Urological Surgeons y la EAU han publicado sus recomendaciones para el uso apropiado de las RRSS. Se ha hecho un esfuerzo por adaptar y resumir a nuestro idioma las recomendaciones de la EAU y publicarlas en ACTAS UROLÓGICAS ESPAÑOLAS(@actasurologicas) revista oficial de la AEU (@InfoAEU) y la CAU (@CAU_URO). Síntesis de la evidencia: Las RRSS incluyen plataformas bien conocidas como Twitter, Facebook o YouTube que indudablemente han cambiado la forma como los humanos nos comunicamos e interactuamos. RRSS ofrece claras ventajas para la comunicación entre profesionales, trabajo en equipo, difusión del conocimiento, creación de perfiles profesionales, y cada vez son más utilizadas por pacientes y profesionales de la salud. La introducción de las RRSS en la comunidad urológica ha generado toda una revolución en la forma en la que se comparten los artículos científicos, se participa en congresos y en como las asociaciones urológicas internacionales se comunican con sus seguidores. Sin embargo, las RRSS representan un entorno abierto al público en general con potenciales riesgos para la confidencialidad y la relación médico-paciente debido a la naturaleza de la información que se comparte. Las presentes recomendaciones incluyen herramientas para la creación del perfil profesional, protección de la confidencialidad, así como para la creación de contenido honesto y responsable. Conclusiones: Las RRSS representan un área fascinante para la comunicación, la diseminación del conocimiento, con gran aplicabilidad en el cuidado de la salud y en la comunidad urológica. Nuevos esfuerzos se están dirigiendo a extender el uso de las RRSS en la comunidad urológica, medir su impacto académico real y estandarizar el lenguaje utilizado

Objective: To adapt to Spanish the recommendations for the appropriate use of social media (SoMe) in the urological setting prepared by the European Association of Urology (EAU). Acquisition of evidence: The use of SoMe has become fairly popular in the international urological community. Due to the nature of the medical content shared among healthcare professionals through SoMe, however, there is the risk of medical and legal problems. For this reason, various international urological associations such as the American Urological Association, the British Association of Urological Surgeons and EAU have published their recommendations for the appropriate use of social media. Efforts have been made to adapt and summarise the recommendations of the EAU in Spanish and to publish them in ACTAS UROLÓGICAS ESPAÑOLAS (@actasurologicas), the official journal of the Spanish Urological Association (@InfoAEU) and the American Confederation of Urology (@CAU_URO). Synthesis of the evidence: SoMe include well-known platforms such as Twitter, Facebook and YouTube, which have undoubtedly changed the way in which people communicate and interact. SoMe offer clear advantages for communicating between professionals, working in teams, disseminating knowledge and creating professional profiles and are increasingly used by patients and healthcare practitioners. The introduction of SoMe in the urological community has started a revolution in how scientific articles are shared, how people participate in congresses and how international urological associations communicate with their followers. However, SoMe is generally an open public setting, with potential risks for confidentiality and the doctor-patient relationship due to the nature of the shared information. The present recommendations include tools for creating professional profiles, protecting confidentiality and creating honest and responsible content. Conclusions: SoMe represents a fascinating area for the communication and dissemination of knowledge, with considerable applicability in health care and the urological community. New efforts are being directed to extend the use of social media in the urological community, measuring its actual academic impact and standardising the language employed

Portfolio as a tool to evaluate clinical competences of traumatology in medical students.

This article investigates whether a reflexive portfolio is instrumental in determining the level of acquisition of clinical competences in traumatology, a subject in the 5th year of the degree of medicine. A total of 131 students used the portfolio during their clinical rotation of traumatology. The students' portfolios were blind evaluated by four professors who annotated the existence (yes/no) of 23 learning outcomes. The reliability of the portfolio was moderate, according to the kappa index (0.48), but the evaluation scores between evaluators were very similar. Considering the mean percentage, 59.8% of the students obtained all the competences established and only 13 of the 23 learning outcomes (56.5%) were fulfilled by >50% of the students. Our study suggests that the portfolio may be an important tool to quantitatively analyze the acquisition of traumatology competences of medical students, thus allowing the implementation of methods to improve its teaching.

Spanish adaptation of the recommendations for the appropriate use of social networks in urology of the European Association of Urology. / Adaptación al español de las recomendaciones para el uso apropiado de las redes sociales en Urología de la European Association of Urology (EAU).

OBJECTIVE: To adapt to Spanish the recommendations for the appropriate use of social media (SoMe) in the urological setting prepared by the European Association of Urology (EAU). ACQUISITION OF EVIDENCE: The use of SoMe has become fairly popular in the international urological community. Due to the nature of the medical content shared among healthcare professionals through SoMe, however, there is the risk of medical and legal problems. For this reason, various international urological associations such as the American Urological Association, the British Association of Urological Surgeons and EAU have published their recommendations for the appropriate use of social media. Efforts have been made to adapt and summarise the recommendations of the EAU in Spanish and to publish them in Actas Urológicas Españolas (@actasurologicas), the official journal of the Spanish Urological Association (@InfoAEU) and the American Confederation of Urology (@CAU_URO). SYNTHESIS OF THE EVIDENCE: SoMe include well-known platforms such as Twitter, Facebook and YouTube, which have undoubtedly changed the way in which people communicate and interact. SoMe offer clear advantages for communicating between professionals, working in teams, disseminating knowledge and creating professional profiles and are increasingly used by patients and healthcare practitioners. The introduction of SoMe in the urological community has started a revolution in how scientific articles are shared, how people participate in congresses and how international urological associations communicate with their followers. However, SoMe is generally an open public setting, with potential risks for confidentiality and the doctor-patient relationship due to the nature of the shared information. The present recommendations include tools for creating professional profiles, protecting confidentiality and creating honest and responsible content. CONCLUSIONS: SoMe represents a fascinating area for the communication and dissemination of knowledge, with considerable applicability in health care and the urological community. New efforts are being directed to extend the use of social media in the urological community, measuring its actual academic impact and standardising the language employed.

Tendencia y distribución municipal de la incidencia de cáncer de vejiga en el área de salud de León (1996-2010) / Municipal distribution and trends in bladder cancer incidence in health area of León, Spain (1996-201

Objetivo: España presenta unas de las tasas más elevadas de incidencia y mortalidad por cáncer de vejiga del mundo. El presente estudio tiene por objeto conocer la incidencia, tendencia y distribución geográfica del cáncer de vejiga en el área de salud de León. Material y métodos: Fueron incluidos los casos nuevos de cáncer de vejiga (CIE-188) del registro hospitalario de tumores del Centro Asistencial Universitario de León, entre 1996-2010 con residencia en el ASL. Se calcularon las incidencias brutas trienales y ajustadas a población mundial y europea. Como denominador se utilizaron los datos del INE de población desagregada por sexo y grupos quinquenales de edad de residentes en municipios del ASL. Para el análisis de la distribución espacial se estimaron los riesgos relativos (RR) municipales suavizados mediante el ajuste del modelo de Besag, York y Mollié y sus probabilidades posteriores de que los RR fuesen > 1 (PP), utilizando métodos bayesianos. Resultados: Se incluyeron 1.573 casos. Las tasas estandarizadas a población europea ascendieron de 20,8 (1996-98) a 33,1 (2006-2008) casos nuevos por 100.000 hombres y de 1,9 a 5,9 en las mujeres. No se observaron diferencias de interés en la distribución municipal de las incidencias. Conclusiones: Las tasas de incidencia observadas son elevadas en el contexto europeo. Se observan tendencias ascendentes en hombres y especialmente relevantes en mujeres

Objective: Spain is a country where bladder cancer incidence and mortality rates are some of the highest in the world. The aim of this study is to know the incidence, trends and geographical distribution of bladder cancer in the health area of León. Material and methods: the new cases of bladder cancer (CIE-188) in patients residing in the health area of León and registered in the Hospital Tumor Registry of the Centro Asistencial Universitario in León (Spain) between 1996-2010 were included in this study. Triennial crude incidence and adjusted incidence rates to the worldwide and European population were calculated. Population data of the municipalities of Leon (Spain) were obtained from National Institute of Statistic of Spain (INE, Instituto Nacional de Estadística). Data were disaggregated by sex-groups and five-year age groups. Spatial distribution of smoothed municipal relative risks (RR) of bladder cancer was carried out using a Besag, York and Mollié model. Bayesian model were used to calculate the posterior probability (PP) of RR greater than one. Results: 1.573 cases were included. Incidence rates standardized to European population increased among men from 20,8/100.000 (1996-98) to 33,1/100.000 (2006-2008) and among women these rates increased from 1,9/100.000 to 5,9/100.000 for the same period of time. No relevant differences were found in the municipal distribution of the incidences. Conclusions: bladder cancer incidence rates are high in the European context. Rising trends in incidence in both sexs, particularly in women are observed

Municipal distribution and trends in bladder cancer incidence in health area of León, Spain (1996-2010).

OBJECTIVE: Spain is a country where bladder cancer incidence and mortality rates are some of the highest in the world. The aim of this study is to know the incidence, trends and geographical distribution of bladder cancer in the health area of León. MATERIAL AND METHODS: the new cases of bladder cancer (CIE-188) in patients residing in the health area of León and registered in the Hospital Tumor Registry of the Centro Asistencial Universitario in León (Spain) between 1996-2010 were included in this study. Triennial crude incidence and adjusted incidence rates to the worldwide and European population were calculated. Population data of the municipalities of Leon (Spain) were obtained from National Institute of Statistic of Spain (INE, Instituto Nacional de Estadística). Data were disaggregated by sex-groups and five-year age groups. Spatial distribution of smoothed municipal relative risks (RR) of bladder cancer was carried out using a Besag, York and Mollié model. Bayesian model were used to calculate the posterior probability (PP) of RR greater than one. RESULTS: 1.573 cases were included. Incidence rates standardized to European population increased among men from 20,8/100.000 (1996-98) to 33,1/100.000 (2006-2008) and among women these rates increased from 1,9/100.000 to 5,9/100.000 for the same period of time. No relevant differences were found in the municipal distribution of the incidences. CONCLUSIONS: bladder cancer incidence rates are high in the European context. Rising trends in incidence in both sexs, particularly in women are observed.

Symptoms, location and prognosis of pulmonary embolism.

BACKGROUND AND OBJECTIVE: Pulmonary embolism (PE) is a common disease with variable symptoms and high overall mortality. The clinical relevance of the extent of PE is still debatable, and the role of anticoagulation in patients with subsegmental involvement has been contested. Our objective is to describe the clinical details of patients with PE in our hospital and to analyze their prognosis based on the extent of the disease. MATERIALS AND METHODS: Retrospective study of 313 patients diagnosed with PE by chest computed tomography (CT) scan at the Hospital Complex of Pontevedra in Spain for six years. Predictors of mortality were determined by multivariate analysis. RESULTS: Women accounted for 56% of patients, and patient median age was 70 years (interquartile range 53-78 years). Subsegmental PE accounted for 7% of all cases; these patients were younger and had lower comorbidity; they reported chest pain more often, performed better in blood gas analysis and none of them had proximal deep vein thrombosis (DVT). Patients with subsegmental PE had a higher survival rate. Factors independently associated with mortality were cancer diagnosis and higher comorbidity. CONCLUSIONS: Patients with subsegmental PE clinically differ from those with more proximal PE. Underlying diseases have more influence on the prognosis than the extent of the disease.

Timeliness of care and prognosis in patients with lung cancer.

BACKGROUND: Timeliness of care is an important dimension of health care quality. The determining factors of less timely care and their influence on the survival of patients with lung cancer (LC) remain uncertain. AIMS: To analyse the delays in the diagnosis and treatment of LC in our health area, the factors associated with the timeliness of care and their possible relationship with the survival of these patients. METHODS: A retrospective study was conducted on all patients with a cytohistologically confirmed diagnosis of LC between 1 June 2005 and 31 May 2008. The time delays for consultation (specialist delay), diagnosis (diagnosis delay), and treatment (treatment delay), were analysed, as well as the factors associated with these delays and the influence of the timeliness of care on survival. RESULTS: A total of 307 cases were included (87 % males). The mean specialist delay was 53.6 days (median 35 days), diagnosis delay 31.5 days (median 18 days), treatment delay 23.5 days (median 14 days). The greater age of the patient and a more advanced stage were associated with a shorter specialist delay. Male sex, a more advanced stage, and poor general status were associated with a shorter treatment delay. The survival is longer in patients with a longer treatment delay. CONCLUSIONS: The delay in the diagnosis in our population seems to be excessively long. The greater the age, a more advanced tumour stage, male sex, and poor general health status are associated with shorter delays. A longer treatment delay is associated with a longer survival.

[Lung cancer in the Pontevedra health area: incidence, clinical presentation and survival]. / Cancer de pulmon en el area sanitaria de Pontevedra: incidencia, presentación clinica y supervivencia.

BACKGROUND: To describe the clinical and epidemiological characteristics, and survival of patients with lung cancer (LC) in the Pontevedra Health Area. METHODS: A retrospective observational study was conducted on all patients with a diagnosis of LC in the Pontevedra Hospital Complex (CHOP) health area over a three-year period. The data recorded included, age, gender, smoking history, comorbidity, functional status, diagnostic method, histology type, stage, treatment received, and survival. The patients were followed up for 3 years. RESULTS: A total of 358 cases of LC were included in the study, which gave a crude incidence rate adjusted to the standard European population of 37.33/100,000 inhabitants/year in males and 4.88/100,000 inhabitants/year in females. The large majority were males (87%). The mean age was 68.7 years, and 82% were smokers or ex-smokers. The most common histology type was epidermoid, with 35.2% of the cases. The diagnosis was made in stages III-B or IV in 79% of cases. Chemotherapy was the first treatment in 53% of the cases. Survival after the first year was 25%, which decreased to 4% at the third year. CONCLUSIONS: The incidence of LC in our health area continues to be mainly in male smokers, although the incidence in females and in people who never smoked is higher than in other populations in our country. It is diagnosed in the advance stages of the disease, and survival is poor.

Cáncer de pulmón en el área sanitaria de Pontevedra: incidencia, presentación clínica y supervivencia / Lung cancer in the Pontevedra health area: incidence, clinical presentation and survival

Fundamento. Describir las características clínicas, epidemiológicas y supervivencia de los pacientes con cáncer de pulmón (CP) en el área sanitaria de Pontevedra. Material y métodos. Se realizó un estudio observacional, retrospectivo, incluyendo todos los pacientes con diagnóstico de CP en el área sanitaria del Complexo Hospitalario de Pontevedra(CHOP), incluyendo todos los casos diagnosticados en un período de 3 años. De cada paciente se incluyeron edad, sexo, tabaquismo, comorbilidad, estado funcional, método diagnóstico, tipo histológico, estadio, tipo de tratamiento y supervivencia. Los pacientes fueron seguidos durante 3 años Resultados. Se incluyeron en el estudio un total de 358 casos de CP, lo cual supone una tasa cruda de incidencia ajustada a la población europea estándar de 37,33/100.000 habitantes/año en varones y de 4,88/100.000 habitantes/año en mujeres. El 87%fueron varones, de 68,7 años de edad media, el 82% fumadores o exfumadores. El tipo histológico más frecuente fue el epidermoide, con el 35,2% de los casos. En el 79% de los casos se realizó el diagnóstico en estadios III-B o IV. La quimioterapia fue el primer tratamiento en el 53% de los casos. La supervivencia al primer año es del 25%, que se reduce al 4% al tercer año. Conclusiones. La incidencia de CP en nuestra área sanitaria sigue predominando en varones fumadores, aunque la incidencia en el sexo femenino y en nunca fumadores es superior a otras poblaciones de nuestro entorno. El diagnóstico se lleva a cabo en fases avanzadas de la enfermedad y la supervivencia es pobre (AU)

Backgroud. To describe the clinical and epidemiological characteristics, and survival of patients with lung cancer (LC) in the Pontevedra Health Area. Methods. A retrospective observational study was conducted on all patients with a diagnosis of LC in the Pontevedra Hospital Complex (CHOP) health area over a three-year period. The data recorded included, age, gender, smoking history, comorbidity, functional status, diagnostic method, histology type, stage, treatment received, and survival. The patients were followed up for 3 years. Results. A total of 358 cases of LC were included in the study, which gave a crude incidence rate adjusted to the standard European population of 37.33/100,000 inhabitants/year in males and 4.88/100,000 inhabitants/year in females. The large majority were males (87%). The mean age was68.7 years, and 82% were smokers or ex-smokers. The most common histology type was epidermoid, with 35.2% of the cases. The diagnosis was made in stages III-B or IV in 79% of cases. Chemotherapy was the first treatment in 53% of the cases. Survival after the first year was 25%, which decreased to 4% at the third year. Conclusions. The incidence of LC in our health area continues to be mainly in male smokers, although the incidence in females and in people who never smoked is higher than in other populations in our country. It is diagnosed in the advance stages of the disease, and survival is poor (AU)

Influence of pollen level on hospitalizations for asthma.

The effect of pollen level on asthma hospitalizations is still under debate. The aim of this study was to analyze hospital admissions due to asthma and its relation with environmental pollen and meteorological factors. During 13 years, we included every patient admitted with asthma as primary or secondary diagnosis. For this purpose, we used a case-crossover analysis to compare pollen concentrations at the time of admission with values of the same variables 2 to 6 days before admission. We included 6,687 hospital admissions. High maximum temperature and low humidity were associated with lower risk of asthma admissions. High mean pollen levels exerted a moderate effect and high maximum pollen levels led to a dramatic increase of hospital admissions due to asthma, especially among females. In conclusion, environmental pollen level increases the risk of asthma hospital admissions.