[Surgical wound infection in urological patients. a four-year review]. / Infección de herida quirúrgica en pacientes urológicos. Revisión de los casos registrados en cuatro años.

INTRODUCTION: Surgical site infection (SSI) is a constant concern for health care professionals. OBJECTIVE: To ascertain the accumulated incidence (CI) rates of SSI, overall and by surgical procedure, at our department of urology, and to find areas for improvement. MATERIALS AND METHODS: A retrospective and analytical study was conducted (January 2004/December 2007) of 91 patients. Variables examined included age, sex, mean hospital stay, diagnosis, surgical procedure, infection site, organism, and department and hospital rates. Procedures performed in more than 2 patients were analyzed. Patients with SSI caused by an infectious condition were excluded. A descriptive statistical analysis, comparison of percentages, Chi-square test were performed as appropriate. RESULTS: Eighty-five males and 6 females with a mean age of 64.3+/-13.6 years were analyzed. The AI rate for the department was 1.99%, lower than for the rest of the hospital. Mean hospital stay was 22.4+/-17.9 days. According to the CDC criteria, there were 56 superficial (61.5%), 10 deep (10.9%) and 25 organ/space (27.4%) infections. Cultures were performed in 54infections (59.4%, lower than the hospital rate). Fifty percent of cultures were positive. Very high rates were found in cystectomy (25, 26.04%), adenomectomy (21, 16.00%) and urethroplasty (4; 10.26%), while the rates found for other procedures were lower than reported in the literature. CONCLUSIONS: Our overall SSI rates were similar to those of other urology departments and lower than the hospital rate. SSI rates in adenomectomy were very high and a study should be conducted to find areas for improvement. SSI rates in cystectomy were also very high, in agreement with previous reports, and must also be improved, as well as the percentage of wound cultures.

[Impact of Spanish-language urological publications in periodicals in the English language]. / Impacto de las publicaciones urológicas en lengua española en revistas en lengua inglesa.

OBJECTIVE: A study was conducted to analyze the impact of the articles published by Spanish authors in the English language urological journals and those published in Spanish journals in the bibliography referenced in the English language urological literature. METHODS: We randomly analyzed volumes 147, 39 and 69 of the Journal of Urology, Urology and the British Journal of Urology, respectively. All articles in the foregoing volumes were reviewed and analyzed as follows: sections, country, no of references, no of Spanish publications referenced, no of references of Spanish publications and the number of Spanish references cited in these. RESULTS: 356 articles were published in the Journal of Urology: of these, 59% were by American and only 6 (1.68%) were by Spanish authors, which ranked 8th according to number. These 6 articles by Spanish authors cited 84 references; of these, only 3 were Spanish publications. Overall, there were 6,708 references (mean 18.8); 6 (0.11%) were articles published by Spanish authors. In Urology, 140 articles were published: of these, 75% were by American and only one (0.71%) by Spanish authors, which ranked 6th according to number. This article by Spanish authors cited 38 references; of these, only 3 were Spanish publications. Overall, there were 2,055 references (mean 14.6); only 8 (0.38%) were articles published by Spanish authors. In the British Journal of Urology, 177 articles were published: of these, 96 (54.2%) were by British authors and only one (0.56%) by Spanis authors, which ranked 9th according to number. This article by Spanish authors cited 11 references; none of them were Spanish publications. Overall, there were 1,988 references (mean 11.2); 14 (0.7%) were articles published by Spanish authors. CONCLUSION: Spanish authors are not worse off than those of other neighbouring countries in regard to the number of articles published (1.18%) in the three journals analyzed, where most of the articles were chiefly by American or British authors. Spanish publications have no impact in the English-speaking countries, although the number of Spanish publications has been slowly but steadily growing and currently account for 1.21% of the publications worldwide: 41.5% of these are referenced in the Science Citation Index and the Uro-Andrological publications rank 6th (4.2%). Moreover, when Spanish authors are able to publish articles in the English-language journals, they rarely reference Spanish publications. However, in proportion, these have more impact than the Spanish publications. The current trend in the prevalence of the English language in the scientific field is probably the cause of the nonexistent impact outside Spain, where they are hardly-read by the Spanish-speaking communities. The foregoing situation is further assisted by the fact that indexing is also done in the English language. Spanish authors are encouraged to increase the number of Spanish publications referenced, particularly those publishing articles in the foreign journals.

[Do patients want to know the truth of their disease? Study on urologic patients]. / Desean los pacientes conocer la realidad de su enfermedad? Estudio en pacientes urológicos.

Presentation of a study, based on a survey conducted among urology patients on the extend of their wish to know the truth of their illness. The results indicate that the majority of patients DO want to know the truth, although such option is mediated by many environmental factors (such as age, sex, place of residence, education level, etc.). Some remarks are made on the lack of literature on the subject and the belief that awareness of this fact may be useful in the currently difficult physician-patient relationship.

[Utilization of a continuing care center by the child population, assessing the need of care delivered by pediatricians]. / Utilización de un punto de atención continuada por la población infantil, valorando la necesidad de atención prestada por pediatras.

OBJECTIVE: To discover the paediatric demand at a child health clinic (CHC) and its hourly spread. Based on this, to see if the attendance of paediatricians is justified during the hours covered by the CHC. To evaluate, too, whether consumers properly use the CHC. DESIGN: Descriptive, crossover, non-random study. SETTING: Primary Care. PARTICIPANTS: All children under 14 attended at Soria's urban Primary Care centre between 31 January and 31 March, 1991, by the paediatricians and general practitioners. MEASUREMENTS AND MAIN RESULTS: Paediatricians attended 49.8% of the consultations, which covered 17.7% of the weekly opening-time. Nine per cent of children were breast-fed. The most common reasons for attending were: temperature (48%) and cough (20%). The most common diagnoses were tonsillitis (29.4%), Acute Respiratory Infection (16%) and otitis (12.3%). Emergency treatment was given in 4.5% of cases. Prescriptions were given for 94.7% of cases and 1.6% were referred to hospital. CONCLUSIONS: Paediatric demand is to a high degree occasioned by infectious, respiratory and ENT conditions. The proportion of referrals to hospital and the application of treatment in the Primary Care centre indicate insufficient use by the consumer. On the basis of the present study, we are unable to determine whether the presence of paediatricians is justified or not.

[Postoperative sclerosis of the bladder neck: surgical treatment]. / Aportaciones al conocimiento de la esclerosis post-operatoria del cuello vesical: tratamiento quirúrgico.

We analyzed the results of surgical treatment of vesical neck sclerosis in 81 patients who underwent 97 procedures. Most of these patients had post-operative sclerosis of the vesical neck. The different surgical techniques and their results are reviewed. Excision of the sclerotic tissue by transurethral encircling resection has been the most widely used and has achieved better results. It is frequently necessary, however, to use it together with other complementary techniques such as retrograde resection, knife incision, or combined procedures. Knife incision of the diaphragm has achieved the worst results. Overall, the results have been poor (approximately 36% poor results). The results achieved by these procedures are even worse (75% poor results) in recurrence.

[Postoperative sclerosis of the bladder neck: pathogenic mechanisms]. / Aportaciones al conocimiento de la esclerosis post-operatoria del cuello vesical: mecanismos patogénicos.

A study was conducted in 69 patients with postoperative sclerosis of the vesical neck to analyze the different pathogenic mechanisms that have been put forward. This complication, however, could not be ascribed to any underlying cause. It presents in patients who undergo surgery of the prostate early, when their adenoma is generally small and frequently with inflammatory lesions as those of chronic prostatitis. Surgery appears to be the triggering mechanism in these patients who are likely to be predisposed to developing this condition as some patients are predisposed to develop keloid from cicatricial hypertrophy.