Factors Associated with Urethral and Bladder Neck Stricture After Transurethral Resection of the Prostate.

Introduction: Urethral and bladder neck stricture (U/BNS) is a complication that occurs in up to 9% of patients following transurethral resection of the prostate (TURP). The most relevant risk factors reported are prolonged surgical duration and prostatic volume. The purpose of this study is to analyze risk factors associated with the development of U/BNS following TURP. Materials and Methods: Case-control study. Population: patients who underwent TURP. Cases: patients with U/BNS following TURP, diagnosed between January 2010 and December 2018. We included patients with obstructive symptoms after TURP with clinical or radiographical evidence of U/BNS. Controls were patients who underwent TURP between January 2016 and December 2017, without evidence of stricture. Patients with history of pelvic fracture and previous U/BNS were excluded. We analyzed as risk factors age, prostatic volume, diabetes mellitus, previous use of transurethral catheter, urinary tract infection, bladder calculi, prostate cancer, previous TURP, resection time, resected volume during TURP, transoperative complications, and number of surgical procedures performed during the same event. We used chi-square or Mann-Whitney's U test for between-group comparison; association was established by odds ratios (ORs) and 95% confidence interval (CI), variables with p < 0.05 were included in the logistic regression. Results: We included 101 cases and 207 controls. Cases had lower incidence of prostate cancer, smaller prostates, less resection time during TURP, lower grams resected and prostate-specific antigen values than controls. History of transurethral catheter was more frequent in controls than cases (46% vs 29%, p = 0.004); there were no differences between groups in the other factors analyzed. On multivariate analysis, the use of a transurethral catheter was a protective factor against U/BNS (OR 0.16, 95% CI 0.064-0.442, p < 0.001). Conclusions: In this study, the use of urethral catheter before TURP is a protective factor against U/BNS.

[Prevalence of type 2 diabetes mellitus in elderly patients and associated factors in a general hospital of the north of Mexico]. / Prevalencia de diabetes mellitus de tipo 2 y factores asociados en la población geriátrica de un hospital general del norte de México.

UNLABELLED: There are few reports on the impact of diabetes in the geriatric population. OBJECTIVE: To determine the prevalence of diabetes in the geriatric population in a hospital in Northeast Mexico. DESIGN: A cross-sectional study and a probabilistic sampling were made. The files of outpatients of the geriatrics department in a General Hospital in Monterrey, Mexico,were examined. The information obtained from these files was related to the patient's personal pathological and non-pathological background, besides a full geriatric evaluation. RESULTS: A total of 171 files were examined, out of which 97 (56.7%) belonged to females and 74 (43.3%) to males. The mean age was 78 ± 6.9 years. Diabetes was found in 76 patients (44%), major depression was found in 85 patients (50%), with the latter being more common in diabetic patients (p = 0.002). It was also found that diabetic patients take more drugs during their disease. Adjusting for age, gender, and academic level, cognitive impairment was found in 110 patients (64.3%). CONCLUSIONS: Diabetes mellitus is more frequent in the geriatric population and it uses more resources.

[Critical reading ability in research during medical internship]. / Lectura crítica de investigación en el internado de pregrado en hospitales generales.

OBJECTIVE: To evaluate level of development that medical interns achieve, before graduating, in critical reading ability during their internship in five general hospitals. MATERIAL AND METHODS: During the academic year, we compared the initial and final scores of critical reading of medical interns before graduation in five general hospitals in IMSS. An instrument using 98 items that explored interpretation, judgment and proposal was developed and validated by four medical education researchers. In hospitals 1, 4, and 5, professors developed active-participative strategies related to critical reading in clinical research. In Hospital 2, no course was given and in Hospital 3, a traditional course (mainly clinical exposure) was offered. RESULTS: The final global scores were better for those students in Hospitals 1, 4 and 5 versus Hospitals 2 and 3 (median: 31, 29, 31 versus 9 and 24) (Kruskal-Wallis < 0.05). Initial and final differences in global and interpretation, judgment and proposal were also better in those same students. CONCLUSIONS: Active-participative educational strategies may develop the ability for critical reading of clinical research in internship and these strategies must be included in the curriculum during internship.