Zika virus infection during pregnancy is now known to cause congenital microcephaly and severe brain defects. In 2016, rates of microcephaly appeared to start increasing around May, peaking in July, and declining through December. The occurrence of microcephaly appears to have increased nearly 4-fold in 2 large cities in Colombia, concurrently with the reported Zika virus epidemic in the country.
Objectives Patients undergoing retropubic radical prostatectomy (RRP) may suffer from lower urinary tract symptoms (LUTS). We aim to characterize LUTS and to evaluate the correlation and agreement between uroflowmetry and the International Prostate Symptom Score (IPSS) in patients after RRP in two reference centers.
Methods An observational multicenter prospective study was conducted between December 2015 and September 2016. Patients with at least 12-months of follow-up after RRP were included; these were evaluated with uroflowmetry and the IPSS.
Results A total of 90 patients were included. The mean follow-up was of 54.6 months (standard deviation [SD] = 27.52), and the mean age was 65 (SD = 6.85) years old. The mean IPSS was 7.41 (SD = 6.29), with 33.3% (n = 54) of the patients with moderate symptoms and 6.7% (n = 6) with severe symptoms. A total of 50% (n = 45) of the patients had normal uroflowmetry. Patients with an abnormal/equivocal result in the uroflowmetry had a mean of 9.31 (SD = 7.03) points in the IPSS versus 5.51 (SD = 4.82) in patients with a normal uroflowmetry result (p < 0.01). The level of agreement between mild versus moderate-to-severe LUTS and normal uroflowmetry versus abnormal/equivocal was 61.1% (k = 0.22, p = 0.04). We found that a score ≥ 10 in the IPSS had a level of agreement of 65.6% (k = 0.31, p = 0.0004).
Conclusions We consider that although the IPSS cannot replace uroflowmetry and vice versa, these tests are complementary and may be useful tools in the evaluation of patients with LUTS after RRP.
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What is ‘medicine’? To answer this question, published definitions or conceptualizations were sought through adapted search strategies of Google Scholar, Medline, Embase, and the Cochrane Database of Systematic Reviews; Top-11 English dictionaries; and the websites of top-ranked medical schools, all 113 members of the World Medical Association, the US Institute of Medicine, the World Federation for Medical Education and the World Health Organization up to March 2020. Three articles in scholarly journals, all of the dictionaries and none of the medical schools, associations, or institutions provided a definition or conceptualization. No source described a systematic, replicable process to capture the meaning of ‘medicine’. Bold, systematic, and replicable initiatives are needed to fill this gap, as a means to guide the contributions of the medical profession, governments, academia, and corporations; to separate medicine from other professions, and to clarify its role in the creation and preservation of health beyond the chemical-mechanical view of patients and their diseases as humanity goes through the COVID-19 pandemic and enters ‘the next normal’.
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