RESUMEN
BACKGROUND: Diabetes and urological diseases are widespread health problems, whose incidence increases with age. The aim of this observational, retrospective study was to analyze the particularities of urinary disorders, which appeared in patients with diabetes, admitted in a urology ward. MATERIAL AND METHODS: A total of 6910 patients admitted in "Th. Burghele" Hospital from January 2013 to July 2014 were analyzed. Only admissions in urology wards and the first hospitalization of the patient were elements that were taken into account. Data was taken from the Hipocrate medical information system and Easy Medical Pro laboratory medical software. Study variables were age and sex of patients, the main discharge diagnosis, the number of days of hospitalization and the laboratory analyses collected on the day of admission. The data of the whole lot was analyzed and then an analysis on subgroups of patients was done. RESULTS: There were 16.52% (n=1142) patients with diabetes in the total group of analyzed patients. Urinary stones were the most frequent cause of hospitalization, both in patients with diabetes and in patients without diabetes (28.5%, respectively 37.5%). The average age was 60.01 years and the mean duration of hospitalization was 6.52 days. Patients with diabetes hospitalized for urinary stones, renal cancer, and infectious pathology were significantly older than patients without diabetes. The presence of diabetes prolonged hospitalization in the case of patients with kidney stones, kidney cancer and in those with infectious pathology. The most common malignancy was bladder cancer in both groups of patients. Malignancies were more common in diabetics (19.08% vs. 15.98%) and diabetes was a risk factor for malignancy in our study. In particular, patients with diabetes had a significantly increased risk of bladder cancer. In the analyzed group, diabetes was positively associated with prostate adenoma, genital infections, and prostate infections. CONCLUSIONS: Diabetes increased the risk for certain urological diseases (bladder cancer, prostate adenoma, prostate and genital infections), it prolonged hospitalizations, and it was associated with certain features of laboratory analysis (leukocytosis, decreased glomerular filtration rate).
Asunto(s)
Diabetes Mellitus/epidemiología , Hospitalización , Enfermedades Urológicas/complicaciones , Enfermedades Urológicas/epidemiología , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de TiempoRESUMEN
INTRODUCTION: Over the past years, there has been an increasing interest in involving the cancer patients in the decision making regarding the therapy management due to several factors. The most important aspect to be taken into consideration is the principle of patient autonomy. More and more patients have become interested in making informed decisions regarding their therapy options and physicians need to be able to provide data on the aspect. Some patient-physician models have been proposed and used for 40 years now. Still, the debate is very important for most of the physicians due to the shifts in the approach. MATERIALS AND METHODS: To really express the concerns that the authors address, the case of a head and neck cancer patient and the possible dialogues with the physician were presented. Each type of communication model with the patient is very important because nowadays, intrications between the four are likely to occur. There are legal aspects that need to be taken into consideration such as the informed consent, the ethical and moral aspects. CONCLUSIONS: The possibility of individualized oncological therapy for the cancer patient leads to different decisions for both the patient and the physician. The decision making process involves the patient at different levels. Legal implications tend to affect the healthiness of the dialogue between the physician and the cancer patient and might be a key-point in the further development of the ethical aspects.