Normal values and determinants of urogenital tract (dys)function in older men: The Krimpen Study

Although symptoms of the lower urogenital tract are common and bothersome in older men,H it seems that only a small percentage of men visit their general practitioner for these symptoms.4•5 With the ageing of the population, the number of men consulting their physician will increase significantly, with a related demand on health care resources. There are various guidelines for the evaluation and treatment of such symptoms,6•8 but these all suffer from a common drawback: in the evaluation of lower urogenital tract symptoms physicians are still hampered by a lack of consensus on definitions and normal values, by a lack of insight into their natural history and, consequently, by the lack of unambiguous diagnostic and therapeutic tools. This thesis addresses some of these problems by applying basic epidemiologic research methods to the following topics. The main research questions addressed in this work are: 1. What is the prevalence of LUTS in the Dutch community? 2. What is the prevalence and incidence of clinical benign prostatic hyperplasia, according to different definitions? 3. What are the normal values for the various components of lower urinary tract function, such as nocturnal and diurnal voiding frequency, urine production patterns, nocturnal urine production, average and functional bladder capacity, 24-hour voided volumes, prostate size, uroflowmetry and post void residual urine volumes? 4. What are appropriate definitions of abnormality for these parameters, especially in relation to LUTS or other conditions? 5. What is the natural history of LUTS, clinical benign prostatic hyperplasia and other urogenital tract parameters? 6. What is the prevalence and incidence of erectile and ejaculatory dysfunction? 7. What are the main determinants of these conditions? 8. What is the relation between LUTS and erectile and ejaculatory dysfunction? 9. What is the prevalence of sexual activity in relation to erectile and ejaculatory dysfunction? 10. How do LUTS and erectile and ejaculatory dysfunction relate to health status, separately and in conjunction with other medical conditions and sociodemographic factors? To address these questions, the Krimpen Study on male urogenital tract dysfunction and general wellbeing is being conducted

Telemonitoring for patients with COVID-19: recommendations for design and implementation

Despite significant efforts, the COVID-19 pandemic has put enormous pressure on health care systems around the world, threatening the quality of patient care. Telemonitoring offers the opportunity to carefully monitor patients with a confirmed or suspected case of COVID-19 from home and allows for the timely identification of worsening symptoms. Additionally, it may decrease the number of hospital visits and admissions, thereby reducing the use of scarce resources, optimizing health care capacity, and minimizing the risk of viral transmission. In this paper, we present a COVID-19 telemonitoring care pathway developed at a tertiary care hospital in the Netherlands, which combined the monitoring of vital parameters with video consultations for adequate clinical assessment. Additionally, we report a series of medical, scientific, organizational, and ethical recommendations that may be used as a guide for the design and implementation of telemonitoring pathways for COVID-19 and other diseases worldwide.Cardiolog