National surveillance pilot study unveils a multicenter, clonal outbreak of VIM-2-producing Pseudomonas aeruginosa ST111 in the Netherlands between 2015 and 2017.

Verona Integron-encoded Metallo-beta-lactamase (VIM) is the most frequently-encountered carbapenemase in the healthcare-related pathogen Pseudomonas aeruginosa. In the Netherlands, a low-endemic country for antibiotic-resistant bacteria, no national surveillance data on the prevalence of carbapenemase-producing P. aeruginosa (CPPA) was available.

Mortality associated with carbapenem-susceptible and Verona Integron-encoded Metallo-β-lactamase-positive Pseudomonas aeruginosa bacteremia.

Background: Studies on various Gram-negative bacteria suggest that resistance to carbapenem antibiotics is responsible for increased mortality in patients; however, results are not conclusive. We first assessed the 28-day in-hospital all-cause mortality in patients with Verona Integron-encoded Metallo-β-lactamase-positive Pseudomonas aeruginosa (VIM-PA) bacteremia compared to patients with VIM-negative, carbapenem-susceptible P. aeruginosa (CS-PA) bacteremia.

Mortality related to Verona Integron-encoded Metallo-β-lactamase-positive : assessment by a novel clinical tool.

Background: Verona Integron-encoded Metallo-β-lactamase-positive (VIM-PA) can cause nosocomial infections and may be responsible for increased mortality. Multidrug resistance in VIM-PA complicates treatment. We aimed to assess the contribution of VIM-PA to mortality in patients in a large tertiary care hospital in the Netherlands.

An unusual case of congestive heart failure in the Netherlands.

Introduction: Chagas disease is caused by infection with the protozoan It is endemic to the American continent due to the distribution of its insect vectors. The disease is occasionally imported to other continents by travel of infected individuals. It is rarely diagnosed in the Netherlands and exact numbers of infected individuals are unknown.

Program for laparoscopic urologic skills: a newly developed and validated educational program.

Objective: To develop and evaluate a program for laparoscopic urologic skills (PLUS) to determine the face, content, and construct validation to achieve uniformity and standardization in training residents in urology.

Methods: The PLUS consists of 5 basic laparoscopic tasks. Three tasks were abstracted from the Fundamentals of Laparoscopic Surgery program, and 2 additional tasks were developed under continuous evaluation by expert urologists.

A simulator for teaching transrectal ultrasound procedures: how useful and realistic is it?

Introduction: : We describe a new simulator for teaching transrectal ultrasound (TRUS) and present the results of a preliminary evaluation of the simulator's realism and usefulness for training.

Methods: : A simulator for abdominal ultrasound was adjusted by the developer to enable simulation of TRUS by providing an opening for inserting a dummy rectal probe. To enable TRUS simulation, data from ultrasound prostate imaging of eight real patients obtained with our regular ultrasound machine were transferred to the simulator by connecting the computer of the simulator to the ultrasound machine.

The effect of a low-fidelity model on cystoscopic skill training: a single-blinded randomized controlled trial.

Introduction: Models for training urological procedures without burdening patients are available at varying costs. We examined the value of training on a low-fidelity model in addition to training on a high-fidelity simulator in a cystoscopy training program.

Methods: Thirty-two medical students were randomized to an intervention and a control group.

Effect of distraction on the performance of endourological tasks: a randomized controlled trial.

Objective: • To establish the effect of distraction on the performance of cystoscopy and basic endourological tasks by using a virtual reality (VR) simulator.

Subjects And Methods: • A total of 86 third-year medical students from Maastricht University, who had no previous experience in performing the tasks on a VR simulator, were randomly assigned to an intervention or control group. • All participants performed three endourological tasks on the VR simulator.

The effect of distractions in the operating room during endourological procedures.

Background: Professionals working in the operating room (OR) are subject to various distractions that can be detrimental to their task performance and the quality of their work. This study aimed to quantify the frequency, nature, and effect on performance of (potentially) distracting events occurring during endourological procedures and additionally explored urologists' and residents' perspectives on experienced ill effects due to distracting factors.

Methods: First, observational data were collected prospectively during endourological procedures in one OR of a teaching hospital.

Analysis of pitfalls encountered by residents in transurethral procedures in master-apprentice type of training.

Background And Purpose: Today's simulators are frequently limited in their possibilities to train all aspects of endourological procedures. It is therefore indicated to first make an inventory of training needs before (re)developing simulators. This study examined pitfalls encountered by residents in real-time transurethral procedures.