External validation of the T.O.HO. score as predictor of success after retrograde intrarenal surgery

Abstract Background To assess the effectiveness of T.O.HO. (Tallness, Occupied lesion, Houndsfield unit evaluation) score in predicting the retrograde intrarenal surgery (RIRS) success and to validate this scoring system. Methods The age, sex, previous stone surgery, hospitalization, surgery duration, postoperative complication, stone length, stone location, stone density, stone number, lateralization, presence of hydronephrosis, and presence of preoperative stent datas of 518 patients who underwent RIRS in our clinic between January 2013 and January 2021 were retrospectively assessed. The patients were divided into two groups as successful and unsuccessful. The T.O.HO scores of all patients were calculated. Results The success rate was 72.5%. Compared to the unsuccessful group, stone length and stone density were lower, surgery duration was shorter and there were less lower pole stones in the successful group (p<0.001). No significant difference was found between the two groups in terms of the other parameters. The T.O.HO. score was significantly lower in the successful group compared to the unsuccessful group (p<0.001). According to the multivariate logistic regression analysis, stone length (OR: 0.905; 95% Cl: 0.866-0.946; p<0.001), lower pole location (OR: 0.546; 95% Cl: 0.013-0.296; p<0.001), stone density (OR: 0.999; 95% Cl: 0.998-1; p=0.044) and the T.O.HO. score (OR: 0.684; 95%Cl: 0.554-0.844; p<0.001) were found as the independent risk factors for RIRS success. ROC curve analysis showed that the T.O.HO. score could predict the RIRS success with 7.5 cut-off point (AUC:0.799, CI: 0.76–0.839; p<0.001). Conclusion The T.O.HO. score can predict RIRS success with a high rate of accuracy.

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External validation of the R.I.R.S. scoring system to predict stone-free rate after retrograde intrarenal surgery

BMC Urology ◽

10.1186/s12894-021-00801-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Cong Wang ◽

ShouTong Wang ◽

Xuemei Wang ◽

Jun Lu

Keyword(s):

Scoring System ◽

Kidney Stone ◽

Medical Center ◽

External Validation ◽

Retrograde Intrarenal Surgery ◽

Stone Burden ◽

Stone Free Rate ◽

Stone Density ◽

Free Rate ◽

Free Status

Abstract Background The R.I.R.S. scoring system is defined as a novel and straightforward scoring system that uses the main parameters (kidney stone density, inferior pole stones, stone burden, and renal infundibular length) to identify most appropriate patients for retrograde intrarenal surgery (RIRS). We strived to evaluate the accuracy of the R.I.R.S. scoring system in predicting the stone-free rate (SFR) after RIRS. Methods In our medical center, we retrospectively analyzed charts of patients who had, between September 2018 and December 2019, been treated by RIRS for kidney stones. A total of 147 patients were enrolled in the study. Parameters were measured for each of the four specified variables. Results Stone-free status was achieved in 105 patients (71.43%), and 42 patients had one or more residual fragments (28.57%). Differences in stone characteristics, including renal infundibulopelvic angle, renal infundibular length, lower pole stone, kidney stone density, and stone burden were statistically significant in patients whether RIRS achieved stone-free status or not (P < 0.001, P: 0.005, P < 0.001, P < 0.001, P: 0.003, respectively). R.I.R.S. scores were significantly lower in patients treated successfully with RIRS than patients in which RIRS failed (P < 0.001). Binary logistic regression analyses revealed that R.I.R.S. scores were independent factors affecting RIRS success (P = 0.033). The area under the curve of the R.I.R.S. scoring system was 0.737. Conclusions Our study retrospectively validates that the R.I.R.S. scoring system is associated with SFR after RIRS in the treatment of renal stones, and can predict accurately.

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Clinical evaluation of a new thyroglobulin immunoradiometric assay in the follow-up of differentiated thyroid carcinoma

Nuklearmedizin ◽

10.1055/s-0038-1625299 ◽

2003 ◽

Vol 42 (02) ◽

pp. 71-77 ◽

Cited By ~ 4

Author(s):

I. Schreivogel ◽

C. Angerstein ◽

U. Siefker ◽

K. Lehmann ◽

G. Altenvoerde ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Residual Disease ◽

False Negative ◽

Differentiated Thyroid Carcinoma ◽

Threshold Concentration ◽

High Rate ◽

Functional Assay ◽

Hypothyroid Patient ◽

Assay Sensitivity ◽

Significant Difference

SummaryAim: Formal and clinical comparison of a new 3rd-gene-ration-Tg-IRMA (3-G-IRMA; Dynotest®Tg-plus) with a conventional Tg-IRMA (3-G-IRMA; SELco®Tg-assay) for patients with differentiated thyroid carcinoma. In addition we evaluated, if thyroglobulin (Tg) levels above a specific threshold concentration indicate the need for further investigations for residual disease. Patients, methods: Tg concentration of 105 sera of 93 consecutive patients with a differentiated thyroid cancer was determined with both assays and compared at different cut-off values (Dynotest®Tg-plus: 0.2, 1, 2 ng/ml; SELco®Tg-assay: 0.5, 1, 2 ng/ml) with the clinical results in respect to the corresponding TSH concentration. Results: Tg concentration did not show any significant difference (SELco®Tg-assay 0.5 ng/ml, Dynotest® Tg-plus 0.2 ng/ml). The Tg-values of both assays correlated with 97%. However, correlation of recovery in both assays was small (40%). The sensitivities and specificities of both assays at different cut-offs and TSH values did not reveal significant differences. In patients with TSH concentration >30 µU/ml the functional assay sensitivity was superior to arbitrary cut-offs in the decision to start further evaluations. Conclusions: In our study neither formal nor clinical significant differences between two Tg-assays were found. In a hypothyroid patient (TSH >30 µU/ml, Tg concentration exceeding the functional assay sensitivity) further investigations for residual disease are warranted. Higher thresholds are of limited value, due to a inacceptable high rate of false negative results.

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External validation and comparison of current scoring systems in retrograde intrarenal surgery: Multi‐institutional study with 949 patients

International Journal of Clinical Practice ◽

10.1111/ijcp.14097 ◽

2021 ◽

Author(s):

Ibrahim Halil Bozkurt ◽

Ahmet Nihat Karakoyunlu ◽

Omer Koras ◽

Serdar Celik ◽

Ertugrul Sefik ◽

...

Keyword(s):

External Validation ◽

Scoring Systems ◽

Retrograde Intrarenal Surgery

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Efficiency of retrograde intrarenal surgery in lower pole stones: disposable flexible ureterorenoscope or reusable flexible ureterorenoscope?

World Journal of Urology ◽

10.1007/s00345-021-03656-y ◽

2021 ◽

Author(s):

Yunus Emre Göger ◽

Mehmet Serkan Özkent ◽

Muzaffer Tansel Kılınç ◽

Hakan Hakkı Taşkapu ◽

Esra Göger ◽

...

Keyword(s):

Lower Pole ◽

Retrograde Intrarenal Surgery

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Donepezil Combined with DL-3-n-Butylphthalide Delays Cognitive Decline in Patients with Mild to Moderate Alzheimer’s Disease: A Multicenter, Prospective Cohort Study

Journal of Alzheimer s Disease ◽

10.3233/jad-201381 ◽

2021 ◽

Vol 80 (2) ◽

pp. 673-681

Author(s):

Jin Wang ◽

Xiaojuan Guo ◽

Wenhui Lu ◽

Jie Liu ◽

Hong Zhang ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Logistic Regression ◽

Regression Analysis ◽

Cohort Study ◽

Prospective Cohort ◽

Daily Living ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Significant Difference

Background: Vascular factors and mitochondria dysfunction contribute to the pathogenesis of Alzheimer’s disease (AD). DL-3-n-butylphthalide (NBP) has an effect in protecting mitochondria and improving microcirculation. Objective: The aim was to investigate the effect of donepezil combined NBP therapy in patients with mild-moderate AD. Methods: It was a prospective cohort study. 92 mild-moderate AD patients were classified into the donepezil alone group (n = 43) or the donepezil combined NBP group (n = 49) for 48 weeks. All patients were evaluated with Alzheimer’s Disease Assessment Scale-Cognitive subscale (ADAS-cog), Clinician’s Interview-Based Impression of Change plus caregiver input (CIBIC-plus), Alzheimer’s Disease Cooperative Study-Activities of Daily Living (ADCS-ADL), and Neuropsychiatric Inventory (NPI) every 12 weeks. All patients were monitored for adverse events (AEs). The efficacy was analyzed using multivariate logistic regression analysis. Results: The multivariate logistic regression analysis showed that the changes of ADAS-cog score (OR = 2.778, 95% CI: [1.087, 7. 100], p = 0.033) and ADCS-ADL score (OR = 2.733, 95% CI: [1.002, 7.459], p = 0.049) had significant difference between donepezil alone group and donepezil combined NBP group, while the changes of NPI (OR = 1.145, 95% CI: [0.463, 2.829], p = 0.769), MMSE (OR = 1.563, 95% CI: [0.615, 3.971], p = 0.348) and CIBIC-plus (OR = 2.593, 95% CI: [0.696, 9.685], p = 0.156) had no significant difference. The occurrence of AEs was similar in the two groups. Conclusion: Over the 48-week treatment period, donepezil combined NBP group had slower cognitive decline and better activities of daily living in patients with mild to moderate AD. These indicated that the multi-target therapeutic effect of NBP may be a new choice for AD treatment.

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Modification and Validation of the Phosphate Removal Model: A Multicenter Study

Kidney & Blood Pressure Research ◽

10.1159/000511375 ◽

2021 ◽

pp. 1-10

Author(s):

Weichen Zhang ◽

Qiuna Du ◽

Jing Xiao ◽

Zhaori Bi ◽

Chen Yu ◽

...

Keyword(s):

Polynomial Regression ◽

External Validation ◽

Original Model ◽

Phosphate Concentration ◽

Phosphate Removal ◽

Internal Validation ◽

Modified Model ◽

New Model ◽

Significant Difference ◽

Removal Model

Background: Our research group has previously reported a noninvasive model that estimates phosphate removal within a 4-h hemodialysis (HD) treatment. The aim of this study was to modify the original model and validate the accuracy of the new model of phosphate removal for HD and hemodiafiltration (HDF) treatment. Methods: A total of 109 HD patients from 3 HD centers were enrolled. The actual phosphate removal amount was calculated using the area under the dialysate phosphate concentration time curve. Model modification was executed using second-order multivariable polynomial regression analysis to obtain a new parameter for dialyzer phosphate clearance. Bias, precision, and accuracy were measured in the internal and external validation to determine the performance of the modified model. Results: Mean age of the enrolled patients was 63 ± 12 years, and 67 (61.5%) were male. Phosphate removal was 19.06 ± 8.12 mmol and 17.38 ± 6.75 mmol in 4-h HD and HDF treatments, respectively, with no significant difference. The modified phosphate removal model was expressed as Tpo4 = 80.3 × C45 − 0.024 × age + 0.07 × weight + β × clearance − 8.14 (β = 6.231 × 10−3 × clearance − 1.886 × 10−5 × clearance2 – 0.467), where C45 was the phosphate concentration in the spent dialysate measured at the 45th minute of HD and clearance was the phosphate clearance of the dialyzer. Internal validation indicated that the new model was superior to the original model with a significantly smaller bias and higher accuracy. External validation showed that R2, bias, and accuracy were not significantly different than those of internal validation. Conclusions: A new model was generated to quantify phosphate removal by 4-h HD and HDF with a dialyzer surface area of 1.3–1.8 m2. This modified model would contribute to the evaluation of phosphate balance and individualized therapy of hyperphosphatemia.

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Effect of Mosses on physical and chemical properties of soil in temperate forests of Garhwal Himalayas

Journal of Tropical Ecology ◽

10.1017/s0266467421000249 ◽

2021 ◽

pp. 1-10

Author(s):

Anshu Siwach ◽

Siddhartha Kaushal ◽

Ratul Baishya

Keyword(s):

Physical Properties ◽

Chemical Properties ◽

Nutrient Status ◽

High Rate ◽

Physical And Chemical Properties ◽

Garhwal Himalayas ◽

Forest Sites ◽

Significant Difference ◽

Physical And Chemical ◽

And Chemical Properties

Abstract Mosses are one of the most important and dominant plant communities, especially in the temperate biome, and play a significant role in ecosystem function and dynamics. They influence the water, energy and element cycle due to their unique ecology and physiology. The present study was undertaken in three different temperate forest sites in the Garhwal Himalayas, viz., Triyuginarayan (Kedarnath Wildlife Sanctuary (KWLS)), Chakrata, and Kanasar forest range. The study was focused on understanding the influence of mosses on soil physical properties and nutrient availability. Different physico-chemical properties were analysed under two different substrata, that is, with and without moss cover in two different seasons, viz., monsoon and winter. We observed mosses to influence and alter the physical properties and nutrient status of soil in both seasons. All soil physical and chemical properties, except magnesium, showed significant difference within the substrates, among all the sites and across the two seasons. Besides the soil characteristics underneath the moss vegetation, the study also highlights the diversity of mosses found in the area. Mosses appear to create high nutrient microsites via a high rate of organic matter accumulation and retain nutrients for longer periods thus, maintaining ecosystem stability.

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The relationship of the serum endocan level with the CHA2DS2-VASc score in patients with paroxysmal atrial fibrillation

The Egyptian Heart Journal ◽

10.1186/s43044-021-00132-1 ◽

2021 ◽

Vol 73 (1) ◽

Author(s):

Gökhan Ceyhun

Keyword(s):

Atrial Fibrillation ◽

Paroxysmal Atrial Fibrillation ◽

Stroke Risk ◽

Low Density Lipoprotein ◽

Multivariate Logistic Regression Analysis ◽

Density Lipoprotein ◽

Roc Curve Analysis ◽

Reactive Protein ◽

Relationship Of ◽

The Relationship

Abstract Background In this study considering the relationship between serum endocan and CHA2DS2-VASc score, we assumed that endocan level could be a new biomarker for stroke risk in patients with paroxysmal atrial fibrillation (PAF). It was examined that endocan could be an alternative to determine the risk of stroke and anticoagulation strategy in patients with PAF. The CHA2DS2-VASc scores were calculated for 192 patients with PAF, and their serum endocan levels were measured. The patients were divided into two groups as those with low to moderate (0-1) and those with high (≥ 2) CHA2DS2-VASc scores, and the endocan levels were compared between these two groups. Results The serum endocan level was significantly higher in the high CHA2DS2-VASc score group (p < 0.001). In the multivariate logistic regression analysis, endocan, C-reactive protein, and low-density lipoprotein were found to be independent determinants of the CHA2DS2-VASc score. The predictive value of endocan was analyzed using the ROC curve analysis, which revealed that endocan predicted a high stroke risk (CHA2DS2-VASc ≥ 2) at 82.5% sensitivity and 71.2% specificity at the cutoff value of 1.342. Conclusion This study indicates that endocan is significantly associated with CHA2DS2-VASc score. We demonstrated that endocan could be a new biomarker for the prediction of a high stroke risk among patients diagnosed with PAF.

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Possible tics diagnosed as stereotypies in patients with severe autism spectrum disorder: a video-based evaluation

Neurological Sciences ◽

10.1007/s10072-020-04995-1 ◽

2020 ◽

Author(s):

Cristiano Termine ◽

Enzo Grossi ◽

Valentina Anelli ◽

Ledina Derhemi ◽

Andrea E. Cavanna

Keyword(s):

Autism Spectrum Disorder ◽

Rating Scale ◽

Young Patients ◽

Autism Spectrum ◽

Repetitive Behaviors ◽

Spectrum Disorder ◽

High Rate ◽

Video Recordings ◽

Significant Difference ◽

Severe Autism

Abstract Background The association of stereotypies and tics is not rare in children with severe autism spectrum disorder (ASD). The differential diagnosis between stereotypies and tics in this patient population can be difficult; however, it could be clinically relevant because of treatment implications. Methods A total of 108 video recordings of repetitive behaviors in young patients with stereotypies in the context of ASD were reviewed by a movement disorders expert and a trainee, in order to assess the prevalence of possible co-morbid tics. The Modified Rush Videotape Rating Scale (MRVS) was used to rate tic frequency and severity. Results Out of 27 patients with stereotypies (24 males; mean age 14 years), 18 (67%) reported possible tics. The most frequently observed tics were eye blinking, shoulder shrugging, neck bending, staring, and throat clearing. The mean MRVS score was 5, indicating mild tic severity. The only significant difference between patients with tics and patients without tics was the total number of stereotypies, which was higher in the subgroup of patients without tics (p = 0.01). Conclusions Expert review of video-recordings of repetitive behaviors in young patients with ASD and stereotypies suggests the possibility of a relatively high rate of co-morbid tics. These findings need to be integrated with a comprehensive clinical assessment focusing on the diagnostic re-evaluation of heterogeneous motor manifestations.

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