scholarly journals Does volume matter? Incorporating estimated stone volume in a nomogram to predict ureteral stone passage

2021 ◽  
Vol 16 (3) ◽  
Author(s):  
Nassib Abou Heidar ◽  
Muhieddine Labban ◽  
David-Dan Nguyen ◽  
Adnan El-Achkar ◽  
Mazen Mansour ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Laboratory Tests ◽  
Ureteral Stone ◽  
Area Under The Curve ◽  
Axial Diameter ◽  
Patient Demographics ◽  
Stone Burden ◽  
Stone Passage ◽  
Better Than

Introduction: Recent studies have shown that software-generated 3D stone volume calculations are better predictors of stone burden than measured maximal axial stone diameter. However, no studies have assessed the role of formula estimated stone volume, a more practical and cheaper alternative to software calculations, to predict spontaneous stone passage (SSP). Methods: We retrospectively included patients discharged from our emergency department on conservative treatment for ureteral stone (≤10 mm). We collected patient demographics, comorbidities, and laboratory tests. Using non-contrast computed tomography (CT) reports, stone width, length, and depth (w, l, d, respectively) were used to estimate stone volumes using the ellipsoid formula: V=π*l*w*d*0.167. Using a backward conditional regression, two models were developed incorporating either estimated stone volume or maximal axial stone diameter. A receiver operator characteristic (ROC) curve was constructed and the area under the curve (AUC) was computed and compared to the other model. Results: We included 450 patients; 243 patients (54%) had SSP and 207 patients (46%) failed SSP. The median calculated stone volume was significantly smaller among patients with SSP: 25 (14–60) mm3 vs. 113 (66–180) mm3 (p<0.001). After adjusting for covariates, predictors of retained stone included: neutrophil to lymphocyte ratio (NLR) ≥3.14 (odds ratio [OR] 6, 95 % confidence interval [CI] 3.49–10.33), leukocyte esterase (LE) >75 (OR 4.83, 95% CI 2.12–11.00), and proximal stone (OR 2.11, 95% CI 1.16–3.83). For every 1 mm3 increase in stone volume, the risk of SSP failure increased by 2.5%. The model explained 89.4% (0.864–0.923) of the variability in the outcome. This model was superior to the model including maximal axial diameter (0.881, 0.847–0.909, p=0.04). Conclusions: We present a nomogram incorporating stone volume to better predict SSP. Stone volume estimated using an ellipsoid formula can predict SSP better than maximal axial diameter.

scholarly journals Role of the gonadal vessels on the stone lodgment in the proximal ureter: Direct observation during laparoscopic ureterolithotomy

2018 ◽  
Vol 90 (3) ◽  
pp. 163-165
Author(s):  
Mohammad Hadi Radfar ◽  
Reza Valipour ◽  
Behzad Narouie ◽  
Mehdi Sotoudeh ◽  
Hamid Pakmanesh
Keyword(s):  
Direct Observation ◽  
Ureteral Stone ◽  
Ureteral Stenosis ◽  
Ureterovesical Junction ◽  
Gonadal Vein ◽  
Close Proximity ◽  
Proximal Ureter ◽  
Radiological Studies ◽  
Stone Passage

Introduction: Previous radiological studies revealed that stones lodge more frequently in the ureterovesical junction (UVJ) as well as the proximal ureter. Factors that prevent stone passage from the proximal ureter are not well studied. Aim: To explore the site of the lodged stones in the proximal ureter with direct observation during laparoscopic ureterolithotomy. Materials and methods: Between November 2014 and February 2015, we included 26 patients including 18 men and 8 women with stones larger than 10 millimeters in the proximal ureter who were candidate for laparoscopic ureterolithotomy. We prospectively recorded the site of the lodged stones in the ureter during laparoscopic ureterolithotomy in relation with the sites of ureteral stenosis as well as the gonadal vessels. Results: Among 26 patients with ureteral stone, in 19 cases stone was found close to the gonadal vein compared with seven cases that stone was in other locations of the ureter (p = 0.02). The characteristics of patients and stones were not different in cases that the stone was close to gonadal vessels compared with other locations. Conclusions: This study showed that most of the stones lodged in the proximal ureter were in close proximity with gonadal vessels. Gonadal vessels may be an extrinsic cause of ureteral narrowing.

Biomarkers, lactate, and clinical scores as outcome predictors in systemic poisons exposures

2016 ◽  
Vol 36 (7) ◽  
pp. 651-662 ◽  
Author(s):  
C Lionte ◽  
V Sorodoc ◽  
C Tuchilus ◽  
D Cimpoiesu ◽  
E Jaba
Keyword(s):  
Laboratory Tests ◽  
Area Under The Curve ◽  
Cardiac Biomarkers ◽  
Characteristic Analysis ◽  
Poor Outcome ◽  
Clinical Scores ◽  
Important Challenge ◽  
A Prospective Study ◽  
Mortality Predictors

Acute exposure to systemic poisons represents an important challenge in clinical toxicology. We aimed to analyze the potential role of cardiac biomarkers, routine laboratory tests, and clinical scores as morbidity and in-hospital mortality predictors in patients intoxicated with various systemic poisons. We conducted a prospective study on adults acutely exposed to systemic poisons. We determined the PSS, Glasgow Coma Scale (GCS), and we performed electrocardiogram, laboratory tests, lactate and cardiac biomarkers (which were reassessed 4 h, respectively 6 h later). Of 120 patients included, 45% developed complications, 19.2% had a poor outcome, and 5% died. Multivariate logistic regression sustained lactate (odds ratio (OR) 1.58; confidence interval (CI) 95%: 0.97–2.59; p 0.066), MB isoenzyme of creatine kinase (6h-CKMB; OR 1.08; CI 95%: 1.02–1.16; p 0.018) as predictors for a poor outcome. A GCS < 10 (OR 0.113; CI 95%: 0.019–0.658; p 0.015) and 4h-lactate (OR 4.87; CI 95%: 0.79–29.82; p 0.087) predicted mortality after systemic poisons exposure. Receiver operating characteristic analysis showed that brain natriuretic peptide (area under the curve (AUC), 0.96; CI 95%: 0.92–0.99; p < 0.001), lactate (AUC, 0.91; CI 95%: 0.85–0.97; p < 0.001), and 6h-CKMB have good discriminatory capacity for predicting a poor outcome. In conclusion, these biomarkers, lactate, and GCS can be used to predict morbidity and mortality after systemic poisons exposure.

Axial Diameter is Superior to Volumetric Measurement in Predicting Ureteral Stone Passage

2021 ◽  
Author(s):  
Parth M. Patel ◽  
Alexander M. Kandabarow ◽  
Victor S. Chen ◽  
Hannah Slovacek ◽  
Abrar Mian ◽  
...  
Keyword(s):  
Ureteral Stone ◽  
Volumetric Measurement ◽  
Axial Diameter ◽  
Stone Passage

scholarly journals Role of SpO2/FiO2 Ratio and ROX Index in Predicting Early Invasive Mechanical Ventilation in COVID-19. A Pragmatic, Retrospective, Multi-Center Study

Biomedicines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 1036
Author(s):  
Ana Alberdi-Iglesias ◽  
Francisco Martín-Rodríguez ◽  
Guillermo Ortega Rabbione ◽  
Ana I. Rubio-Babiano ◽  
María G. Núñez-Toste ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Area Under The Curve ◽  
Non Invasive ◽  
Fraction Of Inspired Oxygen ◽  
Multi Center Study ◽  
Oxygen Ratio ◽  
Inspired Oxygen ◽  
Better Than

The ability of COVID-19 to compromise the respiratory system has generated a substantial proportion of critically ill patients in need of invasive mechanical ventilation (IMV). The objective of this paper was to analyze the prognostic ability of the pulse oximetry saturation/fraction of inspired oxygen ratio (SpO2/FiO2) and the ratio of SpO2/FiO2 to the respiratory rate–ROX index–as predictors of IMV in an emergency department in confirmed COVID-19 patients. A multicenter, retrospective cohort study was carried out in four provinces of Spain between March and November 2020. The discriminative power of the predictive variable was assessed through a prediction model trained using a derivation sub-cohort and evaluated by the area under the curve (AUC) of the receiver operating characteristic (ROC) on the validation sub-cohort. A total of 2040 patients were included in the study. The IMV rate was 10.1%, with an in-hospital mortality rate of 35.3%. The performance of the SpO2/FiO2 ratio was better than the ROX index–AUC = 0.801 (95% CI 0.746–0.855) and AUC = 0.725 (95% CI 0.652–0.798), respectively. In fact, a direct comparison between AUCs resulted in significant differences (p = 0.001). SpO2 to FiO2 ratio is a simple and promising non-invasive tool for predicting risk of IMV in patients infected with COVID-19, and it is realizable in emergency departments.

scholarly journals The Role ofHelicobacter pyloriand NSAIDs in the Pathogenesis of Uncomplicated Duodenal Ulcer

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Ayhan Hilmi Cekin ◽  
Muharrem Taskoparan ◽  
Adil Duman ◽  
Cem Sezer ◽  
Yesim Cekin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Duodenal Ulcer ◽  
Odds Ratio ◽  
Matched Control ◽  
Causative Factor ◽  
Control Group ◽  
Duodenal Ulcers ◽  
Patient Demographics ◽  
Inflammatory Drugs

Background/Aim. To identify the etiological role ofHelicobacter pylori(Hp) and nonsteroidal anti-inflammatory drugs (NSAIDs) in endoscopically diagnosed duodenal ulcers (DUs).Methods. Patients undergoing esophagogastroduodenoscopy in two major hospitals in Antalya and Adiyaman were included in this study and assigned as duodenal ulcer (n=152; median age: 41.0 (16–71) years; 58.6% males) or control group (n=70; median age: 41.0 (18–68) years; 57.1% males). Patient demographics, risk factors, and NSAID/acetylsalicylic acid (ASA) use were recorded.Results.HPwas more commonly located in the corpus (75.0 versus 50.0%; odds ratio [OR] = 3.00; 95% confidence interval [CI]: 1.66–5.44;P<0.001), incisura (75.7 versus 60.0%;OR=2.07; 95% CI: 1.13–3.79;P=0.017), and antrum (80.3 versus 60.0%;OR=2.71; 95% CI: 1.45–5.05;P=0.001) among DU patients than controls.Hppositivity was 84.9% whileHpwas negative in 15.1% of patients including those accompanied with NSAID and/or ASA use (9.2%), and those were negative for all three etiological factors (5.9%).Conclusion. Our findings indicate the substantial role ofHpin the pathogenesis of DU disease as identified in 84.9% of DU patients compatible with the background prevalence of 61.4% among age-matched control subjects.Hpwas the single causative factor in 44.1% of our patients, while NSAID/ASA exposure was in 9.2%.

Examining the Role of Language in Play Among Children With and Without Developmental Disabilities

2020 ◽  
Vol 51 (3) ◽  
pp. 795-806 ◽  
Author(s):  
Elizabeth J. Short ◽  
Rachael Cooper Schindler ◽  
Rita Obeid ◽  
Maia M. Noeder ◽  
Laura E. Hlavaty ◽  
...  
Keyword(s):  
Developmental Disabilities ◽  
Autism Spectrum ◽  
Free Play ◽  
Group Differences ◽  
Typically Developing ◽  
Play Skills ◽  
Critical Aspect ◽  
Hyperactivity Disorder ◽  
Better Than

Purpose Play is a critical aspect of children's development, and researchers have long argued that symbolic deficits in play may be diagnostic of developmental disabilities. This study examined whether deficits in play emerge as a function of developmental disabilities and whether our perceptions of play are colored by differences in language and behavioral presentations. Method Ninety-three children participated in this study (typically developing [TD]; n = 23, developmental language disorders [DLD]; n = 24, attention-deficit/hyperactivity disorder [ADHD]; n = 26, and autism spectrum disorder [ASD]; n = 20). Children were videotaped engaging in free-play. Children's symbolic play (imagination, organization, elaboration, and comfort) was scored under conditions of both audible language and no audible language to assess diagnostic group differences in play and whether audible language impacted raters' perception of play. Results Significant differences in play were evident across diagnostic groups. The presence of language did not alter play ratings for the TD group, but differences were found among the other diagnostic groups. When language was audible, children with DLD and ASD (but not ADHD) were scored poorly on play compared to their TD peers. When language was not audible, children with DLD were perceived to play better than when language was audible. Conversely, children with ADHD showed organizational deficits when language was not available to support their play. Finally, children with ASD demonstrated poor play performance regardless of whether language was audible or not. Conclusions Language affects our understanding of play skills in some young children. Parents, researchers, and clinicians must be careful not to underestimate or overestimate play based on language presentation. Differential skills in language have the potential to unduly influence our perceptions of play for children with developmental disabilities.

Determinants of English as language choice among Unaccompanied Migrant Children (UMC) in Makassar, Indonesia

2019 ◽  
Vol 2 (2) ◽  
pp. 1-7
Author(s):  
Andi Samsu Rijal ◽  
Andi Mega Januarti Putri
Keyword(s):  
Language Choice ◽  
Migrant Children ◽  
Immigrant Communities ◽  
The Public ◽  
International Language ◽  
Language User ◽  
Public Area ◽  
Better Than ◽  
Language Mastery

The essence of language is human activity. Communication with language is carried out through two basic human activities; speaking and listening during the interaction in a group of people. Immigrants in Makassar city communicate with immigrant communities and Makassar people. They used English and Indonesia to communicate with others. The aims of this article were to find out determinant factors of English as language choice among Unaccompanied Migrant Children (UMC) in Makassar and why they used English as their language choice to communicate with other people out of them. The data were taken from UMC in the shelter under the auspices of Makassar’s Social Office and in the public area of Makassar. This research was a qualitative approach; it was from a sociolinguistic perspective and focuses its analysis with the language choice among UMC. This research showed that most immigrants chose English as their language choice since they were in Makassar because they have acquired better than other international language and it has been mastered naturally by doing social interaction among themselves and people outside their community. UMC had more difficulties to socialize with Indonesian than the adult of Immigrants. Other than their lack of language mastery, they also have the anxiety to adapt to other immigrants and Makassar people. English was used by UMC to show their status as a foreigner who lived in a multicultural situation. Language becomes a power for a human being and it becomes a social identity for language user in one community. During the interaction of UMC in Makassar city, the role of English as an International language is shown.

The Role of Chess in the Intellectual Development of Childrens from Primary School

2019 ◽  
pp. 58-62
Author(s):  
Vlad Stegariu ◽  
Simona Andreea Popușoi ◽  
Beatrice Abălașei ◽  
Nicolae Lucian Voinea ◽  
Ioan Stelescu ◽  
...  
Keyword(s):  
Cognitive Development ◽  
Primary School ◽  
Intellectual Development ◽  
Resources Allocation ◽  
Control Group ◽  
Cognitive Resources ◽  
One Year ◽  
Better Than ◽  
Chess Playing

Chess playing has a significant role in participants’ resources allocation, both at a psychological level, but mostly concerning the cognitive resources. The aim of the present study was to examine the effect of chess playing on the intellectual development of primary-class students. 67 children were tested using the Raven Standard Progressive Matrices and were distributed in three different groups according to their experience with chess, namely: the control group (formed by students with no experience with chess playing), the beginners group (students with less than one year in chess playing training) and the advanced group (children with more than two years experience with chess). Results indicated that chess playing had a significant effect on the SPM performance, indicating that those in the advanced group performed significantly better than those in the control or in the beginners group. Conclusions of this study tap into the benefits of playing chess with a focus on the children’s’ cognitive development.

scholarly journals Civil Religion or Nationalism? The National Day Celebrations in Norway

Religions ◽  
2021 ◽  
Vol 12 (3) ◽  
pp. 206
Author(s):  
Pål Ketil Botvar
Keyword(s):  
National Identity ◽  
General Population ◽  
Civil Religion ◽  
Religious Nationalism ◽  
Theoretical Concepts ◽  
Role Of Religion ◽  
Better Than ◽  
The Way

The Norwegian National Day (17 May, also referred to as Constitution Day) stands out as one of the most popular National Day celebrations in Europe. According to surveys, around seven out of every 10 Norwegians take part in a public celebration during this day. This means that the National Day potentially has an impact on the way people reflect upon national identity and its relationship to the Lutheran heritage. In this paper, I will focus on the role religion plays in the Norwegian National Day rituals. Researchers have described these rituals as both containing a significant religious element and being rather secularized. In this article, I discuss the extent to which the theoretical concepts civil religion and religious nationalism can help us understand the role of religion, or the absence of religion, in these rituals. Based on surveys of the general population, I analyze both indicators of civil religion and religious nationalism. The two phenomena are compared by looking at their relation to such items as patriotism, chauvinism, and xenophobia. The results show that civil religion explains participation in the National Day rituals better than religious nationalism.

The clinical relevance of isolated lupus anticoagulant positivity in patients with thrombotic antiphospholipid syndrome

2020 ◽  
Author(s):  
Dong-mei Yin ◽  
Philip de Groot ◽  
Marisa Ninivaggi ◽  
Katrien M.J. Devreese ◽  
Bas de Laat
Keyword(s):  
Antiphospholipid Syndrome ◽  
Clinical Relevance ◽  
Antiphospholipid Antibodies ◽  
Odds Ratio ◽  
Lupus Anticoagulant ◽  
Solid Phase ◽  
Control Group ◽  
Domain I ◽  
Normal Controls ◽  
Better Than

Background: Patients positive for three types of antiphospholipid antibodies (aPLs) (triple positivity) have been identified at a high risk for thrombotic events. However, the clinical significance of isolated lupus anticoagulant (LAC) positivity is debated. Objectives: To investigate the clinical relevance of isolated LAC. Patients/Methods 456 patients were enrolled in this study; 66 antiphospholipid syndrome patients and 390 control patients. The control group existed of autoimmune patients (n=91), patients with thrombosis but without aPLs (n=127) and normal controls (n=172). The criteria LAC, anti-cardiolipin (anti-CL) and anti-beta2glycoprotein I (anti-β2GPI) IgG and IgM and the non-criteria IgA anti-CL and anti-β2GPI, anti-domain I (anti-DI) of β2GPI IgG and anti-phosphatidylserine/prothrombin (anti-PS/PT) IgG and IgM were detected according to the ISTH guidelines for solid phase assays. Results: 70 patients were positive for LAC, of which 44 were negative for both anti-β2GPI and anti-CL. We found that isolated LAC proved to be strongly associated with vascular thrombosis (Odds ratio (OR) (95% CI) 7.3 (3.3-16.1)), even better than triple positive samples (OR 4.3 (1.6-12.2)). The titers of the anti-PS/PT IgG and IgM were significantly higher in triple positivity samples compared to samples with isolated LAC positivity. The majority of single LAC positives were anti-PS/PT negative. We observed that LAC positivity was weaker in isolated LAC positive patients compared to LAC activity in triple positive patients. Conclusions: Isolated LAC was highly associated with thrombosis. The presence of anti-PS/PT could not explain LAC positivity in isolated LAC. Isolated LAC showed a weaker LAC activity compared to triple positive patients.

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