Nefrolitotricia percutánea ambulatoria: nuestra experiencia en 156 casos / Ambulatory Percutaneous Nephrolithotomy: Our experience in 156 cases

OBJETIVOS: analizar y presentar nuestros resultados en el tratamiento de la litiasis renal mediante Nefrolitotricia Percutánea (NLP) ambulatoria en un mismo centro. MATERIALES Y MÉTODOS: entre agosto de 2013 y mayo de 2017 se realizó una recolección prospectiva de datos de los pacientes sometidos a NLP ambulatoria tubeless con catéter doble J o totally tubeless por litiasis renal. Se excluyeron aquellos pacientes con score de ASA >3. Se analizaron los datos preoperatorios, intra- y posoperatorios. Se clasificaron las complicaciones de acuerdo con el sistema de Clavien modificado. Se compararon los valores de hematocrito, hemoglobina, creatininemia y uremia pre- y posoperatoria a las 48 horas. RESULTADOS: en total, se operaron 156 pacientes, a los cuales se les dio el alta el mismo día de la cirugía. La suma de los diámetros máximos de las litiasis, en promedio, fue de 26,6 mm, 32 casos de litiasis coraliforme. La posición más utilizada fue la ventral, con un tiempo promedio de cirugía de 50 minutos. Se realizó NLP tubeless en 125 pacientes y totally tubeless en 29 casos. A 40 pacientes se les colocó un tapón de Surgicel en el tracto de acceso percutáneo. La tasa libre de cálculos fue del 84%, y en pacientes con litiasis coraliforme fue del 53%. No hubo complicaciones intraoperatorias y el 80% de los pacientes no presentó complicaciones. La tasa de reinternación fue del 3%. Si bien se hallaron diferencias significativas entre los valores pre- y posoperatorios de hematocrito y hemoglobina (40% y 13,3 g/dl vs. 39% y 12,8 g/dl; p=0,0001 y 0,0001, respectivamente), estas no fueron clínicamente significativas y solamente un paciente requirió de transfusión de sangre (0,6%). CONCLUSIONES: en nuestra experiencia, la NLP ambulatoria fue segura, con tasas libres de cálculos y complicaciones similares a las realizadas con internación.

OBJECTIVES: To assess the safety and feasibility of ambulatory percutaneous nephrolithotomy (PCNL) at a single institution. METHODS: Data collected prospectively of patients submit for ambulatory PCNL tubeless or totally tubeless between August 2013 and May 2017 were review. Exclusion criteria were patients with ASA score >3. Preoperative, intraoperative, and postoperative data were collected. Complications were classified using the Clavien sistem modified for PCNL. Properative and 48hs postoperative value of hematocrit, hemoglobin, creatininemia and uremia were compare. RESULTS: One hundred and fifty five patients underwent ambulatory PCNL. All patients were discharge the same day of surgery. The median of the sum of the maximum stone diameter was 26,6mm, 32 patients had staghorn calculus. We performed the majority of the surgerys in ventral position with a median time of 50 minutes. One hundred and twenty five patients underwent tubeless PCNL and totally tubeless 29 patients. In 40 cases we used Surgicel for sealing the percutaneous tract. Overall stone-free rate was 84% and 53% in staghorn cases. There were no intraoperative complications and 80% of the patients did not have any complications. Readmission rate was 3%. There was a significant decrease in the postoperative hematocrit and hemoglobin level (40% y 13,3 g/dl vs. 39% y 12,8 g/dl; p=0,0001 y 0,0001), this was not clinically significant. Only one patient required blood transfusion (0,6%). CONCLUSION: Ambulatory PCNL is safe with a stone-free rate, readmisions and complications similar to standard PCNL.

A review on sentiment analysis in psychomedical diagnosis

As the research in sentiment analysis (SA) has reached the advanced level of maturity, scientific community is exploring possibilities of applying SA in different domains for which huge descriptive data is available. Researcher has developed tools for SA in commercial domains like feedback from customers, review rating of movie, political domains like exit poll prediction from tweets, etc. In medical science, huge data is available which can be used for predictive modelling. Psychomedical diagnosis is an interesting field which deals with exploring behavioural patterns to potential psychological problems. In the domain of medical science, little amount of work has been done in clinical SA. However, the efforts are at an elementary level in the course of research of SA for behavioural psychology. Hence, there is an opportunity of applying SA as the first step towards automatic psychomedical diagnosis of teenagers’ behaviour patterns.

Research Status and Implications of Foreign Medical Automatic Question Answering System / 医学信息学杂志

The paper analyzes the documents related to the foreign medical automatic Question Answering (QA) system,and compares the differences between automatic QA and traditional network information retrieval,describes the automatic QA system in the aspects of application researches,common tools and relevant technologies.Combining foreign related researches,it also discusses the current key problems of medical automatic QA system and the implications for China in order to offer reference for further research.

Effects of NLP workshop on resilience of children from divorced family / 中华行为医学与脑科学杂志

Objective To investigate the intervention effects of NLP workshop on resilience of children from divorced family.Methods A pre/post test and subsequent follow-up design between experimental group and control group were performed.Thirty-one children from divorced family with low resilience were intervened by NLP workshop,while the other thirty-one children with low resilience were chosen as the control group.Results There was no significant difference between experimental group and control group before the intervention on resilience.But after the intervention,the two groups achieved statistical significant difference on resilience(experimental group (3:68±0.37),control group(2.99±0.18),t=9.60,P=0.00).Furthermore,the results of follow-up showed that the effect of NLP workshop still existed after six months (total average score of resilience before intervention (2.96±0.17),subsequent follow-ups (3.69±0.35),t=10.40,P=0.00).Conclusion NLP workshop can enhance the level of resilience of children from divorced family.Effect of NLP workshop not only has short-term effect,but also has some long-term effect.

Para uma comunicação mais efetiva / Towards a more effective communication

O presente artigo aborda as diversas formas por meio das quais os seres humanos aprendem a limitar os impulsos do mundo externo e como manipulam dentro de si mesmos os impulsos selecionados. A comunicação intrapessoal serve-se de uma língua, única para cada pessoa, capaz de caracterizá-la. Este artigo procura responder as seguintes questões: como se estabelecem as intenções, as expectativas e os desejos por trás da comunicação? O que se passa no interior de uma pessoa ao assimilar seletivamente os estímulos do mundo, do próprio corpo e da própriamente, manipulando-os para devolver algum comportamento por gestos ou palavras? Como interagem os componentes da mente processando o que entra e o que sai da pessoa?.

This article details the many ways by which people learn to limitate impulses from out sideworld and how they manipulate the selected incoming stimuli within themselves. The in nerdialogue uses a language that is unique for each person. This article aims to answer these following questions: how do the intentions, expectations and desires that lies behind communication establish themselves? What happens inside a person in the process of selective assimilation of the stimuli that comes from the world, the body and the mind, manipulating them to return some reaction by gestures or words? How do mind’s components interact with each other in processing what comes in and what goes out of it?.

Correction System of a Mis-recognized Medical Vocabulary of Speech-based Electronic Medical Record / 대한의료정보학회지

Speech recognition as an input tool for electronic medical record enables efficient data entry at the point of care. We evaluated the speech recognition accuracy of IBM ViaVoiceTM for doctor-patient dialogues and for pronounced medical vocabularies. The recognition accuracy for doctor-patient dialogues was 95.4%, while that for pronounced medical vocabularies was 55.1%. In order to put speech-based electronic medical record to practical use, mis-recognized vocabulary must be significantly corrected. This paper describes a correction system for mis-recognized medical vocabulary for speech recognition-enabled electronic medical record. The correction system is composed of an extraction and a correction steps. In the extraction step, hamming distance between a parsed substring and the nearest medical vocabulary in the vocabulary database greater than 50% of the length of the substring was used to determine if the substring is a possible mis-recognized medical vocabulary. In the correction step, possible mis-recognized medical vocabularies are scored such that when both the code and location of a syllable is the same with those of a medical vocabulary found in our database, +5 is given and when the code is the same but the location is not, +1 is given. The medical vocabulary with the highest score in the database is used as the correction for the mis-recognized one. When 33 patient-doctor dialogues with 33 medical vocabularies were tested for three times by six testees (i.e., 33 x 6 x 3 = 594 sentences), 94% of the mis-recognized words were correctly detected and repaired. Poor recognition performance for hard medical vocabularies can be markedly improved by the mis-recognized medical vocabulary correction system.