ABSTRACT
Introducción: La clasificación de Clavien ha sido propuesta como sistema para determinar el grado de complicaciones perioperatorias en la nefrolitotomía percutánea. Comunicamos las complicaciones acaecidas en los últimos 2 años en la realización de esta técnica utilizando la clasificación estratificada de Clavien-Dindo. Materiales y métodos: Entre 2011 y 2012 se han realizado 255 nefrolitotomías percutáneas en nuestro centro por litiasis renal superior a 2 cm. A partir de los datos obtenidos se lleva a cabo un análisis estadístico para determinar la incidencia de complicaciones según la clasificación de Clavien-Dindo modificada. Resultados: Durante el período analizado se realizaron 255 nefrolitotomías percutáneas en 249 pacientes, 41% del lado derecho, 57% del lado izquierdo y 2% bilateral simultáneo, de ellos 137 fueron hombres y 112 mujeres. Entre las comorbilidades más prevalentes encontramos la HTA en 101 pacientes (40,6%), IMC > 30 en 81 pacientes (32%), diabetes mellitus 46 pacientes (18,5%) y alteraciones de la coagulación en 24 pacientes (9,6%). Encontramos 70 casos (27,4%) de complicaciones que se distribuyen según la clasificación de Clavien-Dindo en: grado i 8,4%, grado ii 8,4%, grado iiia 4,4%, grado iiib 6% y grado iva: 0,8%, grado ivb: 0% y grado v 0%. Conclusiones: Un esquema de clasificación graduada para informar las complicaciones de la nefrolitotomía percutánea es útil para el seguimiento y notificación de los resultados. Consideramos de gran utilidad estandarizar su uso para poder hacer comparables los resultados entre los distintos centros que realizan dicha técnica
Introduction:Clavien-Dindo classification system has been proposed to grade perioperative complications in percutaneous nephrolithotomy. The complications of this technique that have taken place in the last 2 years are reported in this paper according Clavien-Dindo classification. Materials and methods: Between 2011 and 2012 a total of 255 percutaneous nephrolithotomy were performed at our center for stones more than 2 cm in size. In order to determine the incidence of complications classified in the modified Clavien-Dindo system, statistical analysis of the data obtained was carried out. Results: During the period analyzed, 255 percutaneous nephrolithotomy were performed in 249 patients, 41% of the right side, 57% of the left side and 2% bilateral and simultaneous. 137 and 112 patients were males and females, respectively. The most prevalent comorbidities were: hypertension (AHT) in 101 patients (40.6%), BMI > 30 in 81 patients (32%), diabetes mellitus in 46 patients (18.5%) and coagulation abnormalities in 24 patients (9.6%). A total of 70 cases (27.4%) were distributed according to Clavien-Dindo classification: grade i, 8.4%, grade ii 8.4%, grade iiia 4.4%, grade iiib 6% grade iva .8%, grade ivb: 0% and grade v 0%. Conclusions: A graded classification scheme for reporting the complications of percutaneous nephrolithotomy is useful for monitoring and reporting outcomes. We propose a standardized use of this classification in order to make the results comparable among different centers performing the technique
Subject(s)
Humans , Male , Female , Middle Aged , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Nephrostomy, Percutaneous/adverse effects , Prone Position , Intraoperative Complications/classification , Severity of Illness Index , Obesity/epidemiology , Comorbidity , Prospective Studies , Blood Coagulation Disorders/epidemiology , Nephrolithiasis/surgeryABSTRACT
INTRODUCTION: Clavien-Dindo classification system has been proposed to grade perioperative complications in percutaneous nephrolithotomy. The complications of this technique that have taken place in the last 2 years are reported in this paper according Clavien-Dindo classification. MATERIALS AND METHODS: Between 2011 and 2012 a total of 255 percutaneous nephrolithotomy were performed at our center for stones more than 2 cm in size. In order to determine the incidence of complications classified in the modified Clavien-Dindo system, statistical analysis of the data obtained was carried out. RESULTS: During the period analyzed, 255 percutaneous nephrolithotomy were performed in 249 patients, 41% of the right side, 57% of the left side and 2% bilateral and simultaneous. 137 and 112 patients were males and females, respectively. The most prevalent comorbidities were: hypertension (AHT) in 101 patients (40.6%), BMI>30 in 81 patients (32%), diabetes mellitus in 46 patients (18.5%) and coagulation abnormalities in 24 patients (9.6%). A total of 70 cases (27.4%) were distributed according to Clavien-Dindo classification: grade i, 8.4%, grade ii 8.4%, grade iiia 4.4%, grade iiib 6% grade iva .8%, grade ivb: 0% and grade v 0%. CONCLUSIONS: A graded classification scheme for reporting the complications of percutaneous nephrolithotomy is useful for monitoring and reporting outcomes. We propose a standardized use of this classification in order to make the results comparable among different centers performing the technique.
Subject(s)
Nephrostomy, Percutaneous/adverse effects , Postoperative Complications/classification , Prone Position , Severity of Illness Index , Adolescent , Adult , Aged , Aged, 80 and over , Blood Coagulation Disorders/epidemiology , Comorbidity , Diabetes Mellitus/epidemiology , Female , Humans , Hypertension/epidemiology , Male , Middle Aged , Nephrolithiasis/epidemiology , Nephrolithiasis/surgery , Nephrostomy, Percutaneous/methods , Obesity/epidemiology , Postoperative Complications/etiology , Prospective Studies , Young AdultABSTRACT
A new approach is proposed for estimating the incidence curve of HIV infection and obtaining short term prediction of AIDS incidence. It is based on the method of back calculation which utilizes the fact that AIDS incidence is generated from HIV infection incidence by convolution with the incubation period distribution, but avoids the difficulties associated with approximating the infection incidence curve by a class of step functions. Instead, the infection incidence is modelled as a simple stochastic epidemic process which ensures smoothness of the estimate. We first derive the distribution of AIDS incidence knowing infection incidence. The best linear estimators of infection incidence as well as future AIDS incidence are given; a smoothed past AIDS incidence is also obtained. The parameters of the stochastic infection process can be estimated by maximum likelihood using a normal approximation to the marginal distribution of the AIDS incidence. This approach is applied to AIDS incidence data in the United States up to mid 1987. We find that the epidemic started in mid 1976, peaked at the end of 1983 and dropped afterwards.
Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , Bayes Theorem , HIV Infections/epidemiology , HIV Seroprevalence/trends , Acquired Immunodeficiency Syndrome/transmission , France/epidemiology , HIV Infections/transmission , Homosexuality/statistics & numerical data , Humans , Incidence , Models, StatisticalSubject(s)
HIV Infections/epidemiology , Female , France/epidemiology , Hospitals, Teaching , Humans , Male , Population Surveillance/methodsSubject(s)
Adult , Humans , Female , Lymphadenitis/pathology , Lymphadenitis/diagnosis , Necrosis , Diagnosis, Differential , Acute Disease , Lymphoma, Non-Hodgkin/diagnosis , SyndromeABSTRACT
This is the Laudatory speech given at the Academy of Medicine by Dr. Raúl Etcheverry in memory of the late Professor Hernán Alessandri (1900-1981). The lecture, a hematologist and one of Dr. Alessandri's disciples gave touching notes on his outstanding personality, memories of this scholarly by career at the Department of Medicine of the Salvador Hospital in Santiago, and on his contributions to Chilean Medicine.(AU)
Subject(s)
Humans , History of Medicine , Famous Persons , Physicians/history , ChileABSTRACT
This is the Laudatory speech given at the Academy of Medicine by Dr. Raúl Etcheverry in memory of the late Professor Hernán Alessandri (1900-1981). The lecture, a hematologist and one of Dr. Alessandri's disciples gave touching notes on his outstanding personality, memories of this scholarly by career at the Department of Medicine of the Salvador Hospital in Santiago, and on his contributions to Chilean Medicine.
