Is Guy's stone score useful for predicting outcomes in percutaneous nephrolithotomy?

INTRODUCTION: Percutaneous Nephrolithotomy (PCNL) is currently the treatment of choice in large kidney stones. Guy's stone score was developed to predict treatment outcomes. The aim of this study was to evaluate the relationship between Guy's score and outcomes in our institution. MATERIALS AND METHODS: The medical records of patients diagnosed with urolithiasis and treated by PCNL were retrospectively evaluated between January 2017 and December 2018. Analyzed data included: age, sex, Guy's score based on preoperative findings, transfusion, stone-free rate and requirement of auxiliary procedures. Chi-square test was used for the comparison of proportions. Odds ratios (OR) with confidence intervals (CIs) of 95% were calculated by logistic regression. RESULTS: A total of 386 patients, 53.89% female, mean age of 45.59 ±â€¯15 years were analyzed. Guy's score was as follows: 112 patients (29.04%) were classified as Guy I, 92 patients (23.82%) as Guy II, 94 patients (24.34%) as Guy III, and 88 patients (22.80%) as Guy IV. There were no differences between groups in terms of blood transfusions. Stone-free rate was 96.43% (n = 108) for patients Guy I; 84.78% (n = 72) for Guy II; 76.59% (n = 72) for Guy III and 50% (n = 44) for Guy IV categories (p < 0.0001). Taking as a reference Guy I group, the OR to require new treatment for residual stones were: Guy II 4.85 (CI = 0.95 to 24.60, P = 0.05) to Guy III 8.25 (CI = 1.73 to 39.44, P = 0.008) and Guy IV 27 (CI = 5.84 to 124.70; p < 0.0001). CONCLUSION: There was a statistically significant association between Guy's Score and stone-free rates following PCNL. Guy's score was useful to predict results of PCNL in our group.

Biosecurity assessment of Argentinian pig farms.

The pig industry is growing very fast in Argentina with an increasing need for replacement animals, feedstuff and transportation of animals. One of the main competitive advantages of the Argentinian pig industry is its being free of most major pig diseases. Within this context, applying measures aimed to reduce the risk of introduction and spread of pathogens is critical. The aim of the present study was to assess the biosecurity of Argentinian pig farms. Two types of farms were assessed: firstly, all official suppliers of high-genetic-value (n = 110) and secondly, a sample from commercial farms (n = 192). Data on the external and internal biosecurity practices applied on the farms was collected with a questionnaire. Data was analysed using a correspondence analysis and a hierarchical clustering analysis, which allowed identification of types of farms with regard to the biosecurity measures applied. Key variables characterizing the clusters were identified through an indicator value analysis. In addition, the external biosecurity of the farms was evaluated by using risk assessment tools with respect to the potential introduction of porcine epidemic diarrhoea virus. Results made evident three clusters: the first one which, amongst other measures, applied several barriers to prevent the entry of people, trucks and other vehicles, and could be considered as a group of high biosecurity, and the two other groups which applied a lower number of external and internal biosecurity measures. The results of the risk assessment showed that the routes with the highest risk of disease introduction were: replacement animals, vehicles transporting feed or animals, and visitors. The assessment of the external biosecurity showed that most Argentinian farms were not prepared for the contingency of a pathogen such as porcine epidemic diarrhoea virus. Special efforts should be made in official suppliers of high-genetic-value farms with poor biosecurity scores since they are at the top of the pig production chain and can be key for the spread of diseases.

Unplanned flexible ureteroscopy during percutaneous nephrolithotomy in the prone position.

BACKGROUND: Over time, the prone position has been shown to be effective and safe for performing percutaneous nephrolithotomy. One of its disadvantages, however, is the inability to simultaneously perform an ureteroscopy after positioning the patient, which is feasible in the supine position. Our objective is to demonstrate the feasibility of implementing flexible ureteroscopy with the patient in the prone position. MATERIAL AND METHODS: We present a case of percutaneous nephrolithotomy of partial staghorn calculi in the prone position during which access to the middle calyx was not possible. It was therefore necessary to conduct flexible ureteroscopy. The 64-year-old female patient had consulted for lumbar pain of 6 months of evolution. RESULTS: We performed percutaneous nephrolithotomy in the prone position. After extracting calculi from the inner calyx and renal pelvis, access to the fragments located in the middle calyx could not be achieved. Rather than performing a new puncture, we decided to enter in a retrograde manner with a flexible ureteroscope, succeeding in extracting the residual calculi, leaving the patient completely free of calculi. CONCLUSION: In our case, the implementation of retrograde flexible ureteroscopy was feasible without changing the patient's original position.

First confirmed diagnosis of Sheep-associated Malignant Catarrhal Fever in Bison in Argentina

In Argentina, cases of malignant catarrhal fever (MCF) are suspected to have occurred according to macro and microscopic lesions. However, none has been corroborated by molecular tests. We describe here the first laboratory confirmed case of MCF in Argentina occurring in American bison confined in the Buenos Aires Zoo.(AU)

First confirmed diagnosis of sheep-associated malignant catarrhal fever in bison in Argentina

In Argentina, cases of malignant catarrhal fever (MCF) are suspected to have occurred according to macro and microscopic lesions. However, none has been corroborated by molecular tests. We describe here the first laboratory confirmed case of MCF in Argentina occurring in American bison confined in the Buenos Aires Zoo.

[Congenital prepubic sinus: case report]. / Seno prepúbico congénito. A propósito de un caso.

The prepubic congenital sinus is a rare type of urethral duplication of unknown origin. Different embryological theories and classifications has been proposed. Most cases are diagnosed during childhood. The Retrograde Urethrocystography is very important as it determines the diagnosis and helps choosing the best treatment option. We present a case of a prepubic congenital sinus in a 39 years old male who presented with purulent discharge from an accessory meatus in the base of the penis.

Phylogenetic analysis of classical swine fever virus (CSFV) field isolates from outbreaks in South and Central America.

To date, there is little information concerning the epidemiological situation of classical swine fever (CSF) in the Americas. Besides summarizing the available data, genotyping of isolates from outbreaks in domestic pigs in several countries of South and Central America was performed. For this, a 190 base fragment of the E2 envelope glycoprotein gene was used. European strains and isolates, and historical isolates from the United States (US) were included for comparison. In contrast to the situation in most parts of Europe, where group 2 isolates predominate, it was found that all the isolates from the American continent analyzed belonged to group 1 and were further resolved into three subgroups. The Cuban isolates clustered in subgroup 1.2, whereas the isolates from Honduras and Guatemala clustered in subgroup 1.3. The remaining isolates from Argentina, Brazil, Colombia and Mexico generated four poorly resolved clusters in subgroup 1.1, together with the vaccine strains, with historical European and US isolates, and with a recent Russian isolate. While the vaccine strains and the historical European isolates formed a relatively distinct cluster, one of the US isolates clustered together with the Mexican, and another one with Colombian isolates. Historically, CSF (hog cholera) was observed almost simultaneously in the US and in Europe in the first half of the 19th century, and its origin remains a matter of discussion. Our results showed that the US isolates are closely related to isolates from South America, while appearance of isolates in Cuba on one hand and in Honduras and Guatemala on the other hand, seems to have been due to unrelated events. This allows to speculate that at least in the American continent, CSF virus may have appeared independently in several regions, and spreading may have been a secondary effect.

Efectos de la procaina e.v. sobre el sistema de conducción intracardiaco / Effects of the procaine i.v. on the heart conduction system

En el presente trabajo se estudian los efectos producidos por la procaína sobre el sistema de conducción intracardíaco con el método de registro directo del haz de His en perros, observándose a pesar de lo pequeño de la muestra valores altamente significativos de daño al sistema de conducción. Los valores observados se hacen evidentes a partir de la segunda dosis terapéutica lo que refleja el estrecho margen con el cual se trabaja con esta droga en anestesia general quirúrgica (AU)

Efectos de la procaina e.v. sobre el sistema de conducción intracardiaco / Effects of the procaine i.v. on the heart conduction system

En el presente trabajo se estudian los efectos producidos por la procaína sobre el sistema de conducción intracardíaco con el método de registro directo del haz de His en perros, observándose a pesar de lo pequeño de la muestra valores altamente significativos de daño al sistema de conducción. Los valores observados se hacen evidentes a partir de la segunda dosis terapéutica lo que refleja el estrecho margen con el cual se trabaja con esta droga en anestesia general quirúrgica