External validation of Modified Seoul National University Renal Stone Complexity Score to predict outcome and complications of retrograde intrarenal surgery: a RIRSearch Group study.

INTRODUCTION: The Modified Seoul National University Renal Stone Complexity Score (S-ReSC) is a simple model based solely on stone location regardless of stone burden. The aims of this study were to validate S-ReSC for outcomes and complications of retrograde intrarenal surgery (RIRS) and to evaluate its predictive power against the stone burden. MATERIAL AND METHODS: Data of 1007 patients with kidney stones who had undergone RIRS were collected from our RIRSearch database. Linear-by-linear association, logistic regression, ANOVA/post hoc analysis and ROC curve (with Hanley and McNeil's test) were used for evaluation. The main outcomes were stone-free status and complications of RIRS. RESULTS: The overall stone-free rate was 76.8% (773/1007). Higher S-ReSC scores were related to lower stone-free rates and higher total, perioperative and postoperative complication rates (p<.001, p<.001, p=.008 and p<.001, respectively). S-ReSC score (p=.02) and stone burden (p<.001) were independent predictors of stone-free status. But stone burden (AUC = 0.718) had a more powerful discriminating ability than the S-ReSC score (AUC = 0.618). CONCLUSIONS: The S-ReSC score is able to predict not only stone-free status but also complications of RIRS. Although this location-only based scoring system has a fair discriminative ability, stone burden is a more powerful predictor of stone-free status after RIRS. An ideal scoring system aiming to predict outcomes of RIRS must include stone burden as a parameter.

Mean platelet volume and platelet distribution as a diagnostic marker for penile vascular disease in patients with erectile dysfunction / Volumen medio de plaquetas y distribución de plaquetas como marcador diagnóstico para la enfermedad vascular peneana en pacientes con disfunción eréctil

Objective. To investigate the relationship between platelet activation parameters that are involved in the vascular response, the atherothrombotic process, and erectile function, in which epithelial dysfunction plays a significant role. Materials and methods. A study was performed on patients who had a color Doppler ultrasound (CDUS) of the penis due to erectile dysfunction. The patients were divided into two groups: those with normal CDUS findings, and those with vascular dysfunction on CDUS. Patients were also divided into two groups according to their scores using the International Index of Erectile Function (IIEF). The relationships between platelet activation factors, vascular parameters, and severity of the disorder were analyzed. Results. A total of 91 patients who fulfilled the inclusion criteria were included in the study. CDUS showed vascular dysfunction in 55 patients (Group I), while the findings were normal in 36 patients (Group II). Age, cholesterol level, disease duration, mean platelet volume (MPV), and platelet distribution width (PDW) were compared between Groups I and II, with Group I showing significantly higher values. The parameters that could affect Doppler ultrasound results were analyzed using multivariate regression analysis. This showed that PDW and disease duration were independent prognostic factors (p = .021 and p = .005, respectively). When the patients were divided into two groups according to their IIEF scores, in those with mild (Group A) and severe disease (Group B), it was found that there were significant differences between the groups with age, disease duration, and PDW, while two groups were found similar in terms of MPV, cholesterol levels, and hormone parameters. Conclusion. It is supposed that increased platelet activation parameters, and PDW in particular, give important information for disease progression and follow-up of vascular dysfunction in erectile dysfunction (AU)

Objetivo. Investigar la relación entre los parámetros de activación de plaquetas involucrados en la respuesta vascular, el proceso aterotrombótico y la función eréctil, en la que la disfunción endotelial desempeña un papel importante. Material y métodos. Se analizaron los pacientes en los que se realizó una ecografía Doppler color (EDC) del pene por disfunción eréctil. Los pacientes fueron divididos en 2 grupos: con resultados normales en la EDC y con disfunción vascular en la EDC. Los pacientes fueron asimismo divididos en 2 grupos en función de las puntuaciones del Índice Internacional de Función Eréctil (IIFE). Se analizaron las relaciones entre los factores de activación plaquetaria, los parámetros vasculares y la gravedad del trastorno. Resultados. Un total de 91 pacientes que cumplieron los criterios de inclusión fueron incluidos en el estudio. La EDC mostró disfunción vascular en 55 pacientes (grupo i), mientras que los resultados fueron normales en 36 pacientes (grupo ii). La edad, el nivel de colesterol, la duración de la enfermedad, el volumen medio de plaquetas (VMP) y la anchura de distribución de las plaquetas (ADP) se compararon entre los grupos i y ii; además, los valores fueron expresivamente más altos en el grupo i. Los parámetros que podrían afectar los resultados de la EDC se valoraron con el análisis de regresión multivariante, lo que demostró que la ADP y la duración de la enfermedad fueron factores pronósticos independientes (p = 0,021 y p = 0,005, respectivamente). Cuando los pacientes fueron divididos en 2 grupos en función de las puntuaciones IIFE, en aquellos con enfermedad leve (grupo A) y enfermedad grave (grupo B) se encontraron diferencias significativas entre los grupos con la edad, la duración de la enfermedad y la ADP, mientras que ambos grupos fueron similares en términos de VMP, de niveles de colesterol y de parámetros hormonales. Conclusión. Al parecer, el aumento de los parámetros de activación plaquetar, y especialmente la ADP, proporcionan una importante información para la progresión de la enfermedad y el seguimiento de la disfunción vascular en la disfunción eréctil (AU)