Nephrometry scoring with minimal initial instruction was robust across specialties and levels of training. The additional anatomical information that nephrometry score adds to size alone may be associated with other important clinical outcomes such as tumor aggressiveness and survival, and warrants further study.
BackgroundApproximately 12% of all ureteral stents placed are retained or “forgotten.” Forgotten stents are associated with significant safety concerns as well as increased costs and legal issues. Retained ureteral stents (RUS) often occur due to lack of clinical follow-up, communication or language barriers, and economic concerns.MethodsWe describe a multiplatform application that facilitates data collection to prevent RUS. The “Stent Tracker” application can be installed on mobile devices and computers. The encrypted and password-protected information is accessible from any device and provides information about each procedure, stent placement and removal dates, as well as product description. This multicenter retrospective study included 194 patients who underwent stent placement between July and October 2015. Nominal data was tallied and ordinal data was divided into quartiles of 25, 50, and 75%.ResultsA total of 194 patients from three institutions underwent ureteral stent placement. Reasons for stent placement include 122 cases post ureteroscopy (63%), 8 cases post percutaneous nephrolithotomy (PCNL) (4%), 14 cases post extracorporeal shock wave lithotripsy (SWL) (7%), 18 cases of cancer-related ureteral obstruction (9%), 21 cases of hydronephrosis (11%), and 11 for other reasons (6%). Of these patients, only one patient was lost to follow-up (0.5%). On average, ureteral stents were removed within 14 days of placement (IQR: 8-26 days).ConclusionsThe “Stent Tracker” is a patient safety application that provides a secure and simplified interface, which can significantly reduce the incidence of RUS. Further developments could include automated notifications to patients and staff, color-coding, and integrated information with electronic patient charts.
Selection experiments with Drosophila have revealed a possible evolutionary trade-off between cold resistance and starvation resistance that may be controlled by lipid metabolism. To test this trade-off in naturally occurring Drosophila simulans populations, flies were simultaneously collected from two temperate locales experiencing contrasting seasons. Flies from a tropical locale served as a control. Cold coma recovery, starvation resistance and lipid proportion were assayed on adult males and females from each locale. Compared with the summer-collected flies from Canberra, the wintercollected flies from San Diego recovered from cold coma more quickly, were less starvation resistant and had lower lipid levels. These results support an evolutionary trade-off between cold resistance and starvation resistance. Combined, these data also suggest that differences in lipid metabolism may be an underlying mechanism for this trade-off.
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