Objectives:Supracostal access during percutaneous nephrolithotomy(PCNL)increases the risk of pulmonary complications.Although routine postoperative thoracic imaging is commonly performed to detect these events,its cli...Objectives:Supracostal access during percutaneous nephrolithotomy(PCNL)increases the risk of pulmonary complications.Although routine postoperative thoracic imaging is commonly performed to detect these events,its clinical necessity remains controversial.This study aimed to assess the necessity of routine postoperative thoracic imaging for detecting pulmonary complications in patients undergoing supracostal mini percutaneous nephrolithotomy(m-PCNL)surgery.Methods:A retrospective analysis was conducted on data from patients who underwent supracostal m-PCNL between 2017 and 2022 in a tertiary center.Excluding patients under 18,with kidney/skeletal anomalies,or active thoracic disease,112 eligible patients were included.Patients were divided into two groups:those with routine postoperative chest X-ray(CXR)(Group 1,n=40)and those without(Group 2,n=72).Complications and operative data were compared between groups.Results:Mean ages were 44.3±11.4(Group 1)and 42.6±13.1(Group 2),with no significant difference(p=0.102).Stone sizes were 30.8±8.6 mm(Group 1)and 24.8±8.4 mm(Group 2),also not significantly different(p=0.313).High fever occurred in 10% of Group 1 and 4% of Group 2(p=0.246).Minimal effusion was found in 10% of Group 1,with no treatment due to lack of symptoms.However,subsequent CXR revealed hydropneumothorax in 2.5% of cases,necessitating thoracic tube insertion.In Group 2,5% developed postoperative respiratory symptoms,with significant pneumothorax in 1.3%,requiring thoracic tube placement.Thoracic tube insertion rates did not significantly differ between groups(Group 1:2.5%vs.Group 2:1.3%,p=0.671).Conclusions:Routine postoperative thoracic imaging did not show any significant benefit in detecting pulmonary complications post-supracostal m-PCNL.展开更多
Dapoxetine hydrochloride is a selective serotonin reuptake inhibitor and the first drug approved for the on-demand treatment of premature ejaculation （PE）, Our objective in this study was to characterize the efficac...Dapoxetine hydrochloride is a selective serotonin reuptake inhibitor and the first drug approved for the on-demand treatment of premature ejaculation （PE）, Our objective in this study was to characterize the efficacy of on-demand dapoxetine （30 and 60 mg） and daily paroxetine （20 mg） usage in treating PE, We conducted a 1 month study involving a total of 150 patients. Patients were divided into three groups of 50, Group 1 were treated with on-demand dapoxetine （30 mg）, Group 2 with on-demand dapoxetine （60 mg） and Group 3 with daily paroxetine （20 rag）, Our outcome measurement was increased from baseline intravaginal ejaculatory latency time （IELT） after treatment, The IELT increased from baseline to posttreatment by 117%, 117% and 170% in the paroxetine group （P 〈 0,01）, 30 mg dapoxetine group （P 〈 0,01） and 60 mg dapoxetine group （P 〈 0.01）, respectively, The increase from baseline IELT were similar for the 30 mg dapoxetine and paroxetine groups （P 〉 0,05）, while the 60 mg dapoxetine group had a larger posttreatment IELT increase compared with the 30 mg dapoxetine （P〈 0.05） and paroxetine （P〈 0.01） groups, Dapoxetine （60 mg） 1-3 h before planned intercourse is a very effective treatment modality for PE. However, an on-demand dose of 30 mg dapoxetine is no more effective than the currently prescribed paroxetine treatment.展开更多
文摘Objectives:Supracostal access during percutaneous nephrolithotomy(PCNL)increases the risk of pulmonary complications.Although routine postoperative thoracic imaging is commonly performed to detect these events,its clinical necessity remains controversial.This study aimed to assess the necessity of routine postoperative thoracic imaging for detecting pulmonary complications in patients undergoing supracostal mini percutaneous nephrolithotomy(m-PCNL)surgery.Methods:A retrospective analysis was conducted on data from patients who underwent supracostal m-PCNL between 2017 and 2022 in a tertiary center.Excluding patients under 18,with kidney/skeletal anomalies,or active thoracic disease,112 eligible patients were included.Patients were divided into two groups:those with routine postoperative chest X-ray(CXR)(Group 1,n=40)and those without(Group 2,n=72).Complications and operative data were compared between groups.Results:Mean ages were 44.3±11.4(Group 1)and 42.6±13.1(Group 2),with no significant difference(p=0.102).Stone sizes were 30.8±8.6 mm(Group 1)and 24.8±8.4 mm(Group 2),also not significantly different(p=0.313).High fever occurred in 10% of Group 1 and 4% of Group 2(p=0.246).Minimal effusion was found in 10% of Group 1,with no treatment due to lack of symptoms.However,subsequent CXR revealed hydropneumothorax in 2.5% of cases,necessitating thoracic tube insertion.In Group 2,5% developed postoperative respiratory symptoms,with significant pneumothorax in 1.3%,requiring thoracic tube placement.Thoracic tube insertion rates did not significantly differ between groups(Group 1:2.5%vs.Group 2:1.3%,p=0.671).Conclusions:Routine postoperative thoracic imaging did not show any significant benefit in detecting pulmonary complications post-supracostal m-PCNL.
文摘Dapoxetine hydrochloride is a selective serotonin reuptake inhibitor and the first drug approved for the on-demand treatment of premature ejaculation （PE）, Our objective in this study was to characterize the efficacy of on-demand dapoxetine （30 and 60 mg） and daily paroxetine （20 mg） usage in treating PE, We conducted a 1 month study involving a total of 150 patients. Patients were divided into three groups of 50, Group 1 were treated with on-demand dapoxetine （30 mg）, Group 2 with on-demand dapoxetine （60 mg） and Group 3 with daily paroxetine （20 rag）, Our outcome measurement was increased from baseline intravaginal ejaculatory latency time （IELT） after treatment, The IELT increased from baseline to posttreatment by 117%, 117% and 170% in the paroxetine group （P 〈 0,01）, 30 mg dapoxetine group （P 〈 0,01） and 60 mg dapoxetine group （P 〈 0.01）, respectively, The increase from baseline IELT were similar for the 30 mg dapoxetine and paroxetine groups （P 〉 0,05）, while the 60 mg dapoxetine group had a larger posttreatment IELT increase compared with the 30 mg dapoxetine （P〈 0.05） and paroxetine （P〈 0.01） groups, Dapoxetine （60 mg） 1-3 h before planned intercourse is a very effective treatment modality for PE. However, an on-demand dose of 30 mg dapoxetine is no more effective than the currently prescribed paroxetine treatment.
