ABSTRACT
BACKGROUND: The population attributable risk (PAR) percent has used widely in public health policy. We aimed to calculate the attribute risk of hypertension due to hyperuricemia by Levin's formulas compare to direct PAR calculation method. METHODS: This was a sub-study of Yazd Healthy Heart Cohort (YHHC). Overall, 1256 normotensive individuals were enrolled through multistage randomized cluster sampling and followed up for mean 9.8 years, from 2005-2015. The threshold cutoff point of the hyperuricemia was considered equal and more than 75th percentile that equal to 5.5 mg/dl for men and 4.3mg/dl for women. To calculate the attributable risk of hyperuricemia in developing hypertension, two methods were applied. Levin's formulas and direct PAR estimation by population risk calculation via exposure prevalence weighted formula. Multiple logistic regression was used for estimate of odds ratio (OR) of hyperuricemia in developing hypertension. We calculated Relative Risk (RR) from OR. The data were analyzed using SPSS software version 16. A significant level of 0.05 was considered. RESULTS: Hypertension developed in 44.7% of individuals with uric acid level ≥ 75th percentile vs. 35.6% of other individuals (P=0.024). Attributable risk (AR) of hyperuricemia in hypertension incidence was 9.1%. PAR of hyperuricemia for hypertension incidence by using two methods mentioned before was 6%, 5.8% respectively. CONCLUSION: The results of the study confirmed the noticeable contribution of hyperuricemia as an independent other risk factor for the occurrence of hypertension. PAR of hyperuricemia for hypertension incidence by using two methods almost near was 6%, 5.8% respectively.
ABSTRACT
PURPOSE: Our aim was to evaluate the safety and efficacy of percutaneous nephrolithotomy (PCNL) with ultrasonography (US)-guided renal access in the lateral decubitus flank position. PATIENTS AND METHODS: From July 2006 to March 2008, 40 patients with renal stones > 2 cm underwent PCNL with US-guided renal access in the lateral decubitus flank position by a single surgeon. We report our technique and the outcomes in detail. RESULTS: Successful access was achieved in 40 patients (100%). Complete stone clearance rate was 85% (34 patients). After surgery, six (15%) patients had stones (6-11 mm) detected by plain abdominal radiography or sonography and were referred for shockwave lithotripsy. The mean stone size was 29 mm (range 22-43 mm). The mean operative time was 45 minutes (range 32-75 min), and the mean hospital stay was 2.8 days (range 2-4 d). Postoperative US did not reveal considerable fluid collection. There were no visceral injuries. Also, there was no significant bleeding that led to transfusion intraoperatively and postoperatively. CONCLUSION: PCNL with US-guided renal access in the lateral decubitus flank position is safe and convenient, and prevents harmful effects of radiation for the surgeon, the surgical team, and the patient.