Analgesia-free flexible ureteroscopic treatment and laser lithotripsy for removal of a large urinary stone: a case report

The use of eponyms in medical case reports: etymological, quantitative, and structural analysis

BACKGROUND

The present paper focuses on eponyms, that is, terms with proper names, in particular, derived from world mythologies, the Bible, and modern literature. The study highlights the significance of this terminological phenomenon in the English sublanguage of medicine and discusses its role in the process of writing medical case reports. The objectives of the research are to study the prevalence of eponyms in the English language in medical case reports and to analyze the etymology of the revealed terms. The deeper purpose of our study is to demonstrate that eponymic terms in general, and mythological and literary eponyms, in particular, are present in doctors' spoken and written discourse far more extensively than might seem at first glance. By drawing attention to this terminological phenomenon, we will provide relevant guidelines, which will ensure the correct use of eponyms by medical professionals who will deal with the genre of medical case reports.

METHODS

We studied the prevalence of these terms in the issues of Journal of Medical Case Reports (2008-2022) and classified them according to their etymological origin and frequency of use. The selected medical case reports were considered using the methods of quantitative examination, and structural, etymological, and contextual analyses.

RESULTS

We detected the major tendencies in using mythological and literary eponyms in medical case reports. We found a total of 81 mythological and literary eponyms, represented by 3995 cases of use in Journal of Medical Case Reports issues, and traced the etymology of their onomastic components. Hence, we delineated the five most prevalent sources of these terminological units: Greek mythology, Roman mythology, other world mythologies, the Bible, and fiction. The research revealed that modern medical case reports largely rely primarily on Greek mythology (65 eponyms, 3633 results), which is due to a rich informational and metaphorical arsenal of these ancient corpora of human knowledge. The group of eponyms rooted in Roman mythology ranks second, and these terms are much less prevalent in modern medical case reports (6 eponyms, 113 results). Four eponyms (88 results) represent other world mythologies (Germanic and Egyptian). Two terms with onomastic components come from the Bible (15 results), and four eponyms stem from modern literature (146 results). We also detected several widespread mistakes in the spelling of some mythological and literary eponyms. It is our opinion that the awareness of an eponym's etymology can effectively prevent and minimize the appearance of such errors in medical case reports.

CONCLUSIONS

The adequate use of mythological and literary eponyms in medical case reports is an effective way to share one's clinical findings with colleagues from all over the world, because these eponyms are internationally widespread and understood. Correct use of eponyms promotes the continuity of medical knowledge and ensures conciseness and brevity, which are indispensable features of medical case reports as a genre. Therefore, it is highly important to draw students' attention to the most prevalent mythological and literary eponyms, used in contemporary medical case reports, so they could use them appropriately, as well as with due awareness of the origin of these terms. The study also demonstrated that medicine and humanities are closely related and inherently interconnected areas. We believe that the study of this group of eponyms should be an integral component of doctors' training and continuing professional education. This will ensure the interdisciplinary and synergic approach in modern medical education, which in turn will promote the all-round development of future healthcare specialists, endowed not only with professional expertise, but also with extensive background knowledge.

Analysis of the Causes and Preventive Strategies of Urogenic Sepsis after Flexible Ureteroscopic Lithotripsy

Objective. To explore the causes of urogenic sepsis in patients after flexible ureteroscopic lithotripsy and analyze the preventive strategies. Methods. A total of 240 patients who underwent flexible ureteroscopic lithotripsy in our hospital from January 2019 to June 2022 were selected and divided into 2 groups according to whether postoperative ureteral sepsis occurred. 24 cases occurred in the observation group. Logistics multivariate regression analysis was used to analyze the risk factors of urogenic sepsis after flexible ureteroscopic lithotripsy, and the serum albumin (ALB), the peripheral blood neutrophil-to-lymphocyte ratio (NLR), and the level of procalcitonin (PCT) were correlated, and the ROC curve was used to analyze the predictive value of each index for urosepsis. Results. Univariate analysis showed that there were differences in gender, age, diabetes, stone diameter, and urine culture ratio between the two groups ( $P<0.05$ ). The results of multivariate regression analysis showed that female, age ≥60 years, stone diameter >2.5 cm, and positive urine culture were the main influencing factors for the occurrence of urogenic sepsis. After operation, the ALB levels in the two groups were lower than those before operation, and the levels of NLR and PCT in the two groups were higher than those before operation; the ALB levels in the observation group were lower than those in the control group, and the NLR and PCT in the observation group were higher than those in the control group ( $P<0.05$ ). According to Spearman’s correlation analysis, ALB was negatively correlated with the occurrence of uremia ( $P<0.05$ ), r = −0.320, NLR and PCT were positively correlated with the occurrence of uremia ( $P<0.05$ ), r = 0.313, respectively, and 0.417; in addition, Pearson’s correlation analysis showed that ALB was negatively correlated with NLR and PCT in the two groups ( $P<0.05$ , r = −0.507, −0.605 in the control group, respectively, and r were −0.452 and −0.412 in the observation group). There was a positive correlation between NLR and PCT ( $P<0.05$ ), r = 0.840, and there was no correlation between NLR and PCT in the observation group ( $P>0.05$ ). According to the ROC curve analysis, the predictive value AUC of ALB, NLR, PCT and combined use were 0.808, 0.801, 0.901, and 0.925 ( $P<0.05$ ). Conclusion. Gender, age, stone diameter, and urine culture results are the main influencing factors for the occurrence of urinary sepsis. Therefore, preventive measures should be strengthened for this group of patients. In addition, the combined use of postoperative ALT, NLR, and PCT level tests can be better.

Clinical effects of FURL and PCNL with holmium laser for the treatment of kidney stones

In the present study, the clinical effects of flexible ureteroscopy lithotripsy (FURL) and percutaneous nephrolithotomy (PCNL) for the treatment of kidney stones of ≤2 cm was studied. Seventy-two patients with kidney stones were randomly divided into the FURL group (n=39) under ureteroscope lithotripsy with holmium laser and PCNL group (n=33) under PCNL with holmium laser and compared their clinical effects. At 3 months after the operation, the stone removal rate of the FURL group was significantly higher than that of the PCNL group. The subgroup analysis revealed that the difference in the lower kidney calyx was more obvious (P<0.05) while the difference in the complex kidney stones was not statistically significant (P>0.05). The incidence of complications of the FURL group was significantly lower than that of the PCNL group (P<0.05). The operation time and recurrence rate of the FURL group were significantly less than that of the PCNL group (P<0.05). Differences regarding the creatinine and urea nitrogen levels before operation, and 3 and 7 days after the operation between the two groups were not statistically significant (P>0.05). Additionally, 3 and 7 days after operation, the cystatin C levels of the FURL group were significantly higher than those of the PCNL group, and the KIM-1 levels were significantly lower than the PCNL group (P<0.05). In conclusion, compared with PCNL with holmium laser, FURL with holmium laser was more safe and effective in treating kidney stones ≤2 cm. Therefore, the method is worthy of wide application in clinic.