Objective: The objective of the study is to analyze the risk factors determining the outcomes of patients with emphysematous pyelonephritis (EPN) by the adoption of a standardized management algorithm as well as to develop a prognostic scoring model to risk stratify these patients.
Materials And Methods: The hospital records of 72 consecutive patients with EPN from February 2012 to January 2018 were retrospectively reviewed. Demographic, clinicoradiographic, and laboratory characteristics were recorded. Patients were managed with a standard management protocol and based on outcomes divided into three groups. Group I survived with conservative management, Group II survived after emergency nephrectomy, and Group III expired. The risk factors for nephrectomy and mortality were analyzed.
Results: The mean age was 53 years. Male to female ratio was 4:5. There were 61 (84.7%), 4 (5.6%), and 7 (10%) patients in Groups I, II, and III, respectively. Diabetes mellitus was the most common comorbidity detected in 62 (86%) of patients. Type II EPN was the most common radiological presentation observed in 32 (44%) patients. Overall survival rate was 90%, and kidney salvage rate was 80%. was the most common organism isolated. Thirty-two (45%) patients exhibited resistance to third-generation cephalosporin antibiotics. Thrombocytopenia, low body mass index (BMI), presence of >2 comorbidities, high total leukocyte count (TLC), and hypoalbuminemia were significantly associated with mortality. On adoption of the prognostic scoring system, mortality rates according to the risk subgroups were as follows: favorable - 0%, intermediate - 19%, and poor - 100%.
Conclusion: Conservative management adopting appropriate algorithm reduces mortality and avoids unnecessary emergency nephrectomies. Thrombocytopenia, low BMI, presence of >2 comorbidities, high TLC, and hypoalbuminemia were significantly associated with mortality.
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http://dx.doi.org/10.4103/UA.UA_17_19 | DOI Listing |
Eur J Med Res
January 2025
Department of General, Visceral and Thoracic Surgery, German Armed Forces Central Hospital, Koblenz, Germany.
Liquid biomarkers are essential in trauma cases and critical care and offer valuable insights into the extent of injury, prognostic predictions, and treatment guidance. They can help assess the severity of organ damage (OD), assist in treatment decisions and forecast patient outcomes. Notably, small extracellular vesicles, particularly those involved in splenic trauma, have been overlooked.
View Article and Find Full Text PDFBMC Cancer
January 2025
Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking, Beijing, 100023, People's Republic of China.
Background: Pancreatic cancer is a highly aggressive neoplasm characterized by poor diagnosis. Amino acids play a prominent role in the occurrence and progression of pancreatic cancer as essential building blocks for protein synthesis and key regulators of cellular metabolism. Understanding the interplay between pancreatic cancer and amino acid metabolism offers potential avenues for improving patient clinical outcomes.
View Article and Find Full Text PDFAnn Hematol
January 2025
Department of Hematology, Beijing Chaoyang Hospital, Myeloma Research Center of Beijing, Capital Medical University, Gongtinanlu No 8, Chaoyang District, Beijing, 100020, China.
1q21gain/amp is the most common in patients with multiple myeloma. However, there is limited research on the prognostic heterogeneity of 1q21+, and the prognostic of the 1q21 copy remains controversial. In this study, we primarily conducted a retrospective analysis of the prognostic significance of 1q21 gain/amp in 375 newly diagnosed multiple myeloma patients.
View Article and Find Full Text PDFClin Breast Cancer
December 2024
Department of Oncology, The First Hospital of Jiaxing (Affiliated Hospital of Jiaxing University), Jiaxing, Zhejiang, China. Electronic address:
Introduction: The role of postmastectomy radiotherapy (PMRT) in clinical prognostic stage I-III breast cancer patients with positive responses and achieving ypN0 after Neoadjuvant therapy (NAT) is controversial.
Methods: 3557 patients with TNM clinical prognostic stage (AJCC 8th Edition) I-III breast cancer with positive responses and achieving ypN0 following neoadjuvant therapy were selected from the Surveillance, Epidemiology, and End Results (SEER) database and followed through the end of 2020. COX proportional hazards models were employed to examine the associations between clinical or pathological parameters and OS.
J Neurosurg
January 2025
1Department of Neurological Surgery and.
Objective: Traumatic hemorrhagic cerebral contusions are a well-established cause of morbidity and mortality in neurosurgery. This study aimed to determine prognostic factors for long-term functional outcomes and longitudinal contusion volume changes in traumatic brain injury (TBI) patients.
Methods: Data from 285 patients with traumatic cerebral contusions were retrospectively reviewed to identify variables predictive of initial contusion volume, contusion expansion on short-term follow-up imaging, and functional outcomes according to the modified Rankin Scale (mRS).
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