A PHP Error was encountered

Severity: Warning

Message: fopen(/var/lib/php/sessions/ci_sessionncs210f053nnm6dqap6kpd24fs1ued5d): Failed to open stream: No space left on device

Filename: drivers/Session_files_driver.php

Line Number: 177

Backtrace:

File: /var/www/html/index.php
Line: 316
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: session_start(): Failed to read session data: user (path: /var/lib/php/sessions)

Filename: Session/Session.php

Line Number: 137

Backtrace:

File: /var/www/html/index.php
Line: 316
Function: require_once

Renal Pelvis Urine Sampling in Patients with Obstructed, Infected Ureterolithiasis: A Retrospective Quality Improvement Initiative. | LitMetric

AI Article Synopsis

  • - Patients with urinary tract infections related to obstructing kidney stones may not improve with standard urine tests, so the study investigated renal pelvis urine cultures (RPUCx) as a potential alternative to midstream urine cultures (MUSCx) for better treatment guidance.
  • - Of the 257 patients who underwent emergent stenting, 31% had different pathogens in their renal pelvis compared to their MUSCx, indicating that RPUCx offers more accurate identification of infections.
  • - Using RPUCx led to fewer complications after stone management and did not significantly increase the time of the stenting procedure, showing it can effectively inform treatment while minimizing risks.

Article Abstract

Patients who present with urinary tract infections secondary to obstructing stones occasionally fail to improve on treatment based on midstream urine culture (MUSCx). Varying microbiomes between the bladder and the renal pelvis may account for this. In this study, we sought to investigate the utility of obtaining a renal pelvis urine culture (RPUCx) at the time of stenting to guide antibiotic treatment prior to definitive stone operation. RPUCx was obtained in 257 patients presenting with obstructive ureteral stones undergoing emergent stenting. Concordance rates of RPUCx to MUSCx and blood cultures were examined. Operative time and infectious complication rates after definitive stone management between the two groups were studied. A comparison of those who received an intraoperative RPUCx with those who did not was carried out. RPUCx was obtained in patients undergoing emergent stenting from 2018 to -2021; 31% (52/168) of patients had pathogens in the renal pelvis that were absent in the MUSCx. RPUCx had a greater concordance rate with blood culture results compared with MUSCx (95% 50%). Drawing RPUCx intraoperatively did not significantly change operative time (15.9 13.6 minutes, = 0.15). Treatment tailored to RPUCx resulted in lower rates of post-stone management complications (odds ratio 0.26, 95% confidence interval = 0.08-0.83; = 0.01). RPUCx at the time of stenting can guide treatment and decrease post-treatment complications without additional operative time, confirming utility in the treatment of patients with infection secondary to obstructing stones.

Download full-text PDF

Source
http://dx.doi.org/10.1089/end.2024.0179DOI Listing

Publication Analysis

Top Keywords

renal pelvis
16
operative time
12
rpucx
9
pelvis urine
8
secondary obstructing
8
obstructing stones
8
urine culture
8
rpucx time
8
time stenting
8
stenting guide
8

Similar Publications

The aim of the present study was to determine the prognostic significance of a novel marker, the red cell distribution width to lymphocyte percentage (RDW-to-LYM%) ratio, in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). The clinical and follow-up data of 625 patients with UTUC receiving RNU were retrospectively analyzed. The optimal cut-off value of the pre-treatment RDW-to-LYM% ratio was determined as 0.

View Article and Find Full Text PDF

Case 332: Tyrosine Kinase Inhibitor-induced Intestinal Lymphangiectasia.

Radiology

December 2024

From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054.

History A 65-year-old male patient with a history of sarcomatoid renal cell carcinoma and prior right nephrectomy developed recurrent disease adjacent to the inferior vena cava. The patient underwent surveillance imaging 7 months after initiation of treatment with maximum-dose pazopanib and less than 1 month after completing a 2-month regimen of palliative stereotactic body radiation therapy to the right nephrectomy bed and site of recurrence. (Stereotactic body radiation therapy was initiated 5 months after pazopanib treatment was initiated.

View Article and Find Full Text PDF

The primary objective of urolithiasis therapy is complete stone removal and highest stone-clearance rates possible to minimize recurrence. A novel approach that employs a magnetic suspension and a magnetic probe for the passive collection and removal of small residual fragments was developed. This study assessed the feasibility of this system in porcine models.

View Article and Find Full Text PDF

This case report presents a 77-year-old female with dementia and hypertension who experienced reduced consciousness during hydrotherapy. She was found to have hypotension, a low Glasgow Coma Scale score, and right thigh pain. Blood work showed acute kidney injury and elevated inflammatory markers, while imaging revealed surgical emphysema in the right thigh and pelvis without trauma.

View Article and Find Full Text PDF

This retrospective study evaluates the clinical efficacy of combined electroacupuncture and moxibustion for the treatment of neurogenic bladder in patients with spinal cord injury. Ninety patients with neurogenic bladder after spinal cord injury who were admitted to the hospital between January 2021 and August 2023 were included. The patients were divided into the study and control groups (n = 45 each) using a random number table method.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!