The Experts below are selected from a list of 318 Experts worldwide ranked by ideXlab platform
Zhiqiang Chen - One of the best experts on this subject based on the ideXlab platform.
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A novel comprehensive predictive model for obstructive Pyonephrosis patients with upper urinary tract stones.
International journal of clinical and experimental pathology, 2020Co-Authors: Xinguang Wang, Kun Tang, Ding Xia, Ejun Peng, Hailang Liu, Zhiqiang ChenAbstract:BACKGROUND Calculous Pyonephrosis tended not to be accurately diagnosed before operations. It is mostly confirmed during percutaneous nephrolithotripsy or percutaneous nephrostomy. We aimed to evaluate the risk factors for predicting obstructive Pyonephrosis patients with upper urinary tract stones. METHODS Clinical data of 322 patients with upper urinary tract stones and obstructive hydronephrosis were retrospectively searched and analyzed in our study. The patients were divided into two groups; Pyonephrosis and non-Pyonephrosis groups. Both disease related factors and infection-associated indicators were analyzed. Univariate and multivariate logistic analyses were performed on preoperative variables. Accordingly, ROC curves were drawn, and a novel comprehensive model was constructed to predict the Pyonephrosis. OUTCOMES Compared to the non-Pyonephrosis group, patients in the Pyonephrosis group showed statistical differences in sex, urinary tract infection (UTI) within 3 months, stone density, computerized tomography (CT) value of hydronephrosis, serum creatinine, hydronephrosis, contralateral kidney severe hydronephrosis or atrophy, preoperative white blood cells, neutrophils, serum C-reactive protein, urine leukocyte, nitrite, and urine culture revealed statistical difference (P
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a novel comprehensive predictive model for obstructive Pyonephrosis patients with upper urinary tract stones
International Journal of Clinical and Experimental Pathology, 2020Co-Authors: Xinguang Wang, Kun Tang, Ding Xia, Ejun Peng, Hailang Liu, Zhiqiang ChenAbstract:BACKGROUND Calculous Pyonephrosis tended not to be accurately diagnosed before operations. It is mostly confirmed during percutaneous nephrolithotripsy or percutaneous nephrostomy. We aimed to evaluate the risk factors for predicting obstructive Pyonephrosis patients with upper urinary tract stones. METHODS Clinical data of 322 patients with upper urinary tract stones and obstructive hydronephrosis were retrospectively searched and analyzed in our study. The patients were divided into two groups; Pyonephrosis and non-Pyonephrosis groups. Both disease related factors and infection-associated indicators were analyzed. Univariate and multivariate logistic analyses were performed on preoperative variables. Accordingly, ROC curves were drawn, and a novel comprehensive model was constructed to predict the Pyonephrosis. OUTCOMES Compared to the non-Pyonephrosis group, patients in the Pyonephrosis group showed statistical differences in sex, urinary tract infection (UTI) within 3 months, stone density, computerized tomography (CT) value of hydronephrosis, serum creatinine, hydronephrosis, contralateral kidney severe hydronephrosis or atrophy, preoperative white blood cells, neutrophils, serum C-reactive protein, urine leukocyte, nitrite, and urine culture revealed statistical difference (P<0.05). Univariate analysis showed that there were significant differences for sex, UTI history, degree of hydronephrosis, contralateral severe hydronephrosis or atrophy, serum creatinine, and CT value of hydronephrosis (P<0.001). Multivariate analysis demonstrated several independent risk factors for Pyonephrosis, including degree of hydronephrosis (P=0.02), CT value of hydronephrosis (P=0.001), urine leukocyte (P=0.002), urine culture (P=0.001) and blood neutrophils (P=0.009). Based on these risk factors, we constructed a novel comprehensive model and confirmed it was an effective method to predict Pyonephrosis (AUC, 0.970). Bootstrapped calibration curves showed no untoward deviation in both training and validation dataset (mean absolute error of 0.027, 0.036). CONCLUSIONS Hydronephrosis, CT value of hydronephrosis, blood neutrophils, urine leukocyte, and urine culture were independent risk factors to predict Pyonephrosis. The novel comprehensive model was found to be an effective method to predict Pyonephrosis and needed to be further confirmed in prospective studies.
Xinguang Wang - One of the best experts on this subject based on the ideXlab platform.
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A novel comprehensive predictive model for obstructive Pyonephrosis patients with upper urinary tract stones.
International journal of clinical and experimental pathology, 2020Co-Authors: Xinguang Wang, Kun Tang, Ding Xia, Ejun Peng, Hailang Liu, Zhiqiang ChenAbstract:BACKGROUND Calculous Pyonephrosis tended not to be accurately diagnosed before operations. It is mostly confirmed during percutaneous nephrolithotripsy or percutaneous nephrostomy. We aimed to evaluate the risk factors for predicting obstructive Pyonephrosis patients with upper urinary tract stones. METHODS Clinical data of 322 patients with upper urinary tract stones and obstructive hydronephrosis were retrospectively searched and analyzed in our study. The patients were divided into two groups; Pyonephrosis and non-Pyonephrosis groups. Both disease related factors and infection-associated indicators were analyzed. Univariate and multivariate logistic analyses were performed on preoperative variables. Accordingly, ROC curves were drawn, and a novel comprehensive model was constructed to predict the Pyonephrosis. OUTCOMES Compared to the non-Pyonephrosis group, patients in the Pyonephrosis group showed statistical differences in sex, urinary tract infection (UTI) within 3 months, stone density, computerized tomography (CT) value of hydronephrosis, serum creatinine, hydronephrosis, contralateral kidney severe hydronephrosis or atrophy, preoperative white blood cells, neutrophils, serum C-reactive protein, urine leukocyte, nitrite, and urine culture revealed statistical difference (P
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a novel comprehensive predictive model for obstructive Pyonephrosis patients with upper urinary tract stones
International Journal of Clinical and Experimental Pathology, 2020Co-Authors: Xinguang Wang, Kun Tang, Ding Xia, Ejun Peng, Hailang Liu, Zhiqiang ChenAbstract:BACKGROUND Calculous Pyonephrosis tended not to be accurately diagnosed before operations. It is mostly confirmed during percutaneous nephrolithotripsy or percutaneous nephrostomy. We aimed to evaluate the risk factors for predicting obstructive Pyonephrosis patients with upper urinary tract stones. METHODS Clinical data of 322 patients with upper urinary tract stones and obstructive hydronephrosis were retrospectively searched and analyzed in our study. The patients were divided into two groups; Pyonephrosis and non-Pyonephrosis groups. Both disease related factors and infection-associated indicators were analyzed. Univariate and multivariate logistic analyses were performed on preoperative variables. Accordingly, ROC curves were drawn, and a novel comprehensive model was constructed to predict the Pyonephrosis. OUTCOMES Compared to the non-Pyonephrosis group, patients in the Pyonephrosis group showed statistical differences in sex, urinary tract infection (UTI) within 3 months, stone density, computerized tomography (CT) value of hydronephrosis, serum creatinine, hydronephrosis, contralateral kidney severe hydronephrosis or atrophy, preoperative white blood cells, neutrophils, serum C-reactive protein, urine leukocyte, nitrite, and urine culture revealed statistical difference (P<0.05). Univariate analysis showed that there were significant differences for sex, UTI history, degree of hydronephrosis, contralateral severe hydronephrosis or atrophy, serum creatinine, and CT value of hydronephrosis (P<0.001). Multivariate analysis demonstrated several independent risk factors for Pyonephrosis, including degree of hydronephrosis (P=0.02), CT value of hydronephrosis (P=0.001), urine leukocyte (P=0.002), urine culture (P=0.001) and blood neutrophils (P=0.009). Based on these risk factors, we constructed a novel comprehensive model and confirmed it was an effective method to predict Pyonephrosis (AUC, 0.970). Bootstrapped calibration curves showed no untoward deviation in both training and validation dataset (mean absolute error of 0.027, 0.036). CONCLUSIONS Hydronephrosis, CT value of hydronephrosis, blood neutrophils, urine leukocyte, and urine culture were independent risk factors to predict Pyonephrosis. The novel comprehensive model was found to be an effective method to predict Pyonephrosis and needed to be further confirmed in prospective studies.
K F Parsons - One of the best experts on this subject based on the ideXlab platform.
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silent hydronephrosis Pyonephrosis due to upper urinary tract calculi in spinal cord injury patients
Spinal Cord, 2000Co-Authors: Subramanian Vaidyanathan, G Singh, B M Soni, Peter L Hughes, J W H Watt, S Dundas, P Sett, K F ParsonsAbstract:Study design: A study of four patients with spinal cord injury (SCI) in whom a diagnosis of hydronephrosis or Pyonephrosis was delayed since these patients did not manifest the traditional signs and symptoms. Objectives: To learn from these cases as to what steps should be taken to prevent any delay in the diagnosis and treatment of hydronephrosis/Pyonephrosis in SCI patients. Setting: Regional Spinal Injuries Centre, Southport, UK. Methods: A retrospective review of cases of hydronephrosis or Pyonephrosis due to renal/ureteric calculus in SCI patients between 1994 and 1999, in whom there was a delay in diagnosis. Results: A T-5 paraplegic patient had two episodes of urinary tract infection (UTI) which were successfully treated with antibiotics. When he developed UTI again, an intravenous urography (IVU) was performed. The IVU revealed a non-visualised kidney and a renal pelvic calculus. In a T-6 paraplegic patient, the classical symptom of flank pain was absent, and the symptoms of sweating and increased spasms were attributed to a syrinx. A routine IVU showed non-visualisation of the left kidney with a stone impacted in the pelviureteric junction. In two tetraplegic patients, an obstructed kidney became infected, and there was a delay in the diagnosis of Pyonephrosis. The clinician's attention was focused on a co-existent, serious, infective pathology elsewhere. The primary focus of sepsis was chest infection in one patient and a deep pressure sore in the other. The former patient succumbed to chest infection and autopsy revealed Pyonephrosis with an abscess between the left kidney and left hemi-diaphragm and xanthogranulomatous inflammation of perinephric fatty tissue. In the latter patient, an abdominal X-ray did not reveal any calculus but computerised axial tomography showed the presence of renal and ureteric calculi. Conclusions: The symptoms of hydronephrosis may be bizarre and non-specific in SCI patients. The symptoms include feeling unwell, abdominal discomfort, increased spasms, and autonomic dysreflexia. Physicians should be aware of the serious import of these symptoms in SCI patients.
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Silent hydronephrosis/Pyonephrosis due to upper urinary tract calculi in spinal cord injury patients
Spinal Cord, 2000Co-Authors: Subramanian Vaidyanathan, G Singh, B M Soni, J W H Watt, S Dundas, P Sett, P Hughes, K F ParsonsAbstract:Study design: A study of four patients with spinal cord injury (SCI) in whom a diagnosis of hydronephrosis or Pyonephrosis was delayed since these patients did not manifest the traditional signs and symptoms. Objectives: To learn from these cases as to what steps should be taken to prevent any delay in the diagnosis and treatment of hydronephrosis/Pyonephrosis in SCI patients. Setting: Regional Spinal Injuries Centre, Southport, UK. Methods: A retrospective review of cases of hydronephrosis or Pyonephrosis due to renal/ureteric calculus in SCI patients between 1994 and 1999, in whom there was a delay in diagnosis. Results: A T-5 paraplegic patient had two episodes of urinary tract infection (UTI) which were successfully treated with antibiotics. When he developed UTI again, an intravenous urography (IVU) was performed. The IVU revealed a non-visualised kidney and a renal pelvic calculus. In a T-6 paraplegic patient, the classical symptom of flank pain was absent, and the symptoms of sweating and increased spasms were attributed to a syrinx. A routine IVU showed non-visualisation of the left kidney with a stone impacted in the pelviureteric junction. In two tetraplegic patients, an obstructed kidney became infected, and there was a delay in the diagnosis of Pyonephrosis. The clinician's attention was focused on a co-existent, serious, infective pathology elsewhere. The primary focus of sepsis was chest infection in one patient and a deep pressure sore in the other. The former patient succumbed to chest infection and autopsy revealed Pyonephrosis with an abscess between the left kidney and left hemi-diaphragm and xanthogranulomatous inflammation of perinephric fatty tissue. In the latter patient, an abdominal X-ray did not reveal any calculus but computerised axial tomography showed the presence of renal and ureteric calculi. Conclusions: The symptoms of hydronephrosis may be bizarre and non-specific in SCI patients. The symptoms include feeling unwell, abdominal discomfort, increased spasms, and autonomic dysreflexia. Physicians should be aware of the serious import of these symptoms in SCI patients.
Demetrius H. Bagley - One of the best experts on this subject based on the ideXlab platform.
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Treatment of Pyonephrosis with a subcutaneous ureteral bypass device in four cats.
Javma-journal of The American Veterinary Medical Association, 2018Co-Authors: Megan T. Cray, Allyson C. Berent, Chick Weisse, Demetrius H. BagleyAbstract:CASE DESCRIPTION 4 cats were examined because of ureteral obstruction. CLINICAL FINDINGS Clinical and clinicopathologic abnormalities were nonspecific and included anorexia, lethargy, weight loss, anemia, leukocytosis, neutrophilia, lymphopenia, and azotemia. A diagnosis of Pyonephrosis was made in all cats. The presence of bacteriuria was confirmed by means of urinalysis in 2 cats, bacterial culture of a urine sample obtained by means of preoperative cystocentesis in 2 cats, and bacterial culture of samples obtained from the renal pelvis intraoperatively in 3 cats. Ureteral obstruction was caused by a urolith in 3 cats; ureteral stricture associated with a circumcaval ureter was identified in 1 cat. TREATMENT AND OUTCOME All 4 cats underwent renal pelvis lavage and placement of a subcutaneous ureteral bypass (SUB) device for treatment of obstructive Pyonephrosis. Postoperatively, the cystostomy tube became occluded with purulent material in 1 cat, requiring exchange. The procedure was successful in relieving the obstruction and Pyonephrosis in all cats. Three of 4 cats had documented resolution of urinary tract infection. One cat had persistent bacteriuria without clinical signs 1 month after SUB device placement. CLINICAL RELEVANCE Results of this small series suggested that renal pelvis lavage with placement of an SUB device may be a treatment option for cats with obstructive Pyonephrosis.
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double pigtail ureteral stenting and renal pelvic lavage for renal sparing treatment of obstructive Pyonephrosis in dogs 13 cases 2008 2012
Javma-journal of The American Veterinary Medical Association, 2015Co-Authors: Jodi A Kuntz, Allyson C. Berent, Chick Weisse, Demetrius H. BagleyAbstract:Objective—To describe the technical aspects and clinical outcome of endoscopic- and fluoroscopic-guided ureteropelvic lavage and ureteral stent placement for treatment of obstructive Pyonephrosis in dogs. Design—Retrospective case series. Animals—13 client-owned dogs (14 obstructed ureters). Procedures—All patients with obstructive Pyonephrosis were treated with a ureteral stent. Medical records were reviewed for history, clinical signs, pre- and postprocedural clinical and imaging data, and short- and long-term outcomes. Results—13 dogs (14 ureters) had unilateral or bilateral ureteral obstructions and Pyonephrosis due to ureterolithiasis (n = 13) or a suspected ureteral stricture (1). Eleven dogs had positive results of bacteriologic culture of urine obtained from the bladder, renal pelvis, or both. Ten were thrombocytopenic, and 8 were azotemic. Stents were placed fluoroscopically with endoscopic (n = 11) or surgical (3) assistance. Median hospitalization time was 48 hours (range, 6 to 260 hours). Medi...
Guo-wei Shi - One of the best experts on this subject based on the ideXlab platform.
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Treatment of Pyonephrosis with upper urinary tract calculi
Zhonghua yi xue za zhi, 2011Co-Authors: Guo-wei ShiAbstract:Objective To improve the treatment of Pyonephrosis with upper urinary tract calculi (UTC).Methods A total of 49 UTC patients with Pyonephrosis were selected at our hospital during May 2004 to February 2010. Among them,22 cases were treated with transurethral ureteroscope lithotripsy followed by tube internal drainage while another 27 cases underwent percutaneous nephrolithotomy.Results No such complications as septicemia and septic shock occurred during the first stage of external and internal drainage.The bacteremic symptoms of chill or fever occurred in 3 cases during the second stage of percutaneous nephrolithotomy and pyelolithotomy/ureterolithotomy(11.1%). There were 3 cases of nephrectomy.A follow-up period of 3 months to 5.5 years showed that all 33 cases had a varying degree of recovered renal functions.And there was no ephrectomy.Conclusion The keys to a successful surgical treatment of Pyonephrosis with upper urinary tract calculi are early diagnosis,timely drainage and relief of obstruction. Ureteroscopic lithotripsy,double-J placement and percutaneous nephrostomy drainage are excellent for relieving obstruction.As a safe procedure with minor complications,it creates proper conditions for a second stage operation. Key words: Urinary calculi; Pyonephrosis; Treatment
