scholarly journals Emphysematous Pyelonephritis

2021 ◽  
Author(s):  
Mohammed Al-Saraf ◽  
Salim Al-Busaidy ◽  
Kurian George ◽  
Mohamed Elawdy ◽  
Issa Al-Salmi
Keyword(s):  
Retrospective Study ◽  
Percutaneous Drainage ◽  
Fluid Collection ◽  
Mortality Rates ◽  
Percutaneous Nephrostomy ◽  
Favourable Outcome ◽  
Class I ◽  
Emphysematous Pyelonephritis ◽  
Double J Stent ◽  
Pelvicalyceal System

Objectives: Emphysematous pyelonephritis (EPN) has high mortality rates reaching 50%, however later studies have reported significantly lower mortality rates ranging from 0 to 37.5%. Renal percutaneous drainage techniques have reduced the mortality and the necessity for surgery.  Nevertheless, the same studies have reported a wide diversity in the usage of percutaneous drainage (PCD) and percutaneous nephrostomy (PCN) techniques. Methods: A retrospective study of 17 patients was conducted over a 10year period, from January 2008 to December 2017. All patients had undergone abdominal computerized tomography, these were reviewed and categorized according to Huang and Tseng’s classification. Results: 13 patients (76%) were categorized as class I and II, 3 (17%) as class IIIA, and 1 (6%) as class IIIB. Five patients from the class I & II categories underwent drainage of the pelvicalyceal system, 4 by PCN and 1 by Double J Stent (DJS) insertion. All the class IIIA and IIIB patients had PCN inserted. One class IIIB patient required PCD for localized gas and fluid collection but later underwent emergency nephrectomy. There were no mortalities. Conclusion: The favourable outcome of this study is in keeping with the more recent studies. However, despite the present classifications and guidelines, wide variations are reported in the use of percutaneous drains with PCD ranging from 2.5 – 91%. The lack of precise guidelines may be a cause of these disparities in the clinical management.Keywords: emphysematous, pyelonephritis, drainage, percutaneous, nephrostomy.

scholarly journals Plasmapheresis in the treatment of myasthenia gravis: retrospective study of 26 patients

2004 ◽  
Vol 62 (2b) ◽  
pp. 391-395 ◽  
Author(s):  
Rosana Carandina-Maffeis ◽  
Anamarli Nucci ◽  
José F.C. Marques Jr ◽  
Eduardo G. Roveri ◽  
Beatriz H.M. Pfeilsticker ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Side Effects ◽  
Myasthenia Gravis ◽  
Plasma Exchange ◽  
Mortality Rates ◽  
Motor Deficit ◽  
Myasthenic Crisis ◽  
Clinical Hospital ◽  
The Mean ◽  
Mean Time

We analyzed the experience of Unicamp Clinical Hospital with plasma exchange (PE) therapy in myasthenia gravis (MG). About 17.8 % of a totality of MG patients had PE performed: 26 cases, 19 women and seven men. The mean age-onset of MG was 28 years, extremes 11 and 69. Minimum deficit observed in the group was graded IIb (O & G) or IIIa (MGFA scale). One patient had prethymectomy PE. In seven the procedures were performed due to myasthenic crisis and in 18 patients due to severe myasthenic symptoms or exacerbation of previous motor deficit. Two patients were also submitted to chronic PE considering refractoriness to other treatments. Twenty-six patients had 44 cycles of PE and 171 sessions. The mean number of sessions was 3.9 (SD ± 1.4) each cycle; median 5, extremes 2 and 6. The mean time by session was 106,5 minutes (SD ± 35.2); median 100.5 (extremes of 55 and 215). The mean volume of plasma exchanged in each session was 2396 ml (SD ± 561); median 2225 (extremes 1512 and 4500). Side effects occurred: reversible hypotension (seven cases), mild tremor or paresthesias (seven cases). Infection and mortality rates due to PE were zero. All patients had immediate benefit of each PE cycle and usually they also received prednisone or other immunosuppressors. Good acceptance of the procedure was observed in 80.7% of patients.

scholarly journals Study of variations in the pelvicalyceal system of kidney and its clinical importance

2013 ◽  
Vol 8 (3) ◽  
pp. 17-21 ◽  
Author(s):  
PR Wadekar ◽  
SD Gangane
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Clinical Importance ◽  
Percutaneous Nephrostomy ◽  
Clinical Implications ◽  
Clear Understanding ◽  
Medical Sciences ◽  
Pelvicalyceal System ◽  
Collecting System

Objective The present study has been undertaken to study the variations in renal pelvicalyceal system, to compare them with previous studies and to find their clinical implications. Materials and Methods A total of 100 kidneys (from 50 cadavers) were included in this study. The following parameters were measured 1)Lower Infundibular length, 2)Infundibular Width – Lower Infundibular Width (LIW), Middle Infundibular Width (MIW), Upper Infundibular Width (UIW), 3)Number of minor calyces and 4)Number of major calyces. Results The obtained data showed that there were numerous variations not only in the numbers of calyces of kidneys but also in the infundibular length and width. Conclusion Developments in endourology, percutaneous nephrolithotomy and techniques for retrograde percutaneous nephrostomy have rekindled interest in the anatomy of the renal collecting system. To perform these procedures safely and efficiently it is essential to have a clear understanding of pelvicalyceal anatomy and its variations. Thus the in-depth knowledge of pelvicalyceal anatomy will be of immense value to the clinicians of related specialties. Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-3, 17-21 DOI: http://dx.doi.org/10.3126/jcmsn.v8i3.8681

scholarly journals Cholera in Vietnam: Changes in Genotypes and Emergence of Class I Integrons Containing Aminoglycoside Resistance Gene Cassettes in Vibrio cholerae O1 Strains Isolated from 1979 to 1996

1999 ◽  
Vol 37 (3) ◽  
pp. 734-741 ◽  
Author(s):  
A. Dalsgaard ◽  
A. Forslund ◽  
N. V. Tam ◽  
D. X. Vinh ◽  
P. D. Cam
Keyword(s):  
Vibrio Cholerae ◽  
Antibiotic Resistance Genes ◽  
Gene Cassette ◽  
Mortality Rates ◽  
Class I ◽  
Pcr Analysis ◽  
Access To Health Services ◽  
Aminoglycoside Resistance ◽  
Class I Integrons ◽  
Antibiotic Susceptibility Patterns

The number of cholera cases and the mortality rates reported from different regions of Vietnam varied considerably in the period from 1979 to 1996, with between 2,500 and 6,000 cases reported annually from 1992 to 1995. Annual mortality rates ranged from 2.0 to 9.6% from 1979 to 1983 to less than 1.8% after 1983. Major cholera outbreaks were reported from the High Plateau region for the first time in 1994 and 1995; this is an area with limited access to health services and safe drinking-water supplies. All cases were associated with Vibrio cholerae O1. Using ribotyping, cholera toxin (CT) genotyping, and characterization of antibiotic susceptibility patterns and antibiotic resistance genes by PCR, we show that strains isolated after 1990 were clearly different from strains isolated before 1991. In contrast to strains isolated before 1991, 94% of 104 strains isolated after 1990 showed an identical ribotype R1, were resistant to sulfamethoxazole and streptomycin, and showed a different CT genotype. Furthermore, PCR analysis revealed that sulfamethoxazole-resistant strains harbored class I integrons containing a gene cassette ant(3")-1aencoding resistance to streptomycin and spectinomycin. This is, to our knowledge, the first report of class I integrons in V. cholerae. The development of cholera and the changes in the phenotypic and genotypic properties of V. cholerae O1 shown in the present study highlight the importance of monitoring V. cholerae O1 in Vietnam as in other parts of the world. In particular, the emergence of the new ribotype R1 strain containing class I integrons should be further studied.

Plasma Lithium Levels and Therapeutic Outcome in the Prophylaxis of Affective Disorders: A Retrospective Study

1982 ◽  
Vol 140 (6) ◽  
pp. 619-622 ◽  
Author(s):  
S. P. Sashidharan ◽  
R. J. McGuire ◽  
A. I. M. Glen
Keyword(s):  
Retrospective Study ◽  
Affective Disorder ◽  
Affective Disorders ◽  
Favourable Outcome ◽  
Therapeutic Outcome ◽  
Lithium Therapy ◽  
Affective Illness

SummaryPatients receiving prophylactic lithium therapy for primary affective disorder during a four year period were studied for recurrence of affective illness. Patients who had affective episodes during this period did not differ from those who remained well in age, sex or diagnosis. Those with a favourable outcome had spent significantly less time at serum lithium levels above 0.9 mmol/litre than those who had a recurrence of affective episodes.

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