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PubMed · 9214213

[Emphysematous pyelonephritis].

Abstract

OBJECTIVE: To present an uncommon but startling case of a urinary tract infectious disease such as renal emphysematous pyelonephritis. METHOD/RESULTS: We report the case of a decompensated diabetic female patient who presented an intrarenal infectious picture with gas formation compatible with emphysematous pyelonephritis that showed good evolution following medical treatment and simple nephrectomy surgery. CONCLUSIONS: Emphysematous pyelonephritis is a serious infective disease that occurs almost exclusively in diabetic patients and requires a fast and correct diagnosis differentiating between diffuse from focused processes in order to advise conservative or aggressive therapy on the renal unit (percutaneous drainage/nephrectomy), based on immediate hemodynamic and antibiotic medical support, due to its serious prognosis such as is described in the literature.

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BibTeXRIS

R J Valbuena Alvarez, J L Cajide Montero, J L Santos-Ascarza Tabares, M De la Rosa Kehrmann, J Rodríguez De la Rua, O Esteban Hernández, A Barreiro Mouro. 1997. [Emphysematous pyelonephritis].. https://pubmed.ncbi.nlm.nih.gov/9214213/

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Lung volume reduction surgery for emphysema: correlation of CT and V/Q imaging with physiologic mechanisms of improvement in lung function.

PURPOSE: To compare the relationship between computer-derived and visually assessed ventilation-perfusion (V/Q) scintigraphy and computed tomographic (CT) scores in evaluating disease severity and distribution in identifying optimal candidates for lung volume reduction surgery (LVRS) and to correlate these radiologic indices with physiologic measures of outcome. MATERIALS AND METHODS: In 39 patients, preoperative V/Q and CT scans were visually scored by two radiologists for disease severity and distribution. Results were compared with computer-derived scores for the same cohort. These indices were correlated with clinical improvement measured with forced expiratory volume in 1 second (FEV(1)), forced vital capacity (FVC), and ratio of FEV(1) to FVC. RESULTS: The disease distribution scores measured with the different methods correlated closely: computer-based and visually assessed CT scores (r = 0.89, P <.001), computer-based and visually assessed V/Q scores (r = 0.83, P <.001), visually assessed CT and V/Q scores (r = -0.50, P <.001), and computer-derived CT and V/Q scores (r = -0.57, P =.015). Similarly, a statistically significant correlation was noted between each of the radiologic methods and clinical outcome measurements (P <.001). CONCLUSION: CT and V/Q preoperative assessment, with either visual scoring or computer-based algorithms, are nearly equivalent in their utility in predicting improvement in FEV(1) measures.

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