Is routine micropuncture access necessary for percutaneous nephrostomy? A randomized trial.
Bibliographic record
Abstract
OBJECTIVE: To compare the micropuncture technique and the conventional large-bore needle approach for renal access. METHODS: From July 1999 to July 2000, patients referred to interventional radiology for emergent or elective percutaneous nephrostomy with normal coagulation profiles were considered for the study. Nephrostomy procedures were performed using a micropuncture system or large-bore needle for collecting system access; 24 nephrostomy procedures were randomized to each group using permuted blocks and opaque sealed envelopes. Gross hematuria, quantitative urine red blood cell counts, pain scores and procedural success were compared between the 2 groups. RESULTS: There was a small difference in the incidence of gross hematuria between the large-bore needle and micropuncture groups (12 [50%] v. 8 [33%] patients), but this difference was not statistically significant. Quantitative urine red blood cell counts obtained immediately after and 24 hours after nephrostomy placement showed no significant differences. Significantly fewer needle passes were required for access in the large-bore needle group than the micropuncture group (1.7 v. 2.8, p = 0.01), and mean procedure duration was 7 minutes longer in the micropuncture group, although this difference was not significant. No differences in pain scores or procedure success were seen. CONCLUSION: Percutaneous nephrostomy performed with a micropuncture system in patients with normal coagulation profiles does not significantly decrease organ bleeding or pain. More needle passes and manipulations are required, which may increase procedure duration. The additional costs of routine micropuncture access for percutaneous nephrostomy are not supported by this study.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".