MP64-20 ARE RENAL BLADDER ULTRASOUNDS NECESSARY FOR ROUTINE FOLLOW-UPS OF VUR PATIENTS AFTER CAP DISCONTINUATION?
Bibliographic record
Abstract
You have accessJournal of UrologyPediatrics: Urinary Tract Infection & Vesicoureteral Reflux (MP64)1 Apr 2019MP64-20 ARE RENAL BLADDER ULTRASOUNDS NECESSARY FOR ROUTINE FOLLOW-UPS OF VUR PATIENTS AFTER CAP DISCONTINUATION? Smruthi Ramesh*, Melissa McGrath, Kornelia Palczek, and Luis H. Braga Smruthi Ramesh*Smruthi Ramesh* More articles by this author , Melissa McGrathMelissa McGrath More articles by this author , Kornelia PalczekKornelia Palczek More articles by this author , and Luis H. BragaLuis H. Braga More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556912.55827.c9AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Patients with VUR are routinely seen at follow-up visits with serial ultrasounds (US) after stopping continuous antibiotic prophylaxis (CAP). Since there is little evidence to support this practice, we sought to examine the impact of US findings on the clinical management of VUR patients at follow-up visits. METHODS: A prospectively collected VUR database from 2009-2018 was reviewed. We identified 218 patients who have stopped CAP. Variables collected included age at CAP discontinuation, follow-up time, gender, circumcision status, SFU grades (low [I-II] vs high [III-IV]) and febrile urinary tract infection (fUTI). Change in management was defined as surgical intervention to treat symptomatic VUR or restarting CAP. RESULTS: The median age at CAP discontinuation and median follow-up time were 20 months (IQR: 19) and 42 months (IQR: 33) respectively. Of 218 VUR patients, 105 (48%) were male and 38 (36%) circumcised. There were 135 (62%) patients with unremarkable serial US findings and 83 (38%) with hydronephrosis (HN). Patients with normal vs. abnormal US findings experienced similar rates of change in management (11% vs. 8%, p=0.7). In patients with normal US findings, those with fUTI were more likely to experience a change in management than those without (52% vs. 0%, p < 0.01). Of patients with abnormal US findings, 58/83 (70%) had low grade HN. In this group, change in management was more likely to occur in patients with fUTI vs. those without (50% vs. 2%, p <0.01). Classification of low vs. high HN did not have a significant effect on change in management (9% vs. 8%, p=1.0). CONCLUSIONS: In 2/3 of VUR patients, US findings were unremarkable and did not impact clinical management. The driving factor for change in management was fUTI post-CAP discontinuation. Thus, asymptomatic VUR patients may not require routine follow-ups with renal US after stopping CAP. Source of Funding: none Hamilton, Canada; Hamilton, ON© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e949-e949 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Smruthi Ramesh* More articles by this author Melissa McGrath More articles by this author Kornelia Palczek More articles by this author Luis H. Braga More articles by this author Expand All Advertisement PDF downloadLoading ...
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.002 |
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".