Emergency “Hot” Shock Wave Lithotripsy
Bibliographic record
Abstract
Ureteroscopy and extracorporeal shock wave lithotripsy (ESWL) are two widely used methods for the treatment of ureteric and pelviureteric junction (PUJ) stones. ESWL remains the only non-invasive therapy modality for the treatment of urinary stones. Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive, safe and effective treatment for urinary tract lithiasis Ureteroscopy and extracorporeal shock wave lithotripsy (ESWL) are two widely used methods for the treatment of ureteric and pelviureteric junction (PUJ) stones. ESWL remains the only non-invasive therapy modality for the treatment of urinary stones. Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive, safe and effective treatment for urinary tract lithiasis Objectives To evaluate the effectiveness of emergency “hot” shock wave lithotripsy in treating symptomatic ureteric/ PUJ stones. Materials and Methods A retrospective study looking at the emergency referrals for shock wave lithotripsy to the Churchill Hos-pital between June 2013 to Dec 2017. The Lithotripsy Database and patients’ electronic records were used to complete this project. Emergency referrals triaged by the on-call urology team and go through a renal colic clinic. Results In total, 201 patients underwent emergency shock wave lithotripsy for ureteric/PUJ stones. The mean stone size was 7.7mm (SD 2.9). 12.4% (25) were PUJ, 45.3% (91) proximal and 42.3% (85) distal ureteric stones. 1% (2) were bilateral ureteric stones. 9% (18) had previous lithotripsy treatment before being referred. The number of shocks used was 4000 in 52.7%, >=3000 in 40.3%, >=2000 in 4.5% and >=1000 in 2.5%. The median shock frequency was 2 Hz. The median number of treatments for the targeted stone was 2. Stone fragmentation was visible in 27.4% (55), possible in 30.8% (62) and not visible in 41.8% (84). In terms of follow up, 48.3% (97) were discharged stone-free, while 17.4% (35) were discharged with residual fragments. 21.8% (44) had further clinic follow up while 12.4% (25) had no follow-up information available, possibly because they were referred from different hospitals. 19.9% (40) needed ureteroscopy, while 7% (14) needed further lithotripsy sessions. Conclusions Emergency extracorporeal lithotripsy can be offered as an effective and safe treatment for patients with symptomatic stones.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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 teacher head, 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".