A new insight into the management of high-grade vesicoureteral reflux
Bibliographic record
Abstract
Introduction High-grade vesicoureteral reflux (VUR) is a major dilemma to urologists, with no clear time for intervention in children without evidence of urinary tract infection. The aim of our study was to show our experience in managing high-grade VUR in children with high postvoiding residual. Material and methods Our study included 24 children with high-grade reflux persistent while being on surveillance and continuous antibiotic prophylaxis. Besides radiological investigations, 24-hour urine output and postvoiding residual were our main clinical parameters to study. Results All the children with high-grade reflux in our study were found to have polyuria and high postvoiding residual. Surgical correction was done through open surgical ureteral reimplantation combined with the use of vasopressin. Reduction cystoplasty was done for 2 children. One-year follow-up showed satisfactory outcomes in reducing bladder capacity and treating reflux. Conclusions Children with high-grade VUR should be assessed for polyuria. The presence of polyuria should be an indication for early surgical management.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 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".