Dextranomer/hyaluronic acid injections for patients with vesicoureteral reflux
Bibliographic record
Abstract
INTRODUCTION: We aimed to assess the impact of age of the initial dextranomer/hyaluronic acid (Dx/HA) injection on the subsequent outcome, including the need for repeated injections. METHODS: The charts of patients who underwent Dx/HA injection from 2010-2020 were retrospectively reviewed. Two groups were created according to the number of Dx/HA injections: single vs. repeated injections. Patients who presented with antenatal hydronephrosis, neurogenic bladder, and followup less than one year after the first injection were excluded. Repeated Dx/HA injections were indicated in patients with documented vesicoureteric reflux (VUR) who experienced recurrent febrile urinary tract infection (fUTI) postoperatively. RESULTS: A total of 172 patients with 189 renal units were included; 139 (73.5%) units underwent single injections, whereas 50 (26.5%) had repeated injections. Twenty-three (48.9%) patients with repeated injections presented before the age of one year vs. 24 (51.1%) after the age of one year (p=0.02). Of the repeated group, 34 (68%) units received two injections, 14 (28%) were injected three times or more, and two (4%) had other treatment modalities. Forty-four percent of units requiring repeated injections had high-grade VUR (grades 4 and 5), compared to only 22.3% of those successfully treated with a single injection (p=0.003). CONCLUSIONS: In our cohort, 26.5% of renal units underwent repeated Dx/HA injections. Forty-four percent of units with repeated injections had grade 4-5 VUR. Patients with VUR who were injected or presented with fUTI before the age of one year old were at higher risk of repeated injections than those who were injected or presented later.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 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 | 0.000 |
| 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 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".