Background:Emphysematous pyelonephritis(EPN)is a necrotizing infection of the kidney and the surrounding tissues associated with considerable mortality.We aimed to formulate a score that classifies the risk of mortali...Background:Emphysematous pyelonephritis(EPN)is a necrotizing infection of the kidney and the surrounding tissues associated with considerable mortality.We aimed to formulate a score that classifies the risk of mortality in patients with EPN at hospital admission.Materials and methods:Patients diagnosed with EPN between 2013 and 2020 were retrospectively included.Data from 15 centers(70%)were used to develop the scoring system,and data from 7 centers(30%)were used to validate it.Univariable and mułtivariable logistic regression analyses were performed to identify independent factors related to mortality.Receiver operating characteristic curve analysis was performed to construct the sconng system and calculate the risk of mortality.A standardized regression coefficient was used to quantify the discriminating power of each factor to convert the individual coefficients into points.The area under the curve was used to quantify the scoring system performance.An 8-point scoring system for the mortality risk was created(range,0-7).Results:In total,570 patients were included(400 in the test group and 170 in the validation group).Independent predictors of mortality in the multivariable logistic regression were included in the scoring system:quick Sepsis-related Organ Failure Assessment score≥2(2 points),anemia,paranephric gas extension,leukocyte count>22,000/pL,thrombocytopenia,and hyperglycemia(1 point each).The mortality rate was<5%for scores≤3,83.3%for scores 6,and 100%for scores 7.The area under the Curve was 0.90(95%confidence interval,0.84-0.95)for test and 0.91(95%confidence interval,0.84-0.97)for the validation group.Condusions:Our score predicts the risk of mortality in patients with EPN at presentation and may help clinicians identify patients at a higher risk of death.展开更多
Background: Hepatocellular carcinoma (HCC) is characterized by the deficiency of specific symptoms in the early stages of the disease and a poor prognosis. Biomarkers that have the diagnostic ability to distinguish be...Background: Hepatocellular carcinoma (HCC) is characterized by the deficiency of specific symptoms in the early stages of the disease and a poor prognosis. Biomarkers that have the diagnostic ability to distinguish between inflammation, cirrhosis, and HCC are needed for early case detection. MidKine (MK) is overexpressed in many malignancies, including hepatocellular carcinoma, gastric carcinoma, colon carcinoma, lung carcinoma, urinary bladder carcinoma and prostate carcinoma. Objective: The objective is to evaluate serum MidKine as a marker of HCC in HCV-related liver cirrhosis. Patients and Methods: This study included 50 patients with HCC (on top of hepatitis C virus-related cirrhosis), 20 cirrhotic patients due to chronic HCV infection, and 10 normal subjects as a control group. History, examination, and laboratory investigations were performed on all subjects in the three groups including MK and Alpha fetoprotein (AFP) serum levels. Results: Serum levels of AFP and MK were higher in the HCC group than in the other study groups (P Conclusion: MidKine is a novel sensitive biomarker that could be used for early detection of HCC and has a high significance in differentiation between cirrhosis and HCC cases. MidKine levels are correlated with HCC stages and sizes.展开更多
文摘Background:Emphysematous pyelonephritis(EPN)is a necrotizing infection of the kidney and the surrounding tissues associated with considerable mortality.We aimed to formulate a score that classifies the risk of mortality in patients with EPN at hospital admission.Materials and methods:Patients diagnosed with EPN between 2013 and 2020 were retrospectively included.Data from 15 centers(70%)were used to develop the scoring system,and data from 7 centers(30%)were used to validate it.Univariable and mułtivariable logistic regression analyses were performed to identify independent factors related to mortality.Receiver operating characteristic curve analysis was performed to construct the sconng system and calculate the risk of mortality.A standardized regression coefficient was used to quantify the discriminating power of each factor to convert the individual coefficients into points.The area under the curve was used to quantify the scoring system performance.An 8-point scoring system for the mortality risk was created(range,0-7).Results:In total,570 patients were included(400 in the test group and 170 in the validation group).Independent predictors of mortality in the multivariable logistic regression were included in the scoring system:quick Sepsis-related Organ Failure Assessment score≥2(2 points),anemia,paranephric gas extension,leukocyte count>22,000/pL,thrombocytopenia,and hyperglycemia(1 point each).The mortality rate was<5%for scores≤3,83.3%for scores 6,and 100%for scores 7.The area under the Curve was 0.90(95%confidence interval,0.84-0.95)for test and 0.91(95%confidence interval,0.84-0.97)for the validation group.Condusions:Our score predicts the risk of mortality in patients with EPN at presentation and may help clinicians identify patients at a higher risk of death.
文摘Background: Hepatocellular carcinoma (HCC) is characterized by the deficiency of specific symptoms in the early stages of the disease and a poor prognosis. Biomarkers that have the diagnostic ability to distinguish between inflammation, cirrhosis, and HCC are needed for early case detection. MidKine (MK) is overexpressed in many malignancies, including hepatocellular carcinoma, gastric carcinoma, colon carcinoma, lung carcinoma, urinary bladder carcinoma and prostate carcinoma. Objective: The objective is to evaluate serum MidKine as a marker of HCC in HCV-related liver cirrhosis. Patients and Methods: This study included 50 patients with HCC (on top of hepatitis C virus-related cirrhosis), 20 cirrhotic patients due to chronic HCV infection, and 10 normal subjects as a control group. History, examination, and laboratory investigations were performed on all subjects in the three groups including MK and Alpha fetoprotein (AFP) serum levels. Results: Serum levels of AFP and MK were higher in the HCC group than in the other study groups (P Conclusion: MidKine is a novel sensitive biomarker that could be used for early detection of HCC and has a high significance in differentiation between cirrhosis and HCC cases. MidKine levels are correlated with HCC stages and sizes.
