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1. Koufadaki, Athina - Maria. Η έγκαιρη έναρξη της θεραπείας των εμπύρετων ουρολοιμώξεων σαν παράγοντας αποφυγής δημιουργίας νεφρικής βλάβης.

Degree: 2015, National and Kapodistrian University of Athens; Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ)

Aims: To evaluate the relationship of the duration of fever before the initiation of treatment of febrile urinary tract infections with transient renal lesions due to acute pyelonephritis, or with renal scarring, based on DMSA scan findings. Moreover, to study the effect of the duration of fever after treatment initiation and the total duration of fever on the creation of renal lesions. Furthermore, to evaluate the predictive value of various demographical, clinical and laboratory parameters on the identification of acute renal involvement in children with febrile UTI.Material and Methods: The medical records of 148 children (median age:2.4 months, range:11 days-24 months), who were admitted during a three year-period with a first episode of febrile UTI, were analyzed. Acute dimercaptosuccinic acid (DMSA) scintigraphy, clinical and laboratory parameters were evaluated.Results: Seventy five children (51%) had abnormal findings on the acute DMSA. Of them, 19 had renal lesions grade 2 (mild), while 56 had grade 3 and 4 (moderate and severe). Among patients with mild lesions, repeat DMSA was normal in 60% of children and showed mild renal scars in 40%. Among 48 children with moderate lesions, repeat DMSA scan revealed normal kidneys in 28% of them, mild lesions in 53% and moderate lesions in 19%. Among patients with severe acute lesions, repeat DMSA had severe renal scars in 25% and moderate scars in 75% of them.It was noticed that there was a tendency of increased presence of moderate and severe acute renal lesions in DMSA scans of children with febrile UTI with increasing duration of fever before treatment initiation. Moreover, when administration of therapy was delayed for ≥ 72 hours from the beginning of fever, children tended to have renal lesions of any grade more often, but the result was not statistically significant. On the other hand, no significant relation was noticed between initiation of therapy after 24 or 48 hours and the likelihood or the severity of renal scars, as detected in the repeat DMSA scan. However, when treatment was delayed for ≥ 72 hours, children had increased percentage of renal scars in a statistically significant way, with the severity of scars being significantly related with this delay.When renal lesions were studied in accordance with the duration of fever after treatment initiation, it was found that children with duration of fever > 48 hours tended to be more likely to develop acute renal lesions or late renal scars. Similarly, when total duration of fever, before and after administration of treatment was studied, it was noticed that there was a tendency of children with total hours of fever > 72 to have acute renal lesions and renal scars more often, without this result being statistically significant.Patients with a DMSA grade 3 and 4 were more likely to have shivering (OR 3.4), WBC ≥ 18,000/μL (OR 2.4), absolute neutrophil count (ANC) ≥ 9,300/μL (OR 4.4), CRP ≥ 50mg/L (OR 2.7)and PCT ≥ 1.64 ng/ml (OR diagnostic). Although ANC and CRP values increased in parallel with the severity…

Subjects/Keywords: Διάρκεια πυρετού; Ουρολοιμώξεις; Κλινικοί και εργαστηριακοί δείκτες; Νεφρικές βλάβες; Σπινθηρογράφημα νεφρών με DMSA; Duration of fever; Urinary tract ιnfections (UTI); Clinical and laboratory indices; Renal lesions; DMSA scan

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Koufadaki, A. -. M. (2015). Η έγκαιρη έναρξη της θεραπείας των εμπύρετων ουρολοιμώξεων σαν παράγοντας αποφυγής δημιουργίας νεφρικής βλάβης. (Thesis). National and Kapodistrian University of Athens; Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ). Retrieved from http://hdl.handle.net/10442/hedi/42513

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Koufadaki, Athina - Maria. “Η έγκαιρη έναρξη της θεραπείας των εμπύρετων ουρολοιμώξεων σαν παράγοντας αποφυγής δημιουργίας νεφρικής βλάβης.” 2015. Thesis, National and Kapodistrian University of Athens; Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ). Accessed January 24, 2019. http://hdl.handle.net/10442/hedi/42513.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Koufadaki, Athina - Maria. “Η έγκαιρη έναρξη της θεραπείας των εμπύρετων ουρολοιμώξεων σαν παράγοντας αποφυγής δημιουργίας νεφρικής βλάβης.” 2015. Web. 24 Jan 2019.

Vancouver:

Koufadaki A-M. Η έγκαιρη έναρξη της θεραπείας των εμπύρετων ουρολοιμώξεων σαν παράγοντας αποφυγής δημιουργίας νεφρικής βλάβης. [Internet] [Thesis]. National and Kapodistrian University of Athens; Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ); 2015. [cited 2019 Jan 24]. Available from: http://hdl.handle.net/10442/hedi/42513.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Koufadaki A-M. Η έγκαιρη έναρξη της θεραπείας των εμπύρετων ουρολοιμώξεων σαν παράγοντας αποφυγής δημιουργίας νεφρικής βλάβης. [Thesis]. National and Kapodistrian University of Athens; Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ); 2015. Available from: http://hdl.handle.net/10442/hedi/42513

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

2. 김, 태환. Can early removal of central venous catheter influence duration of fever in febrile neutropenic patients with acute myeloid leukemia?.

Degree: 2018, Ajou University

Neutropenia and fever precipitated from the state are very common and fatal problems to the patients with hematologic malignancy, especially acute leukemia. Additionally, febrile neutropenia costs a lot of money, because the patients generally need to be admitted to hospitals and treated by lots of medications like antibiotics and antifungal drugs. This study was designed to find out the factors that can decrease the duration of febrile neutropenia in acute myeloid leukemia patients and focused the impact due to early (i.e. less than 3 weeks) removal of the central venous catheter that inserted to most of acute myeloid leukemia patients receiving chemotherapy. This retrospective study in a single center analyzed the effects of age, gender, body mass index(BMI), type of chemotherapy, presence of baseline fever before chemotherapy, presence of blood stream infection (BSI), insertion site of central venous catheter and early removal of central venous catheter on the duration of fever in acute myeloid leukemia patients with febrile neutropenia. The results were significant in both univariate and multivariate analyses depending on age, type of chemotherapy, presence of baseline fever and especially, early removal of central venous catheter (univariate analysis: p=0.001, multivariate analysis: hazard ratio 0.546, 95% confidence interval 0.368-0.810, p=0.003). So, the physicians treating febrile neutropenic patients with acute myeloid leukemia may need to actively consider early removal of central venous catheter for reducing the duration of febrile neutropenia.

호중구 감소와 그로 인해 발생하는 발열은 혈액암, 특히 급성 백혈병을 가진 환자에게 매우 흔히 발생하며 치명적인 문제이다. 또한, 일반적으로 호중구 감소 발열 환자들은 병원에 입원하여 항생제와 항진균제 같은 여러 약물들로 치료가 이루어지기에 많은 비용 또한 수반한다. 본 연구는 급성 골수성 백혈병 환자군에서 호중구 감소 발열의 기간을 줄일 수 있는 요인을 밝혀내고자 하였으며 특히 대부분의 항암화학치료를 받는 급성 골수성 백혈병 환자들에게 삽입되는 중심 정맥관의 조기 제거(3주 이내)의 영향에 초점을 맞추었다. 이 연구는 단일 의료기관에서 시행된 후향적 연구로 호중구 감소 발열을 동반한 급성 골수성 백혈병 환자에서 나이, 성별, 체질량지수(BMI), 항암화학치료의 종류, 항암화학치료 전 기저 발열의 유무, 혈류 감염의 유무, 중심 정맥관 삽입 부위, 중심 정맥관의 조기 제거 여부에 따라 발열의 기간에 어떠한 영향을 미치는지 분석하였다. 결과는 나이, 항암화학치료의 종류, 기저 발열의 유무 그리고 특히, 중심 정맥관의 조기 제거 여부에 따라 일변량 분석과 다변량 분석 모두에서 유의한 결과를 보였다. (일변량 분석: p=0.001, 다변량 분석: 위험 비율 0.546, 95% 신뢰 구간 0.368-0.810, p=0.003). 그러므로 굽성 골수성 백혈병 환자의 호중구 감소 발열을 치료하는 의사는 호중구 감소 발열의 기간을 단축시키기 위해 중심 정맥관의 조기 제거를 적극적으로 고려하는 것이 필요할 것이다.

I. INTRODUCTION 1 II. MATERIALS and METHODS 2 A. Study Population 2 B. Variables of clinical characteristics and experimental definition 2 C. Statistical analysis 3 III. RESULTS 4 A. Characteristics of patients and central catheter insertion cases 4 B. Duration of febrile neutropenia according to the clinical characteristics of central catheter insertion cases 6 IV. DISCUSSION 9 REFERENCES 12 국문요약 15

Master

Advisors/Committee Members: 대학원 의학과, 201424710, 김, 태환.

Subjects/Keywords: Central venous catheter; Duration of fever; Neutropenia; Acute myeloid leukemia; 중심 정맥관; 발열의 기간; 호중구 감소; 급성 골수성 백혈병

…were compared and analyzed by the description for categorical variables. Duration of fever… …x28;8-39) Duration of fever, days (mean, range) 7.9 (1-29)… …cases Univariate and multivariate analyses about duration of fever were performed and the… …results are summarized in Table 2 and Table 3. In univariate analysis, mean duration of fever… …baseline fever. Especially, mean duration of fever in cases with early removal of CVC was 5.6… 

Record DetailsSimilar RecordsGoogle PlusoneFacebookTwitterCiteULikeMendeleyreddit

APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

김, . (2018). Can early removal of central venous catheter influence duration of fever in febrile neutropenic patients with acute myeloid leukemia?. (Thesis). Ajou University. Retrieved from http://repository.ajou.ac.kr/handle/201003/16535 ; http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000027180

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

김, 태환. “Can early removal of central venous catheter influence duration of fever in febrile neutropenic patients with acute myeloid leukemia?.” 2018. Thesis, Ajou University. Accessed January 24, 2019. http://repository.ajou.ac.kr/handle/201003/16535 ; http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000027180.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

김, 태환. “Can early removal of central venous catheter influence duration of fever in febrile neutropenic patients with acute myeloid leukemia?.” 2018. Web. 24 Jan 2019.

Vancouver:

김 . Can early removal of central venous catheter influence duration of fever in febrile neutropenic patients with acute myeloid leukemia?. [Internet] [Thesis]. Ajou University; 2018. [cited 2019 Jan 24]. Available from: http://repository.ajou.ac.kr/handle/201003/16535 ; http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000027180.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

김 . Can early removal of central venous catheter influence duration of fever in febrile neutropenic patients with acute myeloid leukemia?. [Thesis]. Ajou University; 2018. Available from: http://repository.ajou.ac.kr/handle/201003/16535 ; http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000027180

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

.