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“Purpose: Nephrostomy tube placement

is often necessary to avert acute renal failure in patients with cancer with obstructive uropathy or in patients with ureteral leak. However, there have been limited published studies on the rate and risk of nephrostomy tube related pyelonephritis in patients with cancer. Therefore, in this study we determined rates of nephrostomy tube related pyelonephritis and predisposing risk factors in patients with cancer.

Materials and Methods: We retrospectively reviewed patients who underwent nephrostomy tube placement between September 1, 2009 and September 16, 2010 at MD learn more Anderson Cancer Center. Patients were followed for 90 days. The primary outcome assessed was the development of nephrostomy tube related pyelonephritis and the secondary outcome was the development of asymptomatic bacteriuria. We also determined risk factors LEE011 clinical trial associated with pyelonephritis.

Results:

Of the 200 patients analyzed 38 (19%) had pyelonephritis and 15 (7.5%) had asymptomatic bacteriuria. Of the nephrostomy tube related infections 34 cases (89%) were with the primary nephrostomy tube. Subsequently 4 of the patients who underwent nephrostomy tube exchange had an episode of pyelonephritis. Pyelonephritis developed within the first month in 19 (10%) patients. Prior urinary tract infection and neutropenia were found to be significant risk factors for pyelonephritis (p = 0.047 and 0.03, respectively).

Conclusions: The placement of nephrostomy tubes in patients with

cancer is associated with a significant rate of pyelonephritis. Neutropenia and history of urinary tract infection were significant risk factors for pyelonephritis. This finding warrants further investigation into preventive strategies to reduce the infection rate.”
“To the Editor: We are troubled by the ventilation strategy selected for the control group (or nonprotective-ventilation group) selleck in the study by Futier et al. (Aug. 1 issue).(1) This strategy (nonprotective ventilation with a tidal volume of 10 to 12 ml per kilogram of predicted body weight, with no positive end-expiratory pressure [PEEP] and no recruitment maneuvers) is known to be potentially harmful and is outdated (the authors cite a study from 1963(2) to define their standard of care). The tidal volumes recommended in contemporary strategies(3),(4) for perioperative ventilation are less than 10 ml per kilogram of predicted body …”
“At a population level the extent that psychiatric disorders and other health conditions disrupt participation in education and employment is rarely considered simultaneously and remains largely unknown. This is an important issue because policy makers are as concerned with educational attainment, school to work transitions, and workforce skills, as they are with overall labour force participation.