Discussion Board Rebuttal

(Discussion Board Rebuttal)

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Discussion Board Rebuttal

The author offers a compelling discussion on the project topic and the journal to publish the article. The clinical symptoms of emphysematous pyelonephritis, a rare necrotizing pyelonephritis, can range from minor abdominal pain to septic shock.¹ It is a potentially fatal disorder that typically affects diabetic people, and in a limited number of cases, urinary tract obstruction could be responsible.¹ Surgery is a mainstay treatment, but there are more contemporary approaches to address emphysematous pyelonephritis, including correction of any electrolyte and glucose problems and administration of antibiotics targeting Gram-negative bacteria, after resuscitation, before considering surgery, unless it is an emergency. Historically, surgery was the preferred and required form of treatment.¹ Those who underwent surgery for the condition had to undergo long-term dialysis. The effect was frequently lethal if untreated.¹ In this case, the predisposing factor may be a combination of blockage brought on by renal papillary cell carcinoma and poor tissue perfusion brought on by undetected diabetes, which resulted in gas generation and emphysematous pyelonephritis.

The article presented is a case report, hence appropriate to post in the Journal of the American Academy of Physician Assistants (JAAPA). The article topic is definitely an interesting topic for physician assistants because it is about a urologic condition. Also, no article addresses emphysematous pyelonephritis, and the best possible match was emphysematous cystitis. However, I disagree that the topic is too specialized for JAAPA just because no article addresses such a topic. JAAPA invites new research on topics that would interest Pas, and this article is the right one for the journal. The American Urologic Association (AUA) and the American Association of Surgical Physician Assistants (AASPA) journals are also suitable for publishing the topic because PAs are among the audience and can also be the first authors. The author seems limited with the Urologic Association (AUA) and the American Association of Surgical Physician Assistants (AASPA) journals regarding the ability to post case reports. I would say that ANNALS of Surgery, the International Journal of Surgery and Research and Practice, and the Surgery Journal are suitable for the topic because they have a wider audience and allow case reviews, and the author should look into them. (Discussion Board Rebuttal)

References

Surur J. Acute bilateral emphysematous pyelonephritis. BMJ Case Rep. 2017;2017:bcr1020103425. Published 2017 Mar 8. doi:10.1136/bcr.10.2010.3425 https://pubmed.ncbi.nlm.nih.gov/22707665/