Emergency CT usage rate soars for urinary stones

The overall usage rate of emergency CT for patients with suspected urinary...Read more on AuntMinnie.comRelated Reading: Did Image Gently reduce CT use for kidney stones? Which modality works best for diagnosing kidney stones? AI gives one-stop shopping for urinary stone evaluation Ultrasound should be 1st choice for suspected kidney stones Iterative reconstruction cuts CT dose for urinary stone disease
Source: AuntMinnie.com Headlines - Category: Radiology Source Type: news

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Ultrasound (US) imaging is preferred in the initial evaluation for children with suspected nephrolithiasis; however, computed tomography (CT) continues to be used in this setting with resultant unnecessary ionizing radiation exposure. Our institution implemented a standardized clinical pathway to reduce rates of CT utilization for children with nephrolithiasis.
Source: Journal of Pediatric Urology - Category: Urology & Nephrology Authors: Source Type: research
A novel CLDN16 mutation in familial hypomagnesemia with hypercalciuria and nephrocalcinosis
. Clin Nephrol. 2019 Jun 24;: Authors: Zhang H, Ling C, Liu X Abstract Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) is a rare autosomal recessive tubulopathy caused by mutations in either the CLDN16 or CLDN19 genes. Two children from a consanguineous family of Chinese presented with enuresis, polyuria, polydipsia, and failure to thrive. Laboratory studies revealed hypomagnesemia, hypercalciuria, sterile leukocyturia, microscopic hematuria, and renal insufficiency. Renal ultras...
Source: Clinical Nephrology - Category: Urology & Nephrology Authors: Tags: Clin Nephrol Source Type: research
Asymptomatic, or incidental, pediatric kidney stones detected on abdominal imaging pose a clinical challenge as their significance and expected outcome are not well described. Our primary objective was to estimate the incidence of nephrolithiasis in pediatric patients undergoing abdominal ultrasound (US) or computerized tomography (CT), for all indications, in a pediatric tertiary care hospital. Our secondary objective was to determine the clinical outcome of these radiographically detected stones.
Source: Journal of Pediatric Urology - Category: Urology & Nephrology Authors: Source Type: research
AbstractPurposeTo compare iPad-assisted (Apple Inc., Cupertino, USA) percutaneous access to the kidney to the standard puncturing technique for percutaneous nephrolithotomy (PCNL).MethodsFor the iPad-assisted PCNL, a computed tomography is performed prior to surgery, using fiducial radiopaque markers. The important anatomical structures (i.e. kidney, stones) are segmented using specific software enabling the superimposition of images semi-transparently on the iPad by marker-based navigation. Twenty-two patients underwent an iPad-assisted percutaneous puncture of the kidney for PCNL. Twenty-two patients of the clinical data...
Source: World Journal of Urology - Category: Urology & Nephrology Source Type: research
AbstractTo determine whether patients with ureteral stones received different standard of care in the emergency department (ED) according to various sociodemographic factors. We conducted a retrospective study of patients presenting to EDs in a large tertiary-care hospital in the Bronx, New York with a diagnosis of ureteral stones. Electronic chart review was used to assess each patient ’s ED course and to gather socio-demographic information. The primary outcomes of interest were administration of pain medication, prescription of alpha-1 antagonists to facilitate stone passage, and whether or not patients received C...
Source: Urolithiasis - Category: Urology & Nephrology Source Type: research
Abstract Diagnosis, treatment, and follow-up are all influential in determining the overall cost to the health care system for kidney stones. New innovations in the field of nephrolithiasis have been abundant, including disposable ureteroscopes, ultrasound-guided approaches to percutaneous nephrolithotomy, and advanced laser lithotripters. Identifying cost-effective treatment strategies encourages practitioners to be thoughtful about providing value-based high-quality care and remains on important principle in the treatment of urinary stone disease. PMID: 30961862 [PubMed - indexed for MEDLINE]
Source: The Urologic Clinics of North America - Category: Urology & Nephrology Authors: Tags: Urol Clin North Am Source Type: research
Abstract Nephrolithiasis is an increasingly common condition worldwide and mobile technology is revolutionizing how patients with kidney stone are being diagnosed and managed. Emerging platforms include software applications to increase adherence to stone prevention, mobile compatible hardware, online social media communities, and telemedicine. Applications and hardware specifically relevant to increasing hydration, diet modification, medication adherence, and rapid diagnosis (ie, mobile ultrasound and endoscopy) have the greatest potential to reduce stone recurrence and expedite treatment. Social media and online...
Source: The Urologic Clinics of North America - Category: Urology & Nephrology Authors: Tags: Urol Clin North Am Source Type: research
This article reviews new advances in ultrasound technology for urinary stone disease. Recent research to facilitate the diagnosis of nephrolithiasis, including use of the twinkling signal and posterior acoustic shadow, have helped to improve the use of ultrasound examination for detecting and sizing renal stones. New therapeutic applications of ultrasound technology for stone disease have emerged, including ultrasonic propulsion to reposition stones and burst wave lithotripsy to fragment stones noninvasively. The safety, efficacy, and evolution of these technologies in phantom, animal, and human studies are reviewed herein...
Source: The Urologic Clinics of North America - Category: Urology & Nephrology Authors: Tags: Urol Clin North Am Source Type: research
Abstract This comprehensive review updates the advances in extracorporeal lithotripsy, including improvements in external shockwave lithotripsy and innovations in ultrasound based lithotripsy, such as burst wave lithotripsy, ultrasonic propulsion, and histotripsy. Advances in endoscopic technology and training have changed the surgical approach to nephrolithiasis; however, improvements and innovations in extracorporeal lithotripsy maintain its status as an excellent option in appropriately selected patients. PMID: 30961855 [PubMed - indexed for MEDLINE]
Source: The Urologic Clinics of North America - Category: Urology & Nephrology Authors: Tags: Urol Clin North Am Source Type: research
ConclusionOur study demonstrates that in appropriate setting a high stone-free rate can be achieved with minimal morbidity for paediatric patients. There is potentially a need to factor the increasing role of URS in future paediatric urolithiasis guidelines.
Source: World Journal of Urology - Category: Urology & Nephrology Source Type: research
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