Prepubertal Dysuria Not as Simple as a UTI

​Prepubertal boys who present to the emergency department with dysuria are uncommon. The adult with burning on urination is assumed to have a sexually transmitted disease, but of course that diagnosis should not be high on your list for boys.In fact, infectious urethritis in children is quite uncommon unless there is premature sexual activity or sexual abuse by an adult. Unfortunately, a variety of noninfectious urethral pathologies may mimic infectious urethritis in children. A urinary tract infection in a prepubertal boy is an infectious cause of dysuria. Those infections, however, rarely present with the isolated symptom of burning on urination. There is often evidence of bladder irritability manifested by urgency and frequency. Self-inoculation associated with herpes labialis can also result in an HSV genital infection and painful urination.We should consider noninfectious causes of dysuria when a urinary tract infection, balanoposthitis, a candida infection, or a sexually transmitted disease is not present. Noninfectious irritation of the urethra is most commonly caused by chemical exposures (bubble bath), local trauma, or meatal stenosis. Bubble bath is probably the most common cause of noninfectious dysuria in prepubertal boys. The therapeutic solution for this condition is to stop using bubble bath. See the video of a patient with burning on urination due to bubble bath use.Local trauma is another possible etiology of dysuria. It may be self-induced by the prepubert...
Source: M2E Too! Mellick's Multimedia EduBlog - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

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Conclusions: The DC-TAV program is an ambitious, civilian-military, nationwide and long-term program, based on a harmonised standard of care and including multidimensional training. Further studies are required to assess its efficacy.
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
Publication date: Available online 12 October 2019Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): Arnaud Chaumeron, Jeremie Castanie, Louis Philippe Fortier, Patrick Basset, Sophie Bastide, Sandrine Alonso, Jean-Yves Lefrant, Philippe CuvillonABSTRACTBackground: Rapid sequence induction (RSI) is recommended in patients at risk of aspiration, but induced hemodynamic adverse events, including tachycardia. In elderly patients, this trial aimed to assess the impact of the addition of remifentanil during RSI on the occurrence of: tachycardia (primary outcome), hypertension (due to intubation) nor hypotension (rem...
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
Publication date: Available online 12 October 2019Source: Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)Author(s): Q. Xu, M. Lv, Y. Xia, Y. Zhao, W. Zhang, Y. ChenAbstractA 42-year-old woman presented with a ten-day history of dysphagia, slight chest pain and occasional vomiting. With the performance of thoracic and abdominal enhanced computed tomography (CT) and upper gastrointestinal contrast, once esophageal cancer was suspected. Significant activity mass in esophagus and mediastinal lymph nodes could be found on the imaging of 18F-FDG PET/CT, which also supported malignancy. However, T...
Source: Revista Espanola de Medicina Nuclear e Imagen Molecular - Category: Nuclear Medicine Source Type: research
Publication date: Available online 8 October 2019Source: NeuroImageAuthor(s): In-Seon Lee, Elizabeth A. Necka, Lauren Y. AtlasAbstractPain is a subjective, multidimensional experience that is distinct from nociception. A large body of work has focused on whether pain processing is supported by specific, dedicated brain circuits. Despite advances in human neuroscience and neuroimaging analysis, dissociating acute pain from other sensations has been challenging since both pain and non-pain stimuli evoke salience and arousal responses throughout the body and in overlapping brain circuits. In this review, we discuss these chal...
Source: NeuroImage - Category: Neuroscience Source Type: research
ConclusionsThe current rapid, multi-slice acquisition and real-time implementation of temperature and displacement visualization may be useful in clinical practices. It may help defining operational safety margins, improving therapy precision and efficacy. Simulations were in good agreement with experimental data and may thus be used prior treatment for procedure planning.
Source: NeuroImage - Category: Neuroscience Source Type: research
ConclusionsOur device represents an improvement and a valid alternative to the current methods diagnosing regional cerebral circulation.Graphical abstract
Source: Journal of Neuroscience Methods - Category: Neuroscience Source Type: research
Conclusion: Considering the excellent diagnostic accuracy, ultrasonography can be used as an alternative means in diagnosis of metatarsal bone fractures. PMID: 31602432 [PubMed]
Source: Accident and Emergency Nursing - Category: Emergency Medicine Authors: Tags: Arch Acad Emerg Med Source Type: research
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Source: Accident and Emergency Nursing - Category: Emergency Medicine Authors: Tags: Arch Acad Emerg Med Source Type: research
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Source: Journal of Molecular Liquids - Category: Molecular Biology Source Type: research
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Source: Current Pharmaceutical Design - Category: Drugs & Pharmacology Authors: Tags: Curr Pharm Des Source Type: research
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