Disparities in pain medication given to kidney-stone emergency patients
(Reuters Health) - Black and Latino patients treated for kidney stones in emergency departments around the U.S. tend to get less pain-killing medication compared to whites, a new study finds.
Conclusion: This study has a total complication rate of 16%, approximately 10% of those are severe. The most common complication to PCNL was infection (60%), followed by bleeding (5.4%), reoperation (1.6%) and pain (0.5%). The high prevalence of E. faecalis might need to be considered, however the results should be validated in a larger cohort, possibly with a higher rate of antibiotic resistance, before a change of guidelines regarding prophylactic antibiotics could be proposed. PMID: 32208808 [PubMed - as supplied by publisher]
When most people think about E coli, the first thing that comes to mind likely is eating tainted food or as a result of improper handwashing. What came as a surprise to me was that it can also show up as a UTI (Urinary Tract Infection) caused by kidney stones that back up in the urethra, which prohibits the flow of urine. It is more than an academic exercise that had me researching this all too common condition in men and women. As I am writing, I am less than 24 hours post-surgery to remove these pesky critters that have been backing up the works since 2014. It was my fourth go around that culminated in a cystoscopy,...
Conclusion: Pain was the commonest indication for intra-corporeal lithotripsy (92.8%) and also the commonest post-operative complication (9.30%). Funding: None declared. PMID: 32116343 [PubMed - in process]
ConclusionsThis study demonstrated that, compared to standard ECIRS, mini-ECIRS maintained SFR without increasing perioperative complications, tended to reduce postoperative pain and had a potential to reduce bleeding-related complications. This report suggests the advantages of ECIRS miniaturization for renal stones.
Condition: Nephrolithiasis Interventions: Drug: Mirabegron 50 MG; Drug: Placebo oral tablet Sponsors: St. Michael's Hospital, Toronto; Canadian Urological Association Recruiting
We report outcomes of our initial experience with LP in 38 children from 2 months of age. Materials and Methods From June 2015 to December 2017 38 children aged 2-60 months (mean age 1.7 years) underwent LP for correction of PUJ obstruction. The mean pre operative anteroposterior diameter of the renal pelvis (APD) was 43,5mm and all patients had hydronephrosis (APD 21.4-76 mm) and obstructed curve on diuretic renogram. Anderson-Hynes pyeloplasty was the performed technique. Results are reported. Results Mean operative time was 107 minutes (70-180) with no conversion to open procedure. Pain control was needed mainly in the ...
Our purpose is to describe the ultrasound sign for a correct non-invasive diagnosis of omental infarction in children. From January 2014 to December 2018, a total of 234 children (109 boys and 125 girls, age range 3 –15 y) with acute right-sided abdominal pain, admitted to our hospital with a presumptive diagnosis of acute appendicitis, were prospectively evaluated. In all patients, abdominal ultrasound was performed, and the omental fat was always evaluated. In 228 patients, the omental fat resulted to be no rmal or hyperechogenic, never tethered, and they results affected by other causes of abdominal pain different...
ConclusionThe results of this randomized, double-blind, placebo-controlled trial suggest that PVB should be considered an effective strategy to reduce opioid requirement and improve pain control for patients undergoing PCNL.
I'm a PGY-1, and with half of the year done and about 2 months of total actual EM time done, I'm noticing some pretty big recurrent problems. I was hoping to get some advice on how to deal. Firstly, I have a really bad habit of anchoring to diagnoses. Fairly often I'll get a strong bias towards whatever diagnosis seems most likely initially. The other day, a lady with history of kidney stones came in with colicky groin pain and couldn't get comfortable in any position. I got the workup... Recurrent Performance Problems