Alternate Alternatives

2020 ◽  
pp. 241-246
Author(s):  
Pat Croskerry
Keyword(s):  
Emergency Department ◽  
Urinary Tract Infection ◽  
Low Back Pain ◽  
Back Pain ◽  
Urinary Tract ◽  
Tract Infection ◽  
Emergency Physician ◽  
Elderly Female ◽  
Essentially Normal

In this case, an elderly female presents to the emergency department with a complaint of low back pain for the past few months. She has been receiving treatment from a chiropractor for misalignment of her spine but believes she is not improving. She is seen by an emergency physician, who finds an essentially normal exam. Specifically, she has no neurological findings and a completely normal musculoskeletal exam. Urinalysis shows clear signs of a urinary tract infection. She is started on an antibiotic, and at follow-up her back pain has resolved and her urinalysis is normal. The case provides an opportunity to review complementary and alternative medicine and its pitfalls.

Long-term follow-up of premature infants with urinary tract infection

2021 ◽  
Author(s):  
Lotem Goldberg ◽  
Yael Borovitz ◽  
Nir Sokolover ◽  
Asaf Lebel ◽  
Miriam Davidovits
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Premature Infants ◽  
Long Term Follow Up

National Trends in Emergency Department Antibiotic Prescribing for Elders with Urinary Tract Infection, 1996-2005

2009 ◽  
Vol 16 (6) ◽  
pp. 500-507 ◽  
Author(s):  
Jeffrey M. Caterino ◽  
Sarah Grace Weed ◽  
Janice A. Espinola ◽  
Carlos A. Camargo, Jr
Keyword(s):  
Emergency Department ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Prescribing ◽  
National Trends

Urinary Tract Infection

1979 ◽  
Vol 1 (5) ◽  
pp. 133-136
Author(s):  
Richard H. Rapkin
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urine Culture ◽  
Underlying Disease ◽  
Chief Complaint ◽  
Voiding Cystourethrogram ◽  
Intravenous Pyelogram ◽  
Rapid Generation

The identification of urinary tract infection (UTI) is important in order to reduce its morbidity, to prevent its sequelae, and to identify underlying disease. This article will discuss methods of diagnosis and management of UTI, screening for UTI, and the importance of further evaluation and follow-up of children with UTIs. Much of what we know about UTI is controversial and rapid generation of new knowledge may make current recommendations passé. CASE V.M., a 4-year-old girl, was brought to the physician's office with the chief complaint of frequency of urination. Nine months before she had been seen because of frequency and dysuria and two consecutive midstream urine cultures grew >100,000 colonies/ml of a Gramneative rod. Sulfisoxazole was begun and a urine culture was sterile 48 hours after therapy was begun. The dysuria and frequency disappeared; therapy was continued for ten days and a urine culture four days later was sterile. One week later a voiding cystourethrogram (VCU) and an intravenous pyelogram (IVP) were performed and were interpreted as normal. Repeat urine cultures at one, two, three, and six months after the episode were sterile. Two days before the child was seen, she had become irritable and wet the bed during sleep (she had been successfully trained at 27 months of age), and she began to void frequently during the next 24 hours.

scholarly journals Infeções do Trato Urinário numa Coorte de Transplantados Renais

2014 ◽  
Vol 27 (3) ◽  
pp. 364 ◽  
Author(s):  
Ana Bispo ◽  
Milene Fernandes ◽  
Cristina Toscano ◽  
Teresa Marques ◽  
Domingos Machado ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Hospital Admissions ◽  
Female Gender ◽  
Tract Infections

<strong>Introduction:</strong> Urinary tract infection is the most common infectious complication following renal transplantation and its frequency is insufficiently studied in Portugal. The aim of this study was to characterize the incidence of urinary tract infections and recurrent urinary tract infections in renal transplant recipients.<br /><strong>Material and Methods:</strong> This was a retrospective cohort observational study, obtained from clinical files of all patients who received a renal transplant at the Hospital of Santa Cruz, from January 2004 to December 2005, with a mean follow-up period of five years or until date of graft loss, death or loss of follow-up. After a descriptive analysis of the population, we used bivariate tests to identify risk factors for urinary tract infections.<br /><strong>Results:</strong> A total of 127 patients were included, with a 593 patients.year follow-up. We detected 53 patients (41.7%) presenting with at least one episode of urinary tract infection; 21 patients (16.5%) had recurrent urinary tract infection. Female gender was the only risk factor associated with the occurrence of urinary tract infections (p &lt; 0.001, OR = 7.08, RR = 2.95) and recurrent urinary tract infections (p &lt; 0.001, OR = 4.66, RR = 2.83). Escherichia coli (51.6%), Klebsiella pneumoniae (15.5%) and Enterobacter spp (9.9%) were the<br />most frequently identified pathogens. Patients did not reveal an increased mortality or allograft loss. However, urinary tract infections were the most important cause of hospital admissions.<br /><strong>Discussion:</strong> Female gender was the only risk factor for urinary tract infections in this population. Escherichia coli was the most frequent agent isolated.<br /><strong>Conclusion:</strong> Despite preventive measures, urinary tract infections remain an important cause of morbidity and hospital admissions.<br /><strong>Keywords:</strong> Urinary Tract Infections; Postoperative Complications; Risk Factors; Kidney Transplantation; Portugal.

scholarly journals A prospective, follow up study to assess guidelines compliance in uncomplicated urinary tract infection

2020 ◽  
Vol 9 (8) ◽  
pp. 4292
Author(s):  
Manisha Bisht ◽  
PreetinderSingh Manshahia ◽  
Ankur Mittal ◽  
Mohit Bhatia ◽  
ShailendraS Handu
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Uncomplicated Urinary Tract Infection ◽  
Follow Up Study

scholarly journals A Study of Abdomenal Pain in Children

2008 ◽  
Vol 47 (172) ◽  
Author(s):  
Kashyap Narsingh Shakya ◽  
UMS Dangol ◽  
SB Khadka
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Operative Management ◽  
Infantile Colic ◽  
Medical College ◽  
Pain Abdomen ◽  
Cause Of Pain ◽  
Secondary Causes

Pain abdomen is a common pediatric complaint that brings patient to the hospital in Nepal.Knowledge about its etiology and frequency helps in its evaluation and management. The presentstudy was undertaken to find out the causes and their frequency of pain abdomen in Nepalichildren. Children with pain abdomen presenting at the emergency room and pediatric outpatientdepartment of Kathmandu Medical College, Kathmandu from January, 2006 to December 2007 wereclinically evaluated and investigated to find out the causes and frequency of their pain abdomen. Theoutcomes were tabulated and analyzed for interpretation. Of 444 patients attended, 356 completedinvestigations and came for follow up. Cause of pain abdomen was apparent in 117 (32.9%) only.91.5% were medical causes, comprising predominantly of diarrheal diseases (28.3%), infantile colic(9.4%), urinary tract infection (7.7%) and acid peptic disease (6.8%). 8.5% causes were related tosurgical conditions, which needed operative management. Secondary or extra-abdominal causeswere found in 20 cases (17.1%). Pneumonia (2), functional (5), vulvovaginitis (2) and infantile colic(11) were predominant causes. Our study showed that the causes of pain abdomen in children werepredominantly medical. Gastroenteritis was the most frequent cause. Secondary causes, includingfunctional and emotional causes were infrequent. Small percentage needing surgical managementformed a diagnostic challenge.Key words: abdomen, children, gastroenteritis, pain

scholarly journals Leveraging Antimicrobial Stewardship in the Emergency Department to Improve the Quality of Urinary Tract Infection Management and Outcomes

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
Sarah C J Jorgensen ◽  
Samantha L Yeung ◽  
Mira Zurayk ◽  
Jill Terry ◽  
Maureen Dunn ◽  
...  
Keyword(s):  
Emergency Department ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Stewardship ◽  
Treatment Algorithm ◽  
Rapid Change ◽  
Audit And Feedback ◽  
Prescribing Practices ◽  
Return Visits

Abstract Background The complex and fast-paced emergency department (ED) practice setting presents unique challenges that demand a tailored approach to antimicrobial stewardship. In this article, we describe the strategies applied by 1 institution’s antimicrobial stewardship program (ASP) that were successful in improving prescribing practices and outcomes for urinary tract infection (UTI) in the ED. Methods Core strategies included pre-implementation research characterizing the patient population, antimicrobial resistance patterns, prescribing behavior, and morbidity related to infection; collaboration across multiple disciplines; development and implementation of a UTI treatment algorithm; education to increase awareness of the algorithm and the background and rationale supporting it; audit and feedback; and early evaluation of post-implementation outcomes. Results We observed a rapid change in prescribing post-implementation with increased empiric nitrofurantoin use and reduced cephalosporin use (P &lt; .05). Our elevation of nitrofurantoin to firstline status was supported by our post-implementation analysis showing that its use was independently associated with reduced 30-day return visits (adjusted odds ratio, 0.547; 95% confidence interval, 0.312–0.960). Furthermore, despite a shift to a higher risk population and a corresponding decrease in antimicrobial susceptibility rates post-implementation, the preferential use of nitrofurantoin did not result in higher bug-drug mismatches while 30-day return visits to the ED remained stable. Conclusions We demonstrate that an outcomes-based ASP can impart meaningful change to knowledge and attitudes affecting prescribing practices in the ED. The success of our program may be used by other institutions as support for ASP expansion to the ED.

Prediction of renal cortical defect and scar using neutrophil-to-lymphocyte ratio in children with febrile urinary tract infection

2017 ◽  
Vol 56 (03) ◽  
pp. 109-114 ◽  
Author(s):  
Jeong Won Lee ◽  
Joon Soo Park ◽  
Kyeong Bae Park ◽  
Gyeong Hee Yoo ◽  
Seung Soo Kim ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Neutrophil To Lymphocyte Ratio ◽  
Febrile Urinary Tract Infection ◽  
Lymphocyte Ratio ◽  
Cortical Defect ◽  
Febrile Uti ◽  
Dmsa Scan

SummaryAim: This study is aimed to evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR) for cortical defect on initial and follow-up Tc-99m dimercaptosuccinic acid (DMSA) scan in children with the first febrile urinary tract infection (UTI). Methods: We retrospectively enrolled 179 children with the first febrile UTI who underwent DMSA scan and laboratory tests. In patients with abnormal DMSA scan findings, follow-up DMSA scan was performed at least 6 months after the initial scan. All DMSA scans were classified as negative and positive cortical defects. Multiple logistic regression analyses were performed to identify the risk factors for cortical defect on initial and follow-up DMSA scan. Results: Cortical defects on initial DMSA scan were noted in 133 patients. Vesicoureteral reflux (VUR), white blood cell count, absolute neutrophil count, NLR, and serum C-reactive protein level were independent predictive factors for positive cortical defect on initial DMSA scan (p < 0.050). On follow-up DMSA scan, 24 of the 133 patients showed persistent cortical defects, and only VUR was significantly associated with persistent cortical defect (p = 0.002). In 84 patients who showed cortical defect on initial scan and absence of VUR, only NLR was significantly associated with persistent cortical defect on follow-up scan (p = 0.025). Conclusion: NLR was significantly associated with persistent cortical defect on follow-up DMSA scan in patients without VUR, as well as positive cortical defect on initial scan.

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