• Title/Summary/Keyword: Renal colic

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Low-dose intravenous ketamine versus intravenous ketorolac in pain control in patients with acute renal colic in an emergency setting: a double-blind randomized clinical trial

  • Sotoodehnia, Mehran;Farmahini-Farahani, Mozhgan;Safaie, Arash;Rasooli, Fatemeh;Baratloo, Alireza
    • The Korean Journal of Pain
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    • v.32 no.2
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    • pp.97-104
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    • 2019
  • Background: This study was conducted to compare the effectiveness of low-dose ketamine versus ketorolac in pain control in patients with acute renal colic presenting to the emergency department (ED). Methods: This is a double-blind randomized clinical trial. The initial pain severity was assessed using the numerical rating scale (NRS). Then, ketamine or ketorolac was administered intravenously at a dose of 0.6 mg/kg and 30 mg respectively. The pain severity and adverse drug reactions were recorded 5, 15, 30, 60, and 120 min thereafter. Results: The data of 62 subjects in the ketamine group and 64 patients in the ketorolac group were analyzed. The mean age of the patients was $34.2{\pm}9.9$ and $37.9{\pm}10.6\;years$ in the ketamine and ketorolac group, respectively. There was no significant difference in the mean NRS scores at each time point, except for the 5 min, between the two groups. Despite a marked decrease in pain severity in the ketamine group from drug administration at the 5 min, a slight increase in pain was observed from the 5 min to the 15 min. The rate of adverse drug reactions, including dizziness (P = 0.001), agitation (P = 0.002), increased systolic blood pressure (> 140 mmHg), and diastolic blood pressure (> 90 mmHg) was higher in the ketamine group. Conclusions: Low dose ketamine is as effective as ketorolac in pain management in patients with renal colic presenting to the ED. However, it is associated with a higher rate of adverse drug reactions.

Usefulness of Corticomedullary-Phase CT Urography in Patients with Suspected Acute Renal Colic Visiting the Emergency Department (응급실을 방문하는 급성신산통이 의심되는 환자에서 요로조영술 컴퓨터단층촬영의 피질-수질기의 유용성)

  • Seokyoung Lee;Yang Shin Park;Bitna Park;Jongmee Lee;Jae Woong Choi;Kyeong Ah Kim;Chang Hee Lee
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.923-933
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    • 2023
  • Purpose To evaluate the sensitivity of corticomedullary-phase imaging for detecting urinary stones in patients with renal colic who visited the emergency department. Materials and Methods This retrospective study included 253 patients with suspected renal colic from two tertiary hospitals in South Korea, who visited the emergency department and underwent CT urography. Two radiologists blinded to the clinical history independently reviewed the corticomedullary-phase images. The sensitivity for identifying urinary stones were evaluated for each reviewer. After the initial evaluation, the images were re-evaluated based on patient history. The sensitivity of re-evaluation were recorded. Results Of 253 patients, 150 (59%) had urinary stones. Among them, significant stones were observed in 138 patients (92%), and obstructive changes on CT in 124 patients (82.7%). For identifying significant urinary stones, the sensitivity was 98.6% (136/138) for both the reviewers. For identifying significant urinary stones with urinary obstruction, the sensitivity was 99.2% (123/124) for reviewer 1, and 100% (124/124) for reviewer 2. The sensitivity for identifying significant stones increased from 98.6% to 100% for reviewer 1, and from 98.6% to 99.3% for reviewer 2 in the re-evaluation session. Conclusion The corticomedullary-phase CT urography was sensitive for diagnosing urolithiasis in patients with acute renal colic who visited the emergency department.

Cystinuria in Siblings (남매에서 발생한 Cystinuria)

  • Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.1 no.1
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    • pp.18-22
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    • 2001
  • Renal colic, hematuria, dysuria and stone passage were developed in younger brother (4 year 6 month old boy). But the elder sister (6 year old girl)had no specific symptoms and signs. The identification of the disease was proved by cyanide nitroprusside test and amino acid analysis of urine. In our patients the chromatographic amino acid patterns of urine showed remarkably increased excretion of cystine, ornithine, lysine, and arginine. They are managed by adequate hydration with Shohl solution for rendering the urine more alkaline, and alpha-mercaptopropionylglycine (Thiola).

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High Temperatures and Kidney Disease Morbidity: A Systematic Review and Meta-analysis

  • Lee, Woo-Seok;Kim, Woo-Sung;Lim, Youn-Hee;Hong, Yun-Chul
    • Journal of Preventive Medicine and Public Health
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    • v.52 no.1
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    • pp.1-13
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    • 2019
  • Objectives: In recent years, serious concerns have been raised regarding the impacts of rising temperatures on health. The present study was conducted to investigate the relationship between elevated temperatures and kidney disease through a systematic review and meta-analysis. Methods: In October 2017, 2 researchers independently searched related studies in PubMed and Embase. A meta-analysis was conducted using a random-effects model, including only studies that presented odds ratios, relative risks, or percentage changes, along with 95% confidence intervals (CIs). The characteristics of each study were summarized, and the Egger test and funnel plots were used to evaluate publication bias. Results: Eleven studies that met the criteria were included in the final analysis. The pooled results suggest an increase of 30% (95% CI, 20 to 40) in kidney disease morbidity with high temperatures. In a disease-specific subgroup analysis, statistically significant results were observed for both renal colic or kidney stones and other renal diseases. In a study design-specific subgroup analysis, statistically significant results were observed in both time-series analyses and studies with other designs. In a temperature measure-specific subgroup analysis, significant results were likewise found for both studies using mean temperature measurements and studies measuring heat waves or heat stress. Conclusions: Our results indicate that morbidity due to kidney disease increases at high temperatures. We also found significant results in subgroup analyses. However, further time-series analyses are needed to obtain more generalizable evidence.

Computed Tomographic Features of Gallbladder Agenesis in a Golden Retriever

  • Yujung Lee;Dongjun Kim;Jeongin Choi;Youngwon Lee;Hojung Choi
    • Journal of Veterinary Clinics
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    • v.41 no.1
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    • pp.43-48
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    • 2024
  • A two-year-old, intact female Golden Retriever had previously been diagnosed with a portosystemic shunt (PSS) during an ultrasonographic examination at a local animal hospital. The serum biochemistry revealed elevated liver enzymes and bile acid levels. The abdominal radiographic examination revealed mild serosal detail loss and microhepatica, while abdominal ultrasonography revealed mild ascites and high-velocity flow to the caudal vena cava (CVC) suspected as a PSS. The gallbladder was not observed within the hepatic parenchyma during ultrasonography. Computed tomography (CT) revealed an absent gallbladder and dilation of the common bile duct (CBD). Dilations of the gastroduodenal, splenic, colic and renal veins were also observed. A dilated left phrenico-abdominal vein that entered the CVC was previously misinterpreted as a PSS on the ultrasound examination. Based on the imaging examinations, the dog was diagnosed with congenital gallbladder agenesis associated CBD dilation.