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AbdominalPain

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Medical Expulsion Therapy in Ureteral Colic: An Update - R.E.B.E.L. EM - Emergency Medicine Blog

Back in August 2014, we posted a review on medical expulsion therapy (MET) in patients with renal colic, but since then 2 new trials have been published, so we thought a brief review of each of these articles and updated recommendations were warranted.  
rebelem.com
almost 6 years ago
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Interventions for preventing and treating kidney disease in Henoch-Schönlein Purpura | Cochrane

Henoch-Schönlein Purpura (HSP) causes inflammation of small blood vessels in children and affects approximately 20/100,000 children annually. Symptoms and signs include a purpuric skin rash (which comprises small spots and larger bruises), abdominal pain, gastrointestinal bleeding, joint pain and swelling, facial swelling and evidence of kidney disease with blood and protein in the urine. Kidney disease occurs in about one third of children with HSP. In the majority this is mild (small amounts of blood in the urine only) and resolves completely but a few children have persistent kidney disease that can progress to kidney failure.  
cochrane.org
almost 6 years ago
Sinaiem dark
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p-or-iup

A G1P0 10-week pregnant female presents to the ED with lower abdominal pain and vaginal spotting. She’s had no prenatal care. Being the highly motivated resident that you are, before even the urine is collected and the pregnancy is verified, you bring the ultrasound machine bedside and see this:  
sinaiem.org
almost 6 years ago
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9

The impact of biological interventions for ulcerative colitis on health-related quality of life | Cochrane

Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by abdominal pain, urgent bowel movements and bloody diarrhea. Treatment of UC focuses on induction of remission (treatment of symptoms of active disease) and prevention of clinical relapse (resumption of symptoms of active disease) in patients in remission (known as maintenance therapy). UC has a major impact on patients' health related quality of life (HRQL). HRQL refers to a person's physical functioning, social and emotional well-being, ability to work and freedom from disease symptoms. HRQL is significantly lower in patients with UC compared to the general population. Randomized controlled trials (RCTs) evaluating medical interventions for UC have traditionally used clinical disease activity indices which focus on subjective symptoms to define primary outcomes such as clinical remission or improvement. This focus on disease symptoms results in a failure to assess other important indicators of successful treatment such as HRQL.  
cochrane.org
almost 6 years ago
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Emergency Medicine Literature of Note: A Very Odd Look at CT In the ED

Interesting summary, thanks. Although bouncebacks were not prevented, I'm curious whether CTs impacted how patients were treated on their return. For example, were they appropriately or inappropriately stratified into low risk ("3rd visit for abdominal pain after a negative CT...")?  
emlitofnote.com
almost 6 years ago