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相关概念视频

Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

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A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Kidney Transplant II: Surgical Procedure01:26

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
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皮肤性瘤切除的抗菌预防:当代实践模式

Jeffrey Johnson1, Prakash Gorroochurn2, Miyad Movassaghi3

  • 1Department of Urology, Weill Cornell Medical Center, New York, New York, USA.

Journal of endourology
|October 13, 2023
PubMed
概括

几乎一半的泌尿科医生不遵循美国泌尿学会的指导方针,在皮肤透神经切除术 (PCNL) 期间进行抗生素预防. 甲尼达和阿兹特雷诺姆很少使用,这表明需要更新建议.

关键词:
抗生素预防 抗生素预防结石 结石是指结石的发生.通过皮肤进行nephrolithotomy.

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科学领域:

  • 泌尿器科 泌尿器科 泌尿器科 泌尿器科
  • 传染性疾病 传染性疾病
  • 抗微生物药物管理委员会

背景情况:

  • 美国泌尿器官学会 (AUA) 提供了通过皮肤利切除术 (PCNL) 中抗菌预防的指南.
  • 最近的证据表明,这些指导方针可能并不反映当前的临床实践.
  • 内分泌科医生对AUA对PCNL的预防建议的坚持并未得到充分证实.

研究的目的:

  • 评估内分泌科医生是否遵守AUA关于PCNL抗菌预防的最佳实践声明.
  • 确定在PCNL期间影响抗生素选择的处方模式和因素.

主要方法:

  • 一项24个问题的调查被分发给了内分泌学会的成员.
  • 该调查评估了遵守AUA指南和当前的抗生素处方习惯.
  • 进行了后勤回归分析,以确定依从的预测因素.

主要成果:

  • 只有51.4%的内分泌科医生报告说,他们遵循了AUA指导方针,用于不复杂的PCNL预防.
  • 甲尼达和阿兹特雷诺姆很少被用作一线药物 (分别为90.9%和83.6%"从未使用").
  • 对抗生素的持续时间和选择的处方模式有很大的不同,其中头类是最常见的选择.

结论:

  • 很大一部分内分泌科医生不遵守目前AUA关于PCNL抗菌预防的指导方针.
  • 目前的一线抗生素建议,特别是甲尼达和阿兹特雷诺姆,似乎未得到充分利用.
  • 需要更新指南,以与当代实践,抗微生物药物管理原则和新出现的证据保持一致.