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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Based on a personal series of 310 observations, the authors have studied the presenting signs, the etiology, the urinary bacteriology and the localization of the stone in children with urolithiasis. Urinary tract infection is the presenting sign in 55% of the cases, hematuria in 23% and abdominal pain in 20%. Urinary malformation is associated in 26% of cases, whatever the age at diagnosis. The urinary bacteria found in 55% of cases is Proteus. Localization was in the kidney in 228 cases, in the ureter in 71 cases, the bladder in 45 cases and in the urethra in 5 cases.
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PMID:Urolithiasis in children. Presenting signs, etiology, bacteriology and localisation. 667 90

Infants with ureteropelvic junction obstruction usually present with an abdominal mass or a urinary tract infection, which generally leads to prompt diagnosis. In children over age six, the diagnosis is often delayed because they frequently present with poorly localized abdominal pain simulating functional or gastrointestinal illness. Children with unexplained abdominal pain should undergo urologic evaluation, even if urinalysis and urine culture are negative. Ultrasonography is useful for detecting hydronephrosis.
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PMID:Ureteropelvic junction obstruction in children. 670 43

The amount of primary care provided at hospitals is increasing, yet little information exists on the relative costs of this form of care. To address this issue, we compared the treatment resources used by internists practicing in hospital-based and free-standing clinics. The study site was the Kaiser-Permanente Medical Care Program, Oregon Region. To control for case mix, the analysis focused on episodes of six specified conditions; upper respiratory infection, urinary tract infection, hypertension, abdominal pain, chest pain, and physical exam. The California Relative Value Schedule was used to define care intensity by summarizing the clinical, laboratory, and radiology services provided. Results indicate that setting exerts little influence on the intensity of primary care for the episodes studied; care of similar intensity is provided in hospital-based and free-standing settings.
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PMID:Effects of hospital-based primary care setting on internists' treatment of primary care episodes. 679 28

Chronic lower abdominal pain or flank pain in adults may be associated with vesicoureteral reflux. Although it is well known that renal scarring may occur in adults with vesicoureteral reflux associated with urinary tract infection, renal function may vary significantly when these patients are found to have sterile vesicoureteral reflux. We report 2 cases of lifelong intermittent lower abdominal pain associated with vesicoureteral reflux without damage to the upper urinary tracts. A voiding cystourethrogram should be included in the evaluation of adults with chronic lower quadrant pain or flank pain even if excretory urography and cystoscopy are normal and the urine is sterile.
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PMID:Chronic lower quadrant abdominal pain due to vesicoureteral reflux. 682 67

A comparative study was made regarding the complications of abdominal and vaginal sterilization operations in order to evaluate the efficacy and safety of the 2 procedures. The cases were selected from outpatient departments and family planning clinics of the Patna Medical College (Patna, India) over the 1974-79 period. A preoperative assessment and investigation were performed in all cases. The operations were performed by modified Pomeroy's technique in 300 cases (Group A) by abdominal route and in 300 cases (Group B) by vaginal route. General anesthesia was administered in all cases. Subsequent follow-up was done at intervals of 6 weeks, 3 months, 6 months, 1 year, and up to 5 years. Follow-up attendance was unsatisfactory, but a comparative evaluation of the complications was done in both groups among patients who came for follow-up. Puerperal sterilization cases were excluded from the series. In Group A 149 sterilizations were done with medical termination of pregnancy (MTP) and the remaining were interval sterilizations. In Group B 148 were sterilizations with MTP and the remaining were interval sterilizations. The age varied between 28-42 years. The majority of the patients were more than 4 para in both groups. Pelvic sepsis was more common with vaginal sterilization operations. Complications were as follows in Group A: pyrexia, 30 cases; pain in abdomen, 75; urinary tract infection, 30; sore throat, cough, 60; stitch induration, 90; and wound disruption, 3. For Group B, complications were as follows: pyrexia, 90; pain in abdomen, 30; urinary tract infection, 75; sore throat, cough, 60; tuboovarian mass, 12; wound infection, 45; and persistent temperature rise, 12. The nature of complaints at follow-up for Group A were: leukorrhea, 30; menorrhagia, 60; irregular bleeding, 30; dysmenorrhea, 12; dyspareunia, 9; loss of libido, 9; and incisional hernia, 1. Complaints at follow-up were as follows for Group B: leukorrhea, 45; menorrhagia, 21; irregular bleeding, 60; dysmenorrhea, 75; dyspareunia, 60; loss of libido, 12; abdominal pain, 12; and stress incontinence, 3. In sum, the sterilization operation by abdominal route was much safer compared to the vaginal route.
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PMID:Complications after abdominal and vaginal sterilization operation. 687 69

Our experience with 95 pediatric stone patients in the years 1960-1979 is presented. 2/3 of all stones were diagnosed in the pre-school age. Leading symptoms were infection, hematuria and abdominal pain. 52% of the stones were composed of phosphate. 87.5% of the children up to the age of 6 had urinary tract infection. Phosphate stones were mostly accompanied by urea-splitting organisms. An underlying cause for the stone formation could be found in 62% (urodynamic disturbances 32%, metabolic derangements 21%, proteus infection 8%, foreign body 1%). In 76% of the children the stones had to be removed surgically. The recurrence rate was 22% in 6.2 years. From our experience we recommend to use only a crystallographic stone analysis, to perform an exact metabolic check-up and a long term follow-up of the children.
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PMID:[Urolithiasis in childhood]. 704 90

In a research project undertaken to describe the content of adult primary care, episodes of illness for six common primary care conditions were analyzed: URI (upper respiratory infection, UTI (urinary tract infection), HYP (hypertension), AP (abdominal pain), CP (chest pain), and PE (physical examination). Data from the Kaiser-Permanente Medical Care Program-Oregon Region were used in the project. Episode of the six conditions studied tended to be of brief duration; at least half of the episodes of each condition except hypertension involved only a single medical visit. The physical examination episodes typically involved both laboratory and radiology services, but these services were less frequently used for the other five conditions. Few episodes involved a referral to a consultant physician, the use of sophisticated ancillary procedures, repeat tests, or a hospitalization. If patients had been billed for the episode-related care involved in treating each episode, the average charge incurred (in 1980 dollars) would have bee: URI $38.67, UTI and HY $52.27 each, AP $66.59, CP $46.54, and PE $91.65, excluding the costs of pharmaceuticals. Ancillary services accounted for one-third or more of the costs for each type of episode except URI. The results suggest that cost savings in primary care are likely to depend less on the control of sophisticated medical technology than on efficiently meeting patient-initiated demands for care and on influencing physician-generated ordering of simple ancillary procedures. The results also suggest the utility of analyzing the distinctive demands on the medical care system that are generated by diverse primary care conditions.
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PMID:The content of adult primary care episodes. 705 62

We discuss the case of a 24-year-old black woman at 33--34 weeks gestation, who after intravenous injection of Talwin presented with the following symptom complex: pyrexia, nausea, vomiting, shaking, chills, headache, myalgias, polyarthralgias, severe abdominal pain and "contractions." This symptomatology presents a complex diagnostic problem. Systematic laboratory evaluation eliminated more common etiologies, i.e., sub-acute bacterial endocarditis, HAA + hepatitis, placental abruption, chorioamnionitis, and urinary tract infection. The Talwin had been filtered through cotton ball. History plus exclusion of other etiologies led to the diagnosis of "cotton fever." The available literature is reviewed, and the importance of recognizing this entity when servicing a pregnant population with a high rate of drug abuse is discussed.
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PMID:Cotton fever and pregnancy. A confusing clinical problem. 721 12

In the five-year period 1974 to 1978, there were 23,256 deliveries and 204 ectopic pregnancies at Fairfax Hospital. Forty-six patients (22.5%) had had previous pelvic surgery, including 14 salpingectomies for previous ectopic pregnancies. Only 27 patients (13.2%) had a history of salpingitis, but chronic salpingitis was evident in 91 patients (44.6%). Twenty-one patients (10.3%) had an IUD in situ at the time of diagnosis. Presenting symptoms included abdominal pain (95.1%), amenorrhea (73.7%), and abnormal uterine bleeding (63.7%). Abdominal pain (91.2%) and adnexal tenderness (94.6%) were the common pelvic findings. The correct diagnosis was made on admission in 77.5% of cases. Culdocenteses and pregnancy tests were positive in 82.4% and 81.2% of patients, respectively. Unilateral salpingectomy was the primary operative procedure in 78% of patients. Postoperative morbidity was limited almost exclusively to nonspecific fever (41.2%) and urinary tract infection (9.3%).
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PMID:Ectopic pregnancy: a five-year experience. 740 9

Urolithiasis in children is uncommon. We present the case of a 10-year-old boy with anuria resulting from an obstructing stone in the urethral meatus. There are no previously reported cases of pediatric urolithiasis presenting with anuria. We review urolithiasis in children, including predisposing factors, clinical features, stone composition, and natural history. The diagnosis may be confusing in younger children but should be considered with complaints of flank or abdominal pain, hematuria, and urinary tract infection.
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PMID:Urolithiasis in a child: an uncommon presentation of an uncommon disease. 775 11


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