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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The introduction of echography represented a focal step in the management of renal biopsy, resulting in easier and faster procedures. Chiefly, echography allows the diagnosis and monitoring of complications of bioptic procedure. Here we present a series of 722 consecutive echo-guided renal biopsies, carried out from 1990 to 1995, 97 of which on kidney allografts. Echographic examination, performed 24 to 48 hours after renal biopsy, enable to diagnose the presence of perirenal hematoma in 30% of patients. Of these, only 10% presented with clinical symptoms and/or signs (reduction of Hct and arterial pressure, local pain). Our protocol comprises an echographic follow-up to control the evolution of hematoma, that usually resolves within 15-40 days, according to the initial size of the lesion. One time we observed an intra-parenchimal hematoma, which resulted in kidney rupture and consequent nephrectomy. 14% of all patients complained with macrohematuria: in 10% of these cases, echography showed the presence of coaguli in the urinary tract, which was associated with the clinical features of renal colic pain. Only in two cases of persistent macrohematuria, the echography together with echo- and color-doppler, allowed the diagnosis of the arterio-venous fistula. In conclusion, our experience demonstrates that the echographic examination allows not only to simplify the bioptic procedure, but also to early diagnose the complications due to this invasive manouvre.
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PMID:[Echography in the diagnosis and follow-up of renal biopsy complications]. 927 94

The authors report an unusual case of renal colic occurring in a 44-year-old docker. Intravenous urography showed right ureteral extrinsic compression by an osteophyte of the 3rd lumbar vertebra. After failure of medical treatment, the patient was operated with resection of the osteophyte. The postoperative course was uneventful with reduction of pain.
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PMID:[An unusual cause of renal colic. An osteophytic spur of L3, surgically treated with success]. 941 39

The primary care physician has a responsibility not only to recognize and treat acute stone passage but to ensure that the patient with recurrent stones has metabolic evaluation and appropriate preventive care. Renal colic is typically severe, radiates to the groin, is associated with hematuria, and may cause ileus. About 90% of stones that cause renal colic pass spontaneously. The patient with acute renal colic should be treated with fluids and analgesics and should strain the urine to recover stone for analysis. Highgrade obstruction or failure of oral analgesics to relieve pain may require hospitalization; a urinary tract infection in the setting of an obstruction is a urologic emergency requiring immediate drainage, usually with a ureteral stent. Several approaches are available when stones do not pass spontaneously, including extracorporeal shock wave lithotripsy, percutaneous lithotripsy, and ureteroscopic laser lithotripsy. Calcium stone disease has a lifetime prevalence of 10% in men and causes significant morbidity. Renal failure is unusual. Stone types include calcium oxalate, uric acid, struvite, and cystine. Stone analysis is particularly important when a noncalcareous constituent is identified. The majority of patients with nephrolithiasis will have recurrence, so prevention is a high priority. High fluid intake is a mainstay of prevention. Metabolic evaluation will indicate other appropriate preventive measures, which may include dietary salt and protein restriction, and use of thiazide diuretics, neutral phosphate, potassium citrate, allopurinol, and magnesium salts. Dietary calcium restriction may worsen oxaluria and negative calcium balance (osteoporosis).
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PMID:Nephrolithiasis: acute management and prevention. 965 69

The case of a patient with acute onset of flank pain and hematuria is presented. Initial therapy was directed toward relief of pain believed to be caused by renal colic. It was not until the patient developed atypical features that the true diagnosis, ruptured renal angiomyolipoma, was discovered. The case and discussion emphasize the need to carefully consider a complete differential diagnosis when evaluating patients with flank pain and hematuria who have atypical clinical features or an atypical course.
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PMID:Ruptured renal angiomyolipoma presenting as renal colic. 982 40

To study the therapeutic effects of a single 40 mg intramuscular dose of piroxicam versus a single 75 mg intramuscular dose of diclofenac sodium for treatment of acute renal colic. - The study comprised 64 patients (52 men and 12 women, mean age 28 years, range 18 - 42) who presented with acute renal colic and were diagnosed by IVU, a general urine examination and ultrasonography. The patients were randomly assigned to receive either 40 mg of piroxicam i.m (34 patients) or 75 mg of diclofenac sodium i.m (330 patients). The severity of pain was assessed on Visual Analogue Scale. - Results showed that thirty-two patients (94.1%) markedly improved within 1h of receiving piroxicam and 26 patients (86.6%) improved within 1h of receiving diclofenac sodium (P <0.05). Within 30 min, 25 patients (73.5%) markedly improved after piroxicam and 15 patients (50%) markedly improved after diclofenac sodium (P <0.05). After piroxicam, none of the patients showed pain relapse over a period of 24 h while 9 patients had relapse within 24 h after their initial response to diclofenac sodium. No side effects were reported with use of either treatment. - We concluded that piroxicam can be used successfully to treat acute renal colic and it has earlier onset of action and prolong effect as compared with diclofenac sodium.
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PMID:Intramuscular piroxicam versus intramuscular diclofenac sodium in the treatment of acute renal colic: double-blind study. 989 71

To compare the efficacy of intramuscular ketorolac and meperidine in the emergency department (ED) treatment of renal colic, a prospective, controlled, randomized, double-blind trial was conducted in an academic ED with 76,000 annual visits. Participants were volunteer ED patients with a diagnosis of ureterolithiasis confirmed by intravenous pyelogram. Subjects were randomized 1:1 to receive a single intramuscular injection of either 60 mg ketorolac or 100 to 150 mg meperidine, based on weight. Of the 70 patients completing the trial, 33 received ketorolac and 37 received meperidine. Demographic characteristics and baseline pain scores of both groups were comparable (P = NS, Mann Whitney U). Ketorolac was significantly (P < .05) more effective than meperidine in reducing renal colic at 40, 60, and 90 minutes as measured on a 10-cm visual analogue scale. Similar proportions of patients in each group were given rescue analgesia and admitted. Of patients who were discharged home without rescue, those treated with ketorolac left the ED significantly earlier than those treated with meperidine (3.46 v 4.33 h, P < .05). These results show that intramuscular ketorolac as a single agent for renal colic is more effective than meperidine and promotes earlier discharge of renal colic patients from the ED.
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PMID:Efficacy of ketorolac tromethamine versus meperidine in the ED treatment of acute renal colic. 992 87

This study evaluates the effectiveness of desmopressin renal spray, an antidiuretic drug, in treating patients with acute renal colic. One hundred and eight patients admitted to the emergency room of our hospitals with acute renal colic were included in the study. Each patient, except those with hypertension or other cardiac insufficiency, received 40 micrograms desmopressin intranasal spray. In 58 patients (53.7%) pain was eliminated 30 min after desmopressin administration. Forty-four patients (40.7%) did not respond to desmopressin and received prostaglandin synthesis inhibitors, while another 6 patients required intramuscular pethidine for pain relief. No patient showed any side effects. We conclude that the simplicity and effectiveness of intranasal desmopressin spray in treating renal colic makes this simple method a useful means of confronting a frequent and disturbing urological problem.
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PMID:Management of renal colic with intranasal desmopressin spray. 1008 25

The appropriate approach to renal colic, which should be known by the family doctor, is presented. The incidence of this condition in the emergency department of a large general hospital is described as well as the physiopathology of pain, its clinical aspects and the therapeutic attitudes. Renal colic is frequent, it is often possible to diagnose the clinical aspects and general practitioners have the competence for treatment. The use of analgesic drugs, in the correct dosage, is enough to relieve pain and suffering in most of the patients.
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PMID:[Renal colic]. 1042 66

Forty-seven patients with acute renal colic were treated with either tenoxicam 20 mg i.v. or buscopan compositum (hyoscine butylbromide 20 mg and dipyrone 2.5 g) i.v. in a double blind study. Renal colic was diagnosed with use of a general urine examination, intravenous urogram, ultrasonography or voiding of calculus. The severity of symptoms were assessed by a verbal six point scale. Results demonstrated that 80% of patients treated with tenoxicam and 72.7% of patients treated with buscopan compositum showed significant improvement after 1 hour. Sixty-two percent of the patients who showed initial response to buscopan compositum had pain relapse during next 24 hours and required rescue treatment with pethidine 100 mg i.m. None of the patients treated with tenoxicam i.v. had pain relapse. No side effects were reported with use of tenoxicam. It is concluded that tenoxicam i.v. was more effective than antispasmodics and has rapid onset of analgesia and prolonged action in the treatment of acute renal colic.
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PMID:Intravenous tenoxicam to treat acute renal colic: comparison with buscopan compositum. 1053 71

Intravenously administered ketorolac tromethamine provided complete pain relief to a 54-year-old man with right-sided testicular pain and nausea and vomiting. The patient had a ureteral calculus documented by computed tomography. This patient's pain initially failed to respond to intravenously administered hydromorphone hydrochloride. Subsequently, he was admitted to the hospital and had operative removal of his ureteral calculus and placement of a ureteral stent. Based on their findings and review of the literature, the authors recommend that intravenous ketorolac be used as the first-line treatment for acute renal colic in patients in whom the medication is not contraindicated.
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PMID:Use of ketorolac in renal colic. 1061 55


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