Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0451641 (urolithiasis)
 3,973 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 59-year-old female experienced gross hematuria and right back pain, and she visited our hospital in March 2015. Abdominal computed tomography (CT) showed bilateral renal pelvic calculi; the right stone was 15 mm and the left stone was 18 mm in diameter. She had ulcerative colitis and had been taking salazosulfapyridine (SASP) for about 30 years. Urinalysis showed aciduria and deposition of urate crystals. An abdominal X-ray picture did not show a calculus shadow. We suspected uric acid calculus and started treatment with urinary alkalizer and uric acid production inhibitor.Three months later, abdominal CT showed enlargement of the bilateral renal pelvic calculi; the right stone was 25 mm and the left stone was 24 mm in diameter. She also complained of worse right back pain and underwent transurethral ureterolithotripsy for the right renal pelvic stone. The stone was orange, comparatively soft, and chipped down until it was approximately half of its original size. The stone analysis suggested suspected drug-induced urolithiasis, but not uric acid calculus. Thus, we investigated the stone and SASP using infrared spectroscopy, and the infrared absorption pattern was similar in both. The stone analysis demonstrated drug-induced urolithiasis induced by SASP.The patient's ulcerative colitis therapy was switched to mesalazine, and the amount of urinary alkalizer was increased. Abdominal CT 3 months thereafter showed dissipation of bilateral renal pelvic calculi. The patient did not take any preventative medication, and there was no recurrence of urolithiasis.
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PMID:[DRUG-INDUCED BILATERAL NEPHROLITHIASIS IN AN ULCERATIVE COLITIS PATIENT: A CASE REPORT]. 3195 18

Objective-This report describes trends in opioid prescribing at emergency department (ED) discharge among adults from 2006-2007 through 2016-2017, by selected patient and hospital characteristics and the type of opioids prescribed. Methods-Data are from the 2006-2017 National Hospital Ambulatory Medical Care Survey. The study population included all ED visits by patients aged 18 and over. The main outcome studied was opioids prescribed at ED discharge, defined using Cerner Multum's third-level therapeutic category codes for narcotic analgesics (Code 60) and narcotic-analgesic combinations (Code 191). Results-The percentage of ED visits by adults with opioids prescribed at discharge increased from 2006-2007 (19.0%) through 2010-2011 (21.5%) and then decreased from 2010-2011 through 2016-2017 (14.6%). The rate of decrease was highest among visits by younger adults aged 18-44 (from 25.5% in 2010-2011 to 15.3% in 2016-2017) and those living in medium or small metropolitan counties (24.3% in 2010-2011 to 14.5% in 2016-2017). The percentage of visits with morphine-equivalent opioids prescribed increased from 2006-2007 (11.3%) through 2010-2011 (12.4%) and decreased from 2010-2011 through 2016-2017 (6.7%). The percentage of visits with stronger than morphine opioids prescribed similarly increased from 2006-2007 (3.8%) through 2010-2011 (5.5%) and decreased to 3.0% in 2016-2017. In contrast, the percentage of visits with weaker than morphine opioids prescribed decreased from 4.0% in 2006-2007 through 3.6% in 2010-2011 and increased to 5.0% in 2016-2017. Among all opioids prescribed at discharge, the percentage with acetaminophen-hydrocodone prescribed decreased from 53.1% in 2012-2013 to 41.5% in 2016-2017, with a corresponding increase for both tramadol and acetaminophen-codeine. Top diagnoses associated with an opioid prescribed at discharge included dental pain, urolithiasis (stones in the kidney, bladder, or urinary tract), fracture injuries, back pain, and extremity pain. For all top diagnoses, the percentage of visits with an opioid prescribed decreased from 2010-2011 through 2016-2017, though the decrease was not statistically significant for urolithiasis.
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PMID:Trends in Opioids Prescribed at Discharge From Emergency Departments Among Adults: United States, 2006-2017. 3251 Mar 8

BACKGROUND Spinal hematomas can be post-traumatic, iatrogenic, or spontaneous. A spontaneous spinal hematoma is a rare finding, but one with very serious clinical implications. There are some risk factors linked to its occurrence, e.g. arteriovenous malformations, lumbar puncture, coagulopathy, neoplasms, or therapeutic anticoagulation. At present, only a few cases of spontaneous spinal hematoma (SSH) associated with new oral anticoagulants (NOACs) have been described, three of which were linked with rivaroxaban. CASE REPORT We report the case of an 82-year-old Caucasian woman with persistent atrial fibrillation treated with rivaroxaban, who presented to the Urology Department with acute-onset back pain which was thought to be due to urolithiasis. No kidney stones were found, but her creatinine serum level was elevated, so she was transferred to our clinic for further treatment. During hospitalization she quickly developed paraplegia with urine and stool retention. MRI was performed, and demonstrated an acute epidural hemorrhage in her thoracic and lumbar spine. The neurosurgeons disqualified this patient from surgical intervention due to the extent of the hematoma and its location. The patient was referred to the Neurology Department for treatment and rehabilitation, but, to the best of our knowledge, she did not recover her motor function. CONCLUSIONS Although rivaroxaban has been shown to be more effective than warfarin in stroke prevention in patients with atrial fibrillation, physicians must remember that its use also carries the risk of major bleeding. SSH occurrence should be taken into account in a patient taking NOACs who develops paraplegia, even if there is no history of trauma prior to admission.
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PMID:Paraplegia Caused by Spontaneous Spinal Hemorrhage in a Patient Undergoing Rivaroxaban Therapy. 3263 52


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