Emergency Department Ultrasound in Renal Colic
Renal ColicHydronephrosis1 moreRenal colic is a common (1300 visits per year at our institution) and painful condition caused by stones in the kidney and ureter, and can be mimicked by life threatening conditions such as a ruptured abdominal aortic aneurysm (AAA). This can create clinical uncertainty. Emergency department targeted ultrasound (EDTU) is performed by an emergency physician at the patient's bedside, and has been shown to be accurate, safe, and efficient. We have shown that EDTU can accurately identify hydronephrosis, which is a predictor of complications of kidney stones. A normal formal ultrasound (US) predicts an uncomplicated clinical course. We will assess the accuracy of EDTU for the diagnosis of hydronephrosis, and when normal, whether patients can be safely discharged.
Evaluation of Ultra-portable Ultrasound in General Practice
PneumoniaPleural Effusion6 moreThis is an interventional multi-centre study comparing two groups of general practitioners with or without an ultrasound scanner over a period of 6 months. The evaluation focuses on the management of patients for 8 pathologies: Pneumonia Pleural effusion Renal colic Hepatic colic or cholecystitis Subcutaneous abscess or cyst Fracture of long bones Intra-uterine pregnancy or extra-uterine pregnancy or miscarriage Phlebitis The principal hypothesis is that there are fewer complementary exams in the group of doctors using ultrasound scanners. The secondary hypotheses are: There is better patient orientation (emergency care, specialist consultation, return home) in the group of doctors using the ultrasound scanners. The global cost of the care is lower in the group of doctors using the ultrasound. Using ultrasound during the consultation decreases the anxiety of the patient. Using ultrasound increases the duration of the consultation. There is no difference between the predicted and the real orientation of the patients.
Hydronephrosis on Ultrasound With CT Finding in Patients With Renal Colic
HydronephrosisRenal ColicThe purpose of this study is to determine the overall sensitivity and specificity of hydronephrosis on point-of-care bedside ultrasound to identify hydronephrosis as compared to hydronephrosis found by CT.
Prevention of Colic With the Probiotic Lactobacillus Reuteri
ColicColic is a term for inconsolable crying happened in the first months of life. Its etiology is multifactorial and caregiver and pediatrician generates among other problems: anxiety, risk of child abuse as well as economic costs. There is now enough evidence for the treatment of colic using probiotics, especially Lactobacillus reuteri. The investigators study aims to demonstrate the utility for the prevention of colic with L. reuteri and thereby avoid the problems caused by this pathology. Objective: Compare the number of events of colic among infants with oral probiotic Lactobacillus reuteri during the first month of life versus infants with placebo Study Design. Double blind, randomized, controlled, 492 neonates of 37-42 gestational age, breast or formula fed, will receive L. reuteri 5 drops (1x108 CFU) daily or placebo for 28 days. The investigators trial will be performed at Naval Hospital in Mexico City.
"Point of Care" Ultrasound and Renal Colic
Renal ColicThe management of renal colic in emergency departments follows the recommendations established at the 8th consensus conference of 2008 on the management of renal colic in emergency services. It recommends the control of pain by nonsteroidal anti-inflammatory drugs and analgesics, the implementation of an urinary test strip and the use of emergency imaging for compiled forms and patient with medical specificities. Currently, two imaging techniques are recommended during an episode of renal colic: Abdominal x-ray/Ultrasound or non-injected scanner for simple forms to be performed within 24-48h The non-injected scanner for complicated forms In simple forms, the decision to perform any examination remains at the discretion of the physician but with a tendency to carry out a scanner systematically even in the absence of criteria of severity or complication. The use of the scanner exposes the patient to large doses of radiation even if it is a low dose scanner. In recent years, studies have been conducted to determine whether the ultrasound, particularly "point of care" ultrasound performed by an emergency physician could be an alternative in the management of renal colic. Studies show that the sensitivity and specificity of ultrasound is comparable to that of the scanner. It has been found that the performance of an ultrasound by the emergency physician allows the decrease in irradiation and also in costs. In 2014,a study published in the New England Journal of Medicine emphasized that the ultrasound performed by the emergency physician would perform just as well as that performed by the radiologist and would result in a decreased time in the emergency room. The Korean study, published in 2016 in the Clinical and Experimental Emergency Medicine (CEEM), despite some statistical inconsistencies, shows a significant reduction in the time of care by 74 minutes. In this context, we would like to conduct a single-centre, randomised, controlled, open-label study comparing a group of patients benefiting from point of care ultrasound versus a group of patients not benefiting from it. The goal is to determine whether the early ultrasound performed by the emergency physician by detecting expansions of the pelvicalyceal cavities reduces the time spent in the emergency department.
French Observational Study With Colic Capsule
Colic Capsule Interestcolic capsule usings with patients without possible colic endoscopy
Use of Analgesic Drugs in Renal Colic in Emergency Room
Renal ColicA prospective non-interventional study on the use of analgesic drugs in renal colic in emergency rooms
Infants Colics : Towards a Migrainous Origin ?
ColicInfantile2 moreAccording to recent studies, we want to find evidences that infant colics could be a episodic symptom associated to migraine as cyclic vomiting syndrome or abdominal migraine are. The main purpose is to compare the presence of colics in infants between 60 days and 180 days of life and the presence of migraine in their parents to determine if colicky children's parents are more migrainous than other parents.