Collection of Test Tasks on Urology to Control the Level of Knowledge of Students of the Fourth Year of the Medical Faculty
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A Clever Technique for Placement of a Urinary Catheter Over a Wire
[Downloaded free from http://www.urologyannals.com on Monday, August 24, 2015, IP: 107.133.192.199] Original Article A clever technique for placement of a urinary catheter over a wire Joel E. Abbott, Adam Heinemann, Robert Badalament, Julio G. Davalos1 Department of Urology, St. John Providence, Michigan State University, Detroit, MI 48071, 1Chesapeake Urology Associates, University of Maryland, Baltimore, MD 21061, USA Abstract Objective: The objective was to present a straightforward, step-by-step reproducible technique for placement of a guide-wire into any type of urethral catheter, thereby offering a means of access similar to that of a council-tip in a situation that may require a different type of catheter guided over a wire. Materials and Methods: Using a shielded intravenous catheter inserted into the eyelet of a urinary catheter and through the distal tip, a “counsel-tip” can be created in any size or type of catheter. Once transurethral bladder access has been achieved with a hydrophilic guide-wire, this technique will allow unrestricted use of catheters placed over a wire facilitating guided catheterization. Results: Urethral catheters of different types and sizes are easily advanced into the bladder with wire-guidance; catheterization is improved in the setting of difficult urethral catheterization (DUC). Cost analysis demonstrates benefit overuse of traditional council-tip catheter. Conclusion: Placing urinary catheters over a wire is standard practice for urologists, however, use of this technique gives the freedom of performing wire-guided catheterization in more situations than a council-tip allows. This technique facilitates successful transurethral catheterization over wire in the setting of DUC for all catheter types and styles aiding in urologic management of patients at a cost benefit to the health care system. -
The Role of Intravenous Urography with Erect Film and Retrograde
Central Journal of Urology and Research Bringing Excellence in Open Access Research Article *Corresponding author Ahmed N. Ghanem, Department of Urology, Consultant Urologist Surgeon, No1 President Mubarak The Role of Intravenous Street, Mansoura 35511, Egypt, Tel: 001020883243; Email: Submitted: 05 November 2018 Urography with Erect Film and Accepted: 22 November 2018 Published: 26 November 2018 Retrograde Pyelography in ISSN: 2379-951X Copyright © 2018 Ghanem et al. Revealing Patho-Etiology of OPEN ACCESS Keywords the Loin Pain and Haematuria • Intravenous urography • Retrograde pyelography • Loin pain haematuria syndrome Syndrome by Discovering • Nephroptosis its Overlooked Link with Symptomatic Nephroptosis Khalid A Ghanem1, Salma A. Ghanem2, Nisha Pindoria3, and Ahmed N. Ghanem1* 1Department of Urology, Mansoura University Hospital, Egypt 2Department of Urology, Barts & The Royal London NHS Trust Royal London Hospital, Egypt 3Department of Urology, North Middlesex University Hospital, Egypt Abstract Introduction and objectives: To report the role of intravenous urography with erect film (IVU-E) and retrograde pyelography (RGP) in resolving the puzzle of Loin Pain and Haematuria Syndrome (LPHS) by revealing its patho-etiological overlooked link with Symptomatic Nephroptosis (SN). We demonstrate that renal pedicle stretch causes neuro-ischaemia as evidenced by the new IVU 7 sign and the damaged renal medullary papilla shown on RGP. Materials and methods: Images are reported from a series of 190 SN patients. Repeated standard imaging was invariably normal, when supine. However, 190 patients demonstrated SN of > 1.5 vertebrae on repeating IVU-E. Of whom 36 (18.9%) patients developed recurrent episodes of painful hematuria for which no organic pathology was detected on all standard imaging, when supine- thus fitting the definition of LPHS. -
Chest X-Rays | | How to Prepare and What to Expect |
UW MEDICINE | PATIENT EDUCATION | Chest X-rays | | How to prepare and what to expect | This handout explains how chest X-rays work, how to prepare, what to expect, and how to get your results. What is a chest X-ray? An X-ray (radiology exam) is a medical test that produces images (pictures) of a part of a body. These images help doctors diagnose health conditions. Doctors use chest X-rays to assess the lungs, heart, and chest wall. This exam can help diagnose pneumonia, heart failure, emphysema, lung cancer, and other medical problems. How does the exam work? An X-ray machine is like a camera. But, it uses X-rays instead of light to create images. When the machine is turned on, X-rays pass through the part of the body that is being studied. Your doctor will view the X-ray images on a computer screen. How do I prepare? • You do not need to prepare in any special way for chest X-rays. • Women: Tell your doctor or X-ray technologist if there is any chance that you may be pregnant. How is the exam done? • First, we will ask you to: – Change into a hospital gown – Remove jewelry, glasses, Talk with your referring provider about and any metal objects the results of your chest X-ray exam. that could show up on the pictures _____________________________________________________________________________________________ Page 1 of 2 | Chest X-rays UWMC Imaging Services | Box 357115 1959 N.E. Pacific St., Seattle, WA 98195 | 206.598.6200 • For most chest X-rays, you will stand with your chest pressed to the X-ray machine, with your hands on your hips and your shoulders pushed forward. -
CMS Manual System Human Services (DHHS) Pub
Department of Health & CMS Manual System Human Services (DHHS) Pub. 100-07 State Operations Centers for Medicare & Provider Certification Medicaid Services (CMS) Transmittal 8 Date: JUNE 28, 2005 NOTE: Transmittal 7, of the State Operations Manual, Pub. 100-07 dated June 27, 2005, has been rescinded and replaced with Transmittal 8, dated June 28, 2005. The word “wound” was misspelled in the Interpretive Guidance section. All other material in this instruction remains the same. SUBJECT: Revision of Appendix PP – Section 483.25(d) – Urinary Incontinence, Tags F315 and F316 I. SUMMARY OF CHANGES: Current Guidance to Surveyors is entirely replaced by the attached revision. The two tags are being combined as one, which will become F315. Tag F316 will be deleted. The regulatory text for both tags will be combined, followed by this revised guidance. NEW/REVISED MATERIAL - EFFECTIVE DATE*: June 28, 2005 IMPLEMENTATION DATE: June 28, 2005 Disclaimer for manual changes only: The revision date and transmittal number apply to the red italicized material only. Any other material was previously published and remains unchanged. However, if this revision contains a table of contents, you will receive the new/revised information only, and not the entire table of contents. II. CHANGES IN MANUAL INSTRUCTIONS: (N/A if manual not updated.) (R = REVISED, N = NEW, D = DELETED) – (Only One Per Row.) R/N/D CHAPTER/SECTION/SUBSECTION/TITLE R Appendix PP/Tag F315/Guidance to Surveyors – Urinary Incontinence D Appendix PP/Tag F316/Urinary Incontinence III. FUNDING: Medicare contractors shall implement these instructions within their current operating budgets. IV. ATTACHMENTS: Business Requirements x Manual Instruction Confidential Requirements One-Time Notification Recurring Update Notification *Unless otherwise specified, the effective date is the date of service. -
Diagnosis and Primary Care Management of Focal Segmental Glomerulosclerosis in Children
1.5 CONTACTCOCONOONNTATACACACT HOURSHOUROURRS 1.5 CONTACT HOURS Monkey Business Images / Thinkstock Diagnosis and primary care management of focal segmental glomerulosclerosis in children Abstract: Focal segmental glomerulosclerosis (FSGS) is a pattern of kidney damage that can occur in individuals at any age, including children. Pediatric patients with FSGS require medication monitoring, growth, and psychological health. This article discusses the NP’s role in the clinical presentation, diagnostic workup, and treatment of FSGS in pediatric patients. By Angela Y. Wong, MS, CPNP-PC and Rita Marie John, DNP, EdD, CPNP-PC, FAANP P, a 10-year-old girl, told her parents several This article discusses the pathophysiology, epide- times, “I feel puffy,” before the family sought miology, clinical presentation, and treatment options J medical attention. This complaint could in- for FSGS. In addition, the article elucidates the role dicate a myriad of issues ranging from sudden weight of the NP in managing this disease when it occurs gain to simple abdominal gas. For this child, “puffy” during childhood. depicted her progressive edema—the only overt symp- tom of her diagnosis of focal segmental glomerulo- ■ Overview sclerosis (FSGS). Although some children with FSGS FSGS is a pattern of kidney damage involving scarring may only present with asymptomatic proteinuria at of glomeruli in the kidney. This pattern of glomerulo- a routine physical, FSGS can affect individuals of all sclerosis is focal and segmental, meaning not all glom- ages, and is a common cause of end-stage renal disease eruli are affected and only parts of the glomeruli are (ESRD) in children.1 damaged, respectively.2 FSGS is the most common Keywords: end-stage renal disease, focal segmental glomerulosclerosis, kidney transplant, nephrotic syndrome, pediatrics 28 The Nurse Practitioner • Vol. -
Guidelines on Paediatric Urology S
Guidelines on Paediatric Urology S. Tekgül (Chair), H.S. Dogan, E. Erdem (Guidelines Associate), P. Hoebeke, R. Ko˘cvara, J.M. Nijman (Vice-chair), C. Radmayr, M.S. Silay (Guidelines Associate), R. Stein, S. Undre (Guidelines Associate) European Society for Paediatric Urology © European Association of Urology 2015 TABLE OF CONTENTS PAGE 1. INTRODUCTION 7 1.1 Aim 7 1.2 Publication history 7 2. METHODS 8 3. THE GUIDELINE 8 3A PHIMOSIS 8 3A.1 Epidemiology, aetiology and pathophysiology 8 3A.2 Classification systems 8 3A.3 Diagnostic evaluation 8 3A.4 Disease management 8 3A.5 Follow-up 9 3A.6 Conclusions and recommendations on phimosis 9 3B CRYPTORCHIDISM 9 3B.1 Epidemiology, aetiology and pathophysiology 9 3B.2 Classification systems 9 3B.3 Diagnostic evaluation 10 3B.4 Disease management 10 3B.4.1 Medical therapy 10 3B.4.2 Surgery 10 3B.5 Follow-up 11 3B.6 Recommendations for cryptorchidism 11 3C HYDROCELE 12 3C.1 Epidemiology, aetiology and pathophysiology 12 3C.2 Diagnostic evaluation 12 3C.3 Disease management 12 3C.4 Recommendations for the management of hydrocele 12 3D ACUTE SCROTUM IN CHILDREN 13 3D.1 Epidemiology, aetiology and pathophysiology 13 3D.2 Diagnostic evaluation 13 3D.3 Disease management 14 3D.3.1 Epididymitis 14 3D.3.2 Testicular torsion 14 3D.3.3 Surgical treatment 14 3D.4 Follow-up 14 3D.4.1 Fertility 14 3D.4.2 Subfertility 14 3D.4.3 Androgen levels 15 3D.4.4 Testicular cancer 15 3D.5 Recommendations for the treatment of acute scrotum in children 15 3E HYPOSPADIAS 15 3E.1 Epidemiology, aetiology and pathophysiology -
Glomerulosclerosis in Reflux Nephropathy
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector Kidney International, Vol. 21(1982), pp. 528—534 NEPHROLOGY FORUM Glomeruloscierosis in reflux nephropathy Principal discussant: RAMzI S. COTRAN Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts penis, testes, and urethral meatus were normal. The prostate was of normal size. Editors The BUN was 14 mg/dl; creatinine, 1.3 mg/dl (creatinine clearance, 113 mI/mm); blood chemistries were normal; the blood glucose was 93 JORDANJ. COHEN mg/dl; and the complement profile was normal. Serum protein was 7.5 JOHN 1. HARRINGTON gIdI with 4.3 g/dl albumin. Urinalysis showed a pH of 5; a specific JEROME P.KASSIRER gravity of 1.015; 4+ protein, no cells, and no bacteria. Urine culture was sterile. The 24-hour urine protein excretion was 2.4 g. Editor Chest x-ray showed borderline cardiomegaly with clear lungs. An Managing intravenous pyelogram revealed bilateral coarse scarring with caliecta- CHERYL J. ZUSMAN sis. The right kidney was smaller than the left. There was moderate ureterectasia extending down to the ureterovesical junction. A voiding cystourethrogram revealed a large-capacity bladder; the patient had no MichaelReese Hospital and Medical Center urge to void after almost 500 ml of contrast material was instilled. Bilateral reflux was greater and persistent on the left and was intermit- University of Chicago, tent on the right. The left ureter was dilated and tortuous. A left Pritzker School of Medicine ureterocele and right bladder diverticulum were visualized. and A biopsy of the left kidney showed focal scarring with interstitial New England Medical Center fibrosis and chronic inflammation, tubular atrophy, and dilation. -
Pediatric Nephrology: Highlights for the General Practitioner
International Journal of Pediatrics Pediatric Nephrology: Highlights for the General Practitioner Guest Editors: Mouin Seikaly, Sabeen Habib, Amin J. Barakat, Jyothsna Gattineni, Raymond Quigley, and Dev Desi Pediatric Nephrology: Highlights for the General Practitioner International Journal of Pediatrics Pediatric Nephrology: Highlights for the General Practitioner Guest Editors: Mouin Seikaly, Sabeen Habib, Amin J. Barakat, Jyothsna Gattineni, Raymond Quigley, and Dev Desi Copyright © 2012 Hindawi Publishing Corporation. All rights reserved. This is a special issue published in “International Journal of Pediatrics.” All articles are open access articles distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Editorial Board Ian T. Adatia, USA Eduardo H. Garin, USA Steven E. Lipshultz, USA Uri S. Alon, USA Myron Genel, USA Doff B. McElhinney, USA Laxman Singh Arya, India Mark A. Gilger, USA Samuel Menahem, Australia Erle H. Austin, USA Ralph A. Gruppo, USA Kannan L. Narasimhan, India Anthony M. Avellino, USA Eva C. Guinan, USA Roderick Nicolson, UK Sylvain Baruchel, Canada Sandeep Gupta, USA Alberto Pappo, USA Andrea Biondi, Italy Pamela S. Hinds, USA Seng Hock Quak, Singapore Julie Blatt, USA Thomas C. Hulsey, USA R. Rink, USA Catherine Bollard, USA George Jallo, USA Joel R. Rosh, USA P. D. Brophy, USA R. W. Jennings, USA Minnie M. Sarwal, USA Ronald T. Brown, USA Eunice John, USA Charles L. Schleien, USA S. Burdach, Germany Richard A. Jonas, USA Elizabeth J. Short, USA Lavjay Butani, USA Martin Kaefer, USA V. C. Strasburger, USA Waldemar A. Carlo, USA F. J. Kaskel, USA Dharmapuri Vidyasagar, USA Joseph M. -
Focal Segmental Glomerulosclerosis in Systemic Lupus Erythematosus
Relato de Caso Focal Segmental Glomerulosclerosis in Systemic Lupus Erythematosus: One or Two Glomerular Diseases? Glomerulosclerose Segmentar e Focal em Lúpus Eritematoso Sistêmico: Uma ou Duas Doenças? Rogério Barbosa de Deus1, Luis Antonio Moura1, Marcello Fabiano Franco2, Gianna Mastroianni Kirsztajn1 1 Nephrology Division and 2 Department of Pathology - Universidade Federal de São Paulo – EPM/UNIFESP- São Paulo. ABSTRACT Some patients with clinical and/or laboratory diagnosis of systemic lupus erythematosus (SLE) present with nephritis which from the morphological point of view does not fit in one of the 6 classes described in the WHO classification of lupus nephritis. On the other hand, nonlupus nephritis in patients with confirmed SLE is rarely reported. This condition may not be so uncommon as it seems. The associated glomerular lesions most frequently described are amyloidosis and focal segmental glomerulosclerosis (FSGS). We report on a 46 year-old, caucasian woman, who fulfilled the American College of Rheumatology criteria for SLE diagnosis: arthritis, positive anti-DNA, ANA, anti-Sm antibodies, and cutaneous maculae. During the follow-up, she presented arthralgias, alopecia, vasculitis, lower extremities edema and decreased serum levels of C3 and C4. Proteinuria was initially nephrotic, but reached negative levels. The serum creatinine varied from 0.7 to 3.0 mg/dl. The patient was submitted to the first renal biopsy at admission and to the second one, 3 years later, with diagnosis of minimal change disease and FSGS, respectively. No deposits were demonstrated by immunofluorescence. In the present case, we believe that the patient had SLE and developed an idiopathic disease of the minimal change disease-FSGS spectrum. -
Interpretation of Canine and Feline Urinalysis
$50. 00 Interpretation of Canine and Feline Urinalysis Dennis J. Chew, DVM Stephen P. DiBartola, DVM Clinical Handbook Series Interpretation of Canine and Feline Urinalysis Dennis J. Chew, DVM Stephen P. DiBartola, DVM Clinical Handbook Series Preface Urine is that golden body fluid that has the potential to reveal the answers to many of the body’s mysteries. As Thomas McCrae (1870-1935) said, “More is missed by not looking than not knowing.” And so, the authors would like to dedicate this handbook to three pioneers of veterinary nephrology and urology who emphasized the importance of “looking,” that is, the importance of conducting routine urinalysis in the diagnosis and treatment of diseases of dogs and cats. To Dr. Carl A. Osborne , for his tireless campaign to convince veterinarians of the importance of routine urinalysis; to Dr. Richard C. Scott , for his emphasis on evaluation of fresh urine sediments; and to Dr. Gerald V. Ling for his advancement of the technique of cystocentesis. Published by The Gloyd Group, Inc. Wilmington, Delaware © 2004 by Nestlé Purina PetCare Company. All rights reserved. Printed in the United States of America. Nestlé Purina PetCare Company: Checkerboard Square, Saint Louis, Missouri, 63188 First printing, 1998. Laboratory slides reproduced by permission of Dennis J. Chew, DVM and Stephen P. DiBartola, DVM. This book is protected by copyright. ISBN 0-9678005-2-8 Table of Contents Introduction ............................................1 Part I Chapter 1 Sample Collection ...............................................5 -
The Overuse of Diagnostic Imaging and the Choosing Wisely Initiative Vijay M
***ONLINE FIRST: This version will differ from the print version*** Annals of Internal Medicine Ideas and Opinions The Overuse of Diagnostic Imaging and the Choosing Wisely Initiative Vijay M. Rao, MD, and David C. Levin, MD ealth care in America costs too much. There are many common screening and diagnostic tests that they believed Hreasons for this, but an important one is the overuse were overused. The final list contained 37 tests, 18 of of diagnostic tests—including but not limited to imaging which were imaging studies—13 commonly performed by studies. radiologists and 5 commonly performed by cardiologists. A report by Iglehart (1) indicated that, between 2000 In an accompanying editorial, Laine (10) cited an estimate and 2007, use of imaging studies grew faster than that of that up to 5% of the country’s gross national product is any other physician service in the Medicare population. spent on tests and procedures that do not improve patient Another report by the influential group America’s Health outcomes. Considerable overlap exists between the ACP’s Insurance Plans (2) claimed that 20% to 50% of all “high- 18 imaging tests and the 16 in the Table. tech” imaging provides no useful information and may be This suggests a widespread perception among many unnecessary. Reports like these have led to cost concerns branches of medicine that imaging is overused. We agree among key federal agencies like the Congressional Budget that all 16 of the tests shown in the Table are overused. Office, Government Accountability Office, and Medicare We hope that all physicians who order imaging tests will Payment Advisory Commission (3, 4), and steps have been reflect on the Choosing Wisely lists and adjust their order- taken in recent years to reduce reimbursements for imaging ing patterns accordingly. -
What Is Diagnostic Medical Sonography?
WHAT IS DIAGNOSTIC MEDICAL SONOGRAPHY? Diagnostic Medical Sonography is a medical imaging modality that uses sound waves to identify and evaluate soft tissue structures in the human body for disease and pathology. WHAT DOES A DIAGNOSTIC MEDICAL SONOGRAPHER DO? The diagnostic medical sonographer is a healthcare professional who performs diagnostic ultrasound examinations under a physician's supervision. To perform imaging evaluations on patients in the clinical setting, sonographers are required to integrate medical knowledge of anatomy and physiology, pathology, and ultrasound physics. Among the parts of the body most commonly evaluated with sonography are the heart and blood vessels, abdominal organs, superficial structures, pelvic organs and the developing fetus. Sonographers have extensive, direct patient contact that may include performing some invasive procedures. They must be able to interact compassionately and effectively with people who range from healthy to critically ill. The professional responsibilities include, but are not limited, to: • obtaining and recording an accurate patient history • performing diagnostic procedures and obtaining diagnostic images • analyzing technical information • using independent judgment in recognizing the need to extend the scope of the procedure according to the diagnostic findings • providing an oral or written summary of the technical findings to the physician for medical diagnosis • providing quality patient care • collaborating with physicians and other members of the health care team. Sonographers must also be knowledgeable about and limit the risk from possible exposure to blood and body fluids. Many sonographers also assist in electronic and clerical scheduling, record keeping, and computerized image archiving. Sonographers may also have managerial or supervisory responsibilities. Students and sonographers must comply with the ethical behavior expected of a healthcare professional.