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Dysuria in Children

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581. Typhoid Fever

people, infants, and the elderly. Stupor, coma, or shock reflects severe disease and a poor prognosis. Complications occur mainly in patients who are untreated or in whom treatment is delayed. Treatment Ceftriaxone Sometimes a fluoroquinolone or azithromycin Antibiotic resistance is common and increasing, particularly in endemic areas, so susceptibility testing should guide drug selection. In general, preferred antibiotics include Ceftriaxone 1 g IM or IV q 12 h (25 to 37.5 mg/kg in children) for 14 (...) vaccination, the current threat of a smallpox outbreak is most likely to come from which of the following? Bioterrorism Immunodeficiency Travel abroad Vaccination refusal NEWS & VIDEOS MMR Not Linked to Autism in Danish Cohort Study MONDAY, March 4, 2019 (HealthDay News) -- Measles, mumps, rubella (MMR) vaccination is not associated with an increased risk for autism, including in children with autism risk factors, according... Video Overview of Tuberculosis (TB) SOCIAL MEDIA Add to Any Platform Loading

2013 Merck Manual (19th Edition)

582. Fever

, the current threat of a smallpox outbreak is most likely to come from which of the following? Bioterrorism Immunodeficiency Travel abroad Vaccination refusal NEWS & VIDEOS MMR Not Linked to Autism in Danish Cohort Study MONDAY, March 4, 2019 (HealthDay News) -- Measles, mumps, rubella (MMR) vaccination is not associated with an increased risk for autism, including in children with autism risk factors, according... Video Overview of Tuberculosis (TB) SOCIAL MEDIA Add to Any Platform Loading Topic Resources (...) and ultimately failure of most organs; the coagulation cascade is also activated, leading to (DIC). Because fever can increase the basal metabolic rate by about 10 to 12% for every 1 ° C increase over 37 ° C, fever may physiologically stress adults with preexisting cardiac or pulmonary insufficiency. Fever can also worsen mental status in patients with dementia. Fever in healthy children can cause . Etiology Many disorders can cause fever. They are broadly categorized as Infectious (most common) Neoplastic

2013 Merck Manual (19th Edition)

583. Acute Liver Failure

, malaise, anorexia) or result from the causative disorder. Fetor hepaticus (a musty or sweet breath odor) and motor dysfunction are common. Tachycardia, tachypnea, and hypotension may occur with or without sepsis. Signs of cerebral edema can include obtundation, coma, bradycardia, and hypertension. Patients with infection sometimes have localizing symptoms (eg, cough, dysuria), but these symptoms may be absent. Diagnosis Prolongation of PT and/or clinical manifestations of encephalopathy in patients (...) [anti-HCV]) Autoimmune markers (eg, antinuclear antibodies [ANA], anti–smooth muscle antibodies, immunoglobulin levels) Other testing is done based on findings and clinical suspicion, as for the following: Recent travel to developing countries: Tests for A, B, D, and E Females of child-bearing age: Pregnancy testing Age < 40 and relatively normal aminotransferase levels: Ceruloplasmin level to check for Suspicion of a disorder with structural abnormalities (eg, , , ): Ultrasonography and sometimes

2013 Merck Manual (19th Edition)

584. Urinary Incontinence in Adults

urethritis Atrophic vaginitis Thinning of urethral and vaginal epithelium and submucosa may cause local irritation and decrease urethral resistance, length, and maximum closure pressure with loss of the mucosal seal. These disorders are usually characterized by urgency and occasionally by scalding dysuria. Foreign bodies Bladder irritation precipitates spasm. Only symptomatic UTIs cause incontinence. Dysuria and urgency can prevent patients from reaching the toilet before voiding. Neuropsychiatric (...) micturition center Voiding dysfunction of childhood (poor relaxation of the sphincter with bladder contraction can result from the fear of bed wetting or soiling of clothes) *Other prostate surgical procedures rarely cause established incontinence. Outlet incompetence is a common cause of stress incontinence. In women, it is usually due to weakness of the pelvic floor or of the endopelvic fascia. Such weakness commonly results from multiple vaginal deliveries, pelvic surgery (including hysterectomy), age

2013 Merck Manual (19th Edition)

585. Obstructive Uropathy

occasionally cause a palpable flank mass, particularly in massive hydronephrosis of infancy and childhood. Urine volume does not diminish in unilateral obstruction unless it occurs in the only functioning kidney (solitary kidney). Absolute anuria occurs with complete obstruction at the level of the bladder or urethra. Partial obstruction at that level may cause difficulty voiding or abnormalities of the urine stream. In partial obstruction, urine output is often normal and is rarely increased. Increased (...) of bladder catheterization, cystourethroscopy, and imaging (eg, ultrasonography, CT, pyelography), depending on the level of obstruction. Treatment, depending on cause, may require prompt drainage, instrumentation, surgery (eg, endoscopy, lithotripsy), hormonal therapy, or a combination of these modalities. The prevalence of obstructive uropathy, depending on the cause, ranges from five in 10,000 to five in 1,000. The condition has a bimodal distribution. In childhood, it is due mainly to congenital

2013 Merck Manual (19th Edition)

586. Evaluation of the Elderly Patient

, constipation, drugs (eg, antihistamines, opioids), prostate cancer, urinary retention, UTI Dysuria with or without fever Prostatitis, UTI Polyuria Diabetes insipidus (decrease in ADH action), diabetes mellitus, diuretics Incontinence Cystitis, functional decline, normal-pressure hydrocephalus, spinal cord dysfunction, stroke, urinary retention or overflow, UTI Musculoskeletal Back pain Abdominal aortic aneurysm, compression fractures, infection, metastatic cancer, multiple myeloma, osteoarthritis, Paget (...) the number of tablets in each vial during the first and subsequent visits may be necessary. If someone other than a patient administers the drugs, that person is interviewed. Patients should be asked to demonstrate their ability to read labels (often printed in small type), open containers (especially the child-resistant type), and recognize drugs. Patients should be advised not to put their drugs into one container. Alcohol, tobacco, and recreational drug use history Patients who smoke should

2013 Merck Manual (19th Edition)

587. Vesicoureteral Reflux

with a history of fetal hydronephrosis or with a UTI or appear as part of a sibling screening. Rarely, children present with hypertension, which is more commonly a long-term consequence of renal scarring. Children with UTI may have fever, abdominal or flank pain, dysuria, frequency, urgency, wetting accidents, or rarely hematuria. Diagnosis Ultrasonography Voiding cystourethrography (VCUG) Sometimes radioisotope scan Urinalysis and culture are done to detect infection. In infants and young children (...) with an increased risk for being diagnosed with depression, according to a study... 3D Model Cystic Fibrosis: Defective Chloride Transport Video How to Catheterize the Urethra of a Male Infant or Small Child SOCIAL MEDIA Add to Any Platform Loading , MD, University of Rochester Medical Center; , MD, University of Rochester School of Medicine and Dentistry Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Topic Resources Vesicoureteral reflux is retrograde passage of urine from

2013 Merck Manual (19th Edition)

588. Gonorrhea

intercourse, likelihood of transmission from women to men is about 20%, but from men to women, it may be higher. Neonates can acquire during passage through the birth canal, and children may acquire gonorrhea as a result of sexual abuse. In 10 to 20% of women, cervical infection ascends via the endometrium to the fallopian tubes (salpingitis) and pelvic peritoneum, causing (PID). Chlamydiae or intestinal bacteria may also cause PID. Gonorrheal cervicitis is commonly accompanied by dysuria or inflammation (...) and very few infected men are asymptomatic. About 25% of men have minimal symptoms. Male urethritis has an incubation period from 2 to 14 days. Onset is usually marked by mild discomfort in the urethra, followed by more severe penile tenderness and pain, dysuria, and a purulent discharge. Urinary frequency and urgency may develop as the infection spreads to the posterior urethra. Examination detects a purulent, yellow-green urethral discharge, and the meatus may be inflamed. Gonorrhea (Urethritis) ©

2013 Merck Manual (19th Edition)

589. Chlamydial, Mycoplasmal, and Ureaplasmal Mucosal Infections

conjunctivitis, and infant pneumonia. Untreated chlamydial salpingitis can become chronic, causing minimal symptoms but having serious consequences. Diagnosis is by culture, immunoassay for antigens, or nucleic acid–based tests. Treatment is with single-dose azithromycin or a week of ofloxacin , levofloxacin , erythromycin , or a tetracycline . (See also .) Several organisms can cause nongonococcal sexually transmitted cervicitis in women and urethritis, proctitis, and pharyngitis in both sexes (...) transmitted, including and (chlamydiae) and pneumonia (chlamydiae and mycoplasmas). Symptoms and Signs Men develop symptomatic urethritis after a 7- to 28-day incubation period, usually beginning with mild dysuria, discomfort in the urethra, and a clear to mucopurulent discharge. Discharge may be slight, and symptoms may be mild but are frequently more marked early in the morning; then, the urethral meatus is often red and blocked with dried secretions, which may also stain underclothes. Occasionally

2013 Merck Manual (19th Edition)

590. Specific Poisons

with 60–250 mL (2–8 oz) in adults or 8–10 mL (2 tsp) in children Latency period 12–18 h Headache, weakness, leg cramps, vertigo, seizures, retinal injury, dimmed vision, metabolic acidosis, decreased respiration Fomepizole (15 mg/kg, then 10 mg/kg q 12 h); alternatively, 10% ethanol/5% D/W IV with an initial loading dose of 10 mL/kg over 1 h, then 1–2 mL/kg/h to maintain a blood ethanol level of 100 mg/dL (22 mmol/L) Hemodialysis (which is definitive treatment) Aldrin See Chlorinated and other (...) — Antihistamines Anticholinergic symptoms (eg, tachycardia, hyperthermia, mydriasis, warm and dry skin, urinary retention, ileus, delirium) For diagnostic or therapeutic trial or for treatment of severe symptoms refractory to sedation (C aution : Seizures—see Physostigmine ), consideration of physostigmine 0.5–2.0 mg in adults or 0.02 mg/kg in children IV (slowly) Antihyperglycemic drugs, oral See Hypoglycemic drugs, oral — Antimony Stibophen Tartar emetic Throat constriction, dysphagia, burning GI pain

2013 Merck Manual (19th Edition)

591. Vaginal Itching and Discharge

Vaginal Birth Video How to Deliver a Baby in Breech Presentation SOCIAL MEDIA Add to Any Platform Loading , MD, MS, Center for Human Reproduction Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Topic Resources Vaginal itching (pruritus), discharge, or both result from infectious or noninfectious inflammation of the vaginal mucosa ( ), often with inflammation of the vulva (vulvovaginitis). Symptoms may also include irritation, burning, erythema, and sometimes dysuria (...) include Use of antibiotics (which may decrease lactobacilli) Alkaline vaginal pH due to menstrual blood, semen, or a decrease in lactobacilli Poor hygiene Frequent douching Pregnancy Diabetes mellitus An intravaginal foreign body (eg, a forgotten tampon or vaginal pessary) Etiology The most common causes vary by patient age (see table ). Children usually involves infection with GI tract flora (nonspecific vulvovaginitis). A common contributing factor in girls aged 2 to 6 yr is poor perineal hygiene

2013 Merck Manual (19th Edition)

592. Schistosomiasis

in and . With S. haematobium , ulcerations in the bladder wall may cause dysuria, hematuria, and urinary frequency. Over time, chronic cystitis develops. Strictures may lead to hydroureter and hydronephrosis. Papillomatous masses in the bladder are common, and squamous cell carcinoma may develop. Blood loss from both GI and GU tracts frequently results in anemia. Secondary bacterial infection of the GU tract is common, and persistent Salmonella septicemia may occur with S. mansoni . Several species, notably S (...) the likelihood of infection. Adult residents of endemic areas are more resistant to reinfection than children, suggesting the possibility of acquired immunity. Mass community-based or school-based treatment with praziquantel , education programs, and molluscicides to reduce snail populations are used to control schistosomiasis in endemic areas. Vaccine development is under way. Key Points Schistosoma is the only trematode that invades through the skin; about 207 million people are infected worldwide. When

2013 Merck Manual (19th Edition)

593. Efficacy and Safety of Tulobuterol Patch Combined With Tiotropium Bromide for Relieving Dyspnea Symptom of Chronic Obstructive Pulmonary Disease

of hyperthyroidism, hypertension, heart disease and severe arrhythmia, diabetes mellitus, who are not appropriate to useβ2 receptor agonist patients who have undergone pulmonary lobectomy or have tumor active tuberculosis patients people who got acute respiratory tract infection in a month or during screening phase allergic rhinitis patients glaucoma patients people who have diseases which may cause dysuria such as prostatic hypertrophy or bladder neck occlusion gestation, lactation and child-bearing age women

2011 Clinical Trials

594. The Cleveland Clinic experience with adult hypospadias patients undergoing repair: their presentation and a new classification system. Full Text available with Trip Pro

or pendulous) hypospadias (56.4%) and the others had more proximal (bulbar) hypospadias (43.6%). • Voiding symptoms (such as dysuria, weak stream, spraying, urgency, frequency) were the most common presenting complaint (50.9%) and overall symptom (81.8%). About half of patients underwent a two-stage urethroplasty (52.7%). • Based on their history of repair, patients were divided into three categories: I, patients who have undergone continuous multiple surgeries for repair with significant scarring (...) and tissue loss; II, delayed complications after an initially successful childhood repair; and III, no previous repair. Most patients were category I (58.2%); however, seven patients (12.7%) were category III. Balanitis xerotica obliterans (BXO) was more common in this subgroup compared with other categories (42.9% vs 8.3%, respectively, P= 0.037). In two of the three patients in category III with BXO, the stricture length was longer than 7 cm.• Adults with hypospadias represent a heterogeneous group

2011 BJU international

595. Phase III Study of Tolvaptan Tablet to Treat Cirrhosis Ascites

hemorrhage during the study; Heart failure (NYHA2) grade III or IV); Anuresis (daily urine volume is less than 100mL); Dysuria due to urinary tract stricture, urinary calculus, tumor in the urinary tract or other cause. Patients with history of : Alimentary tract hemorrhage within 10 days prior to screening; Cerebral accident suffered within 30 days prior to screening; Past history of hypersensitivity or idiosyncratic reaction to benzazepine derivatives (Benazepril). Patients with systolic pressure below (...) 90mmHg at screening; Patients with any of the following abnormal laboratory parameters at screening: Serum creatinine >1.5x upper limit of normal range; Serum Na+>145mmol/L (or higher than upper limit of normal range); Serum K+>5.5mmol/L; Patients with Child-pugh score3)>12; Patients who are unable to take medicine orally; Female patients who are pregnant, lactating, or who are at child-bearing age without using acceptable contraceptive means; Patients who received blood products including albumin

2011 Clinical Trials

596. GSK2251052 in Complicated Urinary Tract Infection

and during an operative procedure, when oral antibiotics are not indicated or in cases where the cUTI is suspected to be due to a pathogen resistant to current oral antibiotics and at least two of the following UTI symptoms including dysuria, frequency, urgency or suprapubic pain, with the presence of a complicating factor: Male gender; Current bladder instrumentation or indwelling urinary catheter that has to be removed two days before the end of IV study drug administration; Obstructive uropathy (...) ) on direct examination of a Gram-stained specimen of spun/unspun MSU or catheter urine. Subject is considered unlikely to survive the 4 6 week study period or has any rapidly progressing disease or immediately life-threatening illness (including acute hepatic failure, respiratory failure or septic shock). Subject has evidence of known or pre-existing severe hepatic disease (Child-Pugh score of B or C). Subject has a known baseline haemoglobin less than 10 g/dL ,haematocrit less than 30% and/or a known

2011 Clinical Trials

597. Brachytherapy Full Text available with Trip Pro

localised bruising, swelling, bleeding, discharge or discomfort within the implanted region. These usually resolve within a few days following completion of treatment. Patients may also feel fatigued for a short period following treatment. Brachytherapy treatment for cervical or prostate cancer can cause acute and transient urinary symptoms such as urinary retention, urinary incontinence or painful urination (dysuria). Transient increased bowel frequency, diarrhoea, constipation or minor rectal bleeding (...) being in close proximity with them. If permanent brachytherapy is used, low dose radioactive sources (seeds) are left in the body after treatment – the radiation levels are very low and decrease over time. In addition, the irradiation only affects tissues within a few millimeters of the radioactive sources (i.e. the tumour being treated). As a precaution, some people receiving permanent brachytherapy may be advised to not hold any small children or be too close to pregnant women for a short time

2012 Wikipedia

598. Chlamydia trachomatis Full Text available with Trip Pro

factors for genitourinary infections include unprotected sex with multiple partners, lack of condom use, and living in an urban area. Pulmonary infections can occur in infants born to women with active chlamydia infections, although the rate of infection is less than 10%. Ocular infections take the form of conjunctivitis or trachoma, both in adults and children. Trachoma is the primary source of infectious blindness in some parts of rural Africa and Asia and is a that has been targeted by the World (...) (genitals), pulmonary (lungs), and ocular (eyes). Genitourinary cases can include genital discharge, vaginal bleeding, itchiness (pruritus), painful urination (dysuria), among other symptoms. Often, symptoms are similar to those of a . Prevalence [ ] Three times as many women as men are diagnosed with genitourinary C. trachomatis infections. Women aged 15–19 have the highest prevalence, followed by women aged 20–24, although the rate of increase of diagnosis is greater for men than for women. Risk

2012 Wikipedia

599. Safety, Pharmacokinetics and Clinical Activity of Oral Rigosertib in Solid Tumors

prior dose. If two or more patients in any cohort experience DLT, then the maximum tolerated dose (MTD) will have been exceeded and no further dose escalation will occur. The MTD will be established as the immediate prior dosing level Identical rules will be applied to all cohorts of patients recruited to the study. A total of up to 24 patients may be treated at the MTD dose level in order to obtain data on the onset and severity of dysuria symptoms in approximately 12 patients including about 6 (...) in at least 1 dimension with longest diameter equal to or greater than 20 mm using conventional techniques (computed tomography [CT] scan or magnetic resonance imaging [MRI]) or equal to or greater than 10 mm with spiral CT scan. If female, has a negative screening for pregnancy. Women of child-bearing potential and men must agree to use adequate contraception prior to study entry (hormonal or barrier method of birth control; abstinence) and for the duration of study participation. Should a woman become

2010 Clinical Trials

600. Management of Urinary Tract Infections in Primary Care Facilities.

Ages Eligible for Study: 16 Years to 55 Years (Child, Adult) Sexes Eligible for Study: Female Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Females 16-55 years Dysuria Increased frequency of urination Exclusion Criteria: Pregnant Breastfeeding child < 1 month of age Diabetes Kidney disease Fever Poor general condition Backpain Abdominal pain Increased amount of vaginal secretions Vaginal itching or pain Urinary tract infection in the last four weeks Use of urinary catheter in the last

2010 Clinical Trials

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