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Dysuria in Children

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601. Reports of Repetitive Penile-Genital Penetration Often Have No Definitive Evidence of Penetration. Full Text available with Trip Pro

Reports of Repetitive Penile-Genital Penetration Often Have No Definitive Evidence of Penetration. The goals were to evaluate the association of definitive hymenal findings with the number of reported episodes of penile-genital penetration, pain, bleeding, dysuria, and time since assault for girls presenting for nonacute, sexual assault examinations.Charts of all girls 5 to 17 of age who provided a history of nonacute, penile-genital, penetrative abuse were reviewed. Interviews and examinations (...) occurred over a 4-year period at a children's advocacy center. Characteristics of the histories provided by the subjects were examined for associations with definitive findings of penetrative trauma.Five hundred six patients were included in the study. Of the 56 children with definitive examination results, 52 had no history of consensual penile-vaginal intercourse and all were > or =10 years of age. Analysis was unable to detect an association between the number of reported penile-genital penetrative

2009 Pediatrics

602. Pediatric Urolithiasis: Clinical Predictors in the Emergency Department. (Abstract)

Pediatric Urolithiasis: Clinical Predictors in the Emergency Department. The objective of this study was to identify factors that predict the presence of urolithiasis detected with unenhanced computed tomography (UCT) in children.A retrospective study of all subjects <21 years of age who presented to the emergency department at Akron Children's Hospital and underwent UCT of the abdomen between January 2002 and December 2005 was performed. Demographic, clinical, diagnostic, treatment (...) %) were renal, and 4 (3.6%) were in the bladder. Among children who did not have a stone identified through UCT, 23 cases (10%) of potentially significant, alternative diagnoses were identified. A history of urolithiasis, a history of nausea and vomiting, the presence of flank pain on examination, and >2 red blood cells per high-power field in urine microscopy were positively associated with urolithiasis. A history of fever or dysuria and costovertebral angle tenderness on physical examination were

2009 Pediatrics

603. Long-Term Outcomes of the Neobladder in Pediatric Continent Urinary Reconstruction. (Abstract)

Long-Term Outcomes of the Neobladder in Pediatric Continent Urinary Reconstruction. In rare instances when native bladder tissue is either unsuitable or unavailable a continent neobladder may be an option for pediatric lower urinary tract reconstruction. We report our long-term outcomes and experience in this challenging patient population.A retrospective cohort study was performed of all patients who underwent creation of a neobladder at 2 pediatric institutions. Patient demographics, surgical (...) obstruction (4), bladder perforation (4) and pelvic lymphocele (1). Five patients had difficulty with catheterization due to stomal stenosis. Gross hematuria with clots developed in 1 patient with anuria who had a gastroileal neobladder and was awaiting renal transplantation. No other patient with a gastric component had the hematuria-dysuria syndrome. Five patients had end stage renal disease and subsequently underwent successful renal transplantation. No upper urinary tract deterioration was observed

2009 Journal of Urology

604. Conservative Management of Pediatric Nephrolithiasis Caused by Melamine-Contaminated Milk Powder. (Abstract)

Conservative Management of Pediatric Nephrolithiasis Caused by Melamine-Contaminated Milk Powder. In this article we report our experience with the diagnostic screening and management of children with melamine-induced nephrolithiasis.A total of 1091 children younger than 4 years who had been exposed to melamine-contaminated formula from September 17 to October 12, 2008, were screened for nephrolithiasis at the department of pediatrics at Shenzhen Nanshan Hospital in China. During the clinical (...) infusion of fluids, urinary alkalinization, increased water consumption, and diuresis.Of the 1091 children screened, 12 (1.1%) were diagnosed with kidney stones. They had been exposed to the contaminated milk from 1 to 24 months. Eleven (91.7%) of these 12 patients had consumed milk with a high level of melamine content (955-2563 ppm); 1 patient (8.3%) had consumed milk with a low-level melamine content (6.2-17.0 ppm). Six patients exhibited dysuria; the remaining 6 patients were asymptomatic. All 12

2009 Pediatrics

605. Urinary tract infection in under 16s: diagnosis and management

there will be a small number of false negative results; therefore clinicians should use clinical criteria for their decisions in cases where urine testing does not support the findings. [2007] [2007] 1.1.5.2 Refer all infants under 3 months with a suspected UTI (see table 1) to paediatric specialist care, and send a urine sample for urgent microscopy and culture manage in line with the NICE guideline on fever in under 5s. [2017] [2017] 1.1.5.3 Use dipstick testing for infants and children 3 months or older (...) treatment should be started if clinically UTI The infant or child should be regarded as not having UTI Urinary tract infection in under 16s: diagnosis and management (CG54) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 8 of 231.1.6 1.1.6 Indication for culture Indication for culture 1.1.6.1 Urine samples should be sent for culture: in infants and children who are suspected to have acute pyelonephritis/upper urinary

2007 National Institute for Health and Clinical Excellence - Clinical Guidelines

606. urinary schistosomiasis

weeks after infection is the first sign of established disease in severe cases, the whole urine sample can be dark coloured. maybe confused with menses in girls dysuria increased frequency of micturition late manifestations proteinuria (often nephrotic syndrome) bladder calcification ureteric obstruction secondary bacterial infection in the urinary tract renal colic hydronephrosis renal failure (1,2,3) In children, structural abnormalities of the urinary tract may be seen in some instances (1 (...) , and increased risk of abortion advances forms of the genital tract lesionscan increase transmission of HIV (3) In men can present with haematospermia, orchitis, prostatitis, dyspareunia, and oligospermia. resolve more readily after antischistosomal treatment than do those of female genital schistosomiasis (3) Note: dysuria and haematuria occur in early and late disease Reference: (1) (2) (3) Links: General Practice Notebook General Practice Notebook The information provided herein should not be used

2010 GP Notebook

607. haematobium schistosomiasis

weeks after infection is the first sign of established disease in severe cases, the whole urine sample can be dark coloured. maybe confused with menses in girls dysuria increased frequency of micturition late manifestations proteinuria (often nephrotic syndrome) bladder calcification ureteric obstruction secondary bacterial infection in the urinary tract renal colic hydronephrosis renal failure (1,2,3) In children, structural abnormalities of the urinary tract may be seen in some instances (1 (...) , and increased risk of abortion advances forms of the genital tract lesionscan increase transmission of HIV (3) In men can present with haematospermia, orchitis, prostatitis, dyspareunia, and oligospermia. resolve more readily after antischistosomal treatment than do those of female genital schistosomiasis (3) Note: dysuria and haematuria occur in early and late disease Reference: (1) (2) (3) Links: General Practice Notebook General Practice Notebook The information provided herein should not be used

2010 GP Notebook

608. Bridion (sugammadex)

/59 One-hundred twenty subjects were enrolled, six per dose group and per age group. The dose groups were 0.5, 1.0, 2.0, or 4.0 mg/kg Bridion or placebo. The age groups were: Infants (28 days - 23 month), children (2-11 years), adolescents (12 – 17 years) and adults (18 -65 years). A total of 91 subjects (8 infants, 24 children, 31 adolescents, and 28 adults) received a single, bolus, intravenous dose of Bridion (0.5, 1, 2, or 4 mg/kg) or placebo. A total of 90 subjects completed the trial (...) Mean (SD) 29.5 (8.4) 3.8 (1.1) 1.6 (0.3) 1.3 (0.3) 1.4 (0.4) Median 28.5 4.2 1.7 1.2 1.4 Min. – max. 19.6 – 44.0 2.3 – 4.8 1.2 – 2.0 0.9 – 1.6 1.0 – 2.0 It was concluded that for children, adolescents and adults a clear dose-response relationship was found. On the contrary, in infants, the mean time to recovery of the T4/T1 ratio to 0.9 markedly decreased with increasing dose of sugammadex. However no plateau, i.e. no limit of recovery was reached and no dose-response effect could be demonstrated

2008 European Medicines Agency - EPARs

609. Modelling the cost effectiveness of rapid point of care diagnostic tests for the control of HIV and other sexually transmitted infections among female sex workers Full Text available with Trip Pro

. They reported favourable cost-effectiveness in comparison with programmes to prevent HIV in sub-Saharan Africa, the prevention of mother-to-child transmission and voluntary counselling and testing. The issue of generalisability was discussed explicitly with the authors using sensitivity analyses, particularly relating to salary, to explore the impact of the results in different settings. The authors noted that their results are likely to apply to other communities with concentrated HIV epidemics (...) female sex workers in Cotonou, Benin: 1993-1999. AIDS 2002;16:463-70. Alary M, Aina G, Ndour M, et al. Evaluation of the PATH GC-Check rapid test for the detection of gonococcal infection among female sex workers in Benin (Abstract WP-013). Amsterdam: ISSTDR; 2005. Available from: URL: www.isstdr.nl/index.html) Alary M, Baganizi E, Guemede A, et al. Evaluation of clinical algorithms for the diagnosis of gonococcal and chlamydial infections among men with urethral discharge or dysuria and women

2006 NHS Economic Evaluation Database.

610. Ultrasound in the diagnosis of testicular torsion

with low or even moderate clinical suspicion – but this question has not been addressed. Clinical Bottom Line Ultrasound examination is a useful addition to clinical examination and experience but should not over-rule clinical suspicion References Stehr M, Boehm R Critical validation of colour Doppler ultrasound in diagnostics of acute scrotum in children European Journal of Pediatric Surgery 13(6):386-92, 2003 Dec. Kravchick S, Cytron S, Leibovici O, Linov L, London D, Altshuler A, Yulish E. Color (...) Doppler sonography: its real role in the evaluation of children with highly suspected testicular torsion. European Radiology 11(6):1000-5, 2001. Baker LA, Sigman D, Mathews RI, Benson J, Docimo SG. An analysis of clinical outcomes using colour doppler testicular ultrasound for testicular torsion. Pediatrics 105(3 Pt 1):604-7, 2000 Mar. Hendrikx AJ, Dang CL, Vroegindeweij D, Korte JH. B-mode and colour-flow duplex ultrasonography: a useful adjunct in diagnosing scrotal diseases? British Journal

2005 BestBETS

611. UK National STI Screening and Testing Guideline

not have symptoms of urethral discharge or dysuria on questioning by a health care worker In some men with NSU Mycoplasma genitalium is probably an important pathogen but commercial test kits are not currently available for its detection. Pelvic Inflammatory Disease (PID) 2 • PID may be symptomatic or asymptomatic. Even when present, clinical symptoms and signs lack sensitivity and specificity (the positive predictive value of a clinical diagnosis is 65-90% compared to laparoscopic diagnosis) 2 (...) J, Krohn MA, Hillier SL, Stamm WE, Holmes KK, Eschenbach DA. Relationships of vaginal Lactobacillus species, cervical Chlamydia trachomatis and bacterial vaginosis to pre-term birth. Obstet Gynecol 1998;71:89-95 6. Hillier SL, Nugent RP, Eschenbach DA et al. Association between bacterial vaginosis and preterm delivery of a low birth-weight infant. New Eng J Med 1995;333:1737-42 7. Sweet RL, Draper DL, Schachter J, James J, Hadley WK, Brooks GF. Microbiology and pathogenesis of acute salpingitis

2006 British Association for Sexual Health and HIV

612. Is the topical application of oestrogen cream an effective intervention in girls suffering from labial adhesions?

, Archimedes, Archives of Disease in Childhood Institution: Department of Paediatrics, Southend University Hospital, Southend-on-Sea Date Submitted: 6th March 2007 Date Completed: 6th March 2007 Last Modified: 6th March 2007 Status: Green (complete) Three Part Question In [a girl with labial adhesions] is [oestrogen cream] an [effective treatment to induce labial separation]? Clinical Scenario A 4-year-old girl presents with low-grade pyrexia and dysuria. A urine dipstick test shows positive results (...) . Br J Obstet Gynaecol 1975;82:424–5 Khanam W, Chogtu L, Mir Z, et al. Adhesion of the labia minora - a study of 75 cases. Aust N Z J Obstet Gynaecol 1977;17:176. Capraro VJ, Greenberg H. Adhesions of the labia minora. A study of 50 patients. Obstet Gynecol 1972;39:65–9. Leung AK, Robson WL, Tay-Uyboco J. The incidence of labial fusion in children. J Paediatr Child Health 1993;29:235–6. Pokorny SF. Prepubertal vulvovaginopathies. Obstet Gynecol Clin North Am 1992;19:39–58. Schroeder B. Pro

2007 BestBETS

613. Does this woman have an acute uncomplicated urinary tract infection?

examination, and dipstick urinalysis. Participants included in the review Healthy women suspected of having acute uncomplicated UTI were included. Studies were excluded if they evaluated infants, children or adolescents, pregnant women, nursing home patients, or patients with complicated UTI. The mean age was only reported in 4 studies (26, 24, 29 and 23 years). Outcomes assessed in the review The studies were only included if they contained sufficient data to allow the calculation of likelihood ratios (...) UTI was defined by the presence of at least 10,000 or 100,000 colony-forming units (CFU)/mL of a single uropathogen, while one study used a cut-off of at least 100 CFU/mL. The clinical symptoms and signs on physical examination that were used in the included studies were: dysuria, frequency, haematuria, fever, flank pain, lower abdominal pain, vaginal discharge, vaginal irritation, back pain, self-diagnosis, vaginal discharge on physical examination, costovertebral angle tenderness on physical

2002 DARE.

614. The relationship between consultation length, process and outcomes in general practice: a systematic review

The relationship between consultation length, process and outcomes in general practice: a systematic review The relationship between consultation length, process and outcomes in general practice: a systematic review The relationship between consultation length, process and outcomes in general practice: a systematic review Wilson A, Childs S Authors' objectives To examine the association between the average consultation time of primary care physicians and consultation process and health outcome (...) history and examining audit criteria for hypertension and dysuria, but not for diabetes or general examination. One study found that faster doctors recorded fewer details of history, while another found that female doctors had longer consultations and used more counselling. Prescribing (5 studies): overall, slower doctors had a lower prescribing rate. One study found that the rate per consultation was 51.5% for slower doctors versus 62.6% for faster doctors (P<0.001). Another study found

2002 DARE.

615. A systematic review of near patient testing in primary care

of urinary tract infection in the presence of dysuria, are of limited value in general practice. EDI may present advantages over traditional means of communication, but its introduction should be subject to evaluation. CRD commentary This was a well-conducted systematic review. The review answered a well-defined question and the inclusion criteria were clearly specified. Detailed literature searches that included attempts to identify unpublished studies were carried out. The authors reported details (...) for the identification of acute infection. A research programme to assess NPT in primary care would be appropriate: phase one initial reliability and safety; phase two - trials in selected populations; phase three - trials in unselected populations and cost-effectiveness and impact studies. Further primary research is recommended where there is promising evidence, but where insufficient material exists to justify a further quantitative review: screening for iron deficiency in the child development clinic; NPT

1997 DARE.

616. Promoting Continence Using Prompted Voiding

McMaster University Hamilton, Ontario Laura Robbs, RN, BScN, ET, NCA, MN(cand) Nurse Continence Advisor Trillium Health Centre – Queensway Site Etobicoke, Ontario Kathleen Romano, RN, NCA Nurse Continence Advisor Adult and Pediatric Urology and Incontinence Treatment Centre Thunder Bay, Ontario Anita Saltmarche, RN, MHSc President – Health Care Associates Toronto, Ontario Josephine Santos, RN, MN Facilitator, Program Coordinator Nursing Best Practice Guidelines Program Registered Nurses’ Association (...) (Rycroft-Malone, Kitson, Harvey, McCormack, Seers, Titchen, et al., 2002). Family Whomever the person defines as being family. Family members can include: parents, children, siblings, neighbours, and/or significant others. Informal Support Support and resources provided by persons associated with the individual receiving care. Persons providing informal support can include: family, friends, members of a spiritual community, neighbours, etc. Meta-analysis The use of statistical methods to summarize

2002 Registered Nurses' Association of Ontario

617. UTI in a child

less than 5 years, are: vomiting poor feeding lethargy irritability abdominal pain or tenderness urinary frequency or dysuria offensive urine or haematuria NICE now state if suspected UTI is an infants younger than 3 months then: there are concerns about sepsis in infants under 3 months with suspected UTI, and usual practice is referral rather than the GP managing symptoms. So the committee recommended that all children under 3 months should be referred to specialist paediatric care and have (...) that a pure growth of 10^5 organisms per ml or greater is indicative of infection (1) about 2% of boys and 8% or more of girls will develop a urinary tract infection during childhood Note that in some children, especially boys, the child may not retain urine in the bladder for a long enough period for multiplication to a pure growth of 10^5 organisms per ml to occur. In these cases a pure growth of 10^4-10^5 organisms may indicate infection. NICE note that clinical features suggestive of UTI, in a child

2010 GP Notebook

618. UTI in childhood

, in a child less than 5 years, are: vomiting poor feeding lethargy irritability abdominal pain or tenderness urinary frequency or dysuria offensive urine or haematuria NICE now state if suspected UTI is an infants younger than 3 months then: there are concerns about sepsis in infants under 3 months with suspected UTI, and usual practice is referral rather than the GP managing symptoms. So the committee recommended that all children under 3 months should be referred to specialist paediatric care and have (...) UTI in childhood UTI in childhood - General Practice Notebook This site is intended for healthcare professionals General Practice Notebook | Medical search UTI in childhood a urinary tract infection is an important diagnosis in a child not to miss because infection may damage the developing kidney as with adults, a urinary tract infection in children is defined as more than 10 to the power 5 organisms per ml in voided urine (studies on urine specimens from large numbers of hospital patients

2010 GP Notebook

619. What are the positive and negative predictive values for urine infections of positive white cells on dipstick urinalysis?

, offensive smell, and dysuria and/or nocturia of moderate severity, was less sensitive (65%) (specificity 69%; PPV 77%, NPV 54%). NPV was 71% for none of the four clinical features, and the PPV was 84% for three or more features. CONCLUSIONS: Simple decision rules could improve targeting of investigation and treatment. Strategies to use such rules need to take into account limited negative predictive value, which is lower than expected from previous research.” [2] A number of evidence-based sources (...) tests (dipsticks) and clinical scores. Little P, Turner S, Rumsby K et al. BMC Pediatr. 2005 Apr 5;5(1):4. ( ). 3. PRODIGY. UTI-lower in women. Last revised in July 2006. ( ). 4. Institute for Clinical Systems Improvement (ICSI). Uncomplicated urinary tract infection in women. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2006 Jul. ( ). Answered 2 May 2007 Follow us: © 2019 Trip Database Ltd. company number 04316414. Trip is proud to be made in the UK.

2007 TRIP Answers

620. What is the negative/positive predictive value of urinaysis for diagnosis of UTI?

(dipsticks) and clinical scores. Little P, Turner S, Rumsby K et al. BMC Pediatr. 2005 Apr 5;5(1):4. ( ). 3. CKS. Urinary tract infection (lower) – men. July 2006. ( ) 4. Koeijers JJ, Kessels AG and Nys S et al. Evaluation of the nitrite and leukocyte esterase activity tests for the diagnosis of acute symptomatic urinary tract infection in men. Clin Infect Dis. 2007 Oct 1;45(7):894-6. ( ) 5. CKS. UTI- children. July 2006. ( ) 6. NICE. UTI in children. August 2007. ( ) Answered 30 November 2007 Follow us (...) of the following: urine cloudiness, offensive smell, and dysuria and/or nocturia of moderate severity, was less sensitive (65%) (specificity 69%; PPV 77%, NPV 54%). NPV was 71% for none of the four clinical features, and the PPV was 84% for three or more features. CONCLUSIONS: Simple decision rules could improve targeting of investigation and treatment. Strategies to use such rules need to take into account limited negative predictive value, which is lower than expected from previous research.” [2] The CKS

2007 TRIP Answers

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