EMpills 22 APRILE 2014 - BY CARLO D´APUZZO
C’è poi la signora Anna, ha una colica renale. Ha fatto l’eco dove si vede una lieve idronefrosi, ma non il calcolo, così le ho chiesto la TAC… Queste le parole alla consegna di uno dei turni della scorsa settimana. Anche da noi, recentemente è invalsa la pratica di cercare di definire meglio le caratteristiche della litiasi renale attraverso l’uso della TC senza mezzo di contrasto. Questa pratica pur supportata da alcune linee guida come quella della Società Europea di Urologia è in grado di cambiare la nostra condotta terapeutica oppure ci consente solo una migliore precisazione diagnostica?
http://empills.com/2014/04/colica-renale-tac-serve-davvero/
*
AAA, renal vein thrombosis
http://www.emdocs.net/questions/renal-colic/
*
EMLON - Posted by Ryan Radecki - April 21, 2014
With little fanfare (probably because this Tamiflu document was published the same week), the Cochrane Collaboration published a review of the efficacy of alpha-blockers for stone expulsion. The authors strongly approve of this therapy. They also grievously downplay the tragic disutility of the data reviewed.
http://www.emlitofnote.com/2014/04/sadly-inadequate-cochrane-review-of.html?spref=tw
*
Dr. Anthony Seupaul - Podcast Link: SGEM71 - Date: April 11, 2014
The review attempted to answer a sensible question. Literature search was appropriate and covered a significant range of sources without language bias.
However, only published studies were sought which may have introduced publication bias as the funnel plot implied.
There was variability in the methodological quality among the studies with a range of high and poor quality and a high number of comparisons, which the authors themselves indicated as a limitation. The meta-analysis suffered from significant heterogeneity.
This systematic review draws similar conclusions to early randomized control data touting the benefits of medical expulsion therapy. The majority of these trials enrolled patients from urology clinics where the average stone size exceeded 5mm.
http://thesgem.com/2014/04/sgem71-like-a-rolling-kidney-stone-a-systematic-review-of-renal-colic/