[ { "key": "IDAVASBP", "version": 1, "library": { "type": "group", "id": 85383, "name": "Renal Colic", "links": { "alternate": { "href": "https://www.zotero.org/groups/renal_colic", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/85383/items/IDAVASBP", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/renal_colic/items/IDAVASBP", "type": "text/html" } }, "meta": { "createdByUser": { "id": 988107, "username": "larahimi", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/larahimi", "type": "text/html" } } }, "creatorSummary": "Moak et al.", "parsedDate": "2012-01", "numChildren": 0 }, "data": { "key": "IDAVASBP", "version": 1, "itemType": "journalArticle", "title": "Bedside renal ultrasound in the evaluation of suspected ureterolithiasis", "creators": [ { "creatorType": "author", "firstName": "James H", "lastName": "Moak" }, { "creatorType": "author", "firstName": "Michael S", "lastName": "Lyons" }, { "creatorType": "author", "firstName": "Christopher J", "lastName": "Lindsell" } ], "abstractNote": "OBJECTIVE\n\nTo determine whether ultrasound changes emergency physicians' estimated likelihood of acute ureterolithiasis in patients with flank pain.\n\n\nMETHODS\n\nThis prospective, observational study enrolled patients awaiting computed tomographic (CT) scan for presumed renal colic. Using a visual analogue scale, treating physicians estimated the likelihood of acute ureterolithiasis based first on clinical findings and urinalysis, then after ultrasound, and finally after CT. A 20% change in estimated likelihood was considered clinically significant. Test characteristics of ultrasound for any ureteral stone and for those greater than or equal to 5 mm in size were determined.\n\n\nRESULTS\n\nOne hundred seven patients were enrolled. Sensitivity, specificity, and negative predictive value of ultrasound for stones observed on CT were 76.3% (95% confidence interval [CI], 59.4%-88.0%), 78.3% (95% CI, 66.4%-86.9%), and 85.7% (95% CI, 74.1%-92.9%) respectively, and for stones >5 mm 90.0% (95% CI, 54.1%-99.5%), 63.9% (95% CI, 53.4%-73.2%), and 98.4% (95% CI, 90.3%-99.9%), respectively. Ultrasound significantly impacted the estimated likelihood of disease in 33 of 107 cases (30.8%, 95% CI, 22.5%-40.6%). Computed tomography further significantly changed physicians' impression of disease in 55 of 107 cases (51.4%, 95% CI, 41.6%-61.1%).\n\n\nCONCLUSIONS\n\nBedside renal ultrasound had only a limited impact on the physicians' clinical impression of patients with possible ureterolithiasis. The sensitivity of sonographic hydronephrosis was modest for detecting any ureteral stone, but much better for detecting a large stone. Further study is needed to define the precise role ultrasound should play in evaluating patients with suspected ureterolithiasis.", "publicationTitle": "The American journal of emergency medicine", "publisher": "", "place": "", "date": "Jan 2012", "volume": "30", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "218-221", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Am J Emerg Med", "DOI": "10.1016/j.ajem.2010.11.024", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/21185667", "accessDate": "2012-08-17T14:21:59Z", "PMID": "", "PMCID": "", "ISSN": "1532-8171", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 21185667", "tags": [], "collections": [], "relations": {}, "dateAdded": "2012-08-17T14:23:31Z", "dateModified": "2012-08-17T14:23:31Z" } }, { "key": "XJTMECC8", "version": 1, "library": { "type": "group", "id": 85383, "name": "Renal Colic", "links": { "alternate": { "href": "https://www.zotero.org/groups/renal_colic", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/85383/items/XJTMECC8", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/renal_colic/items/XJTMECC8", "type": "text/html" } }, "meta": { "createdByUser": { "id": 988107, "username": "larahimi", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/larahimi", "type": "text/html" } } }, "creatorSummary": "Edmonds et al.", "parsedDate": "2010-05", "numChildren": 0 }, "data": { "key": "XJTMECC8", "version": 1, "itemType": "journalArticle", "title": "The utility of renal ultrasonography in the diagnosis of renal colic in emergency department patients", "creators": [ { "creatorType": "author", "firstName": "Marcia L", "lastName": "Edmonds" }, { "creatorType": "author", "firstName": "Justin W", "lastName": "Yan" }, { "creatorType": "author", "firstName": "Roberts J", "lastName": "Sedran" }, { "creatorType": "author", "firstName": "Shelley L", "lastName": "McLeod" }, { "creatorType": "author", "firstName": "Karl D", "lastName": "Theakston" } ], "abstractNote": "OBJECTIVE\n\nComputed tomography (CT) is an imaging modality used to detect renal stones. However, there is concern about the lifetime cumulative radiation exposure attributed to CT. Ultrasonography (US) has been used to diagnose urolithiasis, thereby avoiding radiation exposure. The objective of this study was to determine the ability of US to identify renal colic patients with a low risk of requiring urologic intervention within 90 days of their initial emergency department (ED) visit.\n\n\nMETHODS\n\nWe completed a retrospective medical record review for all adult patients who underwent ED-ordered renal US for suspected urolithiasis over a 1-year period. Independent, double data extraction was performed for all imaging reports and US results were categorized as \"normal,\" \"suggestive of ureterolithiasis,\" \"ureteric stone seen\" or \"disease unrelated to urolithiasis.\" Charts were reviewed to determine how many patients underwent subsequent CT and urologic intervention.\n\n\nRESULTS\n\nOf the 817 renal US procedures ordered for suspected urolithiasis during the study period, the results of 352 (43.2%) were classified as normal, and only 2 (0.6%) of these patients required urologic intervention. The results of 177 (21.7%) renal US procedures were suggestive of ureterolithiasis. Of these, 12 (6.8%) patients required urologic intervention. Of the 241 (29.5%) patients who had a ureteric stone seen on US, 15 (6.2%) required urologic intervention. The rate of urologic intervention was significantly lower in those with normal results on US (p < 0.001) than in those with abnormal results on US.\n\n\nCONCLUSION\n\nA normal result on renal US predicts a low likelihood for urologic intervention within 90 days for adult ED patients with suspected urolithiasis.", "publicationTitle": "CJEM", "publisher": "", "place": "", "date": "May 2010", "volume": "12", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "201-206", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "CJEM", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/20522284", "accessDate": "2012-08-17T14:22:49Z", "PMID": "", "PMCID": "", "ISSN": "1481-8035", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 20522284", "tags": [], "collections": [], "relations": {}, "dateAdded": "2012-08-17T14:23:28Z", "dateModified": "2012-08-17T14:23:28Z" } }, { "key": "66PSZ5D2", "version": 1, "library": { "type": "group", "id": 85383, "name": "Renal Colic", "links": { "alternate": { "href": "https://www.zotero.org/groups/renal_colic", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/85383/items/66PSZ5D2", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/renal_colic/items/66PSZ5D2", "type": "text/html" } }, "meta": { "createdByUser": { "id": 988107, "username": "larahimi", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/larahimi", "type": "text/html" } } }, "creatorSummary": "Dalziel and Noble", "parsedDate": "2012-06-08", "numChildren": 0 }, "data": { "key": "66PSZ5D2", "version": 1, "itemType": "journalArticle", "title": "Bedside ultrasound and the assessment of renal colic: a review", "creators": [ { "creatorType": "author", "firstName": "Peregrine James", "lastName": "Dalziel" }, { "creatorType": "author", "firstName": "Vicki Elizabeth", "lastName": "Noble" } ], "abstractNote": "Renal colic is a common emergency department (ED) presentation. The use of CT in the diagnosis of renal colic has increased over the past two decades and is now the most common imaging modality used in many institutions. However, with growing concerns about cumulative radiation exposure, increasing healthcare costs and patient flow in EDs, alternative approaches may need to be considered. Point-of-care ultrasound may offer a radiation-free, rapid and cost-effective alternative. The authors reviewed the literature and synthesised some of the data comparing point-of-care ultrasound with CT scanning as well as some of the evidence for how it might be incorporated into a renal colic management strategy. It is concluded that there is enough evidence to define a rational algorithm for renal colic management. A prospectively validated algorithm would greatly assist primary care and emergency practitioners while reducing costs and radiation dose.", "publicationTitle": "Emergency medicine journal: EMJ", "publisher": "", "place": "", "date": "Jun 8, 2012", "volume": "", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "10.1136/emermed-2012-201375", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/22685250", "accessDate": "2012-08-17T14:22:26Z", "PMID": "", "PMCID": "", "ISSN": "1472-0213", "archive": "", "archiveLocation": "", "shortTitle": "Bedside ultrasound and the assessment of renal colic", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 22685250", "tags": [], "collections": [], "relations": {}, "dateAdded": "2012-08-17T14:23:26Z", "dateModified": "2012-08-17T14:23:26Z" } } ]