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Michael Goldman - One of the best experts on this subject based on the ideXlab platform.

  • and transurethral bladder catheterization a randomized controlled study pain in infants who are younger than 2 months during Suprapubic Aspiration
    2013
    Co-Authors: Michael Goldman, Eran Kozer, Ehud Rosenbloom, Dorit Goldman, Gila Lavy, Noa Rosenfeld
    Abstract:

    ABSTRACT OBJECTIVE. Proper diagnosis of urinary tract infections depends on obtaining anuncontaminated urine sample for culture. Suprapubic Aspiration and transurethralcatheterization are the 2 recommended procedures for obtaining specimens forurine culture from young infants. The objective of the current study was tocompare the pain that is experienced during these 2 procedures when performedin young infants. METHODS. A prospective, single-blind, randomized, controlled study was conductedat a university-affiliated hospital in Israel. Institutional Research Ethics Boardapproved the study. Infants who were 0 to 2 months of age and presented to theemergency department with fever and therefore required urine collection forculture were randomly assigned evenly into 2 sample collection groups: suprapu-bic Aspiration or transurethral catheterization. Patients were excluded when theywere born prematurely or had had a previous sepsis workup or other painfulprocedures or an anomaly of the urogenital system or abdominal wall. Eutecticmixture of local anesthetic cream that contained lidocaine and prilocaine wasapplied 1 hour before the procedure. The urethra was catheterized using a 5-Frlatex-free feeding tube that was lubricated with sterile water-soluble jelly thatcontained 2% lidocaine hydrochloride. Pediatric residents who were experiencedwith the procedures performed both Suprapubic Aspiration and transurethralcatheterization.Theparentswereinstructedtouseanycomfortstrategiesthattheywished, including verbal or physical comforting and pacifiers. Pain during collec-tion was assessed on a 100-mm visual analog scale by a nurse and a parent. Inaddition, the infant’s upper part of the body was videotaped during the procedure.An investigator, who was blinded to the procedure, assigned a point score accord-ing to the Douleur Aigue du Nouveaune neonatal acute pain scale. For ensuring asuccessful blinding process, the following steps were taken. First, camera recording

  • pain in infants who are younger than 2 months during Suprapubic Aspiration and transurethral bladder catheterization a randomized controlled study
    Pediatrics, 2006
    Co-Authors: Eran Kozer, Ehud Rosenbloom, Dorit Goldman, Gila Lavy, Noa Rosenfeld, Michael Goldman
    Abstract:

    Objective Proper diagnosis of urinary tract infections depends on obtaining an uncontaminated urine sample for culture. Suprapubic Aspiration and transurethral catheterization are the 2 recommended procedures for obtaining specimens for urine culture from young infants. The objective of the current study was to compare the pain that is experienced during these 2 procedures when performed in young infants. Methods A prospective, single-blind, randomized, controlled study was conducted at a university-affiliated hospital in Israel. Institutional Research Ethics Board approved the study. Infants who were 0 to 2 months of age and presented to the emergency department with fever and therefore required urine collection for culture were randomly assigned evenly into 2 sample collection groups: Suprapubic Aspiration or transurethral catheterization. Patients were excluded when they were born prematurely or had had a previous sepsis workup or other painful procedures or an anomaly of the urogenital system or abdominal wall. Eutectic mixture of local anesthetic cream that contained lidocaine and prilocaine was applied 1 hour before the procedure. The urethra was catheterized using a 5-Fr latex-free feeding tube that was lubricated with sterile water-soluble jelly that contained 2% lidocaine hydrochloride. Pediatric residents who were experienced with the procedures performed both Suprapubic Aspiration and transurethral catheterization. The parents were instructed to use any comfort strategies that they wished, including verbal or physical comforting and pacifiers. Pain during collection was assessed on a 100-mm visual analog scale by a nurse and a parent. In addition, the infant's upper part of the body was videotaped during the procedure. An investigator, who was blinded to the procedure, assigned a point score according to the Douleur Aigue du Nouveaune neonatal acute pain scale. For ensuring a successful blinding process, the following steps were taken. First, camera recording started 30 seconds before the procedure to prevent the possibility of distinguishing between the procedures on the basis of their duration. Second, the physician and the nurse were asked not to speak during the procedure to avoid revealing the nature of the procedure. Third, the person who videotaped the procedure watched the tape before it was analyzed to ensure the impossibility of identifying the procedure from the tape. The Student's t test was used to compare the groups. The primary outcome was the mean Douleur Aigue du Nouveaune score. Secondary outcomes were the mean visual analogue scale for pain as estimated by the parents and by the nurse. We estimated that 25 patients would be needed in each group to detect a difference in the mean Douleur Aigue du Nouveaune score of at least 2 points with a power of 80% and alpha of .05. Results The study was conducted between April 1, 2004, and April 30, 2005. Fifty-eight infants were recruited; 29 were randomly assigned to Suprapubic Aspiration, and 29 were randomly assigned to transurethral catheterization. Seven infants were excluded because of consent withdrawal (3 patients), because of technical difficulties during videotaping (3 patients), or because the child voided during the procedure (1 patient). Twenty-seven infants in the Suprapubic Aspiration group and 24 in the transurethral catheterization group completed the study. All male infants were circumcised. An adequate urine sample was obtained in 18 (66%) of 27 patients in the Suprapubic Aspiration group and in 20 (83.3%) of 24 in the transurethral catheterization group. The mean Douleur Aigue du Nouveaune score was significantly higher in patients who were randomly assigned to Suprapubic Aspiration compared with patients who were randomly assigned to transurethral catheterization (7 and 4.5, respectively). The differences in Douleur Aigue du Nouveaune score also were significant in a subgroup analysis of boys and girls. Mean visual analogue scale scores by parents was higher in the Suprapubic Aspiration group compared with transurethral catheterization (63 +/- 27 mm vs 46 +/- 26, respectively). Similarly, mean visual analogue scale scores by nurses was higher in the Suprapubic Aspiration group compared with transurethral catheterization (3 +/- 18 mm vs 43 +/- 25 mm, respectively). Conclusions In infants who are younger 2 months, Suprapubic Aspiration is more painful than transurethral catheterization. Health professionals should consider these differences when choosing a method for obtaining a urine sample from young infants.

Marcel Afschrift - One of the best experts on this subject based on the ideXlab platform.

  • A simple and efficient urine sampling method for bacteriological examination in elderly women
    Age and ageing, 1997
    Co-Authors: Walter Michielsen, Filip Jc Geurs, Gerda Verschraegen, Geert Claeys, Marcel Afschrift
    Abstract:

    Aim: to determine how collecting urine voided directly into a container compares with urine obtained by Suprapubic Aspiration. Method: urine samples were collected in a sterile recipient placed in the toilet or in the bed-pan during voiding, after the vulval region had been cleaned by water. These samples were compared with samples of the same urine obtained by Suprapubic Aspiration. The samples were examined for pyuria and bacteriuria. Applying the Kass criteria on the voided urine specimen and assessing the presence of leucocyturia, it was possible to differentiate urinary tract infection, asymptomatic bacteriuria and contamination. Results: all 13 cases of infection found on Suprapubic Aspiration were also identified by this sampling technique. The technique produced four false-positive results. Conclusion: this simple sampling method may not only obviate the need for Suprapubic Aspiration but also for bladder catheterization in the diagnosis of urinary tract infection in many elderly women.

Eran Kozer - One of the best experts on this subject based on the ideXlab platform.

  • and transurethral bladder catheterization a randomized controlled study pain in infants who are younger than 2 months during Suprapubic Aspiration
    2013
    Co-Authors: Michael Goldman, Eran Kozer, Ehud Rosenbloom, Dorit Goldman, Gila Lavy, Noa Rosenfeld
    Abstract:

    ABSTRACT OBJECTIVE. Proper diagnosis of urinary tract infections depends on obtaining anuncontaminated urine sample for culture. Suprapubic Aspiration and transurethralcatheterization are the 2 recommended procedures for obtaining specimens forurine culture from young infants. The objective of the current study was tocompare the pain that is experienced during these 2 procedures when performedin young infants. METHODS. A prospective, single-blind, randomized, controlled study was conductedat a university-affiliated hospital in Israel. Institutional Research Ethics Boardapproved the study. Infants who were 0 to 2 months of age and presented to theemergency department with fever and therefore required urine collection forculture were randomly assigned evenly into 2 sample collection groups: suprapu-bic Aspiration or transurethral catheterization. Patients were excluded when theywere born prematurely or had had a previous sepsis workup or other painfulprocedures or an anomaly of the urogenital system or abdominal wall. Eutecticmixture of local anesthetic cream that contained lidocaine and prilocaine wasapplied 1 hour before the procedure. The urethra was catheterized using a 5-Frlatex-free feeding tube that was lubricated with sterile water-soluble jelly thatcontained 2% lidocaine hydrochloride. Pediatric residents who were experiencedwith the procedures performed both Suprapubic Aspiration and transurethralcatheterization.Theparentswereinstructedtouseanycomfortstrategiesthattheywished, including verbal or physical comforting and pacifiers. Pain during collec-tion was assessed on a 100-mm visual analog scale by a nurse and a parent. Inaddition, the infant’s upper part of the body was videotaped during the procedure.An investigator, who was blinded to the procedure, assigned a point score accord-ing to the Douleur Aigue du Nouveaune neonatal acute pain scale. For ensuring asuccessful blinding process, the following steps were taken. First, camera recording

  • pain in infants who are younger than 2 months during Suprapubic Aspiration and transurethral bladder catheterization a randomized controlled study
    Pediatrics, 2006
    Co-Authors: Eran Kozer, Ehud Rosenbloom, Dorit Goldman, Gila Lavy, Noa Rosenfeld, Michael Goldman
    Abstract:

    Objective Proper diagnosis of urinary tract infections depends on obtaining an uncontaminated urine sample for culture. Suprapubic Aspiration and transurethral catheterization are the 2 recommended procedures for obtaining specimens for urine culture from young infants. The objective of the current study was to compare the pain that is experienced during these 2 procedures when performed in young infants. Methods A prospective, single-blind, randomized, controlled study was conducted at a university-affiliated hospital in Israel. Institutional Research Ethics Board approved the study. Infants who were 0 to 2 months of age and presented to the emergency department with fever and therefore required urine collection for culture were randomly assigned evenly into 2 sample collection groups: Suprapubic Aspiration or transurethral catheterization. Patients were excluded when they were born prematurely or had had a previous sepsis workup or other painful procedures or an anomaly of the urogenital system or abdominal wall. Eutectic mixture of local anesthetic cream that contained lidocaine and prilocaine was applied 1 hour before the procedure. The urethra was catheterized using a 5-Fr latex-free feeding tube that was lubricated with sterile water-soluble jelly that contained 2% lidocaine hydrochloride. Pediatric residents who were experienced with the procedures performed both Suprapubic Aspiration and transurethral catheterization. The parents were instructed to use any comfort strategies that they wished, including verbal or physical comforting and pacifiers. Pain during collection was assessed on a 100-mm visual analog scale by a nurse and a parent. In addition, the infant's upper part of the body was videotaped during the procedure. An investigator, who was blinded to the procedure, assigned a point score according to the Douleur Aigue du Nouveaune neonatal acute pain scale. For ensuring a successful blinding process, the following steps were taken. First, camera recording started 30 seconds before the procedure to prevent the possibility of distinguishing between the procedures on the basis of their duration. Second, the physician and the nurse were asked not to speak during the procedure to avoid revealing the nature of the procedure. Third, the person who videotaped the procedure watched the tape before it was analyzed to ensure the impossibility of identifying the procedure from the tape. The Student's t test was used to compare the groups. The primary outcome was the mean Douleur Aigue du Nouveaune score. Secondary outcomes were the mean visual analogue scale for pain as estimated by the parents and by the nurse. We estimated that 25 patients would be needed in each group to detect a difference in the mean Douleur Aigue du Nouveaune score of at least 2 points with a power of 80% and alpha of .05. Results The study was conducted between April 1, 2004, and April 30, 2005. Fifty-eight infants were recruited; 29 were randomly assigned to Suprapubic Aspiration, and 29 were randomly assigned to transurethral catheterization. Seven infants were excluded because of consent withdrawal (3 patients), because of technical difficulties during videotaping (3 patients), or because the child voided during the procedure (1 patient). Twenty-seven infants in the Suprapubic Aspiration group and 24 in the transurethral catheterization group completed the study. All male infants were circumcised. An adequate urine sample was obtained in 18 (66%) of 27 patients in the Suprapubic Aspiration group and in 20 (83.3%) of 24 in the transurethral catheterization group. The mean Douleur Aigue du Nouveaune score was significantly higher in patients who were randomly assigned to Suprapubic Aspiration compared with patients who were randomly assigned to transurethral catheterization (7 and 4.5, respectively). The differences in Douleur Aigue du Nouveaune score also were significant in a subgroup analysis of boys and girls. Mean visual analogue scale scores by parents was higher in the Suprapubic Aspiration group compared with transurethral catheterization (63 +/- 27 mm vs 46 +/- 26, respectively). Similarly, mean visual analogue scale scores by nurses was higher in the Suprapubic Aspiration group compared with transurethral catheterization (3 +/- 18 mm vs 43 +/- 25 mm, respectively). Conclusions In infants who are younger 2 months, Suprapubic Aspiration is more painful than transurethral catheterization. Health professionals should consider these differences when choosing a method for obtaining a urine sample from young infants.

Michael B. Heller - One of the best experts on this subject based on the ideXlab platform.

  • Use of portable ultrasound to assist urine collection by Suprapubic Aspiration
    Annals of Emergency Medicine, 1991
    Co-Authors: Robert F. Gochman, Raymond B. Karasic, Michael B. Heller
    Abstract:

    Study objective: To determine whether portable ultrasound can improve the success rate of Suprapubic Aspiration (SPA). Design: Patients were randomly assigned to either ultrasound or no ultrasound groups. In the ultrasound group, patients underwent SPA if ultrasound revealed urine in the bladder; if no urine was present, patients underwent catheterization instead of SPA. In the no-ultrasound group, SPA was attempted without ultrasound. All unsuccessful SPAs were followed by catheterization and measurement of urine volume. Setting: Children's hospital-based pediatric emergency department. Participants: Children less than 2 years old who required SPA. Interventions: Ultrasound versus no ultrasound. Results: Thirty-five patients were randomized to the ultrasound group, and 31 were randomized to the no-ultrasound group. SPA was successful in 79% of attempts in the ultrasound group compared with 52% in the no-ultrasound group (P = .04). The sensitivity and specificity of ultrasound were 90% and 86%, respectively. Conclusion: Portable ultrasound can significantly improve the success rate of SPA and limit nonproductive attempts at SPA. ?? 1991.

Vaz, Flávio Adolfo Costa - One of the best experts on this subject based on the ideXlab platform.

  • Infecção urinária em recém-nascido de termo: análise de fatores de risco
    Faculdade de Medicina Universidade de São Paulo - FM USP, 2000
    Co-Authors: Falcão, Mário Cícero, Leone, Cléa Rodrigues, D'andrea, Renata A. P., Berardi Roberta, Ono, Nilce A., Vaz, Flávio Adolfo Costa
    Abstract:

    OBJECTIVE: To analyze the correlation of risk factors to the occurrence of urinary tract infection in full-term newborn infants. PATIENTS AND METHODS: Retrospective study (1997) including full-term infants having a positive urine culture by bag specimen. Urine collection was based on: fever, weight loss > 10% of birth weight, nonspecific symptoms (feeding intolerance, failure to thrive, hypoactivity, debilitate suction, irritability), or renal and urinary tract malformations. In these cases, another urine culture by Suprapubic bladder Aspiration was collected to confirm the diagnosis. To compare and validate the risk factors in each group, the selected cases were divided into two groups: Group I - positive urine culture by bag specimen collection and negative urine culture by Suprapubic Aspiration, and Group II - positive urine culture by bag specimen collection and positive urine culture by Suprapubic Aspiration . RESULTS: Sixty one infants were studied, Group I, n = 42 (68.9%) and Group II, n = 19 (31.1%). The selected risk factors (associated infectious diseases, use of broad-spectrum antibiotics, renal and urinary tract malformations, mechanical ventilation, parenteral nutrition and intravascular catheter) were more frequent in Group II (p37,8ºC), perda de peso>10% do peso de nascimento, alterações do estado geral (recusa alimentar, ganho insuficiente de peso e hipoatividade) ou presença de malformações nefro-urológicas. Nesses recém-nascidos foi realizada punção suprapúbica para confirmação diagnóstica. Os recém-nascidos foram divididos em dois grupos, segundo o resultado das uroculturas: Grupo I (diagnóstico presuntivo de infecção urinária) e Grupo II (diagnóstico confirmado de infecção urinária), para avaliação dos fatores de risco pela análise do risco relativo. RESULTADOS: Foram estudadas 61 crianças (5,1% dos recém-nascidos de termo) - Grupo I n=42 (68,9%) e Grupo II n=19 (31,1%). Os fatores de risco avaliados (patologias infecciosas associadas, uso prévio de antibióticos, malformações nefro-urológicas, ventilação mecânica, nutrição parenteral e o uso de cateteres) foram mais freqüentes no Grupo II (p

  • Infecção urinária em recém-nascido de termo: análise de fatores de risco
    Universidade de São Paulo. Faculdade de Medicina, 2000
    Co-Authors: Falcão, Mário Cícero, Leone, Cléa Rodrigues, D'andrea, Renata A. P., Berardi Roberta, Ono, Nilce A., Vaz, Flávio Adolfo Costa
    Abstract:

    OBJETIVOS: Analisar a contribuição dos fatores de risco para a ocorrência de infecção urinária em recém-nascidos de termo. CASUÍSTICA E METODOLOGIA: Estudo retrospectivo (1997), incluindo recém-nascidos de termo com urocultura positiva por saco coletor. A indicação desta coleta foi baseada em: hipertermia (T>;37,8ºC), perda de peso>;10% do peso de nascimento, alterações do estado geral (recusa alimentar, ganho insuficiente de peso e hipoatividade) ou presença de malformações nefro-urológicas. Nesses recém-nascidos foi realizada punção suprapúbica para confirmação diagnóstica. Os recém-nascidos foram divididos em dois grupos, segundo o resultado das uroculturas: Grupo I (diagnóstico presuntivo de infecção urinária) e Grupo II (diagnóstico confirmado de infecção urinária), para avaliação dos fatores de risco pela análise do risco relativo. RESULTADOS: Foram estudadas 61 crianças (5,1% dos recém-nascidos de termo) - Grupo I n=42 (68,9%) e Grupo II n=19 (31,1%). Os fatores de risco avaliados (patologias infecciosas associadas, uso prévio de antibióticos, malformações nefro-urológicas, ventilação mecânica, nutrição parenteral e o uso de cateteres) foram mais freqüentes no Grupo II (pOBJECTIVE: To analyze the correlation of risk factors to the occurrence of urinary tract infection in full-term newborn infants. PATIENTS AND METHODS: Retrospective study (1997) including full-term infants having a positive urine culture by bag specimen. Urine collection was based on: fever, weight loss >; 10% of birth weight, nonspecific symptoms (feeding intolerance, failure to thrive, hypoactivity, debilitate suction, irritability), or renal and urinary tract malformations. In these cases, another urine culture by Suprapubic bladder Aspiration was collected to confirm the diagnosis. To compare and validate the risk factors in each group, the selected cases were divided into two groups: Group I - positive urine culture by bag specimen collection and negative urine culture by Suprapubic Aspiration, and Group II - positive urine culture by bag specimen collection and positive urine culture by Suprapubic Aspiration . RESULTS: Sixty one infants were studied, Group I, n = 42 (68.9%) and Group II, n = 19 (31.1%). The selected risk factors (associated infectious diseases, use of broad-spectrum antibiotics, renal and urinary tract malformations, mechanical ventilation, parenteral nutrition and intravascular catheter) were more frequent in Group II (