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Marc A. Benninga - One of the best experts on this subject based on the ideXlab platform.
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rectal examination in children digital versus transabdominal ultrasound
The Journal of Urology, 2013Co-Authors: Rosa Burgers, Tom P V M De Jong, Marc A. BenningaAbstract:Purpose: We investigate 2 diagnostic tests to assess the rectal filling state.Materials and Methods: The rectal filling state was assessed with transabdominal ultrasound or with digital rectal examination by 2 independent investigators in children with Urological problems before a scheduled diagnostic or surgical Urological Procedure. A dilated rectum filled with stool or large amounts of (usually) hard stool were both considered as a rectal fecal mass. All investigations were performed with the patient under general anesthesia. The kappa test was used to evaluate agreement between transabdominal ultrasound and digital rectal examination.Results: A total of 84 children (54 boys) with a median (p25–p75) age of 9.0 years (6.4–11) were eligible candidates. A rectal mass was found on transabdominal ultrasound and digital rectal examination in 32% and 41% of all children, respectively, with agreement between the 2 tests in 82.5%. Cohen's kappa showed good agreement of 0.62 (95% CI 0.45–0.79) between transabdom...
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899 Rectal Examination in Children: Digital Versus Transabdominal Ultrasound
Gastroenterology, 2012Co-Authors: Rosa Burgers, Tom P V M De Jong, Marc A. BenningaAbstract:Purpose: We investigate 2 diagnostic tests to assess the rectal filling state. Materials and Methods: The rectal filling state was assessed with transabdominal ultrasound or with digital rectal examination by 2 independent investigators in children with Urological problems before a scheduled diagnostic or surgical Urological Procedure. A dilated rectum filled with stool or large amounts of (usually) hard stool were both considered as a rectal fecal mass. All investigations were performed with the patient under general anesthesia. The kappa test was used to evaluate agreement between transabdominal ultrasound and digital rectal examination. Results: A total of 84 children (54 boys) with a median (p25‐p75) age of 9.0 years (6.4‐11) were eligible candidates. A rectal mass was found on transabdominal ultrasound and digital rectal examination in 32% and 41% of all children, respectively, with agreement between the 2 tests in 82.5%. Cohen’s kappa showed good agreement of 0.62 (95% CI 0.45‐0.79) between transabdominal ultrasound and digital rectal examination. The median (IQR) diameter of the rectum was 3.3 cm (2.8‐3.9) in children with a full rectum, and 2.5 cm (1.8‐2.8) and 2.0 cm (1.5‐2.2) in patients with a half filled and empty rectum, respectively. Conclusions: Transabdominal ultrasound is a noninvasive and reliable alternative to assess the rectal filling state, and might replace digital rectal examination in the evaluation of children with constipation.
Rosa Burgers - One of the best experts on this subject based on the ideXlab platform.
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rectal examination in children digital versus transabdominal ultrasound
The Journal of Urology, 2013Co-Authors: Rosa Burgers, Tom P V M De Jong, Marc A. BenningaAbstract:Purpose: We investigate 2 diagnostic tests to assess the rectal filling state.Materials and Methods: The rectal filling state was assessed with transabdominal ultrasound or with digital rectal examination by 2 independent investigators in children with Urological problems before a scheduled diagnostic or surgical Urological Procedure. A dilated rectum filled with stool or large amounts of (usually) hard stool were both considered as a rectal fecal mass. All investigations were performed with the patient under general anesthesia. The kappa test was used to evaluate agreement between transabdominal ultrasound and digital rectal examination.Results: A total of 84 children (54 boys) with a median (p25–p75) age of 9.0 years (6.4–11) were eligible candidates. A rectal mass was found on transabdominal ultrasound and digital rectal examination in 32% and 41% of all children, respectively, with agreement between the 2 tests in 82.5%. Cohen's kappa showed good agreement of 0.62 (95% CI 0.45–0.79) between transabdom...
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899 Rectal Examination in Children: Digital Versus Transabdominal Ultrasound
Gastroenterology, 2012Co-Authors: Rosa Burgers, Tom P V M De Jong, Marc A. BenningaAbstract:Purpose: We investigate 2 diagnostic tests to assess the rectal filling state. Materials and Methods: The rectal filling state was assessed with transabdominal ultrasound or with digital rectal examination by 2 independent investigators in children with Urological problems before a scheduled diagnostic or surgical Urological Procedure. A dilated rectum filled with stool or large amounts of (usually) hard stool were both considered as a rectal fecal mass. All investigations were performed with the patient under general anesthesia. The kappa test was used to evaluate agreement between transabdominal ultrasound and digital rectal examination. Results: A total of 84 children (54 boys) with a median (p25‐p75) age of 9.0 years (6.4‐11) were eligible candidates. A rectal mass was found on transabdominal ultrasound and digital rectal examination in 32% and 41% of all children, respectively, with agreement between the 2 tests in 82.5%. Cohen’s kappa showed good agreement of 0.62 (95% CI 0.45‐0.79) between transabdominal ultrasound and digital rectal examination. The median (IQR) diameter of the rectum was 3.3 cm (2.8‐3.9) in children with a full rectum, and 2.5 cm (1.8‐2.8) and 2.0 cm (1.5‐2.2) in patients with a half filled and empty rectum, respectively. Conclusions: Transabdominal ultrasound is a noninvasive and reliable alternative to assess the rectal filling state, and might replace digital rectal examination in the evaluation of children with constipation.
Tom P V M De Jong - One of the best experts on this subject based on the ideXlab platform.
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rectal examination in children digital versus transabdominal ultrasound
The Journal of Urology, 2013Co-Authors: Rosa Burgers, Tom P V M De Jong, Marc A. BenningaAbstract:Purpose: We investigate 2 diagnostic tests to assess the rectal filling state.Materials and Methods: The rectal filling state was assessed with transabdominal ultrasound or with digital rectal examination by 2 independent investigators in children with Urological problems before a scheduled diagnostic or surgical Urological Procedure. A dilated rectum filled with stool or large amounts of (usually) hard stool were both considered as a rectal fecal mass. All investigations were performed with the patient under general anesthesia. The kappa test was used to evaluate agreement between transabdominal ultrasound and digital rectal examination.Results: A total of 84 children (54 boys) with a median (p25–p75) age of 9.0 years (6.4–11) were eligible candidates. A rectal mass was found on transabdominal ultrasound and digital rectal examination in 32% and 41% of all children, respectively, with agreement between the 2 tests in 82.5%. Cohen's kappa showed good agreement of 0.62 (95% CI 0.45–0.79) between transabdom...
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899 Rectal Examination in Children: Digital Versus Transabdominal Ultrasound
Gastroenterology, 2012Co-Authors: Rosa Burgers, Tom P V M De Jong, Marc A. BenningaAbstract:Purpose: We investigate 2 diagnostic tests to assess the rectal filling state. Materials and Methods: The rectal filling state was assessed with transabdominal ultrasound or with digital rectal examination by 2 independent investigators in children with Urological problems before a scheduled diagnostic or surgical Urological Procedure. A dilated rectum filled with stool or large amounts of (usually) hard stool were both considered as a rectal fecal mass. All investigations were performed with the patient under general anesthesia. The kappa test was used to evaluate agreement between transabdominal ultrasound and digital rectal examination. Results: A total of 84 children (54 boys) with a median (p25‐p75) age of 9.0 years (6.4‐11) were eligible candidates. A rectal mass was found on transabdominal ultrasound and digital rectal examination in 32% and 41% of all children, respectively, with agreement between the 2 tests in 82.5%. Cohen’s kappa showed good agreement of 0.62 (95% CI 0.45‐0.79) between transabdominal ultrasound and digital rectal examination. The median (IQR) diameter of the rectum was 3.3 cm (2.8‐3.9) in children with a full rectum, and 2.5 cm (1.8‐2.8) and 2.0 cm (1.5‐2.2) in patients with a half filled and empty rectum, respectively. Conclusions: Transabdominal ultrasound is a noninvasive and reliable alternative to assess the rectal filling state, and might replace digital rectal examination in the evaluation of children with constipation.
Alain Lozniewski - One of the best experts on this subject based on the ideXlab platform.
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The Brief Case: An Unusual Cause of Infective Endocarditis after a Urological Procedure
Journal of Clinical Microbiology, 2018Co-Authors: Kévin Diallo, Janina Ferrand, François Goehringer, Christine Selton-suty, Thierry Folliguet, Corentine Alauzet, Alain LozniewskiAbstract:KEYWORDS Actinotignum schaalii, endocarditis, urinary tract infection, urinalysis, mass spectrometry, blood culture, infective endocarditis CASE A 63-year-old man who underwent transurethral resection of the prostate for benign prostatic hyperplasia presented to his primary care physician for fever and shortness of breath 3 weeks following the Procedure. He became apyretic with a moderate improvement of dyspnea after an empirical 7-day course of amoxicillin. Two weeks later, the patient underwent a colonoscopy for rectal bleeding, which revealed only hemorrhoids. One week later, he complained of increasing dyspnea. Cardiac ausculta-tion revealed an aortic diastolic murmur. Transthoracic echocardiography revealed a grade 3 aortic regurgitation and a vegetation of 2 by 2 cm on the tricuspid valve. Subsequently, the patient was admitted to the cardiology ward of the University Hospital of Nancy for infective endocarditis. He underwent tricuspid and aortic valve replacement with bioprosthetic valves because of acute heart failure. One of the three sets of blood cultures (Becton Dickinson, Le Pont de Claix, France) obtained at admission was positive for Gram-positive bacilli that grew in aerobic and anaerobic bottles after 64 and 37 h of incubation, respectively. After subcultures on tryptic soy agar with 5% sheep blood (TSS) (bioMérieux, Marcy l'Etoile, France) at 37°C in 5% CO 2 atmosphere, isolates were identified by the use of a Vitek mass spectrometry (MS) system (bioMérieux; database version 3.0) as Actinotignum schaalii (confidence level of Ն99.9%). A systematic examination of the urine, performed at admission, revealed the presence of 10 5 leukocytes/ml. Urine culture, performed using a nonselective chromogenic agar for nonfastidious uropathogens (UriSelect 4; Bio-Rad, Marnes-la-Coquette, France) and incubated at 37°C aerobically, yielded amoxicillin-susceptible Escherichia coli at 10 3 CFU/ml. In order to identify the potential portal of entry of A. schaalii, the urine sample obtained prior to antibiotic therapy and stored at 4°C in tubes with preservative (BD Vacutainer with buffered boric acid) for approximately 84 h was reinoculated on selective Columbia colistin and nalidixic acid (CNA) blood agar (bioMérieux) under anaerobic conditions at 37°C. After 48 h of incubation, A. schaalii was detected at 10 3 CFU/ml. Fresh valvular specimens taken during surgery were processed using standard methods and inoculated on Columbia agar with 5% sheep blood (COS), chocolate agar with PolyViteX (PVX), and TSS agar (bioMérieux) as well as into Schaedler broth supplemented with vitamin K (bioMérieux). All media were incubated at 37°C aerobi-cally (Schaedler broth), aerobically with 5% CO 2 (TSS, PVX), or anaerobically (COS). Gross examination of the tricuspid valve specimen confirmed the presence of a vegetation. Rare branched Gram-positive bacilli were seen on Gram stains of ground valvular Citation Diallo K, Ferrand J, Goehringer F, Selton-Suty C, Folliguet T, Alauzet C, Lozniewski A. 2018. The Brief Case: An unusual cause of infective endocarditis after a Urological Procedure. J Clin Microbiol 56:e01400-17.
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the brief case an unusual cause of infective endocarditis after a Urological Procedure
Journal of Clinical Microbiology, 2018Co-Authors: Kévin Diallo, Janina Ferrand, François Goehringer, Thierry Folliguet, Corentine Alauzet, Christine Seltonsuty, Alain LozniewskiAbstract:KEYWORDS Actinotignum schaalii, endocarditis, urinary tract infection, urinalysis, mass spectrometry, blood culture, infective endocarditis CASE A 63-year-old man who underwent transurethral resection of the prostate for benign prostatic hyperplasia presented to his primary care physician for fever and shortness of breath 3 weeks following the Procedure. He became apyretic with a moderate improvement of dyspnea after an empirical 7-day course of amoxicillin. Two weeks later, the patient underwent a colonoscopy for rectal bleeding, which revealed only hemorrhoids. One week later, he complained of increasing dyspnea. Cardiac ausculta-tion revealed an aortic diastolic murmur. Transthoracic echocardiography revealed a grade 3 aortic regurgitation and a vegetation of 2 by 2 cm on the tricuspid valve. Subsequently, the patient was admitted to the cardiology ward of the University Hospital of Nancy for infective endocarditis. He underwent tricuspid and aortic valve replacement with bioprosthetic valves because of acute heart failure. One of the three sets of blood cultures (Becton Dickinson, Le Pont de Claix, France) obtained at admission was positive for Gram-positive bacilli that grew in aerobic and anaerobic bottles after 64 and 37 h of incubation, respectively. After subcultures on tryptic soy agar with 5% sheep blood (TSS) (bioMerieux, Marcy l'Etoile, France) at 37°C in 5% CO 2 atmosphere, isolates were identified by the use of a Vitek mass spectrometry (MS) system (bioMerieux; database version 3.0) as Actinotignum schaalii (confidence level of Ն99.9%). A systematic examination of the urine, performed at admission, revealed the presence of 10 5 leukocytes/ml. Urine culture, performed using a nonselective chromogenic agar for nonfastidious uropathogens (UriSelect 4; Bio-Rad, Marnes-la-Coquette, France) and incubated at 37°C aerobically, yielded amoxicillin-susceptible Escherichia coli at 10 3 CFU/ml. In order to identify the potential portal of entry of A. schaalii, the urine sample obtained prior to antibiotic therapy and stored at 4°C in tubes with preservative (BD Vacutainer with buffered boric acid) for approximately 84 h was reinoculated on selective Columbia colistin and nalidixic acid (CNA) blood agar (bioMerieux) under anaerobic conditions at 37°C. After 48 h of incubation, A. schaalii was detected at 10 3 CFU/ml. Fresh valvular specimens taken during surgery were processed using standard methods and inoculated on Columbia agar with 5% sheep blood (COS), chocolate agar with PolyViteX (PVX), and TSS agar (bioMerieux) as well as into Schaedler broth supplemented with vitamin K (bioMerieux). All media were incubated at 37°C aerobi-cally (Schaedler broth), aerobically with 5% CO 2 (TSS, PVX), or anaerobically (COS). Gross examination of the tricuspid valve specimen confirmed the presence of a vegetation. Rare branched Gram-positive bacilli were seen on Gram stains of ground valvular Citation Diallo K, Ferrand J, Goehringer F, Selton-Suty C, Folliguet T, Alauzet C, Lozniewski A. 2018. The Brief Case: An unusual cause of infective endocarditis after a Urological Procedure. J Clin Microbiol 56:e01400-17.
Ghulam Nabi - One of the best experts on this subject based on the ideXlab platform.
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Population-based linkage of health records to detect Urological complications and hospitalisation following transrectal ultrasound-guided biopsies in men suspected of prostate cancer
World Journal of Urology, 2014Co-Authors: Dinesh Ganeswaran, Clare Sweeney, Fahad Yousif, S. Lang, C. Goodman, Ghulam NabiAbstract:Background Transrectal ultrasound-guided prostate biopsy is a common Urological Procedure with known complications. We determined the Urological complication and 30-day hospital admission rate in a population-based cohort using unique identifier and deterministic methodology of record linkage. Methods 715 men who underwent a transrectal ultrasound-guided biopsy in Tayside region of Scotland between April 2007 and September 2011 were identified from hospital records using their unique Community Health Index Number. Multiple hospital electronic databases (Central Vision, Insite, Wisdom, and TOPAS) and departmental-based resources (morbidity and mortality records, daily ward electronic records) were linked to estimate Urological complications (urinary tract infection, urinary retention, haematuria) and rates of hospital admission. Cross-validation of information was obtained by searching a drug dispensing information network and microbiology database for infective complications. The hospital admission rate was compared for two different prophylactic antibiotic regimens used during the study period. Results Of the 715 men who underwent transrectal ultrasound biopsy, 386 (53.9 %) were diagnosed with prostate cancer and 329 (46.1 %) were found to have benign histology. The hospital admission rate for Urological complications within 30 days of the Procedure for men without cancer was 1.95 % (14/715). The 30-day hospital admission rate was not different for different regimens of prophylactic antibiotics. There were 50 (6.99 %; 50/715) urine cultures requested to the microbiology department within 30 days of Procedures; out of which 20 (2.79 %; 20/715) were positive. Most of these were generated from general practice requests. Eight blood cultures obtained within the same period were all negative. Eleven patients (1.7 %) presented with urinary retention during the same period and required indwelling catheterisation. None of them had any surgical Procedure. Validation of electronic record linkage against telephonic questionnaires by specialist nurse showed a high reliability of the methodology (κ = 0.91). Conclusion High quality validated record linkage of cohort data in the present study using a unique identifier, protocol-based Procedure and antibiotic prophylaxis showed that hospitalisation following TRUS biopsies occurs in less than 2 % of patients. However, a significant number of patients report to primary care, and centrally held records based on coding alone could underestimate the true incidence of complications.