38 research outputs found
Fate of indeterminate lesions detected on noncontrast computed tomography scan for suspected urolithiasis: a retrospective cohort study with a minimum follow-up of 15 months
No full textObjective: to investigate the fate of indeterminate lesions incidentally found on noncontrast computed tomography (NCCT) for suspected urolithiasis.Methods: aretrospective review of 404 consecutive cases of suspected urolithiasis was undertaken between May 2010 and April 2011. Data were collected for patient demographics, presence of calculus disease, and additional urologic or nonurologic pathologies and their clinical relevance. The indeterminate or suspicious lesions were followed up and the data were reviewed in September 2012.Results: in total, 404 patients underwent NCCT for renal colic (mean age, 50 years [range, 13-91 years]; 165 females). Minimum follow-up period was 15 months. Fifty-eight patients (14%) had ureteric, 85 (21%) had renal, and 39 patients (10%) had combined ureteric and renal stones. Noncalculus pathologies were found in 107 patients (26%). Sixty patients (15%) had indeterminate lesions. Of these patients, 6 required operative intervention, 35 had a benign diagnosis after further imaging and multidisciplinary team meeting, and 13 remained under surveillance after 1 year. Indeterminate pulmonary lesions (8 of 16) were the commonest lesions to remain under surveillance.Conclusion: NCCT is vital for the diagnosis of urolithiasis with a pick up rate of 45% and remains the standard of care. However, with incidental detection of potential malignant lesions, a significant minority will need close monitoring, intervention, or both. In our study, approximately one-third of these lesions either remained under surveillance or had intervention.</p
Samuel Coleridge-Taylor and his Violin sonata in D minor: a lost romantic
No full text(M.M.) -- Towson University, 2018[From Introduction]
There are few composers of African descent in the history of western classical music who have achieved memorable and long lasting success. The few names that are often recognized are French composer Chevalier de Saint-Georges (1745-1799), Polish violinist George Bridgetower (1778-1860), and American composer William Grant Still (1895-1978). Given the significance of his many contributions, composer Samuel Coleridge-Taylor (1875-1912) is a name that deserves to be added to this small, but significant list.
[...]this paper will compare the Sonata for Violin and Piano in D minor by Coleridge-Taylor to works by Dvořák. References will be made to Coleridge-Taylor's life and accomplishments, as well as include analysis of the works cited. Additionally, we will explore his connections to famous contemporary composers and performers, as well as provide references for the spirituals Coleridge-Taylor uses in a number of his other works. With this information as a starting point, we will then explore the Sonata in detail and highlight the many special features of this beautiful work. In its totality, this is a work that deserves more prominence in the repertoire in much the same manner that Coleridge-Taylor's entire career deserves more recognition by modern musical audiences.http://library.towson.edu/digital/collection/etd/id/6796
The Moravian Springplace Mission to the Cherokees
No full textIn 1801 the Moravians, a Pietist German-speaking group from Central Europe, founded the Springplace Mission at a site in present-day northwestern Georgia. The Moravians remained among the Cherokees for more than thirty years, longer than any other Christian group. John and Anna Rosina Gambold served at the mission from 1805 until Anna’s death in 1821. Anna, the principal author of the diaries, chronicles the intimate details of Cherokee daily life for seventeen years. Anna describes mission life and what she heard and saw at Springplace: food preparation and consumption, transactions pertaining to land, Cherokee body ornaments, conjuring, Cherokee law and punishment, Green Corn ceremonies, ball play, and matriarchal and marriage traditions. She similarly recounts stories she heard about rainmaking, the origins of the Cherokee people, and how she herself conversed with curious Cherokees about Christian images and fixtures. She also recalls earthquakes, conversions, notable visitors, annuity distributions, and illnesses. This abridged edition offers selected excerpts from the definitive edition of the Springplace diary, enabling significant themes and events of Cherokee culture and history to emerge. Anna’s carefully recorded observations reveal the Cherokees’ worldview and allow readers a glimpse into a time of change and upheaval for the tribe
29: Is Balloon Diltation Justified as Primary Modality of Treatment in the Management of Pelviureteric Junction Obstruction? 17 Years Experiencein a Single Centre
No full text1936 OUTCOME OF URETEROSCOPY FOR STONE DISEASE IN PATIENTS WITH BLEEDING DIATHESIS: RESULTS FROM A SYSTEMATIC REVIEW OF LITERATURE
No full textMedical expulsive therapy in adults with ureteric colic : a multicentre, randomised, placebo-controlled trial
No full textRP, KS, KSt, GMa, RT, JB, GMc, AM, MK, KG, and SM report grants from National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme during the conduct of the study.Background Meta-analyses of previous randomised controlled trials concluded that the smooth muscle relaxant drugs tamsulosin and nifedipine assisted stone passage for people managed expectantly for ureteric colic, but emphasised the need for high-quality trials with wide inclusion criteria. We aimed to fulfil this need by testing effectiveness of these drugs in a standard clinical care setting. Methods For this multicentre, randomised, placebo-controlled trial, we recruited adults (aged 18–65 years) undergoing expectant management for a single ureteric stone identified by CT at 24 UK hospitals. Participants were randomly assigned by a remote randomisation system to tamsulosin 400 μg, nifedipine 30 mg, or placebo taken daily for up to 4 weeks, using an algorithm with centre, stone size (≤5 mm or >5 mm), and stone location (upper, mid, or lower ureter) as minimisation covariates. Participants, clinicians, and trial personnel were masked to treatment assignment. The primary outcome was the proportion of participants who did not need further intervention for stone clearance within 4 weeks of randomisation, analysed in a modified intention-to-treat population defined as all eligible patients for whom we had primary outcome data. This trial is registered with the European Clinical Trials Database, EudraCT number 2010-019469-26, and as an International Standard Randomised Controlled Trial, number 69423238. Findings Between Jan 11, 2011, and Dec 20, 2013, we randomly assigned 1167 participants, 1136 (97%) of whom were included in the primary analysis (17 were excluded because of ineligibility and 14 participants were lost to follow-up). 303 (80%) of 379 participants in the placebo group did not need further intervention by 4 weeks, compared with 307 (81%) of 378 in the tamsulosin group (adjusted risk difference 1·3% [95% CI −5·7 to 8·3]; p=0·73) and 304 (80%) of 379 in the nifedipine group (0·5% [–5·6 to 6·5]; p=0·88). No difference was noted between active treatment and placebo (p=0·78), or between tamsulosin and nifedipine (p=0·77). Serious adverse events were reported in three participants in the nifedipine group (one had right loin pain, diarrhoea, and vomiting; one had malaise, headache, and chest pain; and one had severe chest pain, difficulty breathing, and left arm pain) and in one participant in the placebo group (headache, dizziness, lightheadedness, and chronic abdominal pain). Interpretation Tamsulosin 400 μg and nifedipine 30 mg are not effective at decreasing the need for further treatment to achieve stone clearance in 4 weeks for patients with expectantly managed ureteric colic.Peer reviewe
Short term urinary catheter policies following urogenital surgery in adults
No full textBackground
Urinary catheterisation (by the urethral or suprapubic routes) is common following urogenital surgery. There is no consensus on how to minimize complications and practice varies.
Objectives
To establish the optimal way to manage urinary catheters following urogenital surgery in adults.
Search strategy
We searched the Cochrane Incontinence Group specialised trials register (searched 30 May 2005) and the reference lists of relevant articles.
Selection criteria
Randomised and quasi-randomised trials were identified. Studies were excluded if they were not randomised or quasi-randomised trials of adults being catheterised following urogenital surgery.
Data collection and analysis
Data collection was performed independently by two of the review authors and cross-checked. Where data might have been collected but not reported, clarification was sought from the trialists.
Main results
Thirty nine randomised trials were identified for inclusion in the review. They were generally small and of poor or moderate quality reporting data on only few outcomes. Confidence intervals were all wide.
Using a urinary catheter versus not using one
The data from five trials were heterogeneous but tended to indicate a higher risk of (re)catheterisation if a catheter was not used postoperatively. The data gave only an imprecise estimate of any difference in urinary tract infection.
Urethral catheterisation versus suprapubic catheterisation
In six trials, a greater number of people needed to be recatheterised if a urethral catheter rather than a suprapubic one was used following surgery (RR 3.66, 95% CI 1.41 to 9.49).
Shorter postoperative duration of catheter use versus longer duration
In 11 trials, the seven trials with data suggested fewer urinary tract infections when a catheter was removed earlier (for example 1 versus 3 days, RR 0.50, 95% CI 0.29 to 0.87) with no pattern in respect of catheterisation.
Clamp and release policies before catheter removal versus immediate catheter removal
In a single small trial, the clamp-and-release group showed a significantly greater incidence of urinary tract infections (RR 4.00, 95% 1.55 to 10.29) and a delay in return to normal voiding (RR 2.50, 95% CI 1.16 to 5.39).
Authors' conclusions
Despite reviewing 39 eligible trials, few firm conclusions could be reached because of the multiple comparisons considered, the small size of individual trials, and their low quality. Whether or not to use a particular policy is usually a trade-off between the risks of morbidity (especially infection) and risks of recatheterisation
Extra-corporeal shock wave lithotripsy (ESWL) versus ureteroscopic management for ureteric calculi
No full text
