Risk Factors Associated with Urologic Intervention in Emergency Department Patients with Suspected Renal Colic.

Background: Whereas most patients with urolithiasis pass their stones spontaneously and require only symptomatic management, a minority will require urologic intervention.

Objective: Our primary objective was to confirm previously reported risk factors and to identify additional predictors of urologic intervention within 90 days, for emergency department (ED) patients with suspected renal colic.

Methods: We conducted a prospective cohort study of adult patients presenting to one of two tertiary care EDs with suspected renal colic over a 20-month period.

Normal renal sonogram identifies renal colic patients at low risk for urologic intervention: a prospective cohort study.

Introduction: Determining which patients with ureterolithiasis are likely to require urologic intervention is a common challenge in the emergency department (ED). The objective was to determine if normal renal sonogram could identify low-risk renal colic patients, who were defined as not requiring urologic intervention within 90 days of their initial ED visit and can be managed conservatively.

Methods: This was a prospective cohort study involving adult patients presenting to the EDs of a tertiary care centre with suspected renal colic over a 20-month period.

When guidelines don't guide: the effect of patient context on management decisions based on clinical practice guidelines.

Purpose: This study examines the influence of patient social context on physicians' adherence to clinical practice guidelines (CPGs).

Method: Expert emergency medicine (EM) physicians and novice physicians (EM residents) were surveyed using an Internet-based program between January and July of 2013. Participants were presented clinical cases and were asked to indicate if they would order or prescribe a specified test or treatment.

Acute allergic reaction due to the administration of fibrinolytic therapy for ST-segment elevation myocardial infarction: case report and discussion.

Although a rare phenomenon, acute allergic reactions to fibrinolytic and heparin therapy have been described in the literature. We report the case of a 63-year-old woman who experienced a severe anaphylactic reaction while undergoing fibrinolytic therapy with tissue plasminogen activator for an ST-segment elevation myocardial infarction. Overall outcome was successful, but patient morbidity was increased because of the reaction and the subsequent therapy administered.