Urology
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Multicenter Study Clinical Trial Controlled Clinical Trial
Hydrogel/silver ion-coated urinary catheter reduces nosocomial urinary tract infection rates in intensive care unit patients: a multicenter study.
Indwelling urinary catheters are the leading source of nosocomial urinary tract infections (NUTIs). The Bardex I.C. catheter is a hydrogel latex Foley catheter with a monolayer of silver metal applied to the inner and outer surfaces of the catheter. We investigated the Bardex I.C. catheter for its ability to decrease the NUTI rate in critical care units. ⋯ A trend toward a reduction in NUTIs with the use of the hydrogel/silver-coated catheter was noted in all intensive care units at each institution as shown by the unadjusted and adjusted catheter-associated infection rates. One hospital demonstrated a statistically significant reduction in NUTIs. However, statistical significance was not met when the results were adjusted. The cost analysis at one institution demonstrated cost savings with the use of the silver-coated catheter. Future analysis may require a double-blind, prospective-controlled study of longer duration to reach statistical significance.
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Clinical Trial
Value of diagnostic ultrasound in patients with chronic scrotal pain and normal findings on clinical examination.
Chronic scrotal pain is a frequent complaint. In many patients with scrotal pain, scrotal ultrasound is performed when the physical examination reveals no abnormalities. We evaluated the yield of scrotal ultrasound in patients with chronic scrotal pain and a normal physical examination. ⋯ Scrotal ultrasound has no diagnostic value in patients with chronic scrotal pain in whom the physical examinations and urinalyses are normal. A patient's history may suggest an extrascrotal cause of his pain.
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The Hydro-Jet technique has been used to cut various industrial materials. In the medical field, this technique has been successfully used for selective dissection of the parenchyma of organs such as the liver. Recently, this technique was successfully used for laparoscopic cholecystectomy in humans. We developed a new Hydro-Jet probe and a technique of Hydro-Jet dissection during laparoscopic nephrectomy (LN) in a porcine model and compared the results with those of conventional laparoscopy. ⋯ To our knowledge, we describe the first report of Hydro-Jet dissection for LN as an alternative to the conventional technique. The improved anatomic dissection may decrease complications. Moreover, shorter operating times were achieved, which may result in cost savings. Further studies in humans are necessary to investigate this technique.