Articles: colic.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative study of the efficacy of lysine acetylsalicylate, indomethacin and pethidine in acute renal colic.
The aim of this study was to compare the analgesic efficacy of intravenous lysine acetylsalicylate 1.8 g, indomethacin 100 mg and pethidine 100 mg in acute renal colic in a randomized double-blind clinical trial. One hundred and fifty patients with acute renal colic were divided into three groups. The first group received lysine acetylsalicylate 1.8 g, the second group received indomethacin 100 mg and the third group received pethidine 100 mg. ⋯ Lysine acetylsalicylate was less effective than indomethacin and pethidine. It is concluded that intravenous indomethacin is an effective alternative to intravenous pethidine in the treatment of acute renal colic. Intravenous lysine acetylsalicylate is inferior to intravenous indomethacin in treatment of acute renal colic.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Comparison of intravenous ketorolac, meperidine, and both (balanced analgesia) for renal colic.
To compare the analgesic efficacy and safety of IV ketorolac, the only nonsteroidal antiinflammatory drug indicated for parenteral use in acute pain in the United States, with IV meperidine and with a combination of the two agents in renal colic. ⋯ IV ketorolac, alone or in combination with meperidine, was superior to IV meperidine alone in moderate and severe renal colic. Because many subjects in all three treatment groups received supplemental meperidine and because response to ketorolac alone cannot be predicted, clinicians may choose to initiate treatment with a ketorolac-meperidine combination.
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Infantile colic concerns about 10-30% of all newborns and has been defined as a condition characterized by paroxysmal episodes of unexplained full force crying for at least three days a week and continuing for one week or more in a thriving well-nourished infant. The disorder more likely occurs in the evening, without identifiable causes and resolves spontaneously by the fourth month of life. The several factors involved in the etiopathogenesis (food intolerance or allergy to cow's milk protein, intolerance to lactose, intestinal hyperperistalsis, neuro-hormonal immaturity, maternal anxiety and familial stress), make the management of infants with colics difficult. We propose a scoring system for the evaluation of colics in infants based on: 1) crying intensity and duration; 2) accompanying characteristics of crises (e.g. meteorism, family history for allergic disease, type of feeding, type of stools); 3) evaluation of parents' opinion of their infants' crying. Type of management is based on the score: a) crying that is unrelated to colics: treatments referred to specific diagnosis. b) crying that is related to colics but not severe: first and second step of management; c) crying that is related to colics and is severe: third step of management. ⋯ first step: pacifier, rocking, dull continuous background noise, hot water bottle on the abdomen, herbal tea, simethicone. Second step: pharmacological treatment and periodic controls. Pharmacological treatment include antispastic drugs (e.g. cimetropium bromide). Third step: dietary modification and/or pharmacological treatment: mothers of breast-fed infants are given a diet with no milk or products containing its proteins, or fish, or eggs. Infants who are not breast-fed receive soy milk and if symptoms continue soy milk is substituted with hydrolyzed casein milk formula. Pharmacological treatment include antispastic drugs (e.g. cimetropium bromide and in non responders dicyclomine hydrochloride). Dietary modifications appear more suitable than pharmacological treatment in resolving symptoms, since side effects of drugs have been described and our recent results indicate appropriate dietary modifications offer better results than pharmacological treatment in resolving crises. However, before interrupting dietary modifications and reintroducing cow's milk proteins, infant's tolerance to such proteins is tested. In any case because of the good prognosis and rapid regression of symptoms, dietary regimens or pharmacological treatment should only be applied if really necessary and for brief periods under medical supervision.
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Randomized Controlled Trial Comparative Study Clinical Trial
Single-dose intramuscular ketorolac versus diclofenac for pain management in renal colic.
A double-blind controlled study was designed to compare the effective- ness of a single intramuscular dose of 60 mg ketorolac with that of 75 mg diclofenac in the treatment of renal colic and to monitor side effects. Fifty-seven patients completed the study, 27 in the ketorolac group and 30 in the diclofenac group. Effectiveness of treatment was monitored by pain relief reported on a 4-point verbal scale at different time points. ⋯ Both groups had an equal 92% significant pain relief at discharge from the emergency department. Both drugs were well tolerated by the patients. Ketorolac therefore, seems as effective as diclofenac in the treatment of renal colic.