Podcasts about hematuria

Join Dr. Leor Arbel, Cullman Regional Medical Group's newest urologist, as she causes of blood in urine, also known as hematuria. Hematuria can indicate conditions like infection, stones, or even cancer. Dr. Arbel explains the importance of evaluation, what patients can expect during the diagnostic process, and how early detection can make a difference.

Hematuria remains one of the most common urologic diagnoses, estimated to account for over 20% of urology evaluations. Women with hematuria have been especially prone to delays in evaluation, often due to practitioners ascribing hematuria to a urinary tract infection (UTI) or gynecologic source, resulting in inadequate evaluation and delay in cancer diagnosis. In this episode, we will review the recently released joint guidance form the AUA and SUFU regarding microhematuria. What defines this condition? If a UTI is also diagnosed, does that end the investigation? And what are the 3 risk profiles for microhematuria? Listen in for details!

Host: Darryl S. Chutka, M.D. Guest: Aaron M. Potretzke, M.D. Today, we're airing a popular episode from Season 2 of Mayo Clinic Talks!  Happy Holidays! Microscopic hematuria, and less commonly gross hematuria, are conditions commonly seen by the primary care provider. Malignancy is the most ominous cause of hematuria. Fortunately, other causes are much more likely. Since this is a relatively common health condition, when should we investigate hematuria and what should the evaluation consist of? How do we evaluate a patient's risk for urinary tract malignancy? Dr. Aaron Potretzke, a urologist at Mayo Clinic, joins us to discuss these questions. Connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

Dr Faridul Islam discussed about investigations and management of Hematuria.

Melihat urine disertai darah saat pipis? Urine disertai darah disebut juga dengan Hematuria, yaitu kondisi yang ditandai dengan perubahan warna urine menjadi kecoklatan atau kemerahan akibat adanya darah yang tercampur urine. Meskipun tidak berbahaya, tapi kondisi ini bisa jadi tanda-tanda penyakit serius, loh! Yuk, cari tahu lebih dalam mengenai kencing berdarah di segmen #LihatMIKA hanya di official Youtube Mitra Keluarga!

This week Dr Faridul Islam is discussing a brief overview of hematuria including history taking.

Hosts: Carolyn McMakin, MA, DC Kim Pittis, LCSP, (PHYS), MT 00:19  Core Seminar Training in San Francisco 01:57  Take your time and listen 02:32  Scarring in the blood supply to the nerve 08:06  Patient medical terminology 10:08  Fundamentals 11:23  The cerebellum 14:59  Loin Pain Syndrome with Hematuria 18:53  Runners knee and other common misdiagnosis 27:55  Amygdala needa a time out 33:39  Undiagnosed Ehlers-Danlos 40:25  Numbness 40:47  How many sessions does it take? 44:44  FSM in the UK, Dublin, Polane, and Rome in 2024 50:53  Published Papers

A new Kidney360 study describes the association between the pre-vaccination microscopic hematuria or proteinuria and post vaccination gross hematuria.

Contributor: Aaron Lessen MD Educational Pearls: Tranexamic acid (TXA) is a common medication to achieve hemostasis in a variety of conditions Patients visiting the ED for gross hematuria (between March 2022 and September 2022) were treated with intravesical TXA 1 g tranexamic acid in 100 mL NS via Foley catheter Clamped Foley for 15 minutes Subsequent continuous bladder irrigation, as is standard in most EDs Compared with a cohort of patients visiting the ED for a similar concern between March 2021 and September 2021, the TXA patients had: A shorter median length of stay in the ED (274 min vs. 411 mins, P < 0.001). A shorter median duration of Foley catheter placement (145 min vs. 308 mins, P < 0.001) Fewer revisits after ED discharge (2.3% vs. 12.3%, P = 0.031) References 1. Choi H, Kim DW, Jung E, et al. Impact of intravesical administration of tranexamic acid on gross hematuria in the emergency department: A before-and-after study. Am J Emerg Med. 2023;68:68-72. doi:10.1016/j.ajem.2023.03.020 Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit, OMSII

Herkese merhabalar. Sporla yatıp sporla kalkan bir millet olma yolunda son hızla ilerlemeye devam ediyoruz. Özellikle spor ve sporcuya verilen değerin gün geçtikçe artmasında en büyük katkıyı kuşkusuz A milli kadın voleybol takımımız veriyor. Bu yazı vesilesiyle onlara da tekrardan büyük teşekkürü bir borç biliyor ve yazıma kaldığım yerden devam ediyorum. Giriş Voleybol takımımız başarıdan başarıya koşarken hemen hemen benzer tarihlerde Filipinler, Japonya ve Endonezya'nın ev sahipliğinde 2023 FIBA Dünya Kupası maçları oynandı. Milli takımımızın yer alamadığı turnuvada oldukça çekişmeli maçlar gerçekleştirildi. Şimdi sizleri yine bu turnuvada yer alan bir müsabakaya, Sırbistan ile Güney Sudan arasındaki maça götürmek istiyorum. Maçta Sırp basketbolcu Borisa Simanic rakip oyuncu ile ikili mücadele sırasında flank bölgesine dirsek darbesi aldı. Bir süre acı içinde yerde kalan Simanic oyuna devam edemedi. Hızlı bir şekilde hastaneye götürülen sporcunun durumunun ciddiyeti uzun uğraşlar ve takım doktorunun ısrarları doğrultusunda yapılan ileri tetkikler sonucunda daha da netlemişti. Simanic'in grade 5 renal travması vardı. Nefrektomi geçirdiği, operasyon sırasında 2 litreye yakın kan kaybının olduğu ve ciddi bir kan replasman sorunu da yaşadığı öğrenildi. Simanic korkunç bir spor travması yaşamıştı. Spor müsabakalarında çok da sık görmediğimiz,  en azından bu evrede karşılaşmadığımız renal travmayı gelin hep birlikte inceleyelim.  Sporcularda Renal Yaralanmalar Sporcularda görülen renal yaralanmalar hem travmatik hem de atravmatik mekanizmalarla meydana gelmektedir. Atravmatik mekanizma  genellikle yoğun egzersiz nedeniyle görülmektedir. Bu mekanizma sonrası sporcularda en sık gördüğümüz bulgular hematüri ve proteinüridir. Proteinüri genellikle renal hasar gelişmeden spontan düzelmektedir. Genellikle egzersize bağlı gelişmektedir​1​. Egzersize bağlı görülebilen bir diğer bulgu ise hematüridir. Altta yatan renal patoloji olmadığı sürece Hematuria tipik olarak 24-48 saat içinde düzelmektedir​2​. Travmatik böbrek yaralanmaları ise künt karın travması veya delici yaralanma sonucu ortaya çıkabilmektedir. Bu durumlarda en sık görülen bulgu mikroskobik hematüridir. İlişkili hipotansiyonun veya makroskopik hematürinin bulunmadığı durumlarda daha ileri görüntülemeye nadiren ihtiyaç duyulmaktadır​3​. Spor İlişkili Hematüri Bilinen bir travma olmadan egzersiz sırasında görülen hematüriye egzersize bağlı hematüri denilmektedir. Literatürde bu patoloji için kullanılan diğer isimler ise spor hematürisi, atletik psödonefrit ve stres hematürisi şeklindedir​4​. Egzersiz sonrasında sporcularda  ortaya çıkabilen hematüri sıklıkla futbol, boks gibi temaslı sporlarda görülmektedir. Ancak koşma, kürek çekme, yüzme gibi temassız sporlarda da ortaya çıkabilir. Hematüri şiddeti, egzersiz süresi ve  egzersiz yoğunluğuna göre değişebilmektedir. Egzersize bağlı hematürinin fiziksel aktivite sonrasında genellikle spontan düzelmesi beklenmektedir. Mikroskobik hematüri ise hem sporcularda hem de sporcu olmayan popülasyonda görülebilmektedir. Genel olarak asemptomatik mikroskobik hematüri prevalansı, popülasyonun yaş ve cinsiyetine bağlı olarak %0,19'dan %21'e kadar değişebilmektedir​5​.   Sporcularda bildirilen prevelans genellikle daha yüksektir. Özellikle yüzücüler ve atletizm sporcularında ortalama %80 oranında hematürinin görülebildiği yapılan birçok çalışmayla gösterilmiştir​4​. Sporla ilişkili olduğu belirlenen asemptomatik mikroskobik hematüride, egzersiz veya spor katılımının kısıtlanmasına gerek yoktur.  Ancak altta yatan böbrek hastalığı ve böbrek fonksiyon bozukluğu saptanan  sporcuların ise tedavi süresince spor müsabakalarına katılmaması sağlanmalı ve böbrek fonksiyonları yakından takip edilmelidir​6​. Spor İlişkili Proteinüri Egzersiz sırasında böbrek fonksiyonunda meydana gelen fizyolojik değişiklikler proteinüri, hematüri, böbrek kan akışında azalma ve glomerüler filtrasyon hızında azalmaya neden...

When there's blood in the water… Work-up hematuria with confidence.  Learn what you should be worrying about, what tests are worth considering, and how to figure out if this is a job for a urologist or nephrologist. Claim free CME for this episode at https://curbsiders.vcuhealth.org! Credits Producer and writer: Paul Williams, MD, FACP Show Notes, Infographic, and Cover Art: Paul Williams, MD, FACP  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Derek Fine, MD

07/13/2023 | Hematuria

Kay Schaefer joins TWiP to solve the case of the German Male with Hematuria, and discusses Tropical Medicine Excursions, which provides patient-oriented training courses for healthcare professionals who wish to improve their clinical skills in tropical medicine and travelers' health in the endemic regions of Uganda, Tanzania and Ghana. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Guest: Kay Schaefer Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join MicrobeTV Discord server TROPMEDEX Letters read on TWiP 214 Become a patron of TWiP Case Study for TWiP 214 Still in Uganda but now in a clinic in Entebbe. A boy, less than age 10, who grows up in very limited conditions, dirt floor home with other siblings presents with recurrent right upper abdominal pain, fevers, and first undergoes blood work that shows eosinophilia. He has an abdominal ultrasound performed which shows what looks like a mobile piece of spaghetti in the gallbladder with dilated ducts. He also has a stool examination performed. Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

01/12/2023 | Hematuria

It's not unusual to be taken by surprise when you see microscopic hematuria on urine dip results. The patients who end up with this as part of their presentation are often asymptomatic, and may even be giving you a urine sample for another reason – which can make chasing down the cause even more of a mystery. If you don't know where to start when it comes to determining the cause of microscopic hematuria, you're not alone. In this video, we will cover a high-level approach to investigating a finding of microscopic hematuria. We will go over the workup for microscopic hematuria, and lots more: ✅ What is the difference between microscopic and macroscopic hematuria?✅ When a urine dip is enough, and when you need to send the sample out✅ What white blood cells and protein in the sample can tell you✅ Essential history and symptom questions to ask✅ When to repeat the urine dip at another timeHaving a simple framework for approaching the sometimes mysterious microscopic hematuria will increase your confidence and help you to take the best care of your patients. Getting to the root cause of microscopic hematuria is another critical part of taking great care of the patients you work with. If you liked this post, also check out:Your Urology Questions - Answered!Treating Patients With Symptoms Of Recurrent UTIDysuria in Primary Care for New Nurse Practitioners -----------------------Don't forget to grab your free Ultimate Resource Guide for the New NP at https://www.realworldnp.com/guideSign up for the Lab Interpretation Crash Course: https://www.realworldnp.com/labs Grab your copy of the Digital NP Binder: https://www.realworldnp.com/binder------------------------Come follow along for even more tips and inspiration:InstagramFacebook______________________________Please note: This episode is intended only for medical providers and students learning to be medical providers. While anyone is welcome to view and listen, for legal and safety reasons, we are unable to diagnose, treat, or answer medical questions for individuals through this channel. We always refer individuals back to their primary care providers for medical care.If you're a medical provider or student and have specific patient cases you have questions about, I cannot answer those here but would love to help you inside our mentorship program! Join the waitlist at https://www.realworldnp.com/mentoring. _______________________________© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details. Hosted on Acast. See acast.com/privacy for more information.

10/24/2022 | CT Evaluation of Hematuria: A Practical Approach - Part 4

10/17/2022 | CT Evaluation of Hematuria: A Practical Approach - Part 3

Fei and Nick discuss the work up and differential for microscopic hematuria. When exactly do you need to send someone for work up? Who is at risk for urologic malignancy? Listen to find out.  Also, SMFM will be emailing out a survey about education preferences. If you respond, you will be entered into a drawing for 10 prizes, five of which is a free registration for SMFM!  Twitter: @creogsovercoff1 Instagram: @creogsovercoffee Facebook: www.facebook.com/creogsovercoffee Website: www.creogsovercoffee.com Patreon: www.patreon.com/creogsovercoffee You can find the OBG Project at: www.obgproject.com

10/10/2022 | CT Evaluation of Hematuria: A Practical Approach - Part 2

10/03/2022 | CT Evaluation of Hematuria: A Practical Approach - Part 1

Locución: Mayra Carrillo y el Doctor Miguel Ángel Ochoa Producción: Irene Mora Sistema Jalisciense de Radio y Televisión Edición: Lupita Jiménez visita: www.jaliscoradio.com

Episode 105: Renal Cell Carcinoma. Manpreet and Jon-Ade explain how to diagnose renal cell carcinoma. Introduction about age and kidney transplant by Dr. Arreaza and Dr. Yomi. Introduction: Too old for a new kidney?By Hector Arreaza, MD. Discussed with  Timiiye Yomi, MD.Today we will be talking about the kidneys, those precious bean-shaped organs that detoxify your blood 24/7. Amazingly, we can live normal lives with one kidney, but when the kidney function is not good enough to meet the body's demands, patients need to start kidney replacement therapy. Modern medicine has made a lot of advances with dialysis, but the perfection of a kidney has not been outperformed by any machine yet. That's why kidney transplant is the hope for many of our patients with end-stage kidney disease.The need for a kidney transplant is growing, likely due to increasing chronic diseases such as diabetes and hypertension, and also because of an increase in elderly population. About 22% of patients on the kidney transplant waiting list are over age 65. A cut-off age to receive kidney transplant has not been established across the globe. Different countries use different criteria for the maximum age for transplant. The American Society of Transplantation's guidelines states “There should be no absolute upper age limit for excluding patients whose overall health and life situation suggest that transplantation will be beneficial.” So, if your patient is older than 65 and needs a kidney, they may qualify for a transplant, and age should not be an absolute contraindication to receive it. Actually, older patients may have lower risk of rejection due to a theoretically weaker immune system. A live donor is likely to be a better option for elderly patients. A condition that would make your elderly patient a poor candidate for kidney transplant would be frailty. Common contraindications to kidney transplant include active infections or malignancy, uncontrolled mental illness, ongoing addiction to substances, reversible kidney failure, and documented active and ongoing treatment nonadherence.So, remember to take these factors into consideration when deciding if you need to refer your elderly patients for a kidney transplant, there is no such thing as being too old for a new kidney if your patient meets all the criteria for a transplant.This is Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care physician for additional medical advice. Renal Cell Carcinoma. By Manpreet Singh, MS3, Ross University School of Medicine, and Jon-Ade Holter, MS3 Ross University School of Medicine. Moderated by Hector Arreaza, MD. Definition:Renal cell carcinoma is a primary neoplasm arising form the renal cortex. 80-85 percent of renal tumors are renal cell carcinomas followed closely by transitional cell renal cancer and Wilms tumor.  Epidemiology: In 2022, 79,000 new cases of kidney cancer were diagnosed with almost 14,000 mortalities. There is a 2:1 male to female ratio and the average age is 64 and normally 65-74. African Americans and American Indians have a higher prevalence rate compared to other racial groups. The lifetime risk for developing kidney cancer in men is about 1 in 46 (2.02%) and 1 in 80 (1.03%) in women.  Risk Factors associated with RCC: Anything that causes assault to the kidneys and affects its function would cause increased demand, injury, and inflammation. This assault can lead to cell derangement and lead to cancer. The risk factors that have been associated with RCC are smoking, obesity, HTN, family history of kidney cancer, Trichloroethylene (a metal degreaser used in large manufacturing factories), acetaminophen, and patients with advanced kidney disease needing dialysis. Patients with syndromes that cause multiple types of tumors: VHL (von Hippel-Lindau) deficiency, a tumor suppressor, gives rise to clear cell renal cell carcinoma. Familial inheritance of VHL deficiency is mostly found in patients that have RCC at a very young age, before 40 y/o. Other tumors can be found in the eye, brain, spinal cord, pancreas, and pheochromocytomas.Hereditary leiomyoma-renal cell carcinoma due to FH gene mutations causing women who have leiomyomas to have a higher risk of developing papillary RCC.Birt-Hogg-Dube (BHD) syndrome mutation in FLCN gene who develop various skin and renal tumors.Cowden syndrome is a mutation in the PTEN gene giving rise to cancers associated with breast, thyroid , and kidney cancers.Tuberous sclerosis causes benign tumors of the skin, brain, lungs, eyes, kidneys, and heart. Although kidney tumors are most often benign, occasionally they can be clear cell RCC. Screening For RCC:Screening is unnecessary because of the low prevalence of this cancer in the general population, though certain groups require annual repeat imaging via US, CT, or MRI. Inherited conditions that are associated with RCC such as VHL syndrome or Tuberous SclerosisESRD patients who have been on dialysis for 3-5 yearsFamily history of RCCPrior kidney irradiation Clinical Picture: Most patients with RCC are asymptomatic until cancer grows large enough to cause disruption of local organs, such as the kidney, bladder, or renal vein, and dysregulates other organs via metastasis. Therefore, it's important to look at other signs and symptoms caused by RCC.  The patient most likely will be an older male who presents with the classic triad of: Flank pain: caused by rapid expansion and stretching of the renal capsule.Hematuria: occurs from the invasion of the neoplasm into the collecting duct.Palpable abdominal mass: mass tends to be homogenous and mobile with respirations. Though this presents only in 9% of patients during the presentation, having physical symptoms is a sign of advanced disease and 25% of patients with these signs tend to have distant metastasis.  Anemia: normally associated with anemia of chronic disease. It precedes the disease by at least 8 months to 1 year. Males can develop varicoceles because of decreased emptying due to neoplasm obstruction. Patients normally develop varicoceles on the left due to the spermatic vein emptying in the higher resistance left renal vein, which causes backup of the blood in the pemphigus plexus. Though a right-sided varicocele should raise a higher suspicion of obstruction due to the spermatic vein draining directly into the IVC which is lower in resistance. A right-sided varicocele is seen in approximately 11 percent of patients. The paraneoplastic syndrome can also arise from RCCEpo: Erythrocytosis with symptoms of weakness, fatigue, headache, and joint pain.PTHrP: PTH-related peptide acts like PTH which gives rise to hypercalcemia with the prevalent symptoms of arthritis, osteolytic lesions, confusions, tetany, ventricular tachycardia, shortened QTc, and nausea and vomiting.Renin: overproduction from the juxtaglomerular cells can cause disarrangement of the RAAS system causing hypertension.Others also like ACTH and beta-HCG. Other disorders present include hepatic dysfunction, cachexia, secondary amyloidosis, and thrombocytosis. Workup If a patient comes in with painless hematuria, then the first test should be abdominal CT or abdominal ultrasound. A CT is more sensitive than the US but it can quickly indicate if the abdominal mass felt can be a cyst or a solid tumor.  US of kidneys should show if it's a simple cyst:-The cyst is round and sharply demarcated with smooth walls- It's anechoic – appears solid black-There is a strong posterior wall echo-Use the Bosniak classification to classify mass  Bosniak I: benign simple cyst with thin wall less than equal to 2mm, no septa or calcifications. No future workup is needed. Bosniak II: benign cyst, 3 cm diameter, requires f/u with US/CT/MRI at 6 months, 12 months, and annually for the next 5 years. Chance of malignancy: 5%.  Bosniak III: indeterminate cystic mass with thick, irregular or smooth walls. This requires nephrectomy or radiofrequency ablation. Chance of malignancy: 55%  Bosniak IV: Clearly a malignancy its grade III with enhancing soft tissue components that its independent from the wall or septum. Requires total or partial nephrectomy. Chance of malignancy 100%.  CT of the kidneys for a neoplasm should show:-Thickened irregular walls or septa -Enhancement after contrast injection are suggestive of malignancy-CT can also help detect invasion in local tissue areas such as renal vein and perinephric organs  MRI is used if the patient cannot use contrast or kidney function is poor. MRI can also evaluate the growth of the cancer. Other imaging studies:Other imaging studies that may be useful for assessing for distant metastases include bone scan, CT of the chest, magnetic resonance imaging (MRI), and positron emission tomography (PET)/CT. Treatment and staging Nephrectomy, partial or total, will be used as the initial tissue collection for pathology. If the patient is not a surgical candidate, you can also obtain a percutaneous biopsy. The nephrectomy is preferred because first, it serves as a definitive treatment option, but also it allows for definitive staging of the cancer with tumor and nodal staging. Regardless of the size, any solid mass may indicate malignancy and point towards RCC, requiring resection.   TNM staging Stage I: Tumor is 7cm across or smaller and only in the kidney with no lymph nodes or distant mets. T1N0M0 Stage IIa: Tumor size is larger than 7cm but still in the kidney but no invasion of lymph node or mets. T2N0M0 Stage IIb: Tumor is growing into the renal vein or IVC, but not into neighboring organs such as adrenals or Gerota's fascia and still lacks lymph node invasion and mets. T3N0M0.  Stage III: Tumor can be any size but has not invaded outside structures such as adrenals, though nearby lymph node invasion is present but not distant. There is no distant mets. T3N1M0. Stage IV:  The main tumor is beyond the Gerota's fascia and may grow into the adrenal gland . It may or may not spread to the lymph nodes or may not have distant mets. Stage IV also consists of any cancer that has any number of distant mets. T4 Adjuvant therapy can be done with immune therapy. Conclusion: Now we conclude our episode number 105 “Renal cell carcinoma.” This type of cancer may be asymptomatic until it is large enough to cause symptoms. Keep it on your list of differentials on patients with hematuria, flank pain, weight loss, and abnormal imaging. Keep in mind the features of simple kidney cysts vs complex cysts when assessing kidney ultrasounds. Your patient will be grateful for an early diagnosis of RCC and a prompt treatment. Even without trying, every night you go to bed being a little wiser.This week we thank Hector Arreaza, Timiiye Yomi, Manpreet Singh, Jon-Ade Holter. Thanks for listening to Rio Bravo qWeek Podcast. If you have any feedback, contact us by email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. Audio edition: Suraj Amrutia. See you next week!  Bibliography: Is There a Cut Off Age for Kidney Transplant?, Mayo Clinic Connect, Jul 18, 2017, https://connect.mayoclinic.org/blog/transplant/newsfeed-post/is-there-a-cut-off-age-for-kidney-transplant/ Atkins, Michael. “Clinical Manifestations, Evaluation, and Staging of Renal Cell Carcinoma.” UpToDate, January 21. https://www.uptodate.com/contents/clinical-manifestations-evaluation-and-staging-of-renal-cell-carcinoma American Cancer Society. “Key Statistics About Kidney Cancer”. Cancer.Org, 2022, https://www.cancer.org/cancer/kidney-cancer/about/key-statistics.html. Escudier B, Porta C, Schmidinger M, Rioux-Leclercq N, Bex A, Khoo V, Grünwald V, Gillessen S, Horwich A; ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol. 2019 May 1;30(5):706-720. doi: 10.1093/annonc/mdz056. PMID: 30788497. https://pubmed.ncbi.nlm.nih.gov/30788497/. Gaillard, F., Bell, D. Bosniak classification system of renal cystic masses. Reference article, Radiopaedia.org. (accessed on 20 May 2022) https://doi.org/10.53347/rID-1006. Kopel J, Sharma P, Warriach I, Swarup S. Polycythemia with Renal Cell Carcinoma and Normal Erythropoietin Level. Case Rep Urol. 2019 Dec 11;2019:3792514. doi: 10.1155/2019/3792514. PMID: 31934488; PMCID: PMC6942735. https://pubmed.ncbi.nlm.nih.gov/31934488/. Leslie SW, Sajjad H, Siref LE. Varicocele. [Updated 2022 Feb 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448113/. Maguire, Claire. “Understanding Endoscopic Ultrasound and Fine Needle Aspiration.” Educational Dimension, Educational Dimensions, 1 Jan. 2007, educationaldimensions.com/eLearn/aspirationandbiopsy/eusterm.php. Maller, V., Hagir, M. Renal cell carcinoma (TNM staging). Reference article, Radiopaedia.org. (accessed on 20 May 2022) https://doi.org/10.53347/rID-4699. Palapattu GS, Kristo B, Rajfer J. Paraneoplastic syndromes in urologic malignancy: the many faces of renal cell carcinoma. Rev Urol. 2002 Fall;4(4):163-70. PMID: 16985675; PMCID: PMC1475999. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1475999/.

July Live podcast – Mindfulness, blood in urine, and hormone Q&A I quote from this book: https://amzn.to/3JhCfie Better Sex Through Mindfulness by Lori Brotto I talk about mindfulness What is Hematuria? Hormone Q&A 1) Breast Cancer and Hormones – Are Any Okay? I've been having issue getting sexually aroused and having an orgasm. 2) My mom is 79 with osteoporosis, she stopped her hormone therapy 20 years ago. Can she restart? 3) I'm going to talk to my doctor about HRT… I've been having hot flashes so bad! It's awful! I'm wondering what exactly I should ask for? 4) What risks do oral estrogen have? 5) Thoughts about Premarin? See you in the membership! www.kellycaspersonmd.com/membership

Therapeutic fashion and conduction system pacing, early rhythm control in AF, statins in CKD, and salt intake in HF are the topics discussed by John Mandrola, MD, in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I – Therapeutic Fashion and Conduction System Pacing - Medical Necessity vs Therapeutic Fashion: How Evidence-Based Is Your Field of Medicine? https://www.medscape.com/viewarticle/977358 - Conduction System Pacing Noninferior to Biventricular Pacing for HF With Wide QRS https://www.medscape.com/viewarticle/971740 - His Corrective Pacing or Biventricular Pacing for Cardiac Resynchronization in Heart Failure https://www.jacc.org/doi/full/10.1016/j.jacc.2019.04.026 II – Early Rhythm Control - Benefit of Early Rhythm Control Questioned in Newly Diagnosed Atrial Fibrillation https://www.medscape.com/viewarticle/977584 - Presenting Pattern of Atrial Fibrillation and Outcomes of Early Rhythm Control Therapy https://doi.org/10.1016/j.jacc.2022.04.058 - Early Rhythm-Control Therapy in Patients with Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMoa2019422 III – Statins and CKD - Rosuvastatin Again Linked With Risks to Kidneys https://www.medscape.com/viewarticle/977646 - Association of Rosuvastatin Use with Risk of Hematuria and Proteinuria https://doi.org/10.1681/ASN.2022020135 - Atorvastatin in Patients with Type 2 Diabetes Mellitus Undergoing Hemodialysis https://www.nejm.org/doi/10.1056/NEJMoa043545 - Rosuvastatin and Cardiovascular Events in Patients Undergoing Hemodialysis https://www.nejm.org/doi/full/10.1056/nejmoa0810177 IV – Sodium and HF - Overly Tight Sodium Restriction May Worsen HFpEF Outcomes https://www.medscape.com/viewarticle/977441 - Salt restriction and risk of adverse outcomes in heart failure with preserved ejection fraction https://heart.bmj.com/content/early/2022/06/07/heartjnl-2022-321167 - Spironolactone for Heart Failure with Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/nejmoa1313731 - Reduction of dietary sodium to less than 100 mmol in heart failure (SODIUM-HF): an international, open-label, randomised, controlled trial https://doi.org/10.1016/S0140-6736(22)00369-5 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

In this VETgirl online veterinary continuing education podcast, we interview Dr. Margie Scherk, DVM, DABVP on all things lower urinary tract in our feline patients! What do we do with our FLUTD / FIC cases? What do we do when we see cats presenting with these clinical signs, and is antimicrobial therapy warranted? Should I do a urinalysis on these feline patients, and what's the diagnostic approach to hematuria in cats?

A 40-year-old man with no past medical history presents to the clinic to establish care. He reports that he had a prior urinalysis that revealed blood as an incidental finding. The urinalysis was done as a standard screening test by his former employer. He denies ever seeing any blood in his urine and denies any voiding difficulties, dysuria, sexual dysfunction, or any history or risk factors for sexually transmitted diseases (STDs). His review of systems is otherwise negative. He has smoked a half-pack of cigarettes per day for the past 10 years and exercises by jogging 15 minutes and lightweight training daily.    On examination, his vital signs are normal and the entire physical examination is unremarkable. A complete blood count (CBC) and a chemistry panel (electrolytes, blood urea nitrogen [BUN], and creatinine) are normal. The results of a urinalysis done in your office are specific gravity, 1.015; pH 5.5; leukocyte esterase, negative; nitrites, negative; white blood cell count (WBC), 0; red blood cell count (RBC), 4 to 5 per high-power field (HPF).    Be sure to listen until the end when I will be presenting four questions with multiple choice answers and check back on Friday to the May's Anatomy Podcast instagram page for the answers!    Case Files: Family Medicine   To try my absolute favorite CBD product line from Cured Nutrition, use code "MAY10" at checkout for 10% off your entire order or simply click the link here Cured Nutrition   If you're interested in consuming slow-release caffeinated vanilla or matcha lattes, or if you're a coffee drinker who wants a little more collagen and protein in their diet, use code "MAY15" at checkout for 15% off your entire order or simply click the link here Strong Coffee   Use my WearFigs code to get a $20 gift card on purchases of $100+ http://fbuy.me/ofl13   For nursing tips, my experiences, and more musings on the show, follow our Instagram @_maysanatomy or follow my personal account  @mayyazdi   This is an Operation Podcast production. chase@operationpodcast.com

Invitados: Dra. Albertina Liendo / Internista. Explica todo sobre los trastornos del sueño y cómo poder mejorar esto para tener mejor calidad de vida. Dr. Ricardo Soto-Rosa/ Urólogo. Nos cuenta sobre la Hematuria (sangre en la orina) y conoceremos todos los orígenes y consecuencias de padecerlo. Todo sobre el Eclipse y Mercurio Retrógrado con Iliana Strubinger y Jose Tarot Las noticias de la semana en el mundo con Beatriz Galindo. En la conducción junto a Efraín Cruz estarán Verónica Oliveros y Yered Castro. FUERA DE LUGAR VENEZUELA

Dr. Moumita Barua and Dr. Sarah Gagliano Taliun summarize the results of their study "GWAS of Hematuria," on behalf of their colleagues.

In this podcast, Dr. Kim Thielen, a nephrologist/kidney specialist with Minnesota Kidney Specialists joins us today to continue part 2 of our discussion on acute kidney injury, as we wade further "into the weeds"  discuss intrinsic renal disease. This episode will break down hallmark urinary findings and further subdivide intrinsic concerns into bland, nephrotic and nephritic, various causes, and treatment. Enjoy the podcast! Objectives:   Upon completion of this podcast, participants should be able to: State the 3 types of urinary analysis findings related to instrinic acute kidney injury. Describe etiology of presentation of each type of intrinsic acute kidney injury. CME credit is only offered to Ridgeview Providers & Allied Health Staff for this podcast activity. Complete and submit the online evaluation form, after viewing the activity.  Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within approximately 2 weeks. You may contact the accredited provider with questions regarding this program at  rmccredentialing@ridgeviewmedical.org. To receive continuing education credit for this activity - click the link below, to complete the activity's evaluation. CME Evaluation (**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.)  DISCLOSURE ANNOUNCEMENT  The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition; and are property/rights of Ridgeview Medical Center & Clinics.  Any re-reproduction of any of the materials presented would be infringement of copyright laws.  It is Ridgeview's intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker's outside interest may reflect a possible bias, either the exposition or the conclusions presented. Ridgeview's CME planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event. Thank-you for listening to the podcast. SHOW NOTES: *See the attachment for additional show information.  Intrinsic Kidney Injuries: Urinary analysis findings- Bland Urine: no protein - Nephrotic: protein - Nephritic: protein and blood Hallmark Urinary Findings: Casts - Tamm Horsfall Protein : Mucoprotein made by tubular epithelial cells that precipitate out and congeal    to form casts on whatever is in the cells at the time.  (i.e. RBCs, WBCs, tubular debris) Bland Urine States- Crystalline Induced Renal Injury: obstruction and infllamatory response       - Uric Acid Neuropathy (Most common)              - Cancers, lymphomas, etc.              - Drugs: acyclovir, methotrexate, protease inhibitors, etc.              - Toxins: Ethylene glycol - Bland Urine Disease states: results from injury to tubules, instertim or pre glomerular blodd vessels, not    the filters of the kidney       - Interstital Nephritis              - Hallmark: pyuria and WBC casts                      - Biopsy: inflammatory infiltrate              - Causes:  viral, PPIs, Adenover, mizalamin, etc., Checkpoint inhibitors       - Acute Tubular Necrosis              - Hallmark: tubular epithelial cell cast                      - Granular: (course or fine) diagnostic of ATN              - Biopsy: denuded dilated tubular cells              - Causes: #1: Ischemia;  toxins, drugs, contrast dye;  pigment injury. myoglobin              - What about contrast dye?                      - Categorized under ATN                      - Per Dr. Thielen, plays a role, but injury is not solely dependent on dye alone.       - Hepatorenal Syndrome: ischemic injury to the kidney due to unopposed vasocontstriction               - Ace inhibitors cause unopposed efferent vasoconstriction + nonsteroidals cause                 unposed afferent vasoconstriction = no glomerular perfusion pressure       - Multiple Myeloma              - Hallmark: Light chain cast nephropathy or myeloma kidney                      - Light chains precipitate  out causing obstruction, inflammatory response and causes                        tubular damage              - Presentation: older possibly with anemia, bone pain and elevated creatinine with a bland urine.              - Protein to creatinine ratio: + for protein (non albumin)              - Dipstick: (which measures for albumin and not light chains) will be negative for protein aka                 bland urine       - Hypertensive Nephrosclerosis              - Small vessel vascular disease                     - Blood vessels prematurely atherosclerosis causing glomerular drop out and scarring of the                        interstim       - Scleroderma                - Limited cutaneous systemic sclerosis                - Diffuse cutaneous systemic sclerosis: 60-80% have renal injury from disease state itself                           - FANA positive                           - Concern for Scleroderma Renal Crisis = medical emergency                                   - AKI, moderate to severe HTN and bland urine                                   - Uncontrolled accumulation of collage, thickens vascular walls, narrowing and renal                                       ischemia                          - Occurs in 10-15% of those with Diffuse Cutaneous Systemic sclerosis and happens early                              in disease                                     - Left untreated: renal failure in 1-2 months and death in 1 year                          - Treatment: ACE Inhibitor Nephrotic Urine States - Urine protein: albumin excretion greater than 3.5g in 24 hours - Nephrotic Syndrome:      - Present with 3 things (nephrotic range protein, hypoalbuminemia, peripheral edema)       - Hyperlipidemia: due to increased hepatic lipogenesis                - Increased risk of renal disease and arthroscleratic       - Venous thrombotic disease:                 - Loose proteins other than albumin and develop a hypercoagulale state                 - Renal and peripheral venous thrombosis      - Lipiduria (forms fatty casts,  looks like a latese cross under microscope)  -Pathophysiology or nephrotic syndrome    - Glomerular capillary wall           - 3 layers that work as a glomerular filtration and responsible in the filtration between blood and             urine                  - Fenestrated Capillary Enothelial cells (fenestrations allow plasma through to the basement                     membrane)                 - Glomerular Basement Membrane (maintains glomerular filtration barrier; negatively charged,                     repels albumin)                 - Epithelium: Podocytes (Have highly specialized foot processes that connect and form slit                     diaphragms; Slit diaphragm important for the efficient flow of small solute and water)          - Anything that messes with any of these layers: nephrotic proteinuria - Nephrotic Disease States:     - Biopsy: anyone with nephrotic proteinuria (besides diabetics)          1) Light microscopy: high overview          2) Immunofluorescens: looks for nephritic component and identif immunce complexes          3) Electron microscopy: (EM) helps look at the ultrastructure and better identify immune deposits    - Diabetic nephropathy           - Leading cause of kidney disease in U.S. and western society           - Responsible for 30-40% of all ESRD causes           - Hyperglycemia: produces inflammatory responses, oxidative stress, and injures the podocytes and             deposits that charge and affect the ability of the kidney to filter.     - Amyoidosis            - Organize into betapleted sheets and produce spikes of the capillary uniion and poke through the               GF membrane            - Easily identified by apple green birefringence on congo red            - Terminal illness            - Present with HTN, cardiac effects and elevated creatine  - Nephrotic Disease states based of histologic appearance      - Diagnosed by histologic appearance but does not determine the etiology      - Minimal Change Disease              - Fairly common              - Minimal change under light microscope              - EM: podocytes are abnormal, fused, no unique cell-cell junction              - Primary: Immune generated circulating facture;  alters the cytoskeleton of the podocytes       - Secondary               - Nonsteriodal - most common cause of secondary minimal change disease               - Gama interferon               - Hodgkin's lymphoma               - Allergy: 30% of minimal change have associate allergy (mechanism unknown)       - Presentation               - Sudden onset (days to weeks)               - Marked edema and hypoablbuminemia               - 60% have normal blood pressure,    82% have normal creatinine - Focal Segmental Glomerulosclerosis (FSGS) - primary and secondary         - Most common cause idopathic nephrotic syndrome in adults        - Primary glomerulonephritis in the US that causes ESRD        - Widespread podocyte injury     - Primary: circulating factor that messes with regulation of foot process and adhesion to the         glomerular basement membrane (afffect all podocytes)          - Present with nephrotic syndrome and rapid progression          - HTN and elevated creatinine    - Secondary: the visceral epithelial cells don't replicate          - Nephron loss or obesity or direct foot process injury          - Cannot replicate (podocytes), leads to decreased to podo denisty at specific areas (focal injury)          - 2/3 of all cases FSGS          - Present: with slowly increasing proteinuria and kidney impairment over time          - Causes: interferon, bisphosphonates, talc, anabolic steroids    - Genetics: gene mutations that encode for the slit diaphragms of the podocytes (affect all podocytes)            - Present in Childhood: full blown nephrotic and progress rapidly to ESRD Membranous Nephropathy - Most common cause of nephrotic syndrome in caucasion adults - 80% present with nephrotic but develops more slowly to ESRD - Primary: Major antigen identified      - antibody to trans-membrane receptor that is highly expressed on the glomerular podocyte - Secondary: Cancers (lung, breast, GI), Lupus, Thyroiditis, Hep B, Syphilis, Nonsteroidals, Monoclonal    Antibodies Nephritic Syndrome - Hematuria and proteinuria    - Hematuria: blood from kidney or outside the kidney             - Outside the kidney: look the same             - Inside the kidney: dysmorphic red cells    - Present:             - Renal impairment for days to weeks             - Edmatous, HTN and look critically ill              - Vasculitis, sinusitis, oral ulcers             - Pulmonary renal syndrome: short of breath or hemoptysis             - Skin changes: bruising , bleeding, purpura             - Myalgias and arthritis     - Urine:             - Hallmark: red blood cell casts (polymorphic red cells)             - dipstick + for blood             - elevated proteinuria    - Biopsy: nephritic and + urine Nephritic Disease States (based on immunofluorescence staining) - Pauci Immune Disease         - Ankle vasculitis, common         - A paucity (little amount) of immune complexes         - See black on imaging         - Lab work: check on ANCA and peripheral eosinophils - Anti-GBM Disease         - Renal limited, or classic pulmonary renal: Good Pasture's          - linear staining of the glomerular basement with anti IGG (looks like a ribbon on a package)          - Treat with cytotoxic agents - Immune Complex          - Starry sky pattern          - Glomerulus looks dotted with stars                - Stars = immune complex definition          - Diseases:  Lupus (FANA), Post Infectious GN, Membranous Proliferative GN  - IGA Nephropathy           - Most common cause of glomerulonephritis in the world          - Presentation:                 - Peak incidence is the 2nd and 3rd decades of life                - 40-50% gross hematuria with upper respiratory and GI illness          - Risk Factors for Progression:                - younger age or hypertension at time of presentation                - > 1g proteinuria                - Elevated creatinine at time of presentation Thanks for listening.

We talk with Dr. Shahrokh Shariat, chairman of Urology at the Medical University of Vienna, about diagnosis and management of upper tract urothelial carcinoma (UTUC) as well as differing AUA and EAU approaches to these malignancies. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/OVNyKk --- SHOW NOTES In this episode of BackTable Urology, Dr. Aditya Bagrodia and Dr. Shahrokh Shariat, chairman of Urology at the Medical University of Vienna, about diagnosis and management of upper tract urothelial carcinoma (UTUC) as well as differing AUA and EAU approaches to these malignancies. First, the doctors discuss common history and physical examination findings of patients with UTUC. Hematuria is the the most common sign, followed by flank pain and hydronephrosis. 10-15% of UTUC patients will also have Lynch syndrome, which is a condition that indicates a genetic predisposition to UTUC as well as other cancers. After initial hematuria workup, imaging of the upper tract and kidney must be obtained. Dr. Shariat obtains a CT urogram and an ultrasound for patients with suspected UTUC but waits until a tumor is identified to get a chest X-ray. Indirect signs of UTUC are: filling defects, thickening of the ureter wall, and hydronephrosis. Performing a ureteroscopy is the next step in UTUC patients. A ureteroscopy obtains adequate specimen for grading and reveals tumor behavior and location. A ureteroscopy can also be used as a therapeutic approach if kidney preservation is possible. Dr. Shariat uses a “no touch technique” in which he uses an access sheath to prevent tumor seeding. He prefers to use a flexible ureteroscope, a holmium laser, and a basket for collection. After ureteroscopy, he places a double J stent in his patients and waits for 6 weeks before taking a second look and starting alternating imaging, if needed. Surgical intervention may be required to treat non-metastatic UTUC. Dr. Shariat usually administers four rounds of neoadjuvant chemotherapy to his patient before operating. He recommends checking the patient's renal function to see if cisplatin-based therapy can be tolerated. Dr. Bagrodia and Dr. Shariat then compare the outcomes of cisplatin and carboplatin-based therapy. Next, Dr. Shariat shares his tips for segmented ureterectomy. Although this procedure is relatively uncommon, he advocates for careful closure, intraoperative chemotherapy, and clipping the ureter above and below the tumor to prevent seeding. To end the episode, the doctors discuss new UTUC therapeutic options, such as JELMYTO, a gel-based chemotherapy administered through a catheter. Finally, Dr. Shariat emphasizes once more that UTUC is a heterogenous cancer that requires multimodal therapy.

Today's Episode Today Dr. Suzanne Boyle reviews the case of a 22 year old male who presents with 3 days of "cola colored" urine. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? Crush Step 1 Step 2 Secrets Physiology by Physeo Step 1 Success Stories The InsideTheBoards Study Smarter Podcast The InsideTheBoards Podcast Study on the go for free! Download the Audio QBank by InsideTheBoards for free on iOS or Android. If you want to upgrade, you can save money on a premium subscription by customizing your plan until your test date on our website! Produced by Ars Longa Media To learn more about us and this podcast, visit arslonga.media. You can leave feedback or suggestions at arslonga.media/contact or by emailing info@arslonga.media. Produced by: Christopher Breitigan Executive Producer: Patrick C. Beeman, MD Legal Stuff InsideTheBoards is not affiliated with the NBME, USMLE, COMLEX, or any professional licensing body. InsideTheBoards and its partners fully adhere to the policies on irregular conduct outlined by the aforementioned credentialing bodies. The information presented in this podcast is intended for educational purposes only and should not be construed as professional or medical advice. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this podcast, Dr. Donna explores the strengths and the weaknesses of both conventional medicine and holistic medicine and how, in the perfect world, the two would be blended at every veterinary clinic to maximize successful outcomes for both acute and chronic conditions. When Knugget's person went to one conventional vet after another, because there was no infection, there was no answer for the dog. Faced with what to do next, she decided to try holistic medicine. Luckily, Dr. Donna has seen other cases like Knugget, young dogs with food allergies whose main reaction is severe and immediate blood in the urine. In one day after diet changes and herbal therapies, his urine became normal after weeks of looking like tomato soup. Please join us as we discuss the case in depth and please share. There is a Youtube video coming out tomorrow if you wish to see more including what the herbs look like. The short version: The diet, marshmallow root and yarrow tincture go a long way to treat the condition. --- Support this podcast: https://anchor.fm/donna943/support

Thanks for tuning in to the Armor Men's Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.In this segment, Dr. Mistry and Donna Lee discuss the causes of kidney and bladder cancer. Bladder cancer affects the stretchy, transitional cells of the bladder, which allow it to shrink and expand as bladders so wonderfully do. This transitional cell epithelium exists from the inside of the kidney, through the ureters, into the inner lining of the bladder and the first part of the urethra. Consequently, bladder cancer can actually exist anywhere from the kidney all the way down the ureters and even underneath the bladder. The number one symptom of bladder cancer is visible blood in the urine without any accompanying pain. Blood in the urine should always be treated as an alarming symptom and its cause identified. While it could be something like an infection or kidney stone, it could also be an indication of something much worse. Smokers or those exposed to cigarette smoke are at a higher risk of developing bladder cancer. If your doctor suspects you might be at risk for bladder cancer, a simple CT Scan can help them determine whether further testing, such as a cystoscopy, is necessary. When a tumor is found, it must be removed and examined under a microscope to determine how advanced the cancer is. Having cancer of the bladder makes you much more likely to develop cancer of the kidney, and vice versa. Once a cancer of this kind has been diagnosed, you will require careful monitoring for the rest of your life. If you or someone you love have recently seen or are currently seeing blood in your urine, with or without accompanying pain, please give us a call today!This episode previously aired on 10.23.21. Don't forget to like, subscribe, and share us with a friend! As always, be well!Check our our award winning podcast!https://blog.feedspot.com/sex_therapy_podcasts/https://blog.feedspot.com/mens_health_podcasts/Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.We enjoy hearing from you! Email us at armormenshealth@gmail.com and we'll answer your question in an upcoming episode!Phone: (512) 238-0762Email: Armormenshealth@gmail.comWebsite: Armormenshealth.comOur Locations:Round Rock Office970 Hester's Crossing Road Suite 101 Round Rock, TX 78681South Austin Office6501 South Congress Suite 1-103 Austin, TX 78745Lakeline Office12505 Hymeadow Drive Suite 2C Austin, TX 78750Dripping Springs Office170 Benney Lane Suite 202 Dripping Springs, TX 78620

Hematuria is subdivided into visible (gross) hematuria and microhematuria. Most cases of microhematuria are thankfully benign, but in some patients it may be a red flag (no pun intended) for something more ominous. What defines hematuria? Do all patients need urological referral? In the session, we will summarize and highlight one of the ABOG MOC articles (Jan 2022) which helps clear up the mystery of Hematuria.

Conversamos en mi espacio radial con la Dra. Katiuska Meléndez, nefrólogo pediatra, sobre: La hipercalciuria, una de las primeras causas de litiasis renal y hematuria en niños. La hipercalciuria se define como el aumento mantenido en la excreción urinaria de calcio. Puede ser idiopática, es decir, cuando se desconoce su causa, lo cual es relativamente raro en niños mayores de 6 años. Pero también existe la secundaria, que es la más común, y se debe a factores dietéticos como, por ejemplo: el exceso en la ingesta de sodio, azúcares y proteínas o baja ingesta de potasio. Las manifestaciones clínicas más frecuentes son: hematuria o sangre en la orina, disuria o ardor o dolor al orinar, polaquiuria que es la necesidad de orinar muchas veces en el día; dolor abdominal, urgencia miccional, enuresis nocturna o incontinencia urinaria, infección urinaria y urolitiasis. También pueden presentar retardo de crecimiento y osteopenia que no es más que la pérdida de mineral ósea. La Dra. Meléndez comenta que el tratamiento de primera línea es dietético: aumentar la ingesta de agua, restricción de alimentos salados y azucarados, limitar la ingesta de proteínas a los requerimientos recomendados y asegurar la ingesta de suficiente de frutas y hortalizas. Si quieres saber más … Disfruta de la entrevista completa y escucha mi programa de radio, A Tu Salud La Revista, todos los días de lunes a viernes, de 3 a 5pm, por la @LaRomantica889 en Caracas, en www.laromantica.fm y en las emisoras del interior del Circuito Romántico.

In the debut episode of Look Beneath the Surface: An Expert Dive into Alport Syndrome, Dr George Bakris is joined by Dr Joshua Zaritsky to discuss the link between inherited genetic defects and the inflammation and fibrosis that drive disease progression in Alport syndrome.

Thanks for tuning in to the Armor Men's Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.In this segment, Dr. Mistry and Donna Lee answer a listener question about microscopic hematuria. He asks: "Is it normal for microscopic blood to show in your urine when you get older? If the answer is no, could it be caused by Peyronie's disease?" Dr. Mistry explains that while microscopic hematuria, or small amounts of blood in the urine, always warrants investigation by a urologist, it is often benign. Visible blood in the urine, however, is worrisome, and it should be addressed as soon as possible. If you see blood in your urine but aren't experiencing any pain, your chances of receiving a cancer diagnosis are as high as 30%. To answer the listener's second question, hematuria is generally not caused by Peyronie's disease. Peyronie's disease is characterized by the development of a bend in the penis and/or an hourglass deformity. This condition may be caused by the slowly accumulating effects of microtrauma to the penis sustained during intercourse with a less-than-fully-erect penis, or even by severe, acute trauma. Scar tissue can develop along the penis shaft, causing the often painful and distressing changes associated with this incredibly common condition. If you think you may have Peyronie's disease, please see a urologist! And if you see blood in your urine, don't delay in seeking treatment. If you enjoyed today's episode, don't forget to like, subscribe, and share us with a friend! As always, be well!Check our our award winning podcast!https://blog.feedspot.com/sex_therapy_podcasts/https://blog.feedspot.com/mens_health_podcasts/Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.We enjoy hearing from you! Email us at armormenshealth@gmail.com and we'll answer your question in an upcoming episode!Phone: (512) 238-0762Email: Armormenshealth@gmail.comWebsite: Armormenshealth.comOur Locations:Round Rock Office970 Hester's Crossing Road Suite 101 Round Rock, TX 78681South Austin Office6501 South Congress Suite 1-103 Austin, TX 78745Lakeline Office12505 Hymeadow Drive Suite 2C Austin, TX 78750Dripping Springs Office170 Benney Lane Suite 202 Dripping Springs, TX 78620

In this episode of Look Beneath the Surface: An Expert Dive into Alport Syndrome, Dr George Bakris welcomes Dr Jochen Reiser for a close look at what COL4A genotyping can tell us about the course and impact of Alport syndrome for both patients and their families. Additional resources are available through the Alport Syndrome Foundation at alportsyndrome.org.

Thanks for tuning in to the Armor Men's Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.In this segment, Dr. Mistry and Donna Lee discuss the causes of kidney and bladder cancer. Bladder cancer affects the stretchy, transitional cells of the bladder, which allow it to shrink and expand as bladders so wonderfully do. This transitional cell epithelium exists from the inside of the kidney, through the ureters, into the inner lining of the bladder and the first part of the urethra. Consequently, bladder cancer can actually exist anywhere from the kidney all the way down the ureters and even underneath the bladder. The number one symptom of bladder cancer is visible blood in the urine without any accompanying pain. Blood in the urine should always be treated as an alarming symptom and its cause identified. While it could be something like an infection or kidney stone, it could also be an indication of something much worse. Smokers or those exposed to cigarette smoke are at a higher risk of developing bladder cancer. If your doctor suspects you might be at risk for bladder cancer, a simple CT Scan can help them determine whether further testing, such as a cystoscopy, is necessary. When a tumor is found, it must be removed and examined under a microscope to determine how advanced the cancer is. Having cancer of the bladder makes you much more likely to develop cancer of the kidney, and vice versa. Once a cancer of this kind has been diagnosed, you will require careful monitoring for the rest of your life. If you or someone you love have recently seen or are currently seeing blood in your urine, with or without accompanying pain, please give us a call today! Check our our award winning podcast!https://blog.feedspot.com/sex_therapy_podcasts/https://blog.feedspot.com/mens_health_podcasts/Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.We enjoy hearing from you! Email us at armormenshealth@gmail.com and we'll answer your question in an upcoming episode!Phone: (512) 238-0762Email: Armormenshealth@gmail.comWebsite: Armormenshealth.comOur Locations:Round Rock Office970 Hester's Crossing Road Suite 101 Round Rock, TX 78681South Austin Office6501 South Congress Suite 1-103 Austin, TX 78745Lakeline Office12505 Hymeadow Drive Suite 2C Austin, TX 78750Dripping Springs Office170 Benney Lane Suite 202 Dripping Springs, TX 78620

Speaker: Dr. Meghan Snuckel. Chief Medical Resident at UCONN. In this podcast, we will talk about an approach to hematuria, its causes, and recommended workup. Thank you for listening.

El cáncer de vejiga en sus etapas iniciales puede presentarse como Hematuria (sangre en la orina). Es por eso que si presentas Hematuria, debes acudir con un especialista para que se realicen los estudios para diagnóstico y tratamiento. medicooncologo.com Sígueme en mis redes sociales; Instagram: https://www.instagram.com/drfrancokrakaur/ Facebook: https://www.facebook.com/drfrancokrakaur/ Canal de Youtube: https://bit.ly/3hF5lsk Tik Tok: https://www.tiktok.com/@dr.francokrakaur?lang=es Spotify Podcast: http://spoti.fi/3bOm0Jd Sitio web. medicooncologo.com Whatsapp : +52 55 34 71 05 00 Amazon Author (Libros) : http://amzn.to/2MC1Uta

Guest: Aaron M. Potretzke, M.D. (@potretzke) Host: Darryl S. Chutka, M.D. (@ChutkaMD) Microscopic hematuria, and less commonly gross hematuria, are conditions commonly seen by the primary care provider. Malignancy is the most ominous cause of hematuria. Fortunately, other causes are much more likely. Since this is a relatively common health condition, when should we investigate hematuria and what should the evaluation consist of? How do we evaluate a patient's risk for urinary tract malignancy? Dr. Aaron Potretzke, a urologist at Mayo Clinic joins us to discuss these questions. Specific topics: Definition of hematuria Benign causes of hematuria Risk of malignancy in low, medium, and high-risk patients Stratifying malignancy risk in patients for genitourinary malignancy Recommended evaluation for patients with hematuria How to manage patients with persistent hematuria despite a negative evaluation Role of urine cytology in the evaluation of hematuria Additional resources: American Urological Association hematuria guideline and algorithm: https://www.auanet.org/guidelines/guidelines/microhematuria Connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

El Urólogo Arturo Rodríguez nos qué es la hematuria, qué hacer ante la presencia de glóbulos rojos o comunmente conocido como sangre en la orina, las causas ante una infección en las vías urinarias y el tratamiento adecuado.

S2D: The Symptom to Diagnosis Podcast presents case-based discussions of signs, symptoms, and diagnostics tests to improve clinical reasoning and evidence-based practice.Hematuria: A case that highlights that common things presenting in atypical ways are more common than uncommon things presenting typically.

Con la Dra. Tibisay Olivero - Sexóloga conversaremos sobre la Pedofilia y el movimiento MAP. El Dr. Ricardo Soto Rosa - Urólogo nos explicará todo sobre la hematuria y como puede afectar nuestra vida. El Horóscopo de la semana con los efectos del eclipse y mercurio retrógrado con Iliana Strubinger y José Aparicio. Las noticias de la semana con el reporte CIMA de Beatriz Galindo. Efraín Cruz estará acompañado en la conducción con Verónica Oliveros y Beba Vandenberg. FUERA DE LUGAR VENEZUELA

Hey everyone! Today we discuss the new AUA 2020 Hematuria guidelines. Merry Christmas/Happy Holidays!

November 24, 2020Happy Thanksgiving!Mark, Ray, and Scott discuss the Urology Advanced Coding and Reimbursement Seminar Agenda. Mark explains what we have included and why. Ray emphasizes that there are a lot of big changes this year that can lead to positive outcomes for urology practices.Here is the Agenda for the Upcoming Virtual Live Event: Friday 12/4/20Time (EST) | Topic10:00 AM | Welcome 2021 - Back to the Future10:30 AM | Globals and Modifiers Part 111:00 AM | Globals and Modifiers Part 2 OP note communication12:00 PM | Optimizing Patient Collections -Integrating system-wide solutions1:00 PM | Lunch: New Technology2:00 PM | Globals and Modifiers Procedural Scenarios3:00 PM | MIPS, MACRA, Medicare Updates4:00 PM | Operative Communications, Scheduling, Prior Auths - Break out share your processes5:00 PM | Compensation Trends - Private and Hospital-Based Saturday 12/5/20Time (EST) | Topic10:00 AM | Welcome 2021 - Back to the Future10:30 AM | E&M 202111:00 AM | E&M 2021 Continued, Transition, New Documentation Hints12:00 PM | Practice Operational Challenges and Lessons Learned1:00 PM | Lunch: Online Reputation Mgmnt Presentation2:00 PM | E&M 2021 Scenarios3:00 PM | Telemedicine Optimization - Rules, In Practice4:00 PM | Positioning the Practice for Sustainability - 2021 and beyond5:00 PM | ICD-10 - Update. Examples ICD-10: Hematuria, Bladder Ca, BPH, CaPUrology Advanced Coding and Reimbursement Seminar+ BundleLive Virtual EventDecember 4th and 5th, 202010am - 6pm EST Each DayLearn MoreJoin the discussion:Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom. Click Here to Start Your Free Trial of AUACodingToday.com

This episode covers hematuria!

Mark Litwin, MD, chair of Urology at the UCLA School of Medicine, discusses the evaluation of hematuria and also the presentation, diagnosis, and treatment of bladder cancer. Related Article(s): Bladder Cancer

Dr. Li Yang discusses findings from her study, "Prevalence of Kidney Injury and Associations with Critical Illness and Death in Patients with COVID-19," on behalf of her colleagues.

Dr. Li Yang discusses findings from her study, "Prevalence of Kidney Injury and Associations with Critical Illness and Death in Patients with COVID-19," on behalf of her colleagues.

#13. Neste episódio discuto amplamente sobre o tema hematúria, que é o nome técnico para sangramento na urina. Abordo todos as formas de sangramento e possíveis causas, assim como o raciocínio de investigação. Respondo às seguintes perguntas:- O que é hematúria e quando devo me preocupar?- O tipo de sangramento me ajuda no raciocínio diagnóstico?- Hematúria microscópica: abordagem- Hematúria macroscópica: abordagem- Que exames devo realizar?- Quando meu problema pode ser mais grave?Ouça e aprenda mais! Se gostar, compartilhe e não esqueça de deixar seu comentário e nota nas plataformas de Podcast. Isso ajuda a disseminar o conhecimento. Ouça também em meu site e deixe seu comentários, ficarei muito feliz em tirar suas dúvidas. Link to http://www.ourologista.com.br/podcast/episodio13

In this episode, I talk about the first things to think of when getting this consult, the broad differential of this complaint, evaluation steps, and course of management.

In this episode, I talk about getting a handle on this broad differential, things to look out for on history and physical, initial management, and when to send the patient to nephrology.

06/15/2020 | CT Evaluation of Hematuria: A Practical Approach Part 3

06/08/2020 | CT Evaluation of Hematuria: A Practical Approach Part 2

06/01/2020 | CT Evaluation of Hematuria: A Practical Approach Part 1

This week, Barry and Doctor Bottum discuss Hematuri. Hematuria is the presence of blood in a person's urine. The two types of hematuria are gross hematuria—when a person can see the blood in his or her urine and microscopic hematuria—when a person cannot see the blood in his or her urine, yet it is seen under a microscope. This podcast is hosted by ZenCast.fm

Urinary Retention The sun rises over the San Joaquin Valley, California, today is April 29, 2020. Clinica Sierra Vista’s CEO, Brian Harris, resigned from his position on April 24. We appreciate Brian’s leadership and enthusiasm. He brought positive changes to this institution, and we wish him a successful future. How many times have you checked UpToDate today? UpToDate is probably one of the most used point-of-care reference tools in the world. We’d like to recognize the work of Dr. Burton (Bud) Rose, the founder of UpToDate, who passed away on April 24. Thanks, Bud, for your contributions to the spreading of evidence-based medical knowledge. This week the media have been flooded by comments about “disinfectants”. A disinfectant is a chemical that destroys vegetative forms of harmful microorganisms (such as bacteria and fungi) especially on inanimate objects. President Trump discussed with experts the possibility of developing a “disinfectant” that can be injected to kill SARS-CoV2 inside the body. An official recommendation to “inject disinfectants” was not issued, but misinterpretations and countless remarks, comments, and jokes were made. Please make sure to tell your patients that common household disinfectants are for external use only.Quote: “Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.” Albert Einstein.Dear Residents, what are you good at?  What are your talents?  I invite you to explore those things you know how to do, and continue to perfect them, we are all geniuses. Today our guest is Dr. John Ihejirika. John is one of our second-year residents in the program. We ask 5 questions in this podcast. We’ll start with the first question.Question number 1: Who are you? My name is Dr. John Ihejirika. I am one of the second-year residents at the Rio Bravo Family Medicine Residency Program, here in Bakersfield California. I am originally from Nigeria. My last name was quite a battle for most of my colleagues/coworkers to pronounce at the beginning, but most have now figured out the almost perfect pronunciation, but some still call me Dr. “Ihe” or Dr. “I”, which is still ok, ha-ha. It is pronounced “E – hay- gi- ri- car” which in my local language literally means “What I have that makes me greater than you”.  I grew up in a very humble family and attended and graduated from the College of Medicine University of Nigeria after which I practiced for a few years in General practice especially in very low resource limited communities before immigrating to the United States. It was always my dream to further my Medical career in the US, so with lots of studying, effort, persistence, hopes and prayers I find myself here today in the mist of such a wonderful group of Residents and Faculty, and lucky to be in one of the best Family Medicine Residency Programs in the country. Some of my hobbies are cooking especially Nigerian dishes, playing soccer, traveling, meeting people of different cultures, and watching movies. I am very pleased to be here today and thank you for having me.Question number 2: What did you learn this week? What I learned this week was about the management of acute urinary retention (AUR). Acute urinary retention is defined as the inability to voluntary pass urine.  I had a 68 y/o male patient that came to the clinic as a walk-in for complaints of lower abdominal pain and constipation since the previous night. Upon further questioning, I realized that he had not urinated in over 12 hours, and physical examination revealed lower abdomen/suprapubic tenderness and distention. We were able to get about 1L of urine after straight catheterization in clinic with complete resolution of his symptoms. AUR is usually common in older men and etiologies may include (1) Outflow obstruction (most common) e.g. Benign prostatic hyperplasia BPH, (2) Neurologic impairment, e.g. damage of sensory or motor nerve supply to the detrusor muscle like in spinal cord injuries, demyelination syndromes or neuropathy, (3) Inefficient detrusor muscle, (4) Medications, e.g. anticholinergics, sympathomimetic and some muscle relaxants, (5) Infections, e.g. acute prostatitis, and 6. Trauma.    Evaluation of patients with AURInitial evaluation involves getting a thorough history and Physical examination which usually reveals a patient in discomfort with suprapubic tenderness and distention. We usually pass a 14-18 Fr urethral catheter (depending on degree of resistance) to decompress the bladder and note the amount and color of urine collected. If urinary output is less than 150ml, AUR is less likely.Urine samples should be sent for urinalysis and culture. Other labs like a Basal metabolic panel (BMP) to assess any possible damage to kidney from chronic retention. PSA is usually not ordered because it can be elevated in acute episodes of urinary retention. If the urinary output exceeds 400 mL, the catheter is usually left in place for about 3-5 days after which a voiding trial is done. If postvoid residual urine volume is >300ml or patient still has lower urinary tract symptoms after the voiding trial, the catheter is usually kept in place until evaluation by Urology.  MedicationsAn alpha-1-adrenergic blocker (tamsulosin) and 5-alpha reductase inhibitor (finasteride) medications are usually prescribed, and a referral to Urology is placed at the time of initial catheterization.        Contraindications of catheterizationUrethral catheterization may be contraindicated in patients who have had recent urologic surgery, trauma to or structurally abnormal urethral opening (meatus), or failed urethral catheterization even with the smallest 10 or 12 Fr catheters. These patients should be referred urgently to Urology for possible suprapubic catheterization.      Complications after drainage of urine with a catheter.Some complication can occur during bladder decompression, which may include; Hematuria (usually resolved spontaneously or with irrigation), transient hypotension and Post obstructive diuresis (which is usually seen in chronic urinary retention).Post obstructive diuresis.Postobstructive diuresis is defined as as urine output of 200 mL/hr for two consecutive hours or >3L/24hours. It is a polyuric response initiated by the kidneys after the relief of a ureteral obstruction to eliminate accumulated solute and volume(2). This can be managed by increasing fluid intake in patients who are unable to do so or have severe post-obstructive diuresis, we measure the urine output and replace one half the urine volume with half normal saline. For example, 1 litter of urine should be replaced with 500 mL of normal saline.             Summary of Management of AUR(4). Question number 3: Why is that knowledge important for you and your patients? Acute urinary retention is a very painful and uncomfortable situation for the patient, and It is the most common urologic emergency in men.  It is also important for patients as it may be the first sign of a prostate abnormality/enlargement like BPH, as some men may not have the classic signs and symptoms of lower urinary tract obstruction previously.  It is important for you as the provider because you should be able to look out for the signs in the history e.g. constipation, inability to voluntary urinate etc. and on physical examination for patients that may be presenting with AUR especially when working in an Urgent care or Emergency room.  It also provides a mutual sense of satisfaction to both patient and provider especially when a prompt diagnosis is made and with immediate relief of symptoms after bladder decompression. Question number 4: How did you get that knowledge?I got this knowledge from my faculty, Up to Date, Review/Journal articles and from some of my personal experience.Question number 5: Where did that knowledge come from? This knowledge came from one of our very knowledgeable faculty here Dr. Parker, An article titled “Urinary Retention in Adults: Evaluation and initial management” from the AAFP website; “The Management of acute urinary retention” from the American Journal of Medicine; and  “Acute urinary retention” review topic on Up-to-Date.  You can see our website for further details on theses references.Comment: Insertion of a urinary catheter needs to be learned. I recommend you guys review the technique and practice with your nurses how to place a Foley. Maybe we can have a workshop about catheter placement. It’s important to remember the size 14-18 Fr, you can use a larger one in case of BPH. ____________________________________Speaking Medical: Tumescence by Steven SaitoDuring our daily COVID updates we are given ways to relieve stress for our medical workers.  Today we were told that self-massage was a useful form of stress relief.  Back in the military, when they told me I could massage myself, they did not use as polite a phrasing.In keeping with the theme, the word of the day is tumescence. Tumescence is the quality or state of being tumescent or swollen. Tumescence usually refers to the normal engorgement with blood of the erectile tissues. Nocturnal penile tumescence is a spontaneous erection of the penis during sleep or when waking up. Along with nocturnal clitoral tumescence, it is also known as sleep-related erection. All men without physiological erectile dysfunction experience nocturnal penile tumescence, usually 3-5 times during a period of sleep, typically during rapid eye movement (REM) sleep.Nocturnal penile tumescence (NPT) testing can be used in diagnostic work up for erectile dysfunction. Monitoring devices are now available that provide accurate, reproducible information quantifying the number, tumescence, and rigidity of erectile episodes a man experiences as he sleeps. Nocturnal penile tumescence testing is generally performed when the clinician is trying to assess between psychogenic and organic erectile dysfunctions (ED). Typically, men with psychogenic ED will have normal NPT results. Physiologic ED will have impaired NPT results. Espanish Por Favor: Mal de Orínby Roberto VelazquezThe Spanish word for the week is “Mal de orín”, which is actually three words: Mal – de – orín, meaning: the disease of the urine, and obviously, people use this phrase when they have any urinary symptoms, most commonly: dysuria, urinary frequency, and/or foul-smelling urine. The scenario when your patient complains of “mal de orín” may sound: “Doctor, tengo mal de orín, y no dejo de ir al baño”, what they are trying to tell you is “Doctor, I have dysuria and I may have a UTI”. As temperatures continue to raise this summer, I recommend you assess your patient’s hydration status too. Highly concentrated urine may have a stronger smell and may be confused with “mal de orín”. Now you know the Spanish word of the week, “Mal de orín”, all you need to do is to assess your patient’s “mal de orín”. For your Sanity By Alejandra Felix (MA) and Monica Kumar (MD)Ale: My doctor told me to start killing people, well, not in those exact words, he told me to reduce stress in my life. Same thing. Ale: Doctor, I have a cucumber up my nose, a carrot in my left ear and a banana in my right ear, what’s the matter with me?Dr Kumar: Oh my, you are not eating properly!________________________Conclusion: Did you know that our In-Training Exam scores in 2019 were low in male reproductive medicine? That’s why our episode number 10 was filled with “manly” topics. Dr Ihejirika talked about Acute Urinary Retention, a condition that can be effectively diagnosed and treated, resulting in a relieved patient, a satisfied resident, and a proud attending. We stayed in the same anatomical area and remembered the word tumescence, and learned the Spanish phrase “Mal de orín” as a sign of possible UTI. At the end of the episode, our MA Alejandra was a little stressed. Don’t blame her, we had a long day in clinic.This is the end of Rio Bravo qWeek. We say good bye from Bakersfield, a special place in the beautiful Central Valley of California, United States, a land where growing is happening everywhere.If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. Our podcast team is Hector Arreaza, John Ihejirika, Golriz Asefi, Steven Saito, Roberto Velazquez, Monica Kumar, and Alejandra Felix. Audio edition: Suraj Amrutia. See you soon! ________________________References:Merriam-Webster Dictionary, https://www.merriam-webster.com/dictionary/disinfectantSingh, Amardeep and Bhagwan Dass, Cureus Journal of Medical Science, “Post-obstructive Diuresis: A Cautionary Tale”, December 8, 2019, https://www.cureus.com/articles/25149-post-obstructive-diuresis-a-cautionary-taleFitzpatrick JM, Kirby RS., Management of acute urinary retention. BJU Int. 2006;97 (suppl 2):16–20, discussion 21–22. https://www.amjmed.com/article/S0002-9343(09)00496-3/fulltext“Urinary Retention in Adults: Evaluation and initial management” by DAVID C. SERLIN, MD; JOEL J. HEIDELBAUGH, MD; and JOHN T. STOFFEL, MD, University of Michigan Medical School, Ann Arbor, Michigan, AAFP. 2018 Oct 15;98(8):496-503. https://www.aafp.org/afp/2018/1015/p496.htmlGlen W Barrisford MD, Graeme S Steele MD, “Acute urinary retention”, Up to Date.https://www.uptodate.com/contents/acute-urinary-retention?search=acute%20urinary%20retention&source=search_result&selectedTitle=1~88&usage_type=default&display_rank=1  

Hematuria is the diagnosis of blood in urine. Sometimes it can simply be seen as pinkish urine, but other times it can only be seen with a microscope. With hematuria, you may not have other symptoms, or you may feel pain. But, it is not normal to find blood in your urine, so it’s important to find the cause. Learn more on today's episode of the Urology Care Podcast about hematuria.

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2739056 not all guidelines are equal, think for yourself. Some guidelines even do harm when you actually look at the evidence. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2740207 doacs and surgery what do you do-- low risk surgery stop one day prior and start one day after surgery. with high risk surgery you stop two days prior and start two days after https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2747871?guestAccessKey=90abe76b-3a15-4b95-9b42-4f751c5fbe64&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=etoc&utm_term=081919 Pt in the hospital for a non-cardiac condition and they have a high bp== don't worry about it- no evidence for what one week of high bp will do but we do have evidence that starting medications while in an acute state will cause harm. just let it be!! https://ginasthma.org/wp-content/uploads/2019/04/GINA-2019-main-Pocket-Guide-wms.pdf GINA guidelines- budesonide formoterol prn OR SABA plus ICS prn for stage 1 or for stage two still budesonide formoterol prn OR scheduled ICS twice daily with prn SABA

Today on MedNet21, we're going to discuss Approach to Hematuria.

May is Bladder Cancer Awareness month. Bladder cancer is the 6th most commonly diagnosed cancer in the United States. 80,000 people will be newly diagnosed with bladder cancer this year, representing 5 % of all new cancer diagnoses in the United States.  I have covered the topic of superficial vs invasive bladder cancers a bit more in depth in episodes 37,38, and 39 of this podcast. We  http://whyurologypodcast.com/category/Bladder+Cancer

Hematuria is known as "Blood in the Urine" and it's a common issue in urology. We talked with Dr. Ben Ristau, a urologist with UConn Health, to learn more.

In this podcast, we will cover the combined committee opinion from the ACOG and AUGS regarding asymptomatic microscopic hematuria in women. The ACOG deviates from the American Urological Association recommendation for evaluation of asymptomatic microscopic hematuria in women over age 35, as the risk of any urological malignancy is very low. Data taken from the ACOG committee opinion 703, June 2017.

Host Brad Kearns shares the little known secret about Janet Jackson's racy lyrics in the song "If" that were imperceptible to the human ear when it was getting radio play in the 90s as a hit song. Horrors Casey Kasem! Brad talks about the overstimulation of the fight or flight response leading first to PRs and then to impending doom. A cool success story from James, who was running 14 min miles when starting MAF 3.5 years ago and now being able to hold the same pace at 52 beats per minute below MAF! How's your training gone over the past 3.5 years? Consider being patient and experiencing a significant reduction in your MAF pace, though not in a linear manner   96-year-old golfer WalterKearns.com getting some cameo props for his endurance in life. Jason Trew with a unique and creative way to stay below MAF while running faster spurts and then walking to keep watch from beeping. James Hall asks about the rationale of applying 180-age formula everyone, causing Brad to go off about his burnout experience followed by major medical misfortune in 2015 that he attributes strongly to a chronic training pattern where he routinely exceeded 180-age (by 12 beats in fact) due to using the inferior 75% of max heart rate calculation for an aerobic workout. Oh man, we talk about peeing blood and all kinds of stuff that will have you sorry you ever asked to increase MAF heart rate!! Enjoy this lively show with some memorable takeaway insights.

Episode 48: Dr. Robert Redfield Robert Redfield, MD, is an Assistant Professor in the Division of Transplantation in Department of Surgery here at U.W.—Madison, and holds the Endowed Chair, Berkman Family Transplantation Professorship. Dr. Redfield specializes in pancreatic and multi-organ transplants, along with autotransplantation. Dr. Kohler and Dr. Redfield discuss the rare disease, Loin Pain Hematuria and the treatment offered here at the University of Wisconsin. Dr. Redfield gave an illuminating Grand Rounds talk, which can be found here.

This podcast will cover Hematuria (microscopic and macroscopic) with etiology, diagnosis, and management! Disclaimer: The information presented in this blog is is for educational and informational purposes only. It should not be construed as medical advice; this is general information and is not patient specific. The information is not guaranteed to be correct, complete, or current. Credit to bensound.com for intro/exit music! I referred to pediatric care online and UpToDate for content.

02/26/2018 | Bloody Mess: Evaluation of Hematuria in the ER Patient Part 2

02/19/2018 | Bloody Mess: Evaluation of Hematuria in the ER Patient Part 1

November is National Bladder Health Awareness Month.  According to the Urology Care Foundation the cost of treating bladder problems in the United States is 70 Billion dollars annually. Nursing home costs due to urinary incontinence are estimated at 6 billion dollars annually.  Urinary tract infections create more than 8 million doctor visits every year (5.3 of those 8 million visits are women with infections, 1.3 and 1.2 of those 8 million are children and men respectively). Millions of Americans have neurogenic bladder – a lack of bladder control due to a brain, spinal cord or other nerve problem such as spinal cord injury, multiple sclerosis, Parkinson's disease, stroke, spina bifida, or nerve problems caused by diabetes or major pelvic surgery. An estimated 33 million adults in the U.S. may have overactive bladder. As if that weren't enough, here is a humbling statistic. More than 1 in 10 military service members injured in Afghanistan and Iraq have urologic trauma injuries, damaging the urinary tract or reproductive organs. In preparation for National Bladder Health Awareness Month today we are going to talk about bladder cancer. Although it doesn't make the newspapers much bladder cancer is the 5th most common non-skin cancer in the United States. It is the 4th most common cancer diagnosed in men and by the Veterans Affairs Health System. Nearly 600,000 Americans live with bladder cancer today and 75-80,000 people will be diagnosed in the United States with bladder cancer this year. An estimated 16-17,00 people will die from bladder cancer this year. According to the American Cancer Society bladder cancer is more common as a person grows older. 90% of patients with a new diagnosis of bladder cancer are over age 55, with the average age at diagnosis being 73 years old. Bladder cancer is three times more common in males than females. Whites are diagnosed with bladder cancer about twice as often as African or Hispanic Americans, but African-Americans present more commonly with advanced disease.   You are at risk for bladder cancer if you are over 55 years of age and you have one of the following five risk factors: 1. You smoke tobacco, either in the past or currently. Smoking tobacco may be the cause of half of all bladder tumors. If you need another reason to stop smoking if you are a smoker, please add bladder cancer to your list, 2. You are at risk for bladder cancer if you are exposed to chemicals in the workplace used to make plastics, paints, textiles, leather and rubber, 3. you have had prior pelvic radiation, 4. you have chronic urinary tract infections associated with neurologic disease and chronic catheterization and less commonly 5. you are a patient taking some medications linked with increasing bladder cancer risk such as the chemotherapy cyclophosphamide, the diabetes drug Actos, or dietary supplements containing aristolochic acid (mainly in herbs from the Aristolochia family). I have recently diagnosed patients with bladder cancer without significant risk factors other than age and gender. One gentleman I saw recently had come in for a routine follow up appointment for his enlarged prostate and elevated PSA number.  The day before his appointment, however, he had seen blood in his urine and mentioned it casually at the end of his appt. He was having no other symptoms. Urologists take blood in the urine very seriously.  Blood in the urine is the most common symptom of bladder cancer. When bleeding occurs because of bladder cancer it is generally painless, and is seen in the entire urine stream. If you see blood in your urine you should tell a healthcare provider so they can refer you to a urologist. Even if the blood goes away, you should still talk to your doctor about it. When you see blood in the urine, it is called "gross hematuria." Often, however, you cannot see the blood in your urine but it is detected by the laboratory with a microscope during routine checks of the urine such as during an annual physical exam. A very small amount of blood might be normal in some people and not lead to a medical condition, but ALL patients require evaluation when the amount of blood detected on the urinalysis is more than just a trace amount. Blood in the urine does not always mean that you have bladder cancer either. There are a number of other more common reasons why you may have blood in your urine: urinary tract infection, enlarged prostate or prostate infection, kidney or bladder stones, kidney disease, kidney trauma, or kidney cancer, blood thinning drugs and even a tough workout (what we call runner's hematuria) can cause blood in the urine. When blood is found in the urine, even if it's a small amount, you need to make sure there is not a tumor in the kidney or bladder, or a kidney stone or infection. We have to evaluate the kidneys, ureters, bladder, and the urethra to try to identify a source for the bleeding. A CT scan or ultrasound is ordered to look at the kidneys and ureters, with a CT scan with and without IV contrast dye being the recommended test in most cases. We can run a urine cytology or other bladder tests on the urine to see if there are changes that would indicate bladder cancer. But to evaluate specifically for bladder cancer, unfortunately, the best test is to actually look inside the bladder with a scope. We have to perform a cystoscopy, a procedure to look inside the bladder. A cystoscope is a thin flexible instrument that has a light and camera or fiberoptics at the end of it allowing us to see directly inside the bladder. To get into the bladder we have to pass the cystoscope through the urethra. Cystoscopy is done as an outpatient procedure in the clinic. The average cystoscopy takes just a minute or two. As you would expect the procedure is uncomfortable, and carries with it a small risk of infection from the introduction of the scope into the bladder. A cystoscopy is the most common procedure done in our office. There are many reasons we perform cystoscopy, to rule out cancer of course but also to evaluate the urethra, prostate, and bladder anatomy. Other symptoms of bladder cancer as well as many other urologic problems may include changes in urination. Frequent urination or pain when you pass urine called dysuria are less common symptoms of bladder cancer and often indicate other problems such as infection or overactive bladder. But to evaluate these symptoms more completely we will often perform cystoscopy, even if cancer is not suspected. Cancer is when your body cells grow out of control when the normal DNA instructions for cell growth are disrupted. Most cancers form a lump called a tumor. In the case of bladder cancer that growth occurs inside the bladder and we can visualize it directly with the scope. A review of anatomy is appropriate. The bladder is a hollow organ in the pelvis with flexible, muscular walls. The bladder is where the body stores urine before it leaves the body. The bladder can get bigger or smaller as it fills with urine and empties. When you go to the bathroom, the muscles in your bladder will contract. They then push urine out through a tube called the urethra. In addition to the muscular layer of the bladder the bladder wall has other layers, made up of different types of cells.  The inner lining is called urothelium lined by a special type of cells called transitional cells. Transitional cells are designed to make a transition are able to change shape from very bunched up and contracted when the bladder is empty to being very stretched out and thin when the bladder is full.  In a word, they “transition.” Because most bladder cancers start in the urothelium or transitional epithelium, bladder cancer is often called transitional cell carcinoma. Other types of bladder cancer exist but are much less common and include squamous cell carcinoma (cancer that begins in thin, flat cells lining the bladder) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids). Transitional cell carcinomas grow typically as a polypoid growth, with a stalk and are referred to as being papillary. A person with bladder cancer will have one or more tumors in the lining of the bladder that, if I would have to describe it, appear like mini cauliflower floret, or like a sea coral waving from the ocean floor. Bladder cancers attach to the bladder wall on the lining or the surface. That is called a non-invasive tumor. As the polyp grows it can begin to invade through the top most part, the transitional epithelium to the layers underneath. Bladder cancer gets worse when it grows into or through other layers of the bladder wall. The first layer it invades is a connective layer called the lamina propria. If the cancer begins to invade into the lamina propria layer it becomes a stage 1 cancer. If the cancer is just on the surface it is not considered a stage 1 cancer but rather is referred to as superficial or a stage A cancer. Underneath the lamina propria is a muscle layer called the detrusor muscle. When the tumor reaches the muscle layer it becomes a stage 2 cancer and has a much higher chance of spreading. Beyond the muscle is the fatty connective tissue holding the bladder in place. If the cancer reaches that level it becomes a stage 3 caner. Over time, the cancer becomes a stage 4 bladder cancer grows outside the bladder into tissues close by. Bladder cancer may spread to lymph nodes, lungs, liver, bones and other parts of the body. Stage 2, 3, and 4 cancers require more surgery, radiation, and chemotherapy. Superficial and Stage 1 tumors may need more surgery or treatments instilled into the bladder. When we look inside a bladder and see a tumor or growth we can't officially call it a cancer until we have a biopsy. Diagnosis of bladder cancer is confirmed and staged most commonly during a transurethral resection of a bladder tumor (TURBT).  For many patients, the resection of the bladder tumor will be the only treatment they need. The tumor is resected under anesthesia in the hospital or surgery center.  A scope is placed in the bladder that has a working element that can cut the tumor off of the surface of the bladder. At this time, your doctor will stage your cancer and try to cut it away completely to get rid of the cancer. The surgeon will resect or remove all of the visible tumor if possible and send the biopsy to a pathologist who will review the specimen and assign it a stage and grade. What is left in the bladder can best be described as a divot, much like a golfer leaves his mark on the fairway, because the urologist has to get deep enough to cut the tumor completely out if possible. The bladder heals very fast, relining itself quickly with healthy urothelium. Grade and stage describe a cancer's development and guide future treatment. A tumor grade tells how aggressive the cancer cells are. A tumor stage tells how much the cancer has spread. We have already reviewed the tumor stages above. The pathologist will review the specimen and also assign a grade to the cancer. Tumors can be low or high grade. High-grade tumor cells are very abnormal, poorly organized and tend to be more serious, faster growing cells that are more likely to recur after they are removed and to invade the other layers of the bladder. A low-grade tumor has cells that are abnormal, but less aggressive looking and more uniform in character. They tend to behave less aggressively in terms of putting patients at risk for recurrence or invasion to other layers of the bladder. As I said before many patients are treated with simple resection of the bladder tumor. If the bladder cancer is superficial and low grade the treatment is most often just the removal and routine follow-up cystoscopy in the office. 50% of bladder cancers will recur. Just like dandelions in the yard, the seeds for next year's growth may lie somewhere else in the bladder already at the time of removal.  Careful follow-up is critical to finding tumors early if they recur and treating them before they advance. Routine cystoscopy is initially performed usually on a 3 months basis to make sure we catch bladder cancers early, increasing that interval as appropriate. Our story today ends on a happy note. My patient with the blood in his urine fortuitously just one day prior to his routine f/u with me had superficial bladder cancer and I was able to remove it during the transurethral resection of his bladder tumor. Although he doesn't need further treatment at this time we will need to follow him carefully because of the high rate of recurrence of tumors. Although we don't hear much about bladder cancer, it is a very common disease. Fortunately, many patients can simply have a procedure done in the hospital without further treatment. For patients needing more treatment we will have the opportunity to talk about other options for more aggressive tumors in future episodes. Let me leave you with this thought. It's best to just not get bladder cancer in the first place. There are risk factors that we can't do anything about but the biggest risk factor for bladder cancer is smoking. If you are smoker quit today.  

Interview with Joshua Halpern, MD, author of Cost-Effectiveness of Common Diagnostic Approaches for Evaluation of Asymptomatic Microscopic Hematuria, and Leslee L. Subak, MD, and Deborah Grady, MD, MPH, authors of Asymptomatic Microscopic Hematuria—Rethinking the Diagnostic Algorithm

This episode presents an approach to pediatric hypertension. Listeners will learn about the differential diagnosis, and pathogenesis of hypertension. Listeners will also develop an approach to the clinical presentation and initial investigations for a child with hypertension. This podcast was developed by Dr. Peter Gill, a senior resident at the University of Toronto in collaboration with Dr. Seetha Radhakrishnan, a Pediatric Nephrologist and Assistant Professor at the University of Toronto and the Hospital for Sick Children.    Related Content: Reference: Pediatric Vital Signs Podcast: Evaluation of Proteinuria Podcast: Evaluation of Hematuria

During the last June podcast, Dr. Dimitre talks about what to do when a patient has microscopic hematuria. Please go to our member’s area to access the podcast! Posted on 24/06/2016 by Dr. Dimitre The post Episode 25: Microscopic Hematuria appeared first on Primary Medicine Podcast.

04/18/2016 | Evaluation of Hematuria in the ER Patient Part 3

04/11/2016 | Evaluation of Hematuria in the ER Patient Part 2

04/04/2016 | Evaluation of Hematuria in the ER Patient Part 1

physicianassistantboards.com - Today we're going to discuss the workup needed when presented with asymptomatic microscopic hematuria. Let's discuss the history, physical exam, and labs that need to be ordered. Don't worry - most cases are benign :)

Mark Frydenberg On Hematuria by AgedCareInsite

This episode has talks on acute renal failure, rhabdomyolysis, dialysis emergencies, UTIs and hematuria.

In this episode, Dr Keith Rourke tackles the topic of hematuria. Listen and learn: how should you manage the patient with blood in their pee? where might the blood be coming from? what are the key parts of the history and physical exam? what tests are needed? Running time: 13:26

This podcast addresses the topic of hematuria in children. The podcast helps students develop an approach to the evaluation of hematuria. There is a brief overview of common causes of hematuria in children. This podcast was written by Peter Gill and Dr. Verna Yiu. Peter is a medical student at the University of Alberta. Dr. Yiu is a pediatric nephrologist at the Stollery Children’s Hospital in Edmonton, Alberta, Canada. These podcasts are designed to give medical students an overview of key topics in pediatrics. The audio versions are accessible on iTunes. You can find more great pediatrics content at www.pedscases.com. Related Content: Podcast: Systemic Lupus Erythematosus

08/24/2005 | Kidney Stones, Hematuria, and Beta Blockers

07/19/2005 | Evaluation of Hematuria