Geriatric urolithiasis in the emergency department: risk factors for hospitalisation and emergency management patterns of acute urolithiasis

Urolithiasis is one of the most common conditions seen in emergency departments (ED) worldwide, with an increasing frequency in geriatric patients (>65 years). Given the high costs of emergency medical urolithiasis treatment, the need to optimise management is obvious. We aimed to determine risk factors for hospitalisation and evaluate diagnostic and emergency treatment patterns by ED physicians in geriatric urolithiasis patients to assist in optimising treatment

Effects of subthreshold yellow pattern laser treatment in diabetic macular edema: Optical coherence tomography angiography study

Purpose: The purpose of the study was to assess the effects of subthreshold yellow pattern laser (SYPL) treatment in diabetic macular edema (DME) using optical coherence tomography angiography (OCTA). Methods: Thirty eyes of 30 diabetic patients diagnosed as naïve DME (central subfield thickness [CST] 400 µm) between October 2018 and January 2020 at Ege University Faculty of Medicine, Department of Ophthalmology were prospectively included in the study. Fovea sparing SYPL were performed to the macula. Comprehensive eye examination along with OCTA was performed at baseline, 1st month, and 3rd month of follow-up. Data during the follow-up were compared with the baseline. Results: The mean age of the patients (15 male and 15 female) was 63.7±6.7 (48–74) years. The mean diabetes duration was 17.9±5.4 (13–27) years and mean HbA1c was 6.6±0.5 (5.7–7.7) g/dL. Best-corrected visual acuity (BCVA) did not show significant change during the follow-up (p=0.698). CST measurements were 323.7±40.1 (262–393) µm, 316.8±40.9 (268–377) µm and 318.1±39.9 (226–396) µm at baseline, 1st, and 3rd month, respectively (p=0.591). On OCTA, mean vessel density (VD) in superficial capillary plexus were 44.7±4.6 (37.4–52.3), 45.6±4.7 (38.6–54.9), and 44.6±3.9 (37.5–49.8); while mean VD in deep capillary plexus (DCP) was 43.1±4.8 (36.3–52.7), 45.3±4.8 (38.9–54.2), and 42.7±3.3 (37.4–49.3) at baseline, 1st, and 3rd month, respectively (p=0.383 and p=0.291). Foveal avascular zone area did not change significantly during the follow-up (p=0.998). Conclusion: SYPL treatment in DME appears to be safe with no statistically significant difference in macular capillary perfusion, as well as no change in BCVA and CST during the 3 months of follow-up

Geriatric urolithiasis in the emergency department: risk factors for hospitalisation and emergency management patterns of acute urolithiasis

Abstract Background Urolithiasis is one of the most common conditions seen in emergency departments (ED) worldwide, with an increasing frequency in geriatric patients (>65 years). Given the high costs of emergency medical urolithiasis treatment, the need to optimise management is obvious. We aimed to determine risk factors for hospitalisation and evaluate diagnostic and emergency treatment patterns by ED physicians in geriatric urolithiasis patients to assist in optimising treatment. Methods After receiving ethics committee approval, we examined the records of emergency urolithiasis admissions to our ED between January 2000 and December 2010 to determine risk factors for hospitalisation and to evaluate current diagnostic and emergency treatment patterns in geriatric urolithiasis patients. Results 1,267 consecutive patients at least 20 years of age with confirmed urolithiasis (1,361 ED visits) and complete follow-up data were analyzed. Geriatric patients comprised 10% of urolithiasis patients with more than half of them experiencing their first urolithiasis episode at ED admission. Although stone site, side and size did not significantly differ between groups, urinary stone disease was more severe in the elderly. The risk of severe complications correlated with increasing age, female sex and diabetes mellitus. Geriatric patients had a two-fold greater likelihood of being hospitalised. A significantly lower percentage of geriatric patients received combined analgesic therapy for pain management (37% vs. 64%, p =  Conclusion Geriatric patients with urolithiasis have a higher morbidity than younger patients and may be undertreated concerning analgetic and expulsive treatment in ED.</p