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Haloperidol and droperidol are antipsychotic medications with multimodal pharmacodynamic effects making them useful in the emergency department (ED). Data suggests that droperidol and haloperidol may reduce morphine milliequivalents (MME) administered when used for undifferentiated abdominal pain (UAP) in the ED. However, there is a paucity of data comparing the two agents in this cohort. The purpose of this study was to assess the efficacy of haloperidol versus droperidol in reducing MME requirements for UAP in the ED. This retrospective, single-center study included patients ≥18 years old who presented to the ED for UAP. Patients were excluded if they required urgent surgery or received haloperidol or droperidol for agitation. The primary outcome was the difference in MME administered in the ED between patients who received haloperidol versus droperidol. Secondary outcomes included rates of rescue antiemetics, rescue analgesics, admission to the hospital, hospital length of stay, and adverse effects. A total of 100 patients were evaluated, with 50 patients receiving haloperidol and 50 patients receiving droperidol. Patients in the haloperidol group received a lower median MME compared to those in the droperidol group (0 MME [IQR 0–10] vs 10 MME [IQR 0–20], p-value 0.033). There was no statistical difference between secondary outcomes evaluated, including safety events. Haloperidol was associated with a significant reduction in MME administration compared to droperidol for UAP in the ED. Large high-quality data sets are needed to confirm haloperidol's role in multimodal pain management of UAP compared to droperidol.

Urologic implant revision carries a higher infection risk than virgin implantation. Historically, exchanging device components at the time of revision was performed to reduce infection risk. We hypothesize that revision without replacement of any parts of the device may not be associated with increased infection risk. A single-center, retrospective cohort study was performed on patients undergoing urologic implant revision from 2000 to 2021. Revisions involving exchange of any/all device components (+CE) were compared to revisions without exchange of any components (−CE). The primary outcome was infection or erosion within 12 weeks of revision. Infection rates were compared using Fischer exact test. Infection-free survival (IFS) was compared with Kaplan-Meier (KM) log-rank test and Cox proportional hazards (CPH) model. 551 revisions were included, including 497 revisions with CE and 54 without CE. Among those with at least 12 weeks follow-up, no difference was seen in infection rates within 12 weeks of revision [−CE 3/39 (7.7%) vs. +CE 10/383 (2.6%)], p  = 0.109). In addition, IFS was comparable between groups (log-rank test p  = 0.22, HR for −CE 1.65 (0.65–4.21). Revision surgery for IPP or AUS without CE may not present an elevated risk of infection in the properly selected patient.

Peyronie’s disease (PD) is a connective tissue disorder characterized by the development of dense fibrous collagen plaque deposits in the tunica albuginea of the penis, resulting in curvature of the erection and sexual dysfunction. It is both a physically and psychologically devastating disorder that remains a considerable therapeutic dilemma due to incomplete characterization of its pathophysiology and the paucity of randomized controlled trials. Along with an underlying genetic predisposition, numerous studies have implicated pro-inflammatory cascades and oxidative stress in the development of PD. Medical therapies targeting these pathways can be partially effective at decreasing or inhibiting plaque formation and symptoms of PD. Such therapies include the broad categories of oral medication and vitamin supplements, intralesional injections, and penile traction. The recent FDA approval for intralesional collagenase clostridium histolyticum provides a significant advancement in the medical treatment of PD. In addition to highlighting the latest data supporting intralesional collagenase clostridium histolyticum, this update aims to review the most current literature on all of the available options for medical treatment of PD and to provide a practical approach to the clinical management of PD in the office setting.