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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recommendations for antimicrobial treatment and prophylaxis of urinary tract infections (UTI) have been made according to the results of investigation of resistance of the most frequent causative agents of UTI to antimicrobial drugs. This investigation has been conducted for the past seven years by the Committee for monitoring bacterial resistance to antibiotics in the Republic of Croatia, with consensus of eight professional societies of the Croatian Medical Association. Uncomplicated cystitis is treated 1, 3, or 7 days, complicated 7 days, pyelonephritis 10-14 days, and complicated UTI 7 to 14 days, rarely longer. For the treatment of cystitis fluorokinolons, nitrofurantoin, betalactam antibiotics, and in the fields of lower resistance trimethoprim/sulfamethoxazol are being used. Single treatment with fluorokinolons is administered to otherwise healthy young women with normal urinary tract in whom cystitis symptoms have been present for less than 7 days. Empiric antimicrobial treatment of pyelonephritis, recurrent and all complicated UTI must be reviewed after urine culture finding is obtained. In the treatment of bacterial prostatitis and febrile UTI in males, the drug of first choice is ciprofloxacin. Asymptomatic bacteriuria (AB) is treated in pregnant women, newborns, preschool children with urinary tract abnormalities, before invasive urologic and gynecologic procedures, in kidney transplant recipients, and in the first days of short term urinary bladder catheterization. Recommendations for the treatment of AB in patients with diabetes mellitus have been controversial in the past two years. Antimicrobial prophylaxis is administered mostly one hour prior to the diagnostic or therapeutic invasive urological procedure, using selected antimicrobial agents.
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PMID:[Guidelines for antimicrobial treatment and prophylaxis of urinary tract infections]. 1658 44

Urinary tract bacterial infections are common in women. Moreover, they tend to recur throughout life and in the same relatively small group of women. In most cases, bladder and renal infections are asymptomatic and manifest by demonstrating coincidental bacteriuria. In some instances, however, especially with frequent sexual activity, pregnancy, stone disease, or diabetes, symptomatic cystitis or pyelonephritis develops and antimicrobial therapy is indicated. In most cases, cystitis is easily managed with minimal morbidity. When acute pyelonephritis develops in an otherwise healthy woman, however, consideration for ureteral obstruction is entertained. If her clinical response to proper therapy is not optimal, then imaging studies are indicated. Pregnancy is a common cause of obstructive uropathy, and severe renal infections are relatively common. Because they usually arise from preexisting covert bacteriuria, experts recommend screening and eradication of these silent infections as a routine prenatal practice.
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PMID:Urinary tract infection in women. 1626 May 29

The urinary bladder of four dogs with emphysematous cystitis was assessed radiographically. Ultrasonography was also performed using a 7.5-MHz microconvex probe in dorsal recumbency and in a standing position. Ultrasonographically there were bright echoes and reverberations typical of gas in all dogs. This was entrapped in the bladder wall as it appeared in the same location in recumbent and standing positions. Bladder size was reduced and bladder content was echogenic in all dogs. In only one out of the four dogs was a gas stripe seen in the bladder on radiographs. Proteus mirabilis was isolated from the urine of all patients. Diabetes was ruled out on the basis of urine and blood analysis. A small amount of gas can be difficult to detect on radiographs. Ultrasonography appears to be a more sensitive technique for detection of gas within the bladder at an early stage of emphysematous cystitis. Prevalence of emphysematous cystitis may be underestimated if only radiographs are made.
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PMID:Radiographic and ultrasonographic findings of emphysematous cystitis in four nondiabetic female dogs. 1642 92

A 60-year-old woman visited our clinic with a complaint of gross hematuria. She was under treatment for rheumatoid arthritis, amyloidosis and diabetes mellitus at the Departments of Orthopedic Surgery and Internal Medicine. The results of a urine analysis showed protein urine, glucose urine, hematopyuria and bacteriuria. The diagnosis of emphysematous cystitis was made from radiography, ultrasonogram and cystoscopic findings. Antibiotics were administered effectively. However, one month later, bilateral hydronephrosis was identified by a computed tomographic scan performed by the Department of Internal Medicine. The bilateral hydronephrosis was brought on by urinary retention caused by a neurogenic bladder disorder. Thus, an indwelling catheter followed by intermittent catheterization was performed and cholinergic medication prescribed successfully.
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PMID:[A case of emphysematous cystitis]. 1644 Jul 31

The case is compelling for the involvement of nerve growth factor (NGF) in the pathogenesis of lower urinary tract disease, especially in conditions with altered neural function. Remodeling of the micturition pathways occurs following experimental bladder-outlet obstruction, denervation, spinal cord injury, cystitis, and diabetes mellitus. Clinically, NGF levels are elevated in the bladders of men with benign prostatic hyperplasia, women with interstitial cystitis and in patients with idiopathic overactive bladder. Blockade of NGF, using either an endogenous antibody or an antibody against the NGF receptor, prevents neural plasticity and bladder overactivity in experimental models of these conditions. The ability of NGF to trigger bladder overactivity might rely on altering the properties of sodium or potassium channels (or their expression) in bladder afferent fibers. Therapies based on altered NGF levels, or changes in channel properties in afferent nerves, represent an intriguing avenue of investigation for the management of detrusor overactivity or diabetic cystopathy.
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PMID:Mechanisms of Disease: the role of nerve growth factor in the pathophysiology of bladder disorders. 1647 Feb 9

Urinary tract infections (UTI) are a frequent problem in primary care. They occur mainly in women without underlying diseases and with no functional or structural anomalies of the urinary tract; consequently most cases are considered uncomplicated UTI. Etiology is influenced by factors such as age, diabetes, spinal cord injury, urinary catheterization, and other factors. Escherichia coli causes 80-85% of acute episodes of uncomplicated cystitis. Staphylococcus saprophyticus, Proteus mirabilis, Streptococcus agalactiae and Klebsiella spp. are responsible for most of the remaining episodes. The spectrum of bacteria that causes complicated UTI is much broader. Rates of resistance have undergone considerable variations, and consequently the empirical treatment of UTI requires constant updating of the antibiotic sensitivity of the main uropathogens of the area, country or institution. To correctly interpret the global data on sensitivity, the type of UTI (uncomplicated versus complicated), sex, age and previous antibiotic therapy in each patient must be taken into account. Resistance in uncomplicated UTI has clinical significance (although less than in systemic infections such as bacteremia), which depends on whether the infection is cystitis or pyelonephritis.
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PMID:[Epidemiology and etiology of urinary tract infections in the community. Antimicrobial susceptibility of the main pathogens and clinical significance of resistance]. 1685 52

We present a rare case of cystitis emphysematosa in an 85-year-old female patient in whom the typical risk factors were present: diabetes of long standing, neurogenic bladder and urinary infection with E.coli. Thanks to early diagnosis by cystoscopy and abdominal CT, after antibiotic treatment, appropriate insulin therapy and continuous bladder drainage the course was uneventful. The patient was fit to leave hospital after 14 days.
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PMID:[Cystitis emphysematosa--a case report]. 1696 Jul 28

Emphysematous cystitis is a rare disease characterized by primary infection of the urinary bladder with gas-producing pathogens. There is a paucity of information on this entity in the English-language literature covering the last 45 years, and the clinical picture is poorly outlined. We carried out a comprehensive, retrospective review of the English-language literature from 1986 to 2006, searching for reports describing cases of emphysematous cystitis. The demographic, clinical, laboratory, imaging, and outcome characteristics of every eligible patient were excerpted. In the present report, we describe a typical case of emphysematous cystitis, followed by an analysis of the literature. Of the 53 eligible cases, most were elderly women with diabetes mellitus (62.2%). Classic symptoms of urinary tract infection were present in only 53.3% of cases. Abdominal tenderness and hematuria were noted in 65.6% and 82.3% of cases, respectively. Plain abdominal X-ray was highly sensitive (97.4%), while abdominal computerized tomography was the most sensitive and specific diagnostic tool. A complicated course attributable to emphysematous cystitis was described in 18.8% of cases. The exact mechanism contributing to the formation of gas in such cases is unknown. Various theories have been suggested, including fermentation of glucose in urine, with emphasis on disequilibrium between gas formation and clearance. Emphysematous cystitis has a highly variable presentation and course, with a considerable potential for complications. Further diagnostic imaging is highly recommended in diabetic patients with urinary tract infection who present with abdominal pain and hematuria. Knowledge of this rare entity may lead to early diagnosis and appropriate management.
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PMID:Emphysematous cystitis: illustrative case report and review of the literature. 1722 Jul 55

Fungal urinary tract infections (funguria) are rare in community medicine, but common in hospitals where 10 to 30% of urine cultures isolate Candida species. Clinical features vary from asymptomatic urinary tract colonization (the most common situation) to cystitis, pyelonephritis, or even severe sepsis with fungemia. The pathologic nature of funguria is closely related to host factors, and management depends mainly on the patient's underlying health status. Microbiological diagnosis of funguria is usually based on a fungal concentration of more than 10(3)/mm(3) in urine. No cutoff point has been defined for leukocyte concentration in urine. Candida albicans is the most commonly isolated species, but previous antifungal treatment and previous hospitalization affect both species and susceptibility to antifungal agents. Treatment is recommended only when funguria is symptomatic or in cases of fungal colonization when host factors increase the risk of fungemia. The antifungal agents used for funguria are mainly fluconazole and amphotericin B deoxycholate, because other drugs have extremely low concentrations in urine. Primary and secondary preventions are essential. The reduction of risk factors requires removing urinary catheters, limiting antibiotic treatment, and optimizing diabetes mellitus treatment.
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PMID:[Management of fungal urinary tract infections]. 1754 11

Emphysematous cystitis is a rare condition characterized by air formation in and around the bladder wall by gas-forming organisms. Although diabetes mellitus and chronic urinary infection, which are frequently encountered in patients with endstage renal disease (ESRD), are predisposing factors for this entity, emphysematous cystitis is actually not common in ESRD patients. Here we provide the first report of a hemodialysis patient who developed typical emphysematous cystitis. Unlike other cases, the emphysematous cystitis recurred after discontinuation of urinary drainage and antibiotic therapy. The possible reason that this case is of a less common type that is more refractory than the other cases, and the method by which patients with ESRD are commonly treated, are discussed. Not anuric but rather oliguric diabetic patients, even after long-term hemodialysis, are the patients at risk for emphysematous cystitis.
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PMID:Emphysematous cystitis complication in a patient undergoing hemodialysis. 1789 56


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