Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0016199 (flank pain)
 2,189 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report 7 renal cell carcinomas in 4 patients treated by percutaneous image-guided radiofrequency ablation (RFA). The mean age of the patients was 59 years (male: 2, female: 2). All 4 were imperative cases. Two patients (5 tumor) had hereditary multiple renal cell carcinomas with von Hippel-Lindau (VHL) disease. The other two patients had sporadic renal cell carcinomas. RFA was performed guided by computed tomography under conscious sedation with local anesthetics. The mean size of the treated tumors was 4.5 (1.8-8.1) cm. Impedance-regulated RF energy from a generator at 94 (45-130) watts was applied at 11 (8-14) min intervals. The average procedure time was 91 (45-165) minutes. The maximum tissue temperature reached 82 (56-91) degrees C immediately after ablation. Three of the 7 lesions (42.9 %) were locally well controlled during the mean follow-up period of 6.3 (4-9) months. The two patients with VHL disease developed visceral metastasis after There were no major complications. Minor complications encountered included flank pain, nausea, perinephritic hematoma and fever. Although percutaneous image-guided RFA showed limited success in large or central renal tumors, the therapy against small exophytic renal tumors would be well tolerable and successful.
 ...
PMID:[Conservative therapy by percutaneous radiofrequency ablation of renal cell carcinomas--therapeutic experiments of four patients with seven renal tumors--]. 1668 49

Aortic dissection is a life-threatening illness requiring early diagnosis and treatment. Uncommon early presentations mimicking various illnesses can delay diagnosis. This case study describes a 44-year-old woman with type B aortic dissection initially presenting as acute pyelonephritis (APN). Early clinical manifestations were sudden onset of left flank pain, fever, hematuria and pyuria, and following admission, severe abdominal pain, nausea, vomiting, reduced urine output and renal function deterioration. Abdominal computed tomography showed type B aortic dissection complicated with a small bowel infarct, ischemic ascending colon and left renal infarct. Emergency surgical interventions of small bowel resection, ileoduodenostomy and cholecystectomy were performed; a second laparotomy was subsequently performed for anastomosis leakage. The patient died due to septic shock with multiorgan failure. Aortic dissection initially mimicking APN is rare. Accurate early diagnosis of aortic dissection with indeterminate presentation is crucial. Early surgical intervention for visceral organ ischemia is important to preventing morbidity and mortality.
 ...
PMID:Type B aortic dissection with early presentation mimicking acute pyelonephritis. 1687 95

A 36-year-old patient was admitted to the emergency department with complaints of severe flank pain, nausea, vomiting, anuria, and general illness. Five months earlier, we had placed a subcutaneous pyelovesical prosthesis (Detour; Porges) of the ureter for treatment of a chronically dilated upper urinary tract in a solitary right kidney previously treated by double-J stenting. Ultrasonography of the right kidney revealed severe hydronephrosis. A percutaneous nephrostomy catheter was placed, and antegrade pyelography showed complete obstruction of the prosthesis. Urinalysis and culture demonstrated a Candida infection. A systemic antimycotic was administered, and fluid management was started. On the third day, diuresis appeared, and antegrade nephrostomography confirmed patency of the bypass.
 ...
PMID:Case report: relief of acute obstruction of the Detour subcutaneous pyelovesical bypass. 1699 22

Bilateral emphysematous pyelonephritis is a rare life-threatening condition affecting almost exclusively patients with diabetes mellitus. Symptoms, which include fever, chills, abdominal and flank pain, nausea, vomiting, dysuria and pyuria, usually mimic those of classic pyelonephritis, and thus clinical suspicion for this urgent condition should be raised in every diabetic patient with similar presentation. Computed tomography (CT) remains the gold standard for the diagnosis demonstrating gas in the renal parenchyma, collecting system or perinephric tissue. Treatment, which should be aggressive, is classically surgical, and early nephrectomy is recommended. Percutaneous drainage associated with medical treatment might be an alternative. Successful exclusively medical treatment has been described but is infrequent and is reserved as an alternative for patients in whom surgical intervention is contraindicated. We report a case of bilateral emphysematous pyelonephritis in an 82-year-old female diabetic patient who presented with symptoms of typical pyelonephritis. Diagnosis was confirmed by CT, and Escherichia coli was identified as the causative factor. The patient was successfully treated medically with intravenous administration of cefepime and amikacin for 14 days and recovered fully. The therapeutical options for this severe but rare condition are discussed.
 ...
PMID:Nonsurgical treatment of bilateral emphysematous pyelonephritis in a diabetic patient. 1713 98

Pediatric and adult stone disease differs in both presentation and treatment. Children can present with a wide range of symptoms varying from flank pain and hematuria to nonspecific symptoms such as irritability and nausea. Although ultrasonography and plain radiographs can play a role in diagnosis and follow-up, the standard of care for a child who presents to the emergency department with a history suggestive of a stone is noncontrast spiral CT. Because there is a high yield in identifying predisposing factors in children with urolithiasis and high recurrence rates, metabolic evaluation of every child with a urinary stone should be undertaken and medical treatment should be given if necessary. With recent advances in technology, stone management has changed from an open surgical approach to less invasive procedures such as extracorporeal shock-wave lithotripsy and endoscopic techniques. Herein, we present a review of the recent literature and offer our own preferences to approaches for treatment.
 ...
PMID:Management of pediatric stone disease. 1730 23

The successful endovascular repair of a type III thoracoabdominal aortic aneurysm (TAAA) with the use of a tube endograft is reported. A 56-year-old male with a 6.4-cm type III TAAA, a 4.2-cm infrarenal abdominal aortic aneurysm, and chronic renal insufficiency presented with flank pain, nausea, acute anuria, and serum creatinine of 6.1 mg/dl. Acute occlusion of the left solitary renal artery was diagnosed and emergent recanalization with percutaneous transluminal angioplasty and stenting was performed successfully, with reversal of the serum creatinine level at 1.6 mg/dl. Further imaging studies for TAAA management revealed ostial occlusion of both the celiac artery (CA) and the superior mesenteric artery (SMA) but a hypertrophic inferior mesenteric artery (IMA) providing retrograde flow to the aforementioned vessels. This rare anatomic serendipity allowed us to repair the TAAA simply by using a two-component tube endograft without fenestrations (Zenith; William Cook, Bjaeverskov, Denmark) that covered the entire length of the aneurysm, including the CA and SMA origins, since a natural arterial bypass from the IMA to the CA and SMA already existed, affording protection from gastrointestinal ischemic complications. The patient had a fast and uneventful recovery and is currently doing well 6 months after the procedure. To our knowledge, this is the first report in the English literature of successful endovascular repair of a TAAA involving visceral arteries with the simple use of a tube endograft.
 ...
PMID:Endovascular repair of a type III thoracoabdominal aortic aneurysm in a patient with occlusion of visceral arteries. 1745 Mar 97

We report two cases of acute renal failure in patients with nonfulminant acute hepatitis A. First case is a healthy 25 year-old man complained of myalgia and jaundice. Initial laboratory results showed BUN 40 mg/dL, creatinine 5.23 mg/dL, AST 2,220 IU/L, ALT 3,530 IU/L, total bilirubin 6.26 mg/dL, and positive anti-HAV IgM antibody. Supportive treatments including fluid therapy were started. Serum creatinine and total bilirubin levels were 7.98 mg/dL and 7.66 mg/dL respectively on the 5th hospital day, and decreased gradually. He was discharged on the 12th hospital day, and was being followed up in outpatient department. Second case is a 33 year-old woman who admitted for bilateral flank pain, high fever, nausea, and vomiting. She was diagnosed as acute pyelonephritis and acute hepatitis A. On admission, BUN 13 mg/dL, creatinine 0.74 mg/dL, AST 3,720 IU/L, ALT 2,280 IU/L, total bilirubin 0.9 mg/dL were noted, and acute renal failure developed next day. Fluid therapy with antibiotics administration were started, and maximal BUN and creatinine was 41.7 and 8.09 mg/dL respectively on the 8th day. She recovered without dialysis and was discharged on the 19th hospital day. Proper and prompt comprehensive supportive measures would decrease the need for dialysis in patient of acute renal failue associated with acute hepatitis A.
 ...
PMID:[Two cases of acute renal failure associated with nonfulminant acute hepatitis A]. 1792 55

The major syndromes of mushroom poisoning can be divided by presentation timing: Early syndromes (symptom onset <6 hrs after ingestion) have little probability to cause organ damage. Epigastric pain, nausea, vomiting and diarrhea occur in most cases and treatment includes initial gastrointestinal decontamination with oral activated charcoal and fluid rehydration. In addition, an acute gastrointestinal syndrome can be combined with cholinergic toxicity, epileptiformic response or immuno-hemolytic anemia. Neurotoxic Syndromes may present as dysphoria, delirium, hallucinations or disulfiram-like reactions. Treatment is entirely supportive and if performed in hospital, the prognosis is good. Late syndromes (symptom onset >6 hrs after ingestion) are life-threatening due to liver- and renal failure. Patients who are jaundiced after an acute gastrointestinal episode, are suspected to be poisoned with Amatoxins. Patients with flank pain, hematuria, polyuria or oliguria in the absence of jaundice are suspected to have an intoxication with Cortinarius mushrooms. In both cases an intensive care management is indicated.
 ...
PMID:[Mushroom poisonings: syndromic diagnosis and treatment]. 1803 May 54

Emphysematous pyelonephritis (EPN) is a serious and often life-threatening condition due to a gas-producing and necrotizing infection involving the renal parenchyma and perirenal tissue. The infection is almost exclusively seen in diabetic patients, and the main feature of its presence is finding gas within the kidney. Patients usually present with fever, chills, flank pain, and dysuria. Laboratory testing usually reveals hyperglycemia, leukocytosis, pyuria, an elevated blood urea nitrogen (BUN) level, and high serum creatinine level. Other, nonspecific symptoms such as abdominal pain, nausea, vomiting, and diarrhea can accompany acute pyelonephritis, as found in the reported case. The appropriate management of such serious infection requires combined medical and surgical treatment. In severe infection, nephrectomy should not be delayed. We report a case of EPN in a diabetic patient who presented with gastrointestinal symptoms. A high index of suspicion, coupled with a good imaging study [preferably computed tomography (CT) scanning] of the abdomen can lead to early diagnosis. Appropriate medical and surgical management have resulted in a successful outcome.
 ...
PMID:Emphysematous pyelonephritis presenting as gastroenteritis. 1809 Aug 85

Emphysematous or gas-forming infections, a very small percentage of bacterial infections of the urinary tract, attract importance because of their life threatening potential. Herein, we report a 60-year-old Saudi female patient who was a known case of Diabetes mellitus for 15 years. She was admitted with left flank pain of 5 days duration, abdominal distension, nausea, vomiting and chills associated with increased frequency of urine, urgency, and dysuria. She had leukocytosis, high blood sugar, elevated urea and creatinine and pyuria. Urine culture grew Escherichia coli. Ultrasound and CT scan showed left pelvicalyceal dilatation and air in the left kidney and urinary bladder. She was treated with a prolonged parenteral antibiotic course, and insulin, with complete recovery.
 ...
PMID:Gas-forming urinary tract infection. 1894 Jan 28


<< Previous 1 2 3 4 5 6 7 Next >>