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 24,015 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Vesicorenal reflux raises specific problems in adults, as regards both the surgical indications and the operative technique. The operative results are discussed in relation to fifty seven ureters reimplanted in thirty six patients, and the indications for surgical management are outlined. Refluxes clinically associated with lumbalgia, fever and pyuria, always require surgery. The most difficult problems arise from "asymptomatic" refluxes revealed by checkups for renal insufficiency, proteinuria or arterial hypertension. In these cases, the characteristics of the ureter (e.g. wide or narrow) and the existence or absence of renal scars must be taken into consideration. Refluxes in narrow ureters should be followed closely, and the advisability of surgery should be carefully weighed in patients with a wide ureter with no visible damage to the parenchyma.
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PMID:[Vesico-renal reflux in adults. Study of 57 ureters reimplanted by the submucosal advancement method]. 652 94

Primary vesicoureteral reflux was seen in 2 siblings in a family of 5 (1 daughter and 2 sons). Voiding cystogram of elder sister, who complained of fever and backache, showed bilateral reflux at the age of 6. Left reflux disappeared soon but right reflux persisted. Right antireflux operation was performed at the age of 9, but right renal function deteriorated gradually. Right nephrectomy was done at the age of 12 because of persistent pyuria and renal stones. The second case was her younger brother who was sent to us because of proteinuria and hypertension. Excretory urogram showed left small kidney and voiding cystogram showed bilateral reflux with moderately dilated ureter and calyceal blunting. Urinalysis revealed normal findings except for proteinuria and he had no urological symptoms. Renal angiogram and renal vein renin study were unremarkable, so bilateral antireflux operation was done. Findings of urinalysis of his parents and younger brother were normal and cystogram of his brother was normal.
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PMID:[Familial vesicoureteral reflux]. 667 4

Forty-one Egyptian students with infections due to Schistosoma haematobium, who were selected by results of a urine screening examination, were evaluated for morbidity and response to chemotherapy. Symptoms associated with infection were hematuria, dysuria, and swimmer's itch. A positive correlation existed between the intensity of infection and frequency of exposure to water. Laboratory abnormalities included eosinophilia (41), anemia (9), hematuria (38), pyuria (33), and proteinuria (8). Three of 26 subjects had abnormalities intravenous pyelograms: hydroureter, bladder polyp , and bladder calcification. The bladder polyp was noted also by sonography. Cure rates were 66.7% in 18 subjects treated with two 10-mg/kg doses of trichlorfon and were 89.5% in 19 subjects given three doses. Those not cured had an average reduction in ova excretion of 96%. Follow-up at 12 months of 33 subjects showed that nine had S. haematobium ova in urine, although 75% admitted to exposure to canal or irrigation water in the interim.
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PMID:Clinical characteristics and response to therapy in Egyptian children infected with Schistosoma haematobium. 673 85

Acidosis (arterial pH 6.88 to 7.38) and many other metabolic abnormalities were found in eight patients observed during 16 hospitalizations for paint sniffing. In four episodes, a high anion gap was found, perhaps secondary to an accumulation of metabolites of toluene. The anion gap was normal during 12 episodes, of which seven were associated with a urine pH greater than 5.5 indicating renal tubular acidosis (RTA). Pyuria, hematuria, and proteinuria were frequently observed. There were six episodes of rapidly reversible renal insufficiency (peak serum creatinine values 1.7 mg/dl to 5.4 mg/dl). Hypokalemia (eight episodes) and hypophosphatemia (seven episodes) were also observed. In two patients the urine pH, titratable acid, and ammonium excretion were determined before and after bicarbonate therapy. These results suggested distal but not proximal RTA. Our observations indicate that multiple metabolic abnormalities may result from solvent abuse and suggest guidelines for therapy.
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PMID:Acidosis and other metabolic abnormalities associated with paint sniffing. 683 57

Three clinical cases of toxic nephropathy in young horses were ascribed to gentamicin toxicity. Criteria for defining gentamicin-induced nephrotoxicosis were a serum urea nitrogen value greater than the pretreatment value or cylindruria, hematuria, and proteinuria in the absence of pyuria and bacteriuria. Recommended doses of gentamicin had been given in all cases. The nephropathy was reversible in 1 case in which the toxicosis was detected early and was treated by volume diuresis and drug withdrawal.
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PMID:Gentamicin toxic nephropathy in horses with disseminated bacterial infection. 706 5

From a study of 216 patients with microscopic haematuria who were helped by technically complete intravenous urography (IU), the authors conclude that this investigations method is particularly valuable when haematuria is unaccompanied by proteinuria, pyuria or renal insufficiency. IU led to an etiological diagnosis in almost 50 p. cent of the patients revealing, among other causes, numerous calculi and a non-negligible number of tumours. Renal biopsy is very useful in cases with proteinuria but has few indications in isolated microscopic haematurias. The same applies to diagnostic angiography. Cystoscopy should be considered angiography. Cystoscopy should be considered when IU might be unable to detect small tumours of the bladder or, more generally, lesions of the vesical mucosa, particularly frequent in patients with pyuria.
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PMID:[Contribution of intravenous urography to the etiological diagnosis of microscopic haematurias (author's transl)]. 720 21

Twenty-three women of ages 13 to 44 years were hospitalized with illnesses fulfilling the criteria of the case definition for the toxic-shock syndrome (TSS) associated with coagulase-positive staphylococci. Disease onset occurred during menses in 22, and all were oliguric when admitted. Prolonged hypotension and a reduced central venous pressure were common features. Measurements of urine volume and creatinine clearance in eight patients identified two types of acute renal failure, oliguric and nonoliguric, and prerenal azotemia related to intravascular volume depletion. Urinary sodium excretion and measurement of the renal index (UNa divided by U/PCr) provided further support for the presence of both prerenal and intrinsic renal failure. Hemodialysis was required in one patient in whom findings on renal nuclide scan were consistent with acute tubular necrosis. Pyuria was frequent, but proteinuria and more than five erythrocytes per high-power field were infrequent. Other features included initial hyponatremia and the combination of hypoproteinemia, hypoalbuminemia, hypocalcemia and hypophosphatemia of several days' duration. The hypoalbuminemia was believed to be due to exudation of protein from the intra- to the extravascular space. The hypoalbuminemia was believed to be due to exudation of protein from the intra- to the extravascular space. The hypocalcemia was probably related to the hypoalbuminemia. The pathogenesis of hypophosphatemia in the presence of acute renal failure is unclear. Following the intravenous administration of colloids, fluids and, in seven patients, dopamine, all recovered from the acute illness.
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PMID:Renal manifestations of the staphylococcal toxic-shock syndrome. 728 46

The authors present a case of a 15-year-old girl with Leber's congenital amaurosis with associated nephronophthisis. The main findings in this case are: congenital blindness; enophthalmos; photophobia; nystagmus; keratoconus; cataracts; pigmentary degeneration in the fundus of both eyes; progressive uremia with absence of hematuria, proteinuria, pyuria, and glycosuria; low urinary density, normal lipidic profile; osteoporosis; absence of edema; polydipsia; polyuria; and a history of consanguinity between her parents. Tranmission of this entity allows an autosomal recessive pattern.
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PMID:Leber's congenital amaurosis with associated nephronophthisis. 739 8

Urinary tract infections are among the most frequently encountered health problems in patients of family physicians. The diagnosis requires the demonstration of more than 100,000 bacterial colonies per milliliter in a freshly voided urine specimen. Dysuria, proteinuria, and pyuria are unreliable diagnostic criteria. The pathogenesis is uncertain although vaginal colonization with enteric bacteria, voluntary avoidance of urination, and sexual intercourse are contributing causes. Vesicoureteral reflux is related to recurrent infection but a causal relationship has not been established. Urinary tract infection in children is related to decreased renal growth and kidney scars, but therapy of the infections does not prevent kidney damage. Infections disappear spontaneously in up to 40 percent of adult women. Bacteriuria in pregnancy, however, is related to low birth weight in infants and increased perinatal mortality. Asymptomatic bacteriuria need not be diagnosed or treated except in pregnant women. For symptomatic infections, short-term antibiotic therapy is as effective as long-term therapy. Prophylactic antibiotics and therapy by modification of behavior using a multifaceted regimen can reduce the frequency of recurrent infection.
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PMID:The spectrum of urinary tract infections in family practice. 741 Oct 63

Since 1987, we have experienced 11 children with acute renal failure (ARF) associated with Yersinia pseudotuberculosis (YP) infection. The illness began with the sudden onset of high fever, skin rash and gastrointestinal symptoms. Later in the course, periungual desquamation developed, mimicking Kawasaki disease. Elevated erythrocyte sedimentation rate, C-reactive protein and thrombocytosis were noticeable, and mild degrees of proteinuria, glycosuria and sterile pyuria were common. ARF, which typically developed about 1-3 weeks after the onset of fever, underwent a benign course with complete recovery. The renal biopsies mainly revealed findings of acute tubulointerstitial nephritis. YP should be considered as one of the causes of acute tubulointerstitial nephritis causing ARF, especially in children.
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PMID:Acute renal failure associated with Yersinia pseudotuberculosis infection. 747 20


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