Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bacillus Calmette-Guerin (BCG) is the most effective agent currently available to treat superficial bladder cancer. However, this form of therapy is not without potential serious or fatal complications. In addition to the potentially toxic systemic side effects attributed to hematogenous absorption of the bacillus, direct upper tract seeding may occur in patients with vesicoureteral reflux. We report on a patient treated with intravesical BCG for bladder cancer in whom unilateral necrotizing granulomatous pyelonephritis developed. Although severe, this complication is rare and we conclude that reflux is not a contraindication for intravesical BCG therapy.
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PMID:Complications of intravesical bacillus Calmette-Guerin: a case report. 143 32

The pathogenesis of Candida urinary tract infection (UTI) has been investigated clinically and experimentally with special reference to ascending pyelonephritis in rats. Among the Candida species, Candida albicans was most frequently isolated from clinical specimens including urine in two medical centers, one in Japan and the other in the United States. The isolates of C. albicans serotype B showed a significantly lower susceptibility to 5-fluorocytosine compared to those of serotype A (p less than 0.01). The distribution pattern of the serum antibody titers against C. albicans in 20 candiduria patients (C. albicans 19 and Candida tropicalis 1) was similar to that in 23 bacterial complicated UTI patients. All patients with candiduria had underlying diseases of the urinary tract, such as neurogenic bladder, bladder cancer or benign prostatic hyperplasia: indwelling urinary catheters were present in 15 patients and all had received antimicrobial agents before the study. Ascending Candida pyelonephritis has been investigated in female rats which were transurethrally inoculated into the bladder with C. albicans ATCC 10259 strain. The incidence of Candida pyelonephritis was approximately 80% in rats treated with cyclophosphamide and more than 70% in rats with partial ureteral obstruction. There was a significant relationship between renal and urinary Candida cell populations (p less than 0.01). Furthermore, a significant relationship was revealed between renal Candida cell populations and histological grades of pyelonephritis (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Candida urinary tract infection with special reference to ascending pyelonephritis]. 178 22

Urinary glycyl-prolyl dipeptidyl aminopeptidase (GP-DAP) activity was measured in 18 healthy adults and 252 patients with urological diseases. The GP-DAP activity was significantly higher in patients with prostatic cancer, bladder cancer or renal cancer and also in patients with acute prostatitis or pyelonephritis than in healthy adults. GP-DAP activity was also studied during anticancerous chemotherapy and proved to be a sensitive parameter for renal damage as are urinary N-acetyl-beta-D-glucosaminidase, alanine aminopeptidase, beta 2-microglobulin, alpha 1-microglobulin, and albumin. The analysis of tissue activities suggested that GP-DAP was located not only in the renal parenchyma but also in the prostate and seminal vesicles.
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PMID:[Clinical evaluation of urinary glycyl-prolyl dipeptidyl aminopeptidase in patients with urological disease]. 198 55

Over the last several years, internal reservoir type urinary diversions have become popular. We have already performed Kock continent ileal reservoir for urinary diversion in more than 80 patients. The experience with the Kock pouch prompted us to try a new form of continent urinary reservoir originally reported by Indiana University group. The Indiana pouch is a composite structure using ileum and cecum. The antireflux mechanism is provided with tunneled ureteral implantation along the tenia of the cecum. Plication of the terminal ileal segment along with the ileocecal valve maintains urinary continence. The tubular configuration of the cecum is completely disrupted with either an ileal patch or Heineke-Mikulicz re-configuration to construct a low pressure reservoir. Between October, 1987 and September, 1988, we performed Indiana continent urinary diversion in 15 cases: 13 males and 2 females, from 47 to 73 years old (mean age 61.3 years), 14 bladder cancer patients and 1 bladder sarcoma patient. The initial 8 patients underwent Heineke-Mikulicz type operation and the subsequent 7 patients ileal patch-type operation. Median followup has been 7 months. There were no major early complications but one postoperative death with blood transfusion related graft versus host disease (GVHD). The late complication occurred in 2 patients: 1 stenosis of the pouch due to insufficient detubularization of the cecum and 1 pyelonephritis required no admission. Serum electrolytes and vitamin B12 remained normal in all patients. Patients perform self-catheterization every 3-5 hours during the day and 0-2 times at night for volumes ranging up to 800 ml. With regard to volume capacity and pressure characteristics, the ileal patch type reservoir seemed to be superior to the Heineke-Mikulicz type pouch as a receptacle for urine. Over-all, 12 of 14 patients (86 per cent) have acceptable continence. The remaining 2 patients have significant daytime leakage requiring pads or a cutaneous bag. Followup examination with excretory urography showed no upper tract obstruction and X-rays of the pouch showed no reflux. Indiana pouch is a relatively simple continent urinary reservoir, since the steps of this technique already are familiar to urologists. It may be an alternative form of continent urinary diversion.
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PMID:[Indiana continent urinary reservoir: report of 15 cases]. 280 78

Radical cystectomy for bladder cancer is an operation that presents a low mortality rate, which can still be reduced by a better patient selection, particularly with respect to patients presenting a high cardiac risk. Morbidity is still elevated but a better preparation of the patients against infection, hyperdiuresis during and after the operation and a nonperitonization of the anterior pelvis should reduce the frequency of abscesses, septicemia and pyelonephritis. It seems reasonable to propose this operation as a curative procedure for stage B and recurring stage A and as a palliative procedure for stages C and D.
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PMID:Radical cystectomy in bladder cancer: mortality and morbidity. A series of 123 cases. 323 27

The two most common indications for long-term catheterization are recalcitrant urinary incontinence and urinary obstruction that is not corrected by surgery. For incontinent patients, if behavioral changes, nursing care, special clothes, special bed clothes, and medications have not been successful, then a device to collect urine must be considered. For men such a device is a condom catheter; for women an analogous external collection device would be very useful. Suprapubic catheterization may offer an alternative but has been inadequately studied in this patient population. Long-term urinary catheterization has salutary effects for selected patients including patient comfort, family satisfaction, and nursing efficiency and effectiveness. To the patient for whom any physical movement is uncomfortable or painful, and indwelling catheter may be preferable to frequent changes of clothes. Similarly, the family of of severely impaired patients may want to accept the risks of urethral catheterization in order to keep the patient dry. Further, to the extent that the indwelling catheter is effective in decubitus ulcer prevention and/or management, long-term catheterization may diminish the risk of bacteremia or death from soft tissue infection. These benefits of long-term urethral catheterization, in addition to its risks, should be examined in future studies. Once a urethral catheter is in place, even with good catheter hygiene, bacterial entry can be postponed only temporarily; eventually all patients become bacteriuric. Indeed, as the catheter remains in place, organisms continue to enter, others leave or die, and the bacteriuria becomes complex, polymicrobial, and dynamic. Some organisms, particularly recognized uropathogens such as E. coli and K. pneumoniae, appear to reside in the urinary tract itself. Others, such as P. mirabilis, P. stuartii, and M. morganii, probably establish a niche within the urinary catheter, thus increasing their ability to cause subsequent bladder bacteriuria. The complications of long-term urinary catheterization include fevers, acute pyelonephritis, and bacteremias (such as seen in short-term catheterized patients), as well as catheter obstructions, urinary stones, chronic renal inflammation, local periurinary infections, vasicoureteral reflux, renal failure, and, for very long-term catheterized patients, bladder cancer. The thrust of catheter care for the long-term catheterized patient is to prevent complications of the omnipresent bacteriuria. Unfortunately, clinical opportunities for preventing complications are limited.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Catheter-associated urinary tract infections. 333 61

Epidemiological studies suggest that urinary tract infection is an important risk factor in the development of bladder cancer. Chronic urinary tract infection in rats is associated with urothelial hyperplasia and papillomatosis. In the Sprague-Dawley strain, exposure to the 5-nitrofuran, N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide (FANFT), is associated in particular with the development of renal pelvic tumors. The present study was designed to evaluate whether chronic urinary tract infection could enhance tumor development in FANFT-induced urinary tract carcinogenesis. One hundred forty-four female Sprague-Dawley rats were divided into the following groups. Group 1 received 0.2% FANFT in the diet for 7 wk followed by control diet. Group 2 received 0.2% FANFT in the diet for 7 wk followed by control diet. One wk after completion of FANFT administration, the suspension of 0.5 ml of Escherichia coli (06K13H1) was injected into the bladder through the urethra. Group 3 received 0.2% FANFT in the diet for 7 wk followed by control diet. One wk after completion of FANFT administration, a suspension of heat-killed E. coli (06K13H1) was injected into the bladder through the urethra. Group 4 received a suspension of 0.5 ml of E. coli (06K13H1) through the urethra and received control diet throughout the experiment. Group 5 was fed control diet only. The experiment continued for 104 wk. A significantly higher number of urinary tract tumors, particularly of the renal pelvis, was recorded in Group 2 compared to Groups 1, 3, 4, and 5. The majority of the rats in Groups 2 and 4 had morphological signs of urinary tract infections, particularly pyelitis and/or pyelonephritis. Thus, a single injection of E. coli (06K13H1) into the bladder results in an enhancement of FANFT-induced urinary tract carcinogenesis in the Sprague-Dawley rat, especially for renal pelvic tumors. The formation of dimethylnitrosamine or other nitroso compounds from nitrates in the urine or increased cell proliferation due to chronic inflammation or both may be important pathogenetic factors in the tumor development.
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PMID:Enhancement of N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide-induced carcinogenesis by urinary tract infection in rats. 353 25

Ferritin, carcinoembryonic antigen (CEA) and beta 2-microglobulin (beta 2-MG) levels in urine from 45 patients with cancer (4 with renal adenocarcinoma, 7 with renal pelvic and ureteral cancer and 34 with bladder cancer) at various stages were clinically evaluated for their significance as parameter of urinary tract malignancies as compared to urinary fibrin/fibrinogen degradation products (FDP) and urine cytology. Ferritin levels for the poorly-differentiated and advanced stage groups were higher than those for the well-differentiated and early stage groups, and were especially high in 5 of the 7 patients with renal pelvic and ureteral cancer and all of the 7 patients with bladder cancer involving the upper urinary tract. These data suggest that determination of urinary ferritin is useful in the detection of urinary tract cancer involving the upper urinary tract. The upper limits of CEA levels were determined respectively according to white blood cell counts in urine. Although, CEA levels were elevated in the poorly-differentiated group and the advanced stage group compared to the well-differentiated and early stage groups, the values were positive in only 12 out of 52 cases (23.1%). These values seemed to be low compared to other reports. beta 2-MG levels increased significantly in the poorly-differentiated and advanced stage groups. However, most cases in the above groups were complicated with pyelonephritis or renal impairment. It is suggested that the urinary beta 2-MG secretion from cancer itself is not so significant.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Assessment of urinary ferritin, CEA and beta 2-MG determinations in patients with urinary tract malignancies]. 637 12

Review of complications of the ileal conduit in patients undergoing radical cystectomy for bladder cancer showed a statistically significant increase in renal calculi, ureteral obstruction, acute and chronic pyelonephritis and deterioration of renal function by 60 months postoperatively. Ureteroileal fistulas occurred in 3.3 per cent, stomal stenosis in 5.1 per cent, intestinal fistulas in 5.4 per cent, severe intestinal obstruction in 6 per cent and abdominal wound infection or dehiscence in 20.2 per cent of the cases. The over-all operative mortality was 13.7 per cent, with 8 per cent of the deaths attributed to complications from the ileal conduit. Comparison of colonic conduits to ileal conduits as a means of urinary diversion with radical cystectomy for bladder cancer demonstrated no convincing evidence of its superiority.
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PMID:Complications of ureteroileal conduit with radical cystectomy: review of 336 cases. 744 28

From 1981 through 1990, 21 urologic cancer cases were discovered in 21 uremic patients at our hospital. This constituted 55% (11 of 20) of the total malignancies in nondialyzed uremic patients, 41% (nine of 22) of the total in chronic hemodialysis patients, and 50% (one of two) of those in patients on continuous ambulatory peritoneal dialysis. No cases of urologic cancer were found in kidney transplant recipients. When compared with the general population, the standardized incidence ratio of kidney cancer in chronic hemodialysis patients was found to be 24.1 (P < 0.01) and that of bladder cancer was found to be 16.4 (P < 0.01). Multiple underlying renal diseases contributed to the development of the urologic cancer cases, including four analgesic nephropathy-associated transitional cell carcinoma cases, two acquired cystic kidney disease-associated renal cell carcinoma cases, two chronic pyelonephritis-associated (stone and tuberculosis) squamous cell carcinoma cases, and one xanthogranulomatous pyelonephritis-associated transitional cell carcinoma case. Uremia per se may be an important promoting factor. Hematuria (17 of 21 cases) was the most common presenting feature despite the fact that most of the patients were anuric. The clinical diagnosis of renal parenchymal tumors was based on ultrasonography (five of five cases), whereas most urothelial tumors were detected by cystoscopy or retrograde pyelography (14 of 16 cases). The survival rate of the 17 aggressively treated patients was 82% at 2 years and 45% at 5 years. We conclude that uremic patients are at greater risk of developing urologic cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Urologic cancers in uremic patients. 774 22


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