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)

The Acquired Immunodeficiency Syndrome (AIDS) has involved the pediatric age group and is especially prevalent in babies born of mothers who are intravenous drug abusers or prostitutes. Approximately 30% of children born to mothers who are seropositive for the human immunodeficiency virus (HIV) will develop HIV infection. There are several important differences in children and adults with AIDS. The incubation period of the disease is shorter, and initial clinical manifestations occur earlier in children. In addition, certain infections are more common in children, and the different types of malignancy, especially Kaposi's sarcoma, are unusual in the pediatric age group. The altered immune system involves both T cells and humoral immunity and increases susceptibility to a variety of infections, particularly opportunistic organisms. In this publication the complications of pediatric AIDS involving the lungs, cardiovascular system, gastrointestinal tract, genitourinary system, and neurological system are described. The most common pulmonary complications in our experience are Pneumocystis carinii pneumonia and pulmonary lymphoid hyperplasia. The spectrum of cardiovascular involvement in pediatric AIDS includes myocarditis, pericarditis, and infectious endocarditis. Gastrointestinal tract involvement is usually due to opportunistic organisms that produce esophagitis, gastritis, and colitis. Abdominal lymphadenopathy is a common finding either due to disseminating Mycobacterium avium-intracellulare infection or nonspecific lymphadenopathy. Although cholangitis is more commonly seen in adults, it may occur in children with AIDS and, in most cases, is due to related opportunistic infections. Genitourinary infections may be the first evidence of HIV disease. Cystitis, pyelonephritis, renal abscesses, and nephropathy with renal insufficiency are complications of pediatric AIDS. A variety of neurological abnormalities may occur in pediatric AIDS. The most common cause of neurological dysfunction in children with AIDS is HIV neuropathy. We present the many complications of AIDS in children demonstrated by a variety of imaging modalities, emphasizing the importance of diagnostic imaging in children with this disease.
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PMID:Radiology of AIDS in the pediatric patient. 157 31

Efficiency of ceftriaxone (Rocephin Hoffman Laroche) was assessed in 16 children aged between 3 and 14 years and in 4 adults aged between 17 and 70 years with severe infections of the urinary and respiratory tracts caused by E. coli. S. pneumoniae, P. aeruginosa, P. mirabilis or enterococci. Pyelonephritis as a sole pathology was diagnosed in 10 patients whereas in further 8 patients it complicated other diseases (nephrotic syndrome, hepatitis, cholangitis, leukemia). Pneumonia complicated nephritis leukemia or lymphoma in 8 children. Peritonitis was diagnosed in 1 adult patient. Ceftriaxone was given in a single daily dose of 50 mg/kg to all children and 2.0 g to adult patients for 7-10 days. No adverse reactions were noted. Clinical improvement was achieved in all treated patients. Cultures became negative in 17 cases after the treatment. Significant bacteremia caused by P. aeruginosa persisted in 2 patients and by E. coli in 1 patient. No toxic effects on liver, renal, pancreatic and bone marrow functioning were seen. Ceftriaxone may be safely and efficiently used for the treatment of the urinary and respiratory infections.
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PMID:[Use of ceftriaxone in urinary and respiratory tract infections]. 223 13

Twenty nine patients of an intensive care unit (9 women and 20 men), aged 63.9 +/- 15.8 years, with a mean body weight of 62.5 +/- 11.8 kg were treated during 9.4 +/- 2.1 days by aztreonam (2 x 1 g/24 h) administered by short infusion (30 min) for a severe infection due to a Gram-negative bacilli. The primary (n = 25) or nosocomial (n = 4) infection sites were a peritonitis (14), a septicaemia (6), a cholecystitis (6), a pyelonephritis (5), a cholangitis (2), a subphrenic abscess (1) or a pneumonia (2). The isolated Gram-negative bacilli were all susceptible to aztreonam, their MIC being less than or equal to 0.5 micrograms/ml, except for a Pseudomonas aeruginosa (MIC = 4 micrograms/ml). Aztreonam was administered as a single therapy to 7 patients and in association with metronidazole (18) and/or penicillin G (14) to 22 patients; in fact, anaerobes were isolated in ten patients. The mean serum concentrations of aztreonam, as measured by HPLC, before and after the 7th administration respectively were 83.2 +/- 17.5 and 6.1 +/- 5.5 micrograms/ml for peak and through levels. The treatment of the 29 infections was a success in all the cases. No complication occurred due to the presence of Gram positive cocci (n = 4) in the first bacteriological sample, or due to the emergence (n = 12) of Gram positive cocci, except for one case of sepsis of the abdominal wall by Staphylococcus aureus. Aztreonam (2 x 1 g/24 h) may be a suitable alternative for the treatment of severe infections of intensive care units, mostly due to Gram-negative bacilli.
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PMID:[Aztreonam treatment of severe infections caused by gram-negative aerobic bacilli]. 304 52

Ceftazidime (CAZ) was administered to 34 full-term and premature infants aged 0-27 days with various bacterial infections in a dose of 10 or 20 mg/kg by intravenous bolus injection, and plasma concentrations and urinary recovery rates in these subjects during recovery periods were studied. Because of the small number of the cases recruited, neonates were not divided into the full-term and the premature group, but into 3 groups based on day-age: 0-3 days, 4-7 days, and 8 days or older. Concentrations and rates of transfer of CAZ into cerebrospinal fluid (CSF) were determined in 2 cases, and biliary concentrations in another case. A clinical evaluation of CAZ was performed in 12 male and 6 female infants aged 1 day to 4 months and 19 days, including 2 each with purulent meningitis, pneumonia and pyelonephritis, 3 with septicemia, 1 each with septicemia suspected, cholangitis, osteomyelitis, bronchopneumonia, staphylococcal scaled skin syndrome, and acute enterocolitis and 3 for prophylactic use. Plasma concentrations and urinary recovery rates of CAZ The intravenous bolus injection at 10 mg/kg. Peak plasma concentrations of CAZ were obtained at the first collection (30 minutes) of blood samples or 1 hour in all 3 groups, ranging from 23.3 to 26.9 micrograms/ml with no significant variations, plasma concentrations then slowly decreased, and were still 6.04-9.88 micrograms/ml even at 6 hours after the administration. The half-lives of CAZ in plasma tended to be shorter in older day-age neonates, with mean half-lives being 3.59, 2.50 and 2.50 hours for the youngest. The intravenous bolus injection at 20 mg/kg. Peak concentrations were obtained at the first collection of blood samples in all 3 groups (0-3 days: 15 minutes, the others: 30 minutes), being 54.8, 39.9 and 43.8 micrograms/ml, respectively, then slowly decreased and were still 10.4-15.7 micrograms/ml even at 6 hours after the administration. Inter-age differences in half-lives were marked, i.e., 3.6 hours in 0-3-day group, 3.48 hours in 4-7-day group and 2.75 hours in 8-day or older group. Urinary recovery rates were about 40-60% without reference to day-age neonates. CSF concentrations About 50 mg/kg of CAZ was given to each of 2 cases.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Fundamental and clinical studies on ceftazidime in neonates and premature infants]. 354 Mar 45

Fundamental and clinical studies on aztreonam (AZT), a new monobactam antibiotic, were performed in the pediatric field. The MICs of AZT were assessed against the clinically isolated strains in the pediatric infections. AZT showed an excellent antibacterial activity against Gram-negative bacteria, i.e., against E. coli (20 strains), K. pneumoniae (9), P. mirabilis (16), P. vulgaris (5), P. aeruginosa (10), S. typhimurium (4) and H. influenzae (11); the MICs of AZT against the above strains were less than 0.39 microgram/ml, 0.10 microgram/ml, 0.024 microgram/ml, 0.024 microgram/ml, 6.25 micrograms/ml, 0.10 microgram/ml and 0.10 microgram/ml, respectively. However, antibacterial activity of AZT against Gram-positive bacteria was inferior to that against Gram-negative bacteria, i.e., against the strains of S. aureus (16) and S. pyogenes (4), those MICs were more than 400 micrograms/ml and 3.13 micrograms/ml, respectively. Serum concentrations and urinary excretion of AZT were measured in 2 children aged 7 and 11 years after a single intravenous injection at the dose of 20 mg/kg. The mean serum concentration of AZT followed by the injection 62.5 micrograms/ml at 1/4 hour, 28.5 micrograms/ml at 1/2 hour, 16.5 micrograms/ml at 1 hour, 12.0 micrograms/ml at 2 hours, 3.6 micrograms/ml at 4 hours and 1.1 micrograms/ml at 6 hours, respectively. The mean half-life (beta-phase) was 1.24 hours. The mean urinary concentrations after the injection were 5,000 micrograms/ml in 0-2 hours, 1,650 micrograms/ml in 2-4 hours and 611 micrograms/ml in 4-6 hours and the mean urinary recovery rate up to 6 hours was 61.2%. These results in our studies were considered to be comparable with those reported in adults. In our clinical studies, AZT was administered to a total of 14 cases, i.e., acute pneumonia (4 cases), acute pyelonephritis (4), acute enteritis (5) and acute sppurative cholangitis (1). Clinical effect of AZT was excellent or good in 13 cases except fair in 1 case with acute enteritis and the efficacy rate (excellent and good) was 92.9%. With regard to bacteriological effect, all the strains of H. influenzae (3), E. coli (2), P. mirabilis (1) and P. vulgaris (1) were eradicated, but, S. typhimurium (4) was not eradicated. Neither side effect nor abnormal laboratory findings were observed during the study.
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PMID:[Fundamental and clinical studies on aztreonam in the pediatric field]. 409 59

Patterns of fever, shock, and chills in 100 episodes of febrile, Gram-negative bacillemia were retrospectively analyzed to determine features predictive of the site of infection, organism, and prognosis. Pneumonias most often produced morning temperature rises, whereas infections in other sites were usually associated with an afternoon or evening peak. Peritonitis (usually due to Bacteroides fragilis) tended to cause an indolent temperature rise (over a day or more), whereas pyelonephritis and cholangitis typically produced an abrupt "spike." Relatively low fevers characterized Enterobacter pneumonias while very high fevers were noted in Pseudomonas aeruginosa infections in patients with leukemia. Chills occurred with unusually high frequency in cholangitis and in Klebsiella bacteremia. Patients going into shock had higher fevers than those who did not. More importantly, the development of shock was shown to be related to severity of underlying disease. Shock never developed if the disease was not serious, unless the bacteremia was caused by instrumentation, but occurred in 73% of patients with leukemia or lymphoma. The clinical setting, pattern of fever, and presence or absence of a chill can in many cases usefully guide diagnosis and therapy in patients with Gram-negative bacillemia.
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PMID:Fever, shock and chills in gram-negative bacillemia: clinical correlations in 100 cases. 731 Dec 56

When investigating the asymptomatic significant bacteriuria in cholepathias and disease of the colon was stated that the asymptomatic significant bacteriuria is a frequent concomitant appearance of acute cholecystitis, of chronic cholangitis and ulcerous colitis. The asymptomatic significant bacteriuria does not mean pyelonephritis; but is a sign for the fact that the kidneys are in a condition endangered by pyelonephritis (potential pyelonephritis), that's why an aimed antibacterial treatment and subsequently bacteriological controls of the urine prove necessary.
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PMID:[Frequency of asymptomatic significant bacteriuria in bile duct and colon inflammations]. 742 14

To assess the usefulness of Western blot in the diagnosis of enterococcal infections, a pilot study was conducted with a newly developed Western blot using sera from patients with confirmed enterococcal infections. Sera from 17 of 19 patients with enterococcal endocarditis reacted strongly to enterococcal antigens on the Western blot, and most produced specific bands at molecular weights 98 kDa and 54 kDa. Sera from patients with bacteremic cholangitis and pyelonephritis reacted frequently as well, but the pattern of bands was different from that observed with endocarditis. Eighty-five percent of 26 sera tested from patients with bacteremia and associated deep-seated infections (endocarditis, cholangitis, and pyelonephritis) were positive on Western blot, compared to 30% of sera from bacteremic patients with no clinically determined deep focus of infection (p < 0.001).
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PMID:Serological investigation of enterococcal infections using western blot. 895 May 64

The symptomatic phases of many inflammatory diseases are characterized by migration of large numbers of neutrophils (PMN) across a polarized epithelium and accumulation within a lumen. For example, acute PMN influx is common in diseases of the gastrointestinal system (ulcerative colitis, Crohn's disease, bacterial enterocolitis, gastritis), hepatobiliary system (cholangitis, acute cholecystitis), respiratory tract (bronchial pneumonia, bronchitis, cystic fibrosis, bronchiectasis), and urinary tract (pyelonephritis, cystitis). Despite these observations, the molecular basis of leukocyte interactions with epithelial cells is incompletely understood. In vitro models of PMN transepithelial migration typically use N-formylated bacterial peptides such as fMLP in isolation to drive human PMNs across epithelial monolayers. However, other microbial products such as lipopolysaccharide (LPS) are major constituents of the intestinal lumen and have potent effects on the immune system. In the absence of LPS, we have shown that transepithelial migration requires sequential adhesive interactions between the PMN beta2 integrin CD11b/CD18 and JAM protein family members. Other epithelial ligands appear to be abundantly represented as fucosylated proteoglycans. Further studies indicate that the rate of PMN migration across mucosal surfaces can be regulated by the ubiquitously expressed transmembrane protein CD47 and microbial-derived factors, although many of the details remain unclear. Current data suggests that Toll-like receptors (TLR), which recognize specific pathogen-associated molecular patterns (PAMPs), are differentially expressed on both leukocytes and mucosal epithelial cells while serving to modulate leukocyte-epithelial interactions. Exposure of epithelial TLRs to microbial ligands has been shown to result in transcriptional upregulation of inflammatory mediators whereas ligation of leukocyte TLRs modulate specific antimicrobial responses. A better understanding of these events will hopefully provide new insights into the mechanisms of epithelial responses to microorganisms and ideas for therapies aimed at inhibiting the deleterious consequences of mucosal inflammation.
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PMID:Neutrophil transepithelial migration: role of toll-like receptors in mucosal inflammation. 1596 22

Very few reports are available from the literature related to Enterococcus hirae infection in humans, which is more frequently seen in animals and birds. We report two patients with E hirae bacteremia caused by acute pyelonephritis and acute cholangitis. The clinical courses have been smooth on use of sensitive antibiotic therapy. In both cases, the primary sources and portals of entry are clearly identified.
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PMID:Enterococcus hirae-related acute pyelonephritis and cholangitis with bacteremia: an unusual infection in humans. 2231 39


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