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)

Septic shock may be classified clinically as primary (reversible) or secondary (irreversible). Primary shock is further distinguished as early ("warm-hypotensive") or late ("cold-hypotensive"). Infected abortion, chorioamnionitis, or pyelonephritis of pregnancy calls for appropriate measures directed toward preventing septic shock, including administration of huge doses of antibiotics. If septic shock ensues, extirpation of the nidus of infection becomes a primary consideration. Surgical extirpation should be carried out if possible, and as soon as possible. Besides antibiotics, patients with septic shock may require glucocorticoids, vasomotor drugs, digitalis, and heparin. Careful monitoring is essential.
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PMID:Septic shock in a pregnant or recently pregnant woman. 90 55

The three most commonly used aminoglycosides in obstetrics and gynecology are gentamicin, tobramycin, and amikacin. These drugs bind to subunits of the ribosome and inhibit bacterial protein synthesis. They are primarily active against aerobic gram-negative bacilli. Their principal adverse effects are nephrotoxicity, ototoxicity, and neuromuscular blockage. They may be administered intramuscularly or intravenously and usually are used in combination with other drugs for treatment of disorders such as pyelonephritis, chorioamnionitis, puerperal endometritis, and pelvic inflammatory disease.
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PMID:The aminoglycosides. 143 28

We assessed the relationship between systolic/diastolic ratios as determined by umbilical velocimetry to fetal heart rate. Umbilical velocimetry was performed with continuous-wave Doppler ultrasound and systolic/diastolic ratios and fetal heart rate for the corresponding cardiac cycles were calculated in four groups of patients. Group 1 consisted of 30 patients undergoing antepartum fetal testing; systolic/diastolic ratios were found to be significantly lower (mean +/- SD, 2.0 +/- 0.15) during an evoked fetal heart rate acceleration with an artificial larynx than either before (2.4 +/- 0.14) or after the acceleration (2.35 +/- 0.10, p less than 0.01). In 20 patients with pyelonephritis (group 2), systolic/diastolic ratios were significantly lower during initial fetal tachycardia (1.6 +/- 0.21) as compared with those obtained after its resolution (2.1 +/- 0.12, p less than 0.08). In the 25 patients with chorioamnionitis in group 3, systolic/diastolic ratios were significantly higher during initial fetal tachycardia (1.4 +/- 0.21) than after its resolution (1.9 +/- 0.15, p less than 0.05). Twenty patients in labor (group 4) had 10 serial measurements at 1 to 2-hour intervals of systolic/diastolic ratio and FHR. Least-squares regression of each patient showed a negative slope that differed statistically from zero (p less than 0.05). There were no patients with elevated systolic/diastolic ratios greater than 3.0 in any group and all patients delivered fetuses appropriate for gestational age. These findings suggest an inverse relationship between systolic/diastolic ratio and fetal heart rate. Additionally, an alteration in fetal heart rate within the range studied does not itself produce abnormal ratios. Therefore normalization of the systolic/diastolic ratio for heart rate may be considered in clinical studies for statistical analysis and comparison but may have little practical or clinical relevance when the ratios are abnormal.
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PMID:Relationship of systolic/diastolic ratios from umbilical velocimetry to fetal heart rate. 264 22

A number of organisms, including Mycoplasma, group B Streptococcus, Bacteroides, Neisseria gonorrhoeae and Chlamydia trachomatis, have been isolated more frequently from patients in premature labor than from controls. Prophylactic antibiotic treatment in some studies lowered the incidence of prematurity. Silent chorioamnionitis has been noted in 15% of patients in premature labor. Untreated pyelonephritis is clearly associated with premature labor; however, the association of asymptomatic bacteriuria, appropriately treated pyelonephritis and premature labor is less clear. Some microorganisms have been demonstrated to produce phospholipase A2 and possibly prostaglandins, which might be the mechanism for some of the associations between premature labor and bacteria.
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PMID:Microorganisms and premature labor. 327 13

Uterine unicollis bicornis with one rudimentary horn is a rare event. A case is presented of an infected rudimentary system existing with an intrauterine pregnancy. The differential diagnosis of appendicitis, chorioamnionitis, premature labor, and pyelonephritis makes management of such cases difficult. The successful outcome of one such case is presented.
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PMID:Uterine horn abscess complicating pregnancy. 371 39

The pathophysiology, clinical aspects, medical, and surgical management of endotoxin shock are reviewed. In the primate, the pathophysiology of endotoxin shock is contributed to by selective vasopasm, disseminated intravascular coagulation, and reduced myocardial response to sympathetic stimuli. Studies in the baboon measured various parameters of hemodynamics and coagulation, catecholamines, and some biochemical changes following the injection of a single bolus of endotoxin. Hemodynamic studies pointed to the kidney as a primary target organ. Coagulation changes included alterations in factor XII and XIII (and others) and plasminogen. Deposition of fibrin was also noted. Neurohormonal studies using tritiated norepinephrine showed a sharp rise in catecholamines 3 minutes after injection of endotoxin followed by a return to normal within 120 minutes, confirming the role of vasopasm in reducing renal perfusion early in shock. Prevention of septic shock is the best way to eradicate the extremely high reported mortality rates; infected abortion, chorioamnionitis, and pyelonephritis should all be warning signals. Methods of monitoring the patient in septic shock with special attention to blood pressure, central venous pressure, blood volume changes, and urinary output are discussed. Early surgical intervention and the proper use of vasomotor drugs and corticosteroids enhance patient survival.
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PMID:Septic shock (endotoxic shock). 419 24

Septic shock continues to be a serious problem with a mortality ranging from 11% to 82%, depending upon the cause, the time of diagnosis, and the type of treatment. The condition is seen in pregnant patients with postabortal or postpartal endometritis, chorioamnionitis, and pyelonephritis. In gynecology patients it is seen after severe pelvic infection and in immunosuppressed patients with gynecologic cancer. Prompt diagnosis, adequate monitoring and vigorous treatment are essential if deaths are to be reduced. Over the period July 1, 1959, to June 30, 1981, 91 patients were treated for septic shock with a mortality of 18%. Although medical treatment is important, the most important aspect of treatment for most patients is removal of the septic focus.
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PMID:Septic shock and the obstetrician/gynecologist. 708 49

Ureaplasma urealyticum organisms (ureaplasmas), Mycoplasma hominis, M. fermentans, M. primatum, M. Salivarium and M. pneumoniae have been isolated from the genitourinary tract. The first two of these microorganisms are found most frequently. M. hominis is a cause of some cases of postpartum and postabortal fever, acute pyelonephritis and pelvic inflammatory disease. Ureaplasmas have been associated with chorioamnionitis, habitual spontaneous abortion, low birthweight, the urethral syndrome in women, and nongonococcal urethritis (NGU) in men; but the difficulty of proving an etiological relationship is emphasized. However, in NGU there is accumulating evidence to indicate that ureaplasmas cause some cases. Some patients suffering from NGU, from whom ureaplasmas, mycoplasmas and chlamydiae cannot be isolated, respond to tetracycline therapy. This has suggested that a tetracycline-sensitive microorganism might be responsible. In this context, the isolation of a glucose-metabolizing mycoplasma from the genitourinary tracts of 2 of 13 men with NGU is of interest. This mycoplasma, serologically different from all other tested, has the structural and biological features of a pathogenic organism.
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PMID:Urogenital mycoplasma infections of man: a review with observations on a recently discovered mycoplasma. 728 95

The authors reviewed all documented cases of bacteremia in obstetric patients between 1975 and 1979, with emphasis on the clinical course. The incidence of bacteremia was 7.5:1000 obstetric admissions and 9.7% of those patients sampled. One hundred seventy-six bacteremic obstetric patients had the following diagnoses: endoparametritis (123), pyelonephritis (29), chorioamnionitis (14), and other (10). No deaths, clinical evidence of septic shock, or cases of postinfection endocarditis were found. The most common bloodstream isolates were Escherichia coli (57), group B streptococcus (28), and Bacteroides sp (26). The patients with endoparametritis had a fever index of 86.2 +/- 47.1F-hours, an average hospital stay of 6.5 +/- 3.1 days, a 7.3% rate of complications, and a 19.5% rate of failure of primary antibiotics. The patients with chorioamnionitis had a fever index of 32.7 +/- 48.9F-hours and an average hospital stay of 4.8 +/- 2.3 days. These clinical measures are comparable with those in the general population with the same diagnoses at the authors' hospital. In this obstetric population, prompt, vigorous treatment rendered the clinical course of bacteremic patients with genital infections remarkably similar to that of nonbacteremic patients with the same kinds of infection.
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PMID:Bacteremia in obstetrics: clinical course. 730 Dec 39

The disposition of ornidazole and its two major hydroxylated metabolites was studied in five pregnant women (gestational ages 25 5/7 to 38 4/7 weeks) with either chorioamnionitis or pyelonephritis treated with ceftriaxone 2 g, tobramycin 3 mg/kg body weight and ornidazole 1 g all administered once-daily. Two series of blood samples were obtained, the first on the first day of treatment and the second at steady-state on day 5. Local and systemic tolerability of ornidazole was excellent and patients showed complete remission without premature delivery. There was no evidence of ornidazole accumulation, and the pharmacokinetic parameters were very similar to those seen in healthy subjects. The dosage regimen of ornidazole therefore requires no adjustment during pregnancy. Trough concentrations of ornidazole measured at 24 h post dose were above the MIC of sensitive organisms. Children born to the trial patients showed normal initial development and their growth was normal.
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PMID:Disposition of ornidazole and its metabolites during pregnancy. 759 84


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