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

Not long ago it was customary to expect an atmosphere of confrontation and controversy when urologic surgeons and infectious disease physicians met at conferences and symposia. Even more often each group exhibited an attitude of "benign neglect" towards the other. Times have changed in large part because of the efforts of the leadership group in urology. The establishment of an Advisory Board for this Journal, drawn from non-urological disciplines, is one example of the effort being made to draw together all concerned with urinary tract infections and pyelonephritis. I have been asked to review some practical up-to-date matters relating to the diagnosis and treatment of urinary tract infections and pyelonephritis from the point of view of an infectious disease physician. However, it may be helpful to begin with a synthesis of current concepts of the natural history of urinary tract infection, since the need for early diagnosis and the tactics for treatment depend largely on our expectations for the patient. This synthesis requires definition of terms that are acceptable to a wide variety of disciplines. The review would then focus on new methods for screening and office diagnosis, antimicrobial sensitivity tests, localization of infection and indications for urologic investigation, particularly in relation to vesicoureteral reflux. New developments in treatment of urinary tract infections will be discussed. Special attention will be given to areas in which we are ignorant and require more information. Last, I will direct my attention to the problem of the urinary catheter, hoping to arrive at a synthesis of the situation which will tell it like it is but avoid overstating the case.
 ...
PMID:New developments in the diagnosis and treatment of urinary tract infections. 109 84

Acute infection is accompanied by a characteristic reduction in circulating eosinophils. This study examined the generally held assumption that the eosinopenia of infection is a manifestation of adrenal stimulation. Trichinosis, Escherichia coli pyelonephritis, and early subcutaneous pneumococcal abscess were used as experimental infections of limited severity. Trichinosis is associated with eosinophilia, but pyelonephritis and pneumococcal infection produce eosinopenia. An assay for serum corticosterone was developed that is sufficiently sensitive to be performed with the small volumes of blood obtained sequentially from individual mice. The corticosterone response to trichinosis fits the sterotyped reaction previously reported for several other bacterial, viral, and rickettsial infections. The peak concentrations of corticosterone in serum from mice with trichinosis was approximately twice normal and occurred at the onset of clinical illness. Serum corticosterone levels gradually declined to the normal range over the next several days. E. coli pyelonephritis produced a similar adrenal response, although the peak serum corticosterone caused by pyelonephritis was less than the serum corticosterone occurring during the first peak of eosinophilia during trichinosis. Infection of a subcutaneous air pouch with penumococci produced eosinopenia within 6 h after inoculation, but there was no rise in serum corticosterone during the first 12 h of the pneumococcal infection. In addition, the eosinopenic response produced by a 12-hpneumococcal abscess occurred mice adrenalectomized 1-4 days before infection with pneumococci. The eosinopenia of acute infection cannot be ascribed to adrenal stimulation.
 ...
PMID:Behavior of eosinophil leukocytes in acute inflammation. I. Lack of dependence on adrenal function. 113 70

Infection of the urinary tract in childhood is common. It may start already in neonates or infants. Clinical signs are not always present but asymptomatic socalled bacteriuria may occur at any age. The earlier a child contracts the infection the more common are uncharacteristic clinical signs like loss of appetite, a raised temperature, parenchymatous icterus and, finally signs of involvement of the central nervous system. During the last few years purposeful research has established the important fact that, if there has been a urinary tract infection particularly in the first months of life, recurrence may more often be asymptomatic than on the first occasion. A mid-stream specimen is diagnostically valuable. If this does contain any bacteria, then supapubic aspiration from the bladder is useful in enabling us to start a specific, if possible bactericidal, therapy. Asymptomatic bacteriuria may at any time lead to clinical signs of pyelonephritis, particularly during periods of stress. Such silent unrecognized cases of asymptomatic bacteriuria may, we feel, lead to pyelonephritic nephrosis in a so far unknown percentage of cases.
 ...
PMID:[Recurrent urinary tract infection in childhood. Diagnosis, treatment, prognosis (author's transl)]. 116 77

Concentrations of prostaglandins of the E and F series were estimated by radioimmunoassay in cerebrospinal fluid (CSF) of 30 febrile patients (infants and adults) and of 19 afebrile, adult patients. In CSF of all feverish patients with meningitis, pneumonia, or pyelonephritis, concentrations of prostaglandins of the E series were about twice higher than those of the afebrile subjects. In contrast, concentrations of prostaglandins of the F series remained largely unchanged during fever. In accord with the results of animal experiments prostaglandins of the E series seem to act as mediators of fever during infectious diseases also in man.
 ...
PMID:Prostaglandins in cerebrospinal fluid of patients during various infectious diseases. 121 52

Urinary tract infections are one of the most common types of infection encountered in the practice of medicine. Recent discussions have focused on our current knowledge of natural host defenses that function during normal physiologic conditions in an attempt to prevent urinary infections. However, increased susceptibility to these infections may result from intrinsic risk factors that alter host defenses, or from extrinsic risk factors. Advances in the treatment of urinary infections have focused on short course therapy for women with uncomplicated lower tract infections, and on oral therapy in women with mild acute uncomplicated pyelonephritis. Also, in the area of prevention, reasonable candidates for antimicrobial prophylaxis have been identified. Even so, further studies are needed to define more clearly our understanding of the pathogenesis, treatment, and prevention of infections of the urinary tract.
Infection 1992
PMID:Urinary tract infections in the 90s: pathogenesis and management. 129 12

Most investigators agree that the adverse effects of urinary tract infections in pregnancy can be abrogated by effective early detection and treatment. However, the optimal methods for screening and treatment remain controversial. Although single-dose therapy has not been applied to pregnant women with acute pyelonephritis, most but not all studies which have compared single-dose with longer courses of beta-lactam or other antibiotics in pregnant asymptomatic bacteriuric women have shown no differences in outcome. This paper reviews recent trials of single-dose treatment of bacteriuria in pregnant women.
Infection 1992
PMID:Management of urinary tract infections in pregnancy: a review with comments on single dose therapy. 129 18

Bacteriuria in pregnancy occurs in about one in 20 pregnant women and is usually initially asymptomatic. It is an important marker for acute symptomatic infection (often pyelonephritis) later in pregnancy, which occurs in about one in four bacteriurics. Several considerations surround the antibiotic treatment of the asymptomatic infection; these include a low frequency of in vitro resistance to the agent used, lack of toxicity to the foetus, a low incidence of gastrointestinal side effects, good compliance and proven efficacy. Fosfomycin trometamol seems to fit these requirements. In three controlled studies (two multicentric) 250 patients were treated with fosfomycin trometamol in a 3 g (as fosfomycin) single dose; 197 patients were given one of three other agents. Cure rates for fosfomycin trometamol were 77-94% (68-94% for other agents), which was satisfactory in an infection which is sometimes difficult to eradicate. Further studies are needed in this important but accessible group of patients. Opportunities should be taken to study more foetal outcomes and provide more data on gastro-intestinal tolerability.
Infection 1992
PMID:Treatment of bacteriuria in pregnancy with single dose fosfomycin trometamol: a review. 129 25

Therapeutic standards have not been well defined for many forms of bacterial urinary tract infection. In women with uncomplicated infections, these exist for bacterial cystitis and for acute pyelonephritis. For most other categories of illness, among patients with complicated infections, no treatment regimens have been determined. As a result, well-designed clinical trials for these patient populations should be a priority.
Infection 1992
PMID:Standards of therapy for urinary tract infections in adults. 149 Jul 43

We report on a recent French Consensus Conference on antimicrobial therapy of urinary tract infections (UTI). These guidelines were limited to questions on which a consensus seemed possible, namely lower uncomplicated urinary tract infections, bacteriuria in pregnancy and in the elderly, acute pyelonephritis and prostatitis.
Infection 1992
PMID:French consensus on antibiotherapy of urinary tract infections. The French Society for Infectious Diseases. 149 Jul 44

This overview deals with the optimization of the design of clinical trials in patients with urinary tract infections (UTIs). Despite the fact that UTI is one of the most common types of infection and that the main end-point (elimination or persistence of bacteriuria) is objective and easy to register, the quality of studies performed and published has generally been less than optimal. Problems that should always be addressed in the study protocol are definitions of terms used, for example bacteriuria, level of the infection (cystitis or pyelonephritis), and uncomplicated and complicated infections; dimension of the patient's sample to allow adequate testing of a null hypothesis; procedures before, during and after treatment; methods for analysis of the results.
Infection 1992
PMID:Design of clinical trials in patients with urinary tract infections. 149 Jul 45


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>