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 analysis of urinary proteins and their identification are discussed, particularly in regard to the technique of sodium dodecyl sulphate electrophoresis in polyacrylamide gradient gels. Urine collection, storage and preparation are evaluated, especially in regard to problems connected with concentration and dialysis of such samples. The instrumental approach to sodium dodecyl sulphate polyacrylamide gel electrophoresis represented by the Phast System appears to be particularly valuable in routine clinical analysis of urine specimens, since no sample pretreatment is required. The following types of proteinurias are evaluated: (a) orthostatic proteinurias; (b) post-renal proteinurias; (c) Bence-Jones proteinuria; (d) lower and upper urinary tract infection (cystitis and pyelonephritis) and (e) diabetes mellitus proteinurias.
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PMID:Sodium dodecyl sulphate electrophoresis of urinary proteins. 193 88

The pap operon encodes the gal alpha 1-4gal beta specific adhesins of Escherichia coli. The presence and organization of pap homologous DNA was determined using two probes specific for pap in 217 uropathogenic E. coli samples by dot blot and Southern blot analysis. The frequency of pap homologous DNA was 76% in pyelonephritis, 69% in cystitis, and 52% in an asymptomatic bacteriuria group. Further, the gal alpha 1-4gal beta binding phenotype among the pap-positive strains was expressed more often in acute pyelonephritis (91%) than the cystitis (60%) or asymptomatic bacteriuria (52%) strains. This was explained in part by difference in organization of pap homologous DNA between the genotypically positive pyelonephritis and asymptomatic bacteriuria strains. The pyelonephritis isolates contained three copies of pap significantly more often than the asymptomatic bacteriuria strains, and the pyelonephritogenic O-antigen types had a general increase in pap copy number. The difference in expression of gal alpha 1-4gal beta adhesins between pyelonephritis and asymptomatic bacteriuria isolates was thus not only a function of the frequency of pap homologous DNA but also of phenotypic expression among genotypically pap-positive strains.
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PMID:Frequency and organization of pap homologous DNA in relation to clinical origin of uropathogenic Escherichia coli. 196 35

Acute uncomplicated UTI is one of the most common problems for which young women seek medical attention, and it accounts for considerable morbidity and health care costs. Acute cystitis is a superficial infection of the bladder mucosa, whereas pyelonephritis involves tissue invasion of the upper urinary tract. Localization tests suggest that as many as one third of episodes of acute cystitis are associated with silent upper tract involvement. Acute cystitis or pyelonephritis in the adult patient should be considered uncomplicated if the patient is not pregnant or elderly, if there has been no recent instrumentation or antimicrobial treatment, and if there are no known functional or anatomic abnormalities of the genitourinary tract. Most of these infections are caused by E. coli, which are susceptible to many oral antimicrobials. Because of the superficial nature of cystitis, single-dose and 3-day regimens have gained wide acceptance as the preferred methods of treatment. Review of the published data suggests that a 3-day regimen is more effective than a single-dose regimen for all antimicrobials tested. Regimens with trimethoprim-sulfamethoxazole appear to be more effective than those with beta-lactams, regardless of the duration. Acute pyelonephritis does not necessarily imply a complicated infection. Upper tract infection with highly virulent uropathogens in an otherwise healthy woman may be considered an uncomplicated infection. The optimal treatment duration for acute uncomplicated pyelonephritis has not been established, and 14-day regimens are often used. We prefer to use antimicrobials that attain high renal tissue levels, such as trimethoprim-sulfamethoxazole or quinolones, for pyelonephritis. Women with frequently recurring infections can be successfully managed by continuous prophylaxis, either daily or thrice-weekly, by postcoital prophylaxis, or, in compliant patients, by early self-administration of single-dose or 3-day therapy as soon as typical symptoms are noted. Our drug of choice for all these regimens is trimethoprim-sulfamethoxazole. Acute uncomplicated cystitis in adult men is very uncommon, but it is occasionally noted in homosexual men who practice insertive and intercourse or in heterosexual men whose partners have vaginal colonization with E. coli.
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PMID:Management of acute uncomplicated urinary tract infection in adults. 199 38

Urinary tract infection results in significant morbidity and mortality while consuming large amounts of national resources. The prevention, diagnosis, and treatment of urinary tract infection produce both costs and benefits, and economic analysis provides a rational framework for looking at these effects. The goals and methods of economic analysis in medicine are summarized, and strategies to address uncomplicated cystitis, nosocomial urinary tract infection, and pyelonephritis are reviewed, with an emphasis on the economic trade-offs faced by decision makers.
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PMID:Urinary tract infection: economic considerations. 199 46

Ofloxacin is a quinolone carboxylic acid with a broad spectrum of activity for gram-negative pathogens that are common causes of urologic infections including cystitis, pyelonephritis, and prostatitis. The data in this publication will review clinical trials in urologic infections as well as the literature which dates from January 1983 through February 1989. The database includes over four hundred reports from nineteen foreign countries and involves data from more than 21,000 patients. The data from the United States were accumulated in clinical trials conducted between 1984 and 1988. Ofloxacin has certain attributes that make it a potentially useful drug in the treatment of urologic infections. These include the high bioavailability from oral administration and the fact that the product is excreted almost entirely by the kidney, primarily as the active parent compound. Urinary levels of ofloxacin two to four hours postadministration can achieve concentrations above 600 micrograms/mL after a single 400-mg dose. Urinary levels twenty-four hours after a single dose are noted to be typically around 50 micrograms/mL. Both of these concentrations are well above the minimum inhibitory concentration (MIC90) for uropathogens, which might be below 1 microgram/mL for many uropathogens. With respect to the prostate, ofloxacin penetrates prostatic tissues well and can achieve concentrations of approximately 4.5 micrograms per gram of prostate tissue as a mean peak level. Prostate levels ten hours postdose will typically be approximately 2.7 micrograms per gram of prostatic tissue. These levels exceed the MIC90 for the majority of prostatic pathogens as well.
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PMID:Worldwide clinical experience with ofloxacin in urologic cases. 200 42

To evaluate the natural history of uncomplicated urinary tract infections in women, we observed 51 infection-prone women in a standardized fashion for a median of 9 years. During intervals when patients were not receiving antimicrobial prophylaxis, infections occurred at an average rate of 2.6 per patient-year, but the rate varied widely from patient to patient (range 0.3-7.6 episodes per year). Seventy-three percent of the observed episodes were symptomatic, with an 18:1 ratio of cystitis to pyelonephritis episodes. Infectious episodes were strikingly clustered, and rates of infection decreased in the winter months. Antimicrobial prophylaxis was highly effective in preventing acute cystitis, asymptomatic bacteriuria, and acute pyelonephritis, even when used for as long as 5 years. The proportions of infecting strains resistant in vitro to ampicillin (19%-32%) and nitrofurantoin (5%-18%) were unchanged over the 15-year observation period, while resistance to trimethoprim-sulfamethoxazole increased in the last 5 years of the study.
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PMID:Natural history of recurrent urinary tract infections in women. 196 78

The paper is concerned with the results of ultrasound investigation of the kidneys and bladder in 78 patients with radiation injuries of pelvic tissues and organs. Comparison of the results of USI, isotope renography and excretory urography has shown that with an increase in the gravity of injury of the urinary system, the frequency of ultrasound findings rises from 60.8% in renal dysfunction of a mean gravity up to 91.2% in severe disorders. Echography data on the presence of hydronephrosis, pyelocaliectasis, a granular kidney, pyelonephritis, and nephroptosis usually coincided with the results of excretory urography in these patients. A combined use of echography and renography permits obtaining in most cases necessary data on structural and functional disorders of the urinary tracts. Echographic semiotics of radiation cystitis was studied in detail versus cystoscopy data. The informative value of ultrasound scanning of the bladder was observed in patients with radiation cystitis.
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PMID:[Ultrasonic diagnosis of radiation injuries of the urinary system]. 203 95

The clinical efficiency of tomicid used in the treatment of childhood cystitis was examined by employing clinical, endoscopic, microbiological, and immunological findings. A total of 140 children were examined. These include 78 with chronic obstructive pyelonephritis without cystitis and 62 with chronic cystitis. The urinary bladder was instilled with reference tomicid solution in 18 children with chronic cystitis during 10-12 days. Tomicid was found to produce bactericidal and anti-inflammatory effects. The immunomodulating effect was shown mainly in young children (aged 1-6 years). The lack of toxic and adverse effects of the drug allows one to recommend for use in pediatric urologic practice.
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PMID:[The tomitsid treatment of chronic cystitis in children]. 208 60

Decisions on treatment times with antibiotics are often arbitrary and based on empirical decisions or clinical trials which are too small to exclude even considerable differences between two study groups. Single-dose treatment of uncomplicated cystitis in women has been advocated by many but a careful analysis of available information clearly shows that a single-dose has so far always been inferior to 3-day or greater than 5-day treatment. With trimethoprim-sulphonamide combinations, no further efficacy is gained by increasing the treatment time in uncomplicated cystitis above three days while frequency of side effects increases drastically with extended treatment. In contrast, treatment with beta-lactams, for less than five days seems to result in unacceptable failure rates. In pyelonephritis there are few studies of the efficacy of antibiotic treatment for less than ten days. A comparison of two and six weeks' treatment showed no advantages with the extended time. There has also been a tendency towards reduced treatment times in upper respiratory tract infections such as streptococcal pharyngotonsillitis. However, two studies comparing 10-day treatment to 7-day and 5-day treatments, respectively, have clearly shown that the shorter treatment times give much higher rates of both clinical and bacteriological relapse. In more severe infections such as meningitis, no studies comparing treatment times have been carried out. It seems possible to use treatment for five days or less in meningococcal meningitis while other pathogens should be treated for ten days or longer. In endocarditis, the treatment time must vary with causative pathogens and can only rarely be shorter than four weeks.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Efficacy and safety of antibiotic treatment in relation to treatment time. 209 14

Urinary tract infections are a common problem seen in ambulatory practices. For this reason it is important to have a cost-effective management. Clinical history and findings may allow to make the diagnosis. The laboratory costs can be reduced, if in case of cystitis a rapid test for detection of leucocytes replaces the urine culture. Urine cultures can be restricted to patients with complicated urinary tract infections. Single-dose with cotrimoxazole or 3-day treatment with trimethoprim is adequate for acute cystitis. The new quinolones are useful for the outpatient treatment of benign cases of acute pyelonephritis. In case of urethritis and prostatitis, the same drugs have an appropriate antimicrobial spectrum and an ideal bioavailability in the infected tissues.
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PMID:[Urinary tract infections: which studies? Whom to treat?]. 212 Jul 87


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