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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of emphysematous pyelonephritis with disseminated intravascular coagulation (DIC) is presented. A 54-year-old woman was admitted to our hospital because of unclear consciousness and extremely high blood glucose level. The laboratory data suggested uncontrolled diabetes mellitus (DM) and urinary tract infection with sepsis and DIC. The plain abdominal X-P and abdominal CT revealed the existence of gas in the right renal parenchyma, perinephric tissue and the upper part of the right ureter. Right nephrectomy was performed after the improvement of the patient's condition by the echo-guided drainage of the right kidney and the treatment for infection, DM and DIC. We reviewed 71 cases of emphysematous pyelonephritis in the Japanese literature and the choice of treatment was discussed.
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PMID:[A case of emphysematous pyelonephritis with disseminated intravascular coagulation]. 154 72

A case of emphysematous pyelonephritis with septic shock was present in a 58-year-old diabetic woman. The spontaneous production of gas was present within the right renal pelvis in kidney-ureter-bladder X-ray. The patient's condition deteriorated rapidly after admission, became complicated with acute renal failure, disseminated intravascular coagulation and acute respiratory failure. Transurethral drainage of the pelvis using a 6 Fr. UPJ occlusion balloon catheter and endotracheal intubation with respiratory assistance were performed as a life-saving procedure. The optimal therapy with surgical or conservative approach for such a severe condition is discussed. The use of transurethral drainage of pelvis as a non-invasive treatment is suggested.
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PMID:[A case of emphysematous pyelonephritis with septic shock recovered by transurethral drainage of pelvis]. 267 63

A case of emphysematous pyelonephritis is presented. A 66-year-old woman with diabetes mellitus was hospitalized for sudden pyrexia and left abdominal pain on January 13, 1987. She had shown preshock, pre-disseminated intravascular coagulation, hyperglycemia and renal dysfunction. Plain X-ray films of the abdomen and abdominal computer tomographic scanning showed a gas shadow in the left kidney. Retrograde pyelography demonstrated the left complete ureteral obstruction. A diagnosis was made of emphysematous pyelonephritis associated with diabetes mellitus and ureteral obstruction. Left nephrectomy was performed on January 17, 1987, and the pus obtained from the kidney yielded E. coli. After the operation, she has been doing well with diabetes mellitus under good control without insulin therapy. Thirty two cases of emphysematous pyelonephritis in the Japanese literature including our case are reviewed.
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PMID:[A case of emphysematous pyelonephritis--review of 32 cases in Japanese literature]. 269 28

A nine year retrospective study of hematuria in 14 New Zealand White rabbits was conducted to classify possible etiologies of this clinical finding. Physical examination, laboratory tests, radiography and postmortem examination were utilized in most cases to verify the presence of hematuria and to determine its etiology. Uterine adenocarcinoma was diagnosed in two rabbits. Three rabbits had uterine polyps with hemorrhage. Renal infarction with hemorrhage was diagnosed in three rabbits. Urolithiasis with secondary urethral obstruction and hemorrhagic cystitis was identified as the cause of hematuria in four rabbits. Other causes of hematuria included chronic cystitis, disseminated intravascular coagulation, bladder polyps and pyelonephritis. Hematuria of undetermined origin was observed in one rabbit. This last [corrected] case was negative for both blood and porphyrin in the urine, but positive for excess levels of urobilin, the oxidative product of urobilinogen. This case illustrates that hyperpigmented urine should be a rule out in all cases of suspected hematuria in rabbits.
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PMID:Hematuria in rabbits. 348 37

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

The causes of bacteriotoxic shock were examined in 33 patients (11 lethal outcomes). It has arisen as a complication of treatment given to 7830 patients for urolithiasis. Aggravation of chronic pyelonephritis, occlusion of the urinary tracts, urogenital mucosal and parenchymal injuries, low resistance to infection contribute to microbacteria and their toxins entering blood with resultant bacteriotoxic shock. Transcutaneous operative interventions, therapeutic and diagnostic procedures also produce high risk of blood infection with gram-negative microflora, especially in violation of asepsis and antisepsis rules. As shown by microflora tests, the dominating bacteria consisted of opportunistic agents which had acquired the resistance to antibacterial drugs. In view of rapid progression of bacteriotoxic shock therapeutic efforts should be concentrated on fast normalization of hemodynamics, recovery of urine passage, introduction of sorption detoxication, prevention of DIC syndrome. The schemes of combined antibiotic treatment adjusted to the kind of infectious agent are suggested.
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PMID:[Bacterial toxic shock as a complication of calculous pyelonephritis]. 787 14

A total of 83 patients with chronic renal failure (CRF) at azotemia stage (S. I. Riabov's classification) complicating pyelonephritis were treated: 19 patients received symptomatic standard therapy (group 1), 29 patients received combined therapy with enterosorption (group 2), 35 patients received combined treatment with plasmapheresis (group 3). The efficacy of the treatments was controlled by platelet tests (platelet, coagulative hemostasis, fibrinolytic plasma activity) and parameters of kallikrein-kinin system. Treatment results in group 1 are characterized as poor: insignificant improvement of uremia, DIC syndrome against unchanged inhibition of kallikrein-kinin system. Group 2 patients achieved moderate response: uremia reduced to normal azotemia values, DIC syndrome and inhibition of kallikrein-kinin system reduced. Patients of group 3 got disappeared DIC syndrome and normal kallikrein-kinin system against high azotemia.
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PMID:[Changes in the hemostatic system indices of patients with chronic kidney failure under the influence of enterosorption and plasmapheresis]. 798 57

The paper presents the results of plasmapheresis inclusion into a combined therapy of pyelonephritis. Out of 79 patients treated, 42 had urosepsis, 25 developed pyelonephritis in pregnancy, 12 had complicating chronic renal failure. Uroseptic patients were examined for hemostasis, the rest for immune status. There were symptoms of DIC syndrome in the former and immunity suppression in the latter. After the combined therapy with plasmapheresis, latent hypercoagulation and intoxication disappeared, uroseptic manifestations reduced. The above treatment of pregnancy pyelonephritis stopped inflammation, promoted activation of the immune system. In patients with chronic renal failure adjuvant plasmapheresis enhanced cellular and humoral immunity, neutrophil function, the number of middle-size molecules in the blood diminished. The latter improved renal function in decreasing uremia.
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PMID:[The use of plasmapheresis in treating urology patients]. 829 44

We measured the platelet distribution width, the mean platelet volume, the volume percentage of platelets, and the platelet-to-large-cell ratio in 15 elderly patients with disseminated intravascular coagulation (DIC). Peripheral venous blood mixed with ehtylenediaminetetraacetic acid was analyzed with a Sysmex E-4000 analyzer. The underlying diseases were sepsis, pneumonia, pyelonephritis, and other inflammatory diseases. The mean duration of survival from the onset of DIC was 16.9 +/- 23.9 days. The distribution of red cell sizes before the onset of DIC did not differ significantly from that in patients without DIC, but fragmentation of erythrocytes on blood films was more common in the early stage of DIC (p < 0.01). Before the onset of DIC, the two groups did not differ significantly in the frequency of giant platelets on blood smears. At the onset of DIC, the platelet distribution width, the mean platelet volume, and the platelet-to-large-cell ratio were significantly higher than in patients without DIC. The concentration of glutamic-oxaloacetic transaminase and those of other serum enzymes did not change significantly, but the serum creatinine concentration and the blood urea nitrogen level increased as the platelet-to-large-cell ratio increased. No significant relation was evident between the levels of serum C-reactive protein and creatinine, between the platelet-to-large-cell ratio and the mean volume of red blood cells, or between the platelet-to-large-cell ratio and the distribution of red cell sizes. These data suggest that studies of platelets are more useful in the diagnosis of DIC at early stages of impaired organ function than are other indicators of inflammation such as the level of C-reactive protein.
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PMID:[Changes in erythrocyte structure and in platelets in elderly patients with disseminated intravascular coagulation]. 899 5

The paper analyzes treatment outcomes in 72 patients with chronic pyelonephritis in the phase of active inflammation. The patients have received combined therapy including laser blood radiation to correct hemostatic defects. The latter manifested as DIC syndrome resistant to antibacterial treatment. Attempts to apply transcutaneous laser radiation (TLR) and intravascular laser radiation (ILR) showed that DIC syndrome may be cured only in the combined use of the above modalities.
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PMID:[The use of laser therapy in correcting hemostatic system disorders in patients with chronic pyelonephritis]. 903 98


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