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

Light and electron microscopic examinations of biopsies of the renal cortex were carried out in 24 patients with chronic pyelonephritis and 12 patients with hydronephrosis, as well as of the medullar substance in 7 of these patients after nephrectomy. A detailed analysis of the processes of granule formation in epithelioid cells of the juxtaglomerular apparatus (JGA) using the previously reported method of mathematical evaluation of the shape of granules (ellipticity) established a moderate direction correlation between the ellipticity of the granules and the level of proteinuria. Signs of activation were found in intact JGA: an increased amount of diamondshaped protogranules. The number of lipid granules decreased in interstitial cells of the medullar substance. In exacerbations of chronic pyelonephritis and experimentally, degenerative and necrotic changes were found in interstitial cells due to edema and infiltration of the medullar substance with polymorphonuclear leukocytes and lymphocytes.
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PMID:[Juxtaglomerular apparatus and interstitial cells of kidney medulla in hydronephrosis and chronic pyelonephritis]. 711 24

Charts were reviewed retrospectively for 65 patients with traumatic spinal cord injury discharged from the hospital between 1972 and 1977 on clean intermittent catheterization for management of neurogenic bladders. While 54 patients were still using clean intermittent catheterization 9 had discontinued its use and 2 were lost to followup. Complete urologic followup records were available for 28 long-term clean intermittent catheterization users, with an average followup of 3.7 years. Complications seen in this group included nephrolithiasis-3 cases, cystolithiasis--3, epididymitis--4 and urinary tract infection--12. No patient had hydronephrosis or radiographic pyelonephritis. Clean intermittent catheterization appears to be a safe and satisfactory alternative for long-term management of the neurogenic bladder of selected spinal cord injury patients, since the incidence of serious renal complications is low. Factors that should be considered before long-term clean intermittent catheterization is recommended include type of neurogenic bladder, prognosis for recovery, incontinence despite medication, history of urethral trauma, host resistance, physical independence in self-catheterization, compliance and patient preference.
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PMID:Clean intermittent catheterization for spinal cord injury patients. 712 May 49

Urosonography, ultrasound of the urinary tract, is a noninvasive imaging method used to evaluate renal masses, renal parenchymal disease, hydronephrosis, bladder volume and calculi. The applicability of ultrasound was studied in 54 spinal cord injury patients by correlating uroradiological examinations with ultrasound. Emphasis was placed on ultrasonic imaging of ureterectasis and vesicoureteral reflux. Ultrasound confirmed all positive radiographic findings of renal and bladder abnormalities (renal calculi, chronic pyelonephritis, trabeculated bladder and bladder calculi), and yielded additional information in 27 per cent of the kidney and 13 per cent of the bladder studies. Ultrasound was used to confirm vesicoureteral reflux in 56 per cent of the patients and ureterectasis in 33 per cent. It is recommended that spinal cord injury patients undergo a baseline excretory urogram followed by periodical ultrasound examinations to detect hydronephrosis, renal parenchymal disease, and renal and bladder calculi, and to measure bladder volume and residual urine. Whenever real-time equipment and experienced ultrasonologists are available ultrasound can be used as an alternate to voiding cystourethrography to detect vesicoureteral reflux.
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PMID:Urosonography in spinal cord injury patients. 715 75

A report is presented on a nine year old girl in whom a Spitz-Holter valve had to be implanted after operation on a meningomyelocele while a neonate. Because of a macrohematuria and a hypochromic anemia, she was admitted as an inpatient. In addition, there was a pyuria with bilateral hydronephrosis. The clinical picture was initially misinterpreted as hemorrhagic cystitis with ascending pyelonephritis in neurogenic bladder. Only the reduction of serum complement suggested the presence of a shunt nephritis. The diagnosis was verified by kidney biopsy. After removal of the infected valve system, there was a prompt normalization of all laboratory parameters. Besides description of the case history, above all the diagnostic problems of this rare syndrome, which is nevertheless of practical importance, are dealth with.
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PMID:[Clinical findings and diagnostic problems in a case of shunt nephritis. (author's transl)]. 719 34

The diagnostic work-up of the urologic patient must be tailored to the presenting symptom complex, carefully selecting from the many modilities available, those most likely to establish the diagnosis and extent of the suspected lesions. Intravenous urography is the most rewarding initial procedure for many presenting symptoms, including suspected masses, pyuria, hematuria, and flank pain. Nuclear imaging is particularly effective in differentiating renal lobulations from true masses, in demonstrating parenchymal scarring in chronic pyelonephritis when the IVP is equivocal, and in assessing the decrease in perfusion and function in obstructive nephropathy when the IVP is indeterminate. It is the preferred procedure for acute renal infarction and acute tubular necrosis and has a greater sensitivity of detection for renal trauma than the IVP. Gallium-67 renal imaging appear helpful in the detection of occult pyelonephritis or interstitial nephritis. However, it cannot differentiate focal acute pyelonephritis from abscess or abscess from neoplasm. Ultrasoneography is the initial procedure of choice in the differentiation of cystic from solid renal masses and in anuria or oliguria. When a kidney fails to visualize by IVP or nuclear imaging, it can confirm or rule out obstruction. In upper tract infections, it may demonstrate renal or perirenal abscess. Although retrograde pyelography is performed less frequently in recent years, it remains extremely useful in confirming and relieving obstructive uropathy and in delineating tumors of the collecting system. Computed tomography effectively demonstrates hydronephrosis, renal abscess, tumors, and cysts and retroperitoneal involvement. More experience is needed to judge the efficiency of "dynamic" CT for the quantification of renal function. Renal angiography remains invaluable as a secondary procedure (as opposed to initial screening) in renal trauma, vascular anomalies, and in renal tumors to delineate the anatomy of the arterial supply and possible renal vein involvement.
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PMID:Medical imaging of renal diseases-suggested indication for different modalities. 724 59

We reviewed the records of 255 children who have been managed by clean intermittent catheterization during the last 10 years to determine the incidence of bacilluria and upper tract changes. Bacteriuria was documented in 56 per cent of the children but febrile urinary tract infections occurred in only 11 per cent and fresh renal damage in 2.6 per cent. In the absence of vesicoureteral reflux bacilluria proved to be innocuous, since vesicoureteral reflux, progressive hydronephrosis or increasing parenchymal scarring did not develop. Bacteriuria in association with low grade reflux was rarely harmful and the reflux actually disappeared in up to 50 per cent of cases. However, bacteriuria in patients with high grade reflux was not an innocent phenomenon, since not only did the reflux tend to persist but pyelonephritis occurred in more than 60 per cent of the patients. In this latter group of patients reimplantation is an important therapeutic consideration if sterile urine cannot be achieved.
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PMID:The significance of bacilluria in children on long-term intermittent catheterization. 726 69

Sixty-two children with 90 refluxing ureters and neurogenic bladder dysfunction were initially managed by clean intermittent catheterisation. The upper urinary systems demonstrated hydronephrosis and/or parenchymal scarring in 57 kidneys and were normal in 33. Each child was placed on low dose antimicrobials and followed nonoperatively unless there was evidence of a febrile urinary tract infection or upper tract deterioration at which point antireflux surgery or urinary diversion was performed. Our experience suggests that children with neurogenic bladders and reflux may be safely managed by clean intermittent catheterisation and that low or moderate degrees of reflux may actually disappear. If recurrent bacilliuria or febrile urinary infections are noted then ureteroneocystostomy is a reliable and effective treatment option in neurogenic bladder disease provided that the bladder dysfunction is controlled. Higher grades of reflux have proven more difficult to manage and in our experience the reflux has not spontaneously abated and frequently there are associated episodes of acute pyelonephritis and renal damage. Because of our success with reimplantation surgery, we now favour early ureteroneocystostomy in such circumstances. With effective management of the neurogenic bladder dysfunction with intermittent catheterisation permanent urinary diversion should only occasionally be necessary because of vesicoureteral reflux.
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PMID:The management of vesicoureteral reflux in children with neurogenic bladders. 733 45

A 22-year review of 328 patients with Crohn's disease revealed 70 patients with urinary tract symptoms. Cystitis was the most common problem, occurring in 44 patients. The urinary tract infections were recurrent in most patients, usually with 3 or 4 attacks per year. Despite the persistence of urinary infection, only 3 patients developed chronic pyelonephritis. Forty-nine patients had intravenous urography, and many were found to have slight dilatation of the upper urinary tract on one side. Seven patients had hydronephrosis, 3 with pyonephrosis. Five of 6 patients who developed calculi had a bowel resection. All of the recovered calculi were oxalate stones, but 3 were passed spontaneously and not analyzed. Eight patients, 7 of them males, had an ileovesical fistula. In 1, the colon was also affected. It was unusual for these patients to have severe urinary symptoms. One patient had a fistula from the rectum to the urethra. Although 32 of the 70 patients were female, most of the severe complications occurred in men. Aggressive investigation is not indicated, nor is radical surgery required.
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PMID:Urinary complications of Crohn's disease. 740 53

Intravenous radionuclide cystography using a single intravenous injection of 99mtechnetium diethylenetriaminepentaacetic acid, provides information on individual kidney function, coarse anatomy and vesicorenal reflux. This study investigates the effectiveness of intravenous radionuclide cystography in detecting reflux. In 58 children intravenous radionuclide cystography detected 53 ureters with reflux compared to 32 detected by voiding cystography. This difference was investigated further with patients in whom other test suggested reflux. While there was no statistically significant difference for patients having pyelonephritis or hydronephrosis, intravenous radionuclide cystography detected significantly more ureters with reflux in patients with abnormal ureteral orifices or infected urine and, therefore, predisposed to reflux. Intravenous radionuclide cystography is a more comprehensive and sensitive test for vesicorenal reflux than voiding cystography.
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PMID:Intravenous radionuclide cystography for the detection of vesicorenal reflux. 746 90

The nonionic radioopaque ultravist and the high-molar radioopaque verograffin were studied for their effects on the blood osmotic status of children with lower renal concentrating function. A total of 36 children aged 8 months to 12 years who had pyelonephritis, hydronephrosis and renal injury at their acute stage were studied angiographically under general anesthesia. The radioopaque was injected in a mean dose of 2 ml/kg for 2-3 sec. Ultravist was found to have a less osmotic action on the blood osmotic status than did verograffin. The changes in the detectable major blood osmotic parameters: sodium, potassium, glucose, urea, creatine were less pronounced. Plasma osmolality was moderately increased with ultravist and much higher than its normal values with verograffin at min 1 after its administration and at hour 2 of the study. Ultravist is preferable as a radiopaque used in children with decreased renal concentrating function.
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PMID:[Ultravist - drug of choice for radioopaque studies in children with renal disfunction]. 751 23


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