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

The paper presents the results of surgical treatment of pyodestructive pyelonephritis diagnosed in 111 puerperae and gravidae. Suppurative nephritis, carbuncle and abscess of the kidney ran as unilateral (94 patients, 84.7%) or bilateral (16 patients, 14.4%) process. The diagnosis of pyodestructive pyelonephritis of the solitary kidney was made in 1 gravida. The outcomes of pyodestructive pyelonephritis in puerperae and gravidae depend primarily on individual approach to therapy. Different operative interventions warranted a complete response in 97.3% of the gravidae. 96 of 108 gravidae operated on the kidneys delivered viable neonates. Early operative interventions in many cases preserved the kidney and prevented septic complications. Pyodestructive changes restricted to 1-2 segments of the kidney were effectively treated by nephrostomy. Bilateral pyodestructive pyelonephritis should be managed step-by-step starting at the side of the most evident symptoms. Two-stage bilateral lumbotomy with nephrostomy in combination with antibacterial therapy and plasmapheresis eliminated septic complications thus allowing normal development of the fetus. Nephrectomy is the best treatment in advanced pyodestructive lesion with severe life-threatening septic intoxication.
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PMID:[The surgical treatment of suppurative destructive forms of acute pyelonephritis in pregnant women]. 903 1

The causes of acute renal failure in bacterial allograft pyelonephritis were evaluated using abdominal CT and graft biopsy. Twenty-one recipients, who showed a poor response to antibiotic therapy, comprised this study group. The diagnostic approach taken with this poor responder group was first to perform abdominal CT. If a focal lesion was identified on abdominal CT, a diagnosis of acute focal bacterial nephritis or renal abscess was made. If no focal lesion was found, a graft biopsy was performed for diagnosis. Abdominal CT revealed focal lesions in 9 of the 21 recipients, and renal biopsy showed superimposed acute rejection in 8 of the 12 recipients biopsied. In conclusion, acute renal failure in allograft pyelonephritis is associated with not only severe infection but also a superimposed acute rejection process. Therefore, imaging study and graft biopsy are recommended in the poor responder group.
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PMID:Evaluation of acute renal failure in bacterial allograft pyelonephritis using abdominal CT and graft biopsy. 905 52

The renal pathologic features of 120 consecutively autopsied patients affected by acquired immunodeficiency syndrome was investigated by light microscopic analysis. Variously associated renal changes were found in 82 patients (68.3%). Glomerular changes were present in 25. The following diagnoses were made: mesangial glomerulonephritis (16 patients), defined by the presence of deposits in the mesangium and/or mesangial cell proliferation; membranous glomerulonephritis (4 patients), cirrhotic glomerulosclerosis (2 patients); and lupuslike glomerulonephritis (3 patients). Glomerular diseases seemed to be significantly associated with chronic hepatitis or liver cirrhosis. Interstitial inflammation was present in 19 cases: chronic pyelonephritis (2 patients), focal nephritis (5 patients), multiple cortical abscesses (7 patients), granulomatous nephritis (5 patients). Cryptococci were found in one and undetermined microorganisms in two cases of multiple cortical abscesses. Atypical mycobacteria were found in two cases of granulomatous nephritis. Mycotic infections were identified in another 6 patients, in whom they did not elicit any inflammatory response. It is worth stressing that, although various generalized infections are common in patients with acquired immunodeficiency syndrome, only cryptococci and atypical mycobacteria also frequently involve the kidney. Focal tubular necrosis was observed in 15 patients. Benign nephrosclerosis was the most common vascular change (27 patients). Changes recalling hemolyticuremic and localized intravascular coagulation were found in three and six patients, respectively. Our data, dealing with a European Caucasian population, considerably differ from those reported in North American literature, in as much as we found no cases of human immunodeficiency virus nephropathy. Conversely, immune-mediated glomerular diseases were frequent, in agreement with recent studies on renal biopsy specimens from AIDS patients with acquired immunodeficiency syndrome. This type of infections, supplies multiple sources of antigens that may stimulate immune complex formation and, therefore, glomerular diseases.
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PMID:Renal changes in patients with acquired immunodeficiency syndrome: a post-mortem study on an unselected population in northwestern Italy. 907 21

The medical records of out-patients and in-patients served as the source of information for the incidence of nephrourological diseases, within the period 1983-1992. Cancer Registry and other appropriate registries of central Serbia were analysed, too. Mortality data were taken from the Republic Institute of Statistics. Descriptive method was used in epidemiological analysis. The highest incidence rates of kidney diseases were in central Serbia (59.6%), and the lowest in Kosovo and Metohija (40.2%). The most frequent were nephrolithiasis (26%), bladder and urethral diseases (20%) and pyelonephritis (17%). Mortality rates were highest for nephrosis and nephritis (13.7%). Men died more frequently due to malignant tumours of the bladder (4.9%) and kidney (2.3%) than women (1.2% and 1.6%). Unsteady quality of original data referring to constitutional parts of Serbia interfered with total comprehension of the epidemiological situation.
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PMID:[Descriptive-epidemiologic aspects of nephro-urologic diseases in Serbia]. 910 97

Escherichia coli that express Dr fimbriae and related adhesins recognize the common receptor decay accelerating factor. E. coli strains that express adhesins of the Dr family were postulated to be associated with cystitis (30-50%), pregnancy-associated pyelonephritis (30%), and chronic diarrhea (50%). In this study, we investigated the hypothesis that E. coli renal interstitial binding mediated by the Dr adhesin may be important for the development of chronic pyelonephritis. An insertional dra mutant, E. coli DR14, of the clinical E. coli isolate IH11128 bearing Dr fimbriae, was constructed and used to characterize persistence of infection and interstitial tropism in an experimental model of ascending pyelonephritis. Quantitative cultures of kidney homogenates indicated that Dr hemagglutinin positive (Dr+) E. coli IH11128 established a 1-yr colonization of renal tissue. In the Dr hemagglutinin negative (Dr-) group, 50% of animals cleared infection within 20 wk and 100% between 32 to 52 wk. Dr+ E. coli colonized the renal interstitium. Significant histological changes corresponding to tubulointerstitial nephritis including interstitial inflammation, fibrosis, and tubular atrophy were found in the kidney tissue of the Dr+ but not the Dr- group. A substantial amount of fimbrial antigen was detected in the parenchymal regions affected by interstitial inflammation and fibrosis. The obtained results are consistent with the hypothesis that mutation within the dra region, affecting E. coli binding to tubular basement membranes, prevented renal interstitial tropism and the development of the changes characteristically seen in tubulointerstitial nephritis.
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PMID:Development of experimental model of chronic pyelonephritis with Escherichia coli O75:K5:H-bearing Dr fimbriae: mutation in the dra region prevented tubulointerstitial nephritis. 912 10

Using medical manuscripts and texts from the Byzantine period (330-1453), this article describes various, to date little discussed, aspects of Byzantine nosology, public health and therapeutics. Many diseases in the Byzantine era were widespread and had a high morbidity such as respiratory disease, various kinds of anaemia, pestilential diseases (e.g. quartan fever, plague, dysentery and cholera), parasitic diseases, orthopaedic, rheumatic and psychiatric disorders, trachoma and alcoholism. Other very serious and relatively frequent conditions included leprosy, mania, gout, cancerous tumours and ulcers. Important elements of nephrology and various renal diseases were described and investigated, such as acute and chronic renal failure, acute and chronic nephritis, pyelonephritis, necrotic renal diseases, crush syndrome, and ulcers of the kidneys, i.e. tuberculosis or renal tumours. The microhistology and physiology of the kidneys were first studied by Oribasius, who discerned the existence of the capillaries--tau rho iota chi omicron epsilon iota delta eta--some centuries before Malpighi. He also correctly described the blood circulation, general and pulmonary, as a precursor to Harvey. The first hospitals were organised during the Byzantine period, and the practice of Byzantine medical science and its social applications were regulated by a special medical legislation and deontology. Byzantine medicine was fruitfully connected with the Christian faith and developed the supreme model of the saints unmercenary--alpha nu alpha rho gamma epsilon rho omicron iota--physicians such as Cosmas and Damian (3rd century), Panteleemon (3rd-4th centuries) and the women physicians and miracle-worker saints, Zenais and Philonilla (1st century), the 'friends of peace', and Hermione (1st-2nd centuries).
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PMID:Diseases in the Byzantine world with special emphasis on the nephropathies. 918 37

Our knowledge of the spectrum of renal abscesses has evolved as a result of more sensitive radiologic techniques. The classification of intrarenal abscesses currently includes acute focal bacterial nephritis, acute multifocal bacterial nephritis, renal cortical abscess, renal corticomedullary abscess, and xanthogranulomatous pyelonephritis. The clinical presentation of these entities does not differentiate them, however, and various radiographic studies are helpful in making the diagnosis. The intrarenal abscess is usually treated successfully with antibiotic therapy alone. Antistaphylococcal therapy is indicated for the renal cortical abscess, whereas therapy directed against the common gram-negative uropathogens is indicated for most of the other entities. The perinephric abscess is often an elusive diagnosis, has a more serious prognosis, and is more difficult to treat. Drainage of the abscess and sometimes partial or complete nephrectomy, in addition to antibiotic therapy, are required for resolution.
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PMID:Renal and perirenal abscesses. 937 29

Results of diagnosing pyelonephritis in 106 patients using ultrasonography, CT and thermovision were analyzed. Purulent pyelonephritis (PP) was diagnosed in 57 patients, serous pyelonephritis--in 49 patients. The sensitivity of ultrasonography in the diagnosing of PP was more than 80%, that of CT--90%. The methods used allowed the 100% improvement of the differential diagnosis of renal abscess, apostematous nephritis and pyonephrosis. The greatest problems were met in the diagnosis of renal carbuncle which was detected in 50% of cases by ultrasonography and in 54% of patients by CT. The minimum sizes of the destruction focus when the diagnosis could be reliable were 2 cm for ultrasonography and 1.5 cm for CT. Only using the findings of CT could diagnose emphysematous pyelonephritis. Thermovision could not find any definite criteria of PP. The timely diagnosis of PP allowed the organ-saving operations to be fulfilled in the overwhelming amount of the patients. Positive results of the treatment using the above mentioned diagnostic methods were obtained in 98.8% of the patients.
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PMID:[Characteristics of the diagnosis of purulent pyelonephritis]. 1120 37

Icterohemorrhagic spirochetosis convalescents develop slowly regressing renal dysfunctions most frequent of which are chronic renal failure, pyelonephritis and tubulointersticial nephritis, arterial hypertension. Renal disorders may be due to immunopathological reactions followed by activation of bacterial microflora. Damage from commissures at the sites of prior hemorrhage is also possible. In bovine leptospirosis renal damage is not so severe but it tends to progression. So, renal affection in leptospirosis is a specific pathology observed in any clinical form of the disease and demands surveillance in the regions of local focuses.
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PMID:[Renal involvement in convalescents after icterohemorrhagic leptospirosis]. 1121 Mar 52

Enteric fever is a common infectious disease of the tropical world, about 80% of these cases occur in Asian countries. Enteric fever presenting with isolated cerebellar ataxia or nephritis is rare. We report three cases of enteric fever that presented with these complications. Isolated cerebellar ataxia usually occurs in the second week, whereas in our cases it presented within first four days of fever. The common complications of enteric fever related to the urinary tract are cystitis, pyelitis, and pyelonephritis. Glomerulonephritis is uncommon. Most patients with enteric glomerulonephritis present with acute renal failure, hypertensive encephalopathy, or nephritic syndrome. In comparison, our case had milder manifestations. All three patients were treated with parenteral ceftriaxone and showed a prompt recovery.
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PMID:Nephritis and cerebellar ataxia: rare presenting features of enteric fever. 1129 67


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