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)

Complications are the major causes of illness and death after burning and most of them stem from the burn wound. Their origin and importance are reviewed with emphasis on problems and growing points in knowledge. Fluid leakage from the circulation into the burn is the cause of hypovolemic shock, but the underlying permeability changes in the burn are only partly understood. Other nonbacterial complications include acute cardiac failure, acute anemia, hemolytic jaundice, renal failure, encephalopathy, complex hypermetabolic effects including pseudodiabetes, gastric and duodenal ulceration, deep vein thrombosis and pulmonary embolism, pulmonary and glomerular microthrombosis, hepatic jaundice, and arterial thrombosis. Involvement of the airway in conflagrations carries special hazards like glottic edema and inhalation of irritant fumes. Nowadays, bacterial causes are dominant and these remain the main challenge. Bacterial infection and invasion of the burn are usually responsible for septicemia, bronchopneumonia, and pyelonephritis although other sources also contribute. Indirect manifestations of septicemia include paralytic ileus, acute gastric dilatation, toxic myocarditis, and some cases of renal failure. Therapeutic complications like agranulocytosis, thrombocytopenia, and colitis occur at times. High concentrations of oxygen given therapeutically can produce fatal aseptic hypoxic pneumonitis.
 ...
PMID:A review of the complications of burns, their origin and importance for illness and death. 44 73

In a review of 37,012 autopsies over the last 20 years 202 deceased adults who had had a splenectomy were investigated. The incidence of infections and thromboembolic complications related to death in these patients was compared with that of a matched deceased population (n = 403) who had not undergone splenectomy. Death-related pneumonia was diagnosed frequently in the splenectomy group and to a lesser extent in the control group (57.9 versus 24.1 per cent, P less than 0.001). Lethal sepsis with multiple organ failure occurred in 6.9 per cent of the splenectomy group and in 1.5 per cent of the controls (P less than 0.001). Purulent pyelonephritis was observed in 7.9 per cent of the splenectomy group and was significantly more frequent than in the control group with its rate of 2.2 per cent (P less than 0.001). Finally, pulmonary embolism was the major or a contributory cause of death more often in the splenectomy group than in the control group (35.6 versus 9.7 per cent, P less than 0.001). We conclude that splenectomy generates a considerable life-long risk of severe infection and of thromboembolism.
 ...
PMID:Incidence of septic and thromboembolic-related deaths after splenectomy in adults. 273 68

Clinical experience with 2738 patients treated by extracorporeal shock wave lithotripsy between March 1985 and December 1988 is reported. All treatments were performed with the Dornier HM-3 lithotriptor. 34% of the patients needed auxiliary measures, consisting primarily of urological manipulation to improve urinary drainage or for better localization and/or focussing of the stones. Severe complications were rare; urosepticemia occurred in 0.3%, 2 patients had to undergo nephrectomy because of abscessing pyelonephritis, and there was one death due to recurrent pulmonary embolism in a patient with polycythemia vera. ESWL was used for stones in the entire upper urinary tract. The stone free rate for pelvic calculi smaller than 2 cm was 79% three months after treatment; a further 16% showed desintegrated material smaller than 5 mm, augmenting the success rate to 95%. The success rate dropped to 74% for very large renal stones of more than 4 cm. A stone free rate of 84-96% was ascertained for ureteral calculi 3 months after ESWL. Absolute contraindications for ESWL are acute pyelonephritis, coagulation disorders and pregnancy. The patients must tolerate anesthesia, as most treatments with this lithotriptor must be carried out under peridural or general anesthesia and only in a few exceptional cases is treatment in sedoanalgesia possible. ESWL is now generally accepted in view of its negligible invasiveness, low morbidity and the high success rate. Modern treatment of urinary calculi is inconceivable without considering ESWL.
 ...
PMID:[Clinical experiences with extracorporeal shockwave lithotripsy]. 279 24

Infectious complications increase the risk of postoperative thromboembolism. In order to assess the risk of deep vein thrombosis (DVT) in acute infections not associated with surgery, 36 patients with acute pneumonia or pyelonephritis were evaluated regarding development of DVT with the 125I-fibrinogen uptake test with confirmative phlebography. 1/15 patients with pyelonephritis and 1/21 patients with pneumonia developed DVT. No fatal pulmonary embolism was seen. The frequency of DVT was thus 6%. This low figure may be due to early mobilization of the patients and does not motivate routine anticoagulant prophylaxis against thromboembolic complications in patients with acute infections.
 ...
PMID:Frequency of thromboembolic complications in patients with acute pneumonia and pyelonephritis. 319 14

Ninety-four cases of pyelonephritis including 20 who had concurrent bacteremia were treated with cefamandole alone or in combination with either gentamicin or tobramycin. Doses of cefamandole ranged from 1--2 g by intermittent intravenous (VI) infusion every 4 to 8 h; gentamicin and tobramycin doses ranged from 1--1.7 mg/kg every 8 h also by intermittent IV infusion. Duration of therapy ranged from 5 to 23 days (mean 7.3 days). Both single and combination therapy successfully treated acute pyelonephritis and bacteremia in all patients. Seven strains of E. coli and one of Klebsiella pneumoniae responsible for initial infection were resistant to cephalothin but sensitive to cefamandole. Relapse with cefamandole sensitive bacteria occurred in 27% of patients receiving only cefamandole and 8% of those patients receiving combination therapy. Reinfection with cefamandole resistant organisms, predominantly Pseudomonas aeruginosa occurred in five patients. One patient had an intrarenal abscess due to E. coli which was successfully treated with 23 days of cefamandole. One patient died. However, death was due to acute pulmonary embolism, not infection. None of the patients receiving cefamandole plus gentamicin or tobramycin experienced a significant decrease in creatinine clearance during or after therapy. Skin rash, mild thrombophlebitis at the IV site and transient elevation of alkaline phosphatase and SGOT were the only side effects noted.
 ...
PMID:Cefamandole alone and combined with gentamicin or tobramycin in the treatment of acute pyelonephritis. 701 May 44

Recent studies have suggested that long-term lithium treatment reduces the high mortality rates of recurrent mood disorders in patients selected for and compliant with treatment at specialized lithium clinics. Whether lithium also generally reduces mortality in this diagnostic category under less select treatment conditions is a question of vital public health interest. The impact of prophylactic lithium on mortality was studied in a complete population of 362 unselected patients with DSM-III-R diagnoses of mood disorders or schizoaffective disorder, hospitalized at least once between 1970 and 1977 and treated with lithium for a minimum of one year. The patients were followed until 1991 or until date of death. The final analyses included 3911 patient years with lithium and, because of temporary or permanent discontinuations, 1274 patient years without lithium prophylaxis. A total of 129 deaths were recorded, compared with the 60.7 deaths that would normally be expected in the general population, yielding a Standard Mortality Ratio (SMR) of 2.1, significantly different from 1.0 (p < 0.001, 95% confidence limits 1.8-2.5). The relative risk of death was 1.7 times higher (p < 0.01, 95% confidence limits 1.2-2.6) during periods off lithium than during periods on lithium. The relative risk of suicide was 4.8 times higher off lithium than on lithium (p < 0.02, 95% confidence limits 1.1-12.6). Suicide, pneumonia, pyelonephritis, and, unexpectedly, pulmonary embolism contributed to the excess mortality both on and off lithium.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Mortality in recurrent mood disorders during periods on and off lithium. A complete population study in 362 patients. 774 44

Between August 1992 and April 1993, 60 patients underwent laparoscopic nephrectomy in our institution for benign disease (35 hydronephrosis, 20 chronic pyelonephritis, 4 end-stage kidney, 1 renal hypoplasia). Conversion to open surgery was needed in six cases to overcome intraoperative bleeding or perirenal adhesions. The mean operative time was 3.5 +/- 1.3 hours, and the mean hospital stay was 3.2 +/- 2.1 days. No deaths occurred, but significant complications were encountered in four cases in the form of pulmonary embolism, a large hematoma, postoperative bleeding, and colonic perforation. Laparoscopic nephrectomy is a safe and effective alternative to open nephrectomy for benign renal conditions.
 ...
PMID:Laparoscopic nephrectomy: an established routine procedure. 798 37

Authors used the Mainz pouch II technique for urinary diversion in 40 patients suffering from bladder cancer. They made minor modifications to the original surgical technique: a longer, 40 cm bowel is detubularized, the ureters are pulled through the mesosigma and embedded in a groove of the bowel's mucosa, the sigma pouch is fixed to the dorsal peritoneum, a straight suture is used. Single-row on the dorsal wall and two-rows on the ventral wall. Within a few days after the surgery suture insufficiency occurred in the abdominal wall in 5 cases, in the bowel in 2 cases. To treat suture disrupture of the bowel authors transformed the pouch, added a newly detubularized bowel segment to create a spheric rectum pouch and performed a definitive colostomy. During the follow-up period of six months to four years 8 of the 40 patients died from bladder cancer, 2 from cardiac failure, 1 from pulmonary embolism, and 6 have had a recurrence of the tumor. In the 23 tumor free patients we found no reflux, one has a slight stenosis of the ureter, febrile pyelonephritis did not occur, the pouch did not slip, the ureter had no kinking, and all patients are continent. Hyper-chloraemic acidosis has been prevented by regular administration of sodium bicarbonate or kalium citrate. Authors believe that Mainz pouch II is to be the most appropriate continent urinary diversion if an orthotopic substitution is not possible.
 ...
PMID:Our experience with the Mainz pouch II: 40 patients; follow-up and complications. 855 96

Analysis of early and late post-surgical complications in 44 cases of Studer's type bladder replacement due to carcinoma of the bladder performed over a 6-year period. Follow-up ranges between 6 months and 6 years. 4 patients died during the post-operative (9.09%): 1 myocardial infarction, 1 pulmonary embolism and 2 intestinal fistula. 28 patients (63.64%) had post-operative complications: 4 GI fistula (9.09%) 5 ileus (11.36%), 2 GI bleeding (4.54%), 1 ureteral fistula (2.27%), 1 ureteral stenosis, 6 urethro-intestinal fistula (13.36%), 1 tubular necrosis, 1 ruptured ureteral catheter, 5 wound infections (11.36%), 12 urine infections (27.27%), 6 sepsis (13.63%), 1 lymphocele, 1 evisceration and 2 eventrations. Repeat surgery was required in 6 cases. Within 6 months from discharge, 7 of 40 patients (17.5%) had some complication: 3 acute pyelonephritis, 4 episodes of acidosis-dehydration and 1 ureter stenosis. After 6 months, 7 of 38 patients (18.4%) had complications: 1 acidosis, 3 vesical lithiasis, 2 ureteral stenosis and 1 urethro-intestinal, plus 2 cases of chronic urinary retention. Daytime continence was 97.2% and nighttime continence 30%; after 6 months evolution, no further changes were seen.
 ...
PMID:[Studer's type ileal neobladder. Study of complications and continence]. 994 71

A 74-year-old woman was admitted because of abdominal pain. A few weeks before this admission she had had a cerebral infarction in the right hemisphere, reflected by a left sided paralysis, dysarthria, depression and a slight cognitive disorder. The night before admission she woke up from a sharp, continuous pain in the right upper abdomen. Physical examination disclosed pain in the right upper abdomen on palpation. Laboratory tests showed a slight elevation of all 'liver' enzymes. A differential diagnosis of cholecystitis or pyelonephritis was made. Additional tests did not confirm either of these diagnoses. Because of immobilisation pulmonary embolism was then suspected. This diagnosis was confirmed by scintigraphy. The patient was treated and made a full recovery. Diagnostic errors can be made by faulty triggering and omitting verification. The diagnostic strategy for pulmonary embolism is a ventilation perfusion scan, which is followed in case of a non high-probability result by pulmonary angiography. It is emphasized that the presentation of pulmonary embolism can be aspecific.
 ...
PMID:[Clinical thinking and decision making in practice. A patient with pain in the upper abdomen]. 1006 38


1 2 3 Next >>