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)

Radionuclide angiography (RNA) and cholescintigraphy were performed prospectively in 300 patients with suspected acute cholecystitis (AC). Of 79 patients with positive RNA, 63 had AC (80%). Positive RNA was seen in 23 of 26 cases with gangrenous AC (88%) while 12 of the 26 had a positive "rim" sign (46%). All 12 patients with a positive "rim" sign had positive RNA. The "rim" sign may be caused by increased perfusion. Five of 6 patients with positive RNA and "obstructive" pattern had AC (83%). Patients with negative RNA and positive cholescintigraphy had a positive predictive value of 54% (31/57), while those with positive RNA and positive cholescintigraphy had a positive predictive value of 85% (57/67). RNA showed increased perfusion to nonbiliary pathology such as liver abscesses and pyelonephritis. Positive RNA increases the predictive value of cholescintigraphy and may be useful to shorten cholescintigraphic examinations.
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PMID:Radionuclide angiography in suspected acute cholecystitis: further observations. 260 40

Based on the examination of 1050 patients the authors make a conclusion of great significance of renoscintigraphy, ultrasonic scanning and thermography for differential diagnostics of acute pyelonephritis, acute cholecystitis and pancreatitis.
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PMID:[Radionuclide, ultrasonic and thermographic methods of examination in the differential diagnosis of acute pyelonephritis and diseases of the abdominal organs]. 285 79

Acute cholecystitis is a non-rare disease, the incidence of which was increasing in the last years parallel to biliary lithiasis, which in 90% of cases is the first cause of such pathology. From the anatomopathological standpoint, we distinguish three types of acute cholecystitis: catarrhal, suppurative and gangrenous. The most frequently remarked symptom is ache at right hypochondrium. Only in 30% of cases cholecyst can be palpated, in form of ovoid mass; typical is the positiveness of Murphy's manoeuvre; constant is fever, but not subicterus. The introduction of new methods of ascertainment, exempt from any risks, simple to be performed and remarkably careful, made the diagnostics of acute cholecystites easier: parietal cholecystotomography, hepato-biliary scintigraphy, echotomography (first approach investigation), computerized axial tomography and laparoscopy almost always succeed in dispelling doubts. By using more than one of these investigations, a diagnostic accuracy, touching on 100%, can be reached. The differential diagnosis should be placed with: peptic ulcer, acute pancreatitis, acute appendicitis, gonococcus perihepatitis, virus hepatitis, acute pyelonephritis, right basal pneumonia. The complications an acute cholecystitis can occur are: perforation (localized, in free peritoneum or in a hollow organ), choleperitonaeum, necrosis of hepatic parenchyma, acute pancreatitis. Due to the possible arising of such complications, the mortality unfortunately is not indifferent (5%), especially in patients already weakened by other chronic diseases. Still discussed is the question as to when performing operation. In fact, there are three trends: intervention in immediate emergency, in postponed emergency, or in remote time (preceded by a medical treatment). The Authors prefer the intervention in postponed emergency, as, in their experience, they remarked the poor effectiveness of the delay medical treatment, also involving a greater difficulty in the technical execution of the intervention and a longer stay in hospital. From 1973 up to 1983, 241 cases of acute cholecystitis (158 women and 83 men) were hospitalized at the First Aid Surgical Centre of the Catania University. Eight patients refused the surgical intervention. The remaining 233 underwent, depending upon the seriousness of the affection, the associated diseases and the different reactiveness to the medical treatment, operation: in immediate emergency (26.1%); in postponed emergency (67.8%; in remote time (6.1%). The mortality was 2.2%, with the lowest percentage in the second group.
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PMID:[Acute cholecystitis]. 640 77

A black multipara was shown, by hemoglobin electrophoresis, to have hemoglobin SD disease. The patient exhibited a typically mild anemia that probably was secondary to folate and iron deficiencies as well as to hemoglobinopathic hemolysis. The course of her pregnancy was complicated by pyelonephritis and hyposthenuria, both of which have been reported in association with hemoglobin SD disease in pregnancy. The patient also was shown to have acute cholecystitis probably superimposed on a chronic cholelithiasis. This latter complication was probably the result of hemolysis due to hemoglobin SD disease. The patient was treated medically with good results, and, despite poor compliance and heroin addiction, delivered a viable infant at term.
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PMID:Hemoglobin SD disease associated with cholecystitis and cholelithiasis in pregnancy. 712 20

When investigating the asymptomatic significant bacteriuria in cholepathias and disease of the colon was stated that the asymptomatic significant bacteriuria is a frequent concomitant appearance of acute cholecystitis, of chronic cholangitis and ulcerous colitis. The asymptomatic significant bacteriuria does not mean pyelonephritis; but is a sign for the fact that the kidneys are in a condition endangered by pyelonephritis (potential pyelonephritis), that's why an aimed antibacterial treatment and subsequently bacteriological controls of the urine prove necessary.
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PMID:[Frequency of asymptomatic significant bacteriuria in bile duct and colon inflammations]. 742 14

An open-label, nonrandomized, multicenter study was designed to evaluate the efficacy and safety of intravenous (i.v.) ciprofloxacin, followed by oral ciprofloxacin and/or some other antimicrobial, as presumptive (empiric) therapy in hospitalized patients with clinical and bacteriologic evidence of infection. Out of a total of 149 patients recruited by 31 physician investigators, 148 were assessable for the determination of clinical efficacy and 102 patients were assessable for bacteriologic efficacy. All 149 patients were included in the evaluation of the safety of i.v. ciprofloxacin. The mean duration of IV ciprofloxacin therapy was 6 days, and 111 patients were subsequently switched to oral treatment with ciprofloxacin and/or some other antimicrobial. A clinically favorable response was achieved using i.v. ciprofloxacin in 48 (75%) of 64 patients with pneumonia; 4 (80%) of 5 patients with other lower respiratory tract infection (LRTI); 21 (88%) of 24 patients with pyelonephritis; all 7 (100%) patients with complicated cystitis; 16 (94%) of 17 patients with other complicated urinary tract infection (UTI); all 8 (100%) patients with cellulitis; both (100%) patients with infected ulcer; 4 (80%) of 5 patients with other skin or skin structure infection; 5 (83%) of 6 patients with bone infections; all 8 (100%) patients with septicemia; the 1 (100%) patient with acute cholecystitis; and the 1 (100%) patient with liver abscess. Of the 88 patients from these infection categories who were switched to oral ciprofloxacin, only 2 patients (2.3%) were classified as a clinical failure at the end of all therapy. Eradication of the causative pathogen was demonstrated with i.v. ciprofloxacin in 18 (55%) of 33 assessable patients with pneumonia; 1 (25%) of 4 patients with other LRTI; 17 (81%) of 21 patients with pyelonephritis; 3 (43%) of 7 patients with complicated cystitis; 9 (69%) of 13 patients with other complicated UTI; 3 (60%) of 5 patients with cellulitis; neither (0%) of the 2 patients with infected ulcer; 3 (50%) of 6 patients with other skin or skin structure infection; 2 (33%) of 6 patients with bone infections; and 4 (80%) of 5 patients with septicemia. A causative pathogen was not isolated in the 1 patient with liver abscess; initial bacteriologic culture was not available for the patient with acute cholecystitis. Of the 56 bacteriologically assessable patients from these infection categories who were switched to oral ciprofloxacin, there were only 3 patients (5.4%) in whom the causative bacterial pathogens were not successfully eradicated at the end of all therapy. There were no unexpected adverse events with the use of i.v. ciprofloxacin.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Sequential intravenous/oral ciprofloxacin as an empiric antimicrobial therapy: results of a Canadian multicenter study. The Canadian Collaborative Investigational Group. 792 17

The symptomatic phases of many inflammatory diseases are characterized by migration of large numbers of neutrophils (PMN) across a polarized epithelium and accumulation within a lumen. For example, acute PMN influx is common in diseases of the gastrointestinal system (ulcerative colitis, Crohn's disease, bacterial enterocolitis, gastritis), hepatobiliary system (cholangitis, acute cholecystitis), respiratory tract (bronchial pneumonia, bronchitis, cystic fibrosis, bronchiectasis), and urinary tract (pyelonephritis, cystitis). Despite these observations, the molecular basis of leukocyte interactions with epithelial cells is incompletely understood. In vitro models of PMN transepithelial migration typically use N-formylated bacterial peptides such as fMLP in isolation to drive human PMNs across epithelial monolayers. However, other microbial products such as lipopolysaccharide (LPS) are major constituents of the intestinal lumen and have potent effects on the immune system. In the absence of LPS, we have shown that transepithelial migration requires sequential adhesive interactions between the PMN beta2 integrin CD11b/CD18 and JAM protein family members. Other epithelial ligands appear to be abundantly represented as fucosylated proteoglycans. Further studies indicate that the rate of PMN migration across mucosal surfaces can be regulated by the ubiquitously expressed transmembrane protein CD47 and microbial-derived factors, although many of the details remain unclear. Current data suggests that Toll-like receptors (TLR), which recognize specific pathogen-associated molecular patterns (PAMPs), are differentially expressed on both leukocytes and mucosal epithelial cells while serving to modulate leukocyte-epithelial interactions. Exposure of epithelial TLRs to microbial ligands has been shown to result in transcriptional upregulation of inflammatory mediators whereas ligation of leukocyte TLRs modulate specific antimicrobial responses. A better understanding of these events will hopefully provide new insights into the mechanisms of epithelial responses to microorganisms and ideas for therapies aimed at inhibiting the deleterious consequences of mucosal inflammation.
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PMID:Neutrophil transepithelial migration: role of toll-like receptors in mucosal inflammation. 1596 22

The aim of this study is to report the extrarenal computerized tomography (CT) findings in patients with acute pyelonephritis (APN). Twenty-one CT examinations of 20 patients [19 women and one man, with ages ranging from 18 to 57 years (mean -35.2 years)], presenting either with a clinical diagnosis of APN (n=17) or with a suspected acute appendicitis, fever of unknown origin, and adult respiratory distress syndrome, one in each, were retrospectively reviewed. None had a known preexisting systemic disease. Results showed that renal abnormalities were seen on CT in all patients. In addition, ascites was detected in all women patients associated with subcutaneous edema in five of them. A thickened gallbladder wall was found in 19 cases, all were women, and periportal tracking and a dilated inferior vena cava in 17 CTs. Pleural effusion and thickened interlobular septa were present in 16 and 15 studies, respectively. Relevant laboratory findings included hypoalbuminemia in 14, elevated liver enzymes in 11, hypocholesterolemia in nine, and elevated LDH levels in six cases. In conclusion, radiologists should be familiar with the extrarenal imaging features of APN that may be seen on CT, and on ultrasonography as well, and should look for renal abnormalities to diagnose a clinically unsuspected APN. Alternatively, APN should be included in the differential diagnosis of systemic diseases that cause gallbladder wall thickening to avoid misdiagnosing it as acute cholecystitis.
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PMID:Extrarenal manifestations of severe acute pyelonephritis: CT findings in 21 cases. 1694 Nov 12

Acute appendicitis is a common surgical condition that is usually managed with early surgery, and is associated with low morbidity and mortality. However, some patients may have atypical symptoms and physical findings that may lead to a delay in diagnosis and increased complications. Atypical presentation may be related to the position of the appendix. Ascending retrocecal appendicitis presenting with right upper abdominal pain may be clinically indistinguishable from acute pathology in the gallbladder, liver, biliary tree, right kidney and right urinary tract. We report a series of four patients with retrocecal appendicitis who presented with acute right upper abdominal pain. The clinical diagnoses at presentation were acute cholecystitis in two patients, pyelonephritis in one, and ureteric colic in one. Ultrasound examination of the abdomen at presentation showed subhepatic collections in two patients and normal findings in the other two. Computed tomography (CT) identified correctly retrocecal appendicitis and inflammation in the retroperitoneum in all cases. In addition, abscesses in the retrocecal space (n = 2) and subhepatic collections (n = 2) were also demonstrated. Emergency appendectomy was performed in two patients, interval appendectomy in one, and hemicolectomy in another. Surgical findings confirmed the presence of appendicitis and its retroperitoneal extensions. Our case series illustrates the usefulness of CT in diagnosing ascending retrocecal appendicitis and its extension, and excluding other inflammatory conditions that mimic appendicitis.
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PMID:Ascending retrocecal appendicitis presenting with right upper abdominal pain: utility of computed tomography. 1963 Jan 19

Abdominal abscess is a very important problem nowadays, being responsible for prolonged hospitalisation, because these infections still cause substantial morbidity and mortality. For many years, surgical drainage has been considered the best therapeutic option in abdominal abscesses but several studies have subsequently shown that the percutaneous approach is as effective as surgical drainage. Starting from this background, the aim of this study was to evaluate whether or not percutaneous drainage is a valid treatment of choice. In the Department of Surgical Sciences, Organ Transplantation and Advanced Technologies of the University of Catania, 451 ultrasound guided percutaneous drainages of intra-abdominal abscesses were performed on 430 patients. Abscess drainage was successful in 322/403 (80%) of postoperative abscess, in 16/18 (90%) of primitive abscesses, in 10/12 cases (85%) of acute cholecystitis, in 3/6 cases (50%) of intrahepatic abscess and in 12/12 cases (100%) of pyelonephritis. US-guided drainage is currently the gold standard in the treatment of simple abdominal abscesses.
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PMID:Ultrasound-guided percutaneous treatment of abdominal collections. 1969 36


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