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)

This review article discusses the stages in the development of research on group B streptococcus (GBS), otherwise called Streptococcus agalactiae. Emphasis was placed on the bacteriology, clinical spectrum of disease, immunity to GBS infections and antibiotic susceptibility of the causative organism. The organism, first recognized by Billroth in 1873, is classified into order Eubacteriales, family Lactobacillceae, class Schizomycetes and genus Streptococcus on the basis of its biochemical and physiological characteristics. It is subdivided into types Ia, Ib, Ic, II, III, X and R on the basis of carbohydrate and protein antigens present on its cell wall. Bovine strains of GBS are found in the bovine teat while human strains are present in the female vagina, the oro-pharynx, anorectum and the external auditory canal of newborns. It could be transmitted vertically from mother to child in-utero and during parturition. Cross infection by the nursery staff could also occur during the immediate post partum period. Two types of diseases are caused in the newborn: the early disease occurring within a week of birth; and the late disease presenting during the late neonatal period. The former usually presents in the form of septicaemia while the latter presents as meningitis. Adult infections include puerperal sepsis, pyelonephritis and a wide range of other infections. Usually they are associated with other underlying clinical conditions such as malignancy, diabetes mellitus and sickle cell disease. The organism is sensitive to penicillin which is the drug choice in treating established infections by GBS. Control measures are based on treatment of cases, eradication of vaginal colonization and chemoprophylaxis of infants at risk. An effective vaccine may become available in the near future.
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PMID:Review of group B streptococci and their infections. 241 64

60 cases of endotoxic shock in obstetrics and gynecology in a 7 year period, January 1974 to December 1980 in Nigeria are reviewed. The most common and causative conditions were septic abortion, puerperal sepsis and pyelonephritis in pregnancy. The commonest cultured organism was Eschericha Coli. There were 33 deaths, giving a mortality rate of 55%, which falls within the range reported in the literature. The mortality rate in the institution where this study was conducted has shown a downward trend. Early surgery is advocated in those cases with infected retained products of conception and pyoperitoneum, and more liberal use of steroids, hypertonic glucose solution and digoxin, especially in patients with cardiac decompensation. The patients of the sample met the following criteria: 1) the occurrence of hypotension with consistent reading of 80/50 mm Hg or less; 2) demonstrable evidence of infection as determined by fever, hematological and bacteriological studies; and 3) the presence of persistent tachycardia. Conditions related to pregnancy accounted for 50% of of all cases. A significant finding was that 14 out of 18 patients with induced abortion had it at 2 weeks before admission. A majority of the patients in this study had subnormal temperature. The presence of jaundice, pneumonia, persistent oliguria and hepatomegaly are ominous signs accompanied by high mortality. Pulmonary factors in shock are important in determining patient survival as well as lung functions afterwards. The mortality in endotoxic shock remains high despite widespread use of fluids, antibiotic and steroid therapy, indicating that eliminating bacteria and restoring blood pressure are not the only considerations in treating shock. Insufficient nutrition may contribute to cardiorespiratory deterioration in the acutely ill patient; important physiological variables are improved by administration of hypertonic glucose solution, which leads to increased clearance of E. Coli from the blood.
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PMID:Contribution of endotoxic shock to gynaecological and maternal morbidity and mortality. 1226 57

The spectrum of kidney disease occurring during pregnancy includes preeclampsia, hypertensive disorders of pregnancy, urinary tract infection, acute kidney injury, and renal cortical necrosis (RCN). Preeclampsia affects approximately 3-5% of pregnancies. We observed preeclampsia in 5.8% of pregnancies, and 2.38% of our preeclamptic women developed eclampsia. Severe preeclampsia and the eclampsia or hemolysis, elevated liver enzymes levels, and low platelets count (HELLP) syndrome accounted for about 40% of cases of acute kidney injury (AKI) in pregnancy. Preeclampsia/eclampsia was the cause of acute renal failure (ARF) in 38.3% of the cases. Preeclampsia was the most common (91.7%) cause of hypertension during pregnancy, and chronic hypertension was present in 8.3% of patients. We observed urinary tract infection (UTI) in 9% of pregnancies. Sepsis resulting from pyelonephritis can progress to endotoxic shock, disseminated intravascular coagulation, and AKI. The incidence of premature delivery and low birth weight is higher in women with UTI. The incidence of AKI in pregnancy with respect to total ARF cases has decreased over the last 30 years from 25% in 1980s to 5% in 2000s. Septic abortion-related ARF decreased from 9% to 3%. Prevention of unwanted pregnancy and avoidance of septic abortion are key to eliminate abortion-associated ARF in early pregnancy. The two most common causes of ARF in third trimester and postpartum periods were puerperal sepsis and preeclampsia/HELLP syndrome. Pregnancy-associated thrombotic thrombocytopenic purpura/hemolytic uremic syndrome and acute fatty liver of pregnancy were rare causes of ARF. Despite decreasing incidence, AKI remains a serious complication during pregnancy.
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PMID:The kidney in pregnancy: A journey of three decades. 2308 48

Pregnancy-related acute kidney injury (Pr-AKI) remains a large public health problem, with decreasing incidences in developing countries but seemingly increasing incidences in the United States and Canada. These epidemiologic changes are reflective of the advances in medical and obstetric care, as well as changes in underlying maternal risk factors. The risk factors associated with advanced maternal age, such as hypertension, diabetes, chronic kidney disease, and those associated with reproductive technologies such as multiple gestations, are increasing. Traditional causes of Pr-AKI, such as septic abortions and puerperal sepsis, have been replaced by hypertensive diseases, such as preeclampsia and thrombotic microangiopathies comprising thrombotic thrombocytopenic purpura (TTP) and atypical hemolytic uremic syndrome (aHUS). In this review, we discuss the global impact of Pr-AKI on maternal and fetal outcomes, the predominant etiologies, and key clinical features to distinguish diagnoses, such as preeclampsia/hemolysis elevated liver function test and low platelet (HELLP) syndrome, acute fatty liver disease of pregnancy (AFLP), and other thrombotic microangiopathies. New insights into the pathogenesis of preeclampsia, TTP/aHUS, and AFLP that have unearthed possible therapeutic targets are summarized. We also delve into special consideration needed to give to pyelonephritis and postobstructive causes of Pr-AKI. With each diagnosis, we offer the latest treatment recommendations, such as the positive reports from the use of eculizumab to treat aHUS. In the end, we hope to arm the clinician with the best tools to understand and address this morbid problem that does not seem to be disappearing.
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PMID:Acute Kidney Injury in Pregnancy: The Changing Landscape for the 21st Century. 2972 29