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)

The efficacy and safety of amikacin were evaluated in 42 patients with infections presumed to be due to gram-negative rods. The dosage of 7.5 mg of amikacin/kg every 12 hr was administered intramuscularly to 32 patients and intravenously to seven patients; three patients with renal impairment were given a modified regimen. The duration of treatment was three to 51 days (mean, 9.6 days). Of 19 patients with acute pyelonephritis, five had positive blood culture results. Ten patients had chronic urinary infection, and isolates of Pseudomonas aeruginosa from four of these patients acquired resistance to amikacin during therapy. Of seven patients with gram-negative bacteremia from sources other than the urinary tract, four showed satisfactory and three had less than optimal responses to therapy with amikacin. Two patients with chronic osteomyelitis or soft tissue infection improved but subsequently relapsed. Two patients with acute febrile illness, in whom the etiologic agent was unidentified, recovered. Serial audiograms revealed no change in 26 of 27 patients; one had a significant deterioration in hearing. A transient rise in the level of serum creatinine was noted in three patients. Serial tests of liver function revealed no abnormalities.
 ...
PMID:Clinical evaluation of amikacin in treatment of infections due to gram-negative aerobic bacilli. 82 90

The effect of co-trimoxazole was studied in 29 cases of acute or chronic pyelonephritis. The therapy produced the desired effect in 22 out of 23 cases and in the 6 cases treated prophylactically. We used a special dosage schedule for the combination of sulphamethoxazole and trimethoprim in the treatment of patients with normal renal function and with varying degrees of renal impairment. The results show that the plasma concentrations were at satisfactory therapeutic levels, with no accumulation of the three substances and without causing any toxic side effects, even in patients with severe impairment of the renal function. The mean duration of the treatment was 12.3 months. The material is, however, not largelu enough to warrant the recommendation of standardized treatment according to the schedule described, in spite of the favourable experience gained. It does, however, permit us to recommend that the plasma concentrations should be determined, particularly of the total sulphamethoxazole in patients with severely impaired renal function.
 ...
PMID:Co-trimoxazole in the long-term treatment of pyelonephritis with normal and impaired renal function. 106 15

An adult patient is described with recurrent urinary tract infections who developed renal scarring while under observation. Intravenous urography (I.V.U.) and renal arteriography were performed during an initial attack of pyelonephritis and I.V.U.s were repeated at intervals during follow-up, when the patient was having recurrent infections. Over 2 years the right kidney size diminished from 10.5 to 7.0 cm, the cortex became irregular and calyceal clubbing occurred. During a further 2 years, when on regular treatment, attacks became less frequent but left-sided symptoms predominated. Repeat I.V.U. at the end of this period showed that the left kidney size had reduced from 12 to 10 cm, again with the development of cortical irregularity and calyceal clubbing. Biochemical evidence of renal impairment developed. At no time were obstruction, reflux or associated pathology demonstrated and there was no history of analgesic abuse. Recurrent infection is suggested as the etiology of the scarring.
 ...
PMID:Development of renal scarring in an adult with recurrent urinary tract infection. 127

The therapeutic efficacy of ticarcillin/clavulanate was assessed in 71 patients with severe infections: 38 acute pyelonephritis, 16 septicaemia and 19 miscellaneous infections. The patients were classified according to their renal function in: Group A, normal (16 cases); B, mild renal impairment (RI) with creatinine clearance (Clcr) between 80 and 40 ml/min (18 cases); C, moderate RI with Clcr between 40 and 15 ml/min (12 cases); D, severe RI with (Clcr) between 15 and 5 ml/min (13 cases) and E, terminal with (Clcr) less than 5 ml/min (12 cases). A total of 105 microorganisms (48.6% resistant to ticarcillin): 31 Pseudomonas aeruginosa, 18 Escherichia coli, 21 other Enterobacteriaceae, 2 Haemophilus influenzae, 10 Bacteroides spp., 14 enterococci, 8 staphylococci and 1 streptococcus, were isolated. All except six Ps. aeruginosa were sensitive to ticarcillin/clavulanate, using 75:10 microgram discs. Bacteriological eradication was obtained in 97% of the cases on the third day and at the end of treatment, and in 82% of the cases after one month. In all the assessable cases, the clinical symptoms disappeared on the third day except in one patient who developed a resistant strain (Klebsiella oxytoca). The wide range of bacteria assessed and the clinical-bacteriological success rates demonstrated that the ticarcillin/clavulanate combination had an efficacy/safety profile that could be considered excellent. Tolerance was good and side effects were not observed. This study confirms the practical efficacy of the recommended dosages derived from our previous kinetic studies in RI.
 ...
PMID:Ticarcillin/clavulanate in severe infections in patients with varying renal function. 260 15

Cystectomy with ureterosigmoid anastomosis by modified Goodwin's technique was performed in 47 patients with local vesical cancer. Pre- and postoperative functional status of the kidneys was assessed by means of renography, excretory urography and laboratory tests. Unilateral or bilateral renal dysfunction developed within 12 to 18 months after surgery in 22.2% of patients with good pretreatment renal status. In cases of preoperative renal impairment, it improved postoperatively in just 35% of the patients. Rectoromanoscopy, contrast sigmoidography and excretory urography demonstrated pathological conditions in the area of ureterointestinal anastomoses (strictures, gaping or anastomositis) or sigmoid changes (sigmoiditis, kinking or stenosis in the perianastomosis area) in 83.3% of patients with impaired postoperative renal function. These conditions lead to hydroureteronephrosis, intestinoureteral refluxes and progress or development of pyelonephritis as a result. It is concluded that the state of ureterointestinal anastomoses and the sigmoid should be assessed specifically in postureterosigmoid anastomosis patients with impaired renal function. The surgical techniques and the degree of ureteral dilatation can make an important contribution to pathologic conditions developing around the anastomoses. Good functional activity of the kidneys and the absence of upper urinary dilatation are the principal prerequisite for ureterosigmoid anastomosis.
 ...
PMID:[Causes of the functional disorder of the kidneys in patients with bladder cancer after cystectomy with ureterosigmoid anastomosis]. 280 77

Twenty-one patients were included in an open randomized study comparing vancomycin 1 g bd with teicoplanin 400 mg daily in severe methicillin-resistant Staphylococcus aureus infections. The median duration of therapy was 15 days for vancomycin and 21 days for teicoplanin. Most patients presented with severe underlying conditions, such as major surgery (8), solid tumours (5), multiple trauma (3). The infections treated, included septicaemia, osteomyelitis, bronchopneumonia, cellulitis and acute pyelonephritis. Mean MICs of the strains were 0.39 mg/l for vancomycin and 0.195 mg/l for teicoplanin. Mean trough and peak serum concentrations of vancomycin were 14.3 +/- 5 mg/l and 34.3 +/- 13 mg/l, while the teicoplanin values were 7.5 +/- 4 mg/l and 17 +/- 7 mg/l. The cure rate was seven of 12 in the teicoplanin group and six of nine in the vancomycin group, with four and three cases, respectively, of improvement and one failure in the teicoplanin group. Transient renal impairment occurred in two cases with both regimens; superinfection and colonization in three patients and one patient, respectively, with both regimens.
 ...
PMID:Teicoplanin compared with vancomycin in methicillin-resistant Staphylococcus aureus infections: preliminary results. 296 35

The progression of renal failure was analyzed in 108 patients with mild to moderate renal impairment, none of whom had received any form of dietary protein, phosphate restriction or immunosuppressive treatment. The reciprocal of plasma creatinine was plotted against time using a minimum of six plasma creatinine values taken over at least six months (mean 13 values over 41 months). Plots indicated there was linear deterioration in 70 patients, non-linear deterioration in 15 and stable renal function in 24. Progressive renal failure was common in patients with glomerulonephritis, diabetic nephropathy, chronic pyelonephritis and polycystic kidney disease. Most patients with hypertensive nephrosclerosis, analgesic nephropathy and renal impairment following acute renal failure were stable. Among those with progressive impairment the mean rates of deterioration were significantly faster for patients with glomerulonephritis and diabetic nephropathy compared to those with chronic pyelonephritis, polycystic kidney disease and undiagnosed renal disease (p less than 0.01). Hence the underlying renal pathological changes appear to be important in determining progression of renal failure and also the subsequent rate of deterioration. For those with linear progression of renal failure there was a significant correlation between 24-h urinary protein excretion and the rate of deterioration. This relationship held for glomerulonephritis and chronic pyelonephritis as separate diagnostic groups only. Proteinuria, therefore, may be a useful prognostic index for the rate of progression of established renal failure. Calcium phosphate product correlated poorly with the rate of deterioration. We were unable to demonstrate a relationship between spontaneous protein intake and deterioration of renal function. However, patients prescribed high protein diets were not included in dietary analysis and we cannot, therefore, exclude the possibility that a high dietary protein intake may accelerate renal failure. Similarly we were unable to show a significant relationship between blood pressure and progression of renal failure although there were weak correlations between mean arterial pressure and rate of deterioration for chronic pyelonephritis and glomerulonephritis.
 ...
PMID:Renal pathology and proteinuria determine progression in untreated mild/moderate chronic renal failure. 320 6

During 1974-1984 altogether 481 patients were treated for end-stage renal disease (ESRD). Eight patients, five women and three men, with chronic pyelonephritis as the primary cause of ESRD, had staghorn urinary calculi as a predisposing factor for renal failure. These eight patients were studied retrospectively concerning epidemiological and bacteriological aspects, the treatment of the stone disease, and the development of uraemia. Anatomical and metabolic abnormalities such as bladder outlet disturbances, primary hyperparathyroidism, phenacetin abuse or metabolic stone disease were found in six patients. The women had all been infected with Proteus mirabilis, whereas the men had been infected with various microorganisms. The average time taken for the development of ESRD, estimated from the first sign of renal impairment, was 7.4 +/- 2.9 (SD) years. Five patients had died before this study commenced. One of the patients still alive was on dialysis treatment. Two patients who were doing well without dialysis were stone free and had sterile urine after successful pyelolithotomy. It is concluded that the prevalence of infectious urinary calculi as a cause of uraemia in patients with ESRD is low. The time taken for uraemia to develop is short in these patients and they often have anatomical abnormalities. Proteus is commonly found in this group of patients. Patients with staghorn calculi, urinary tract infection and impairment of renal function are at risk of developing uraemia.
 ...
PMID:Infection-induced urinary calculi and renal failure. 332 3

Ferritin, carcinoembryonic antigen (CEA) and beta 2-microglobulin (beta 2-MG) levels in urine from 45 patients with cancer (4 with renal adenocarcinoma, 7 with renal pelvic and ureteral cancer and 34 with bladder cancer) at various stages were clinically evaluated for their significance as parameter of urinary tract malignancies as compared to urinary fibrin/fibrinogen degradation products (FDP) and urine cytology. Ferritin levels for the poorly-differentiated and advanced stage groups were higher than those for the well-differentiated and early stage groups, and were especially high in 5 of the 7 patients with renal pelvic and ureteral cancer and all of the 7 patients with bladder cancer involving the upper urinary tract. These data suggest that determination of urinary ferritin is useful in the detection of urinary tract cancer involving the upper urinary tract. The upper limits of CEA levels were determined respectively according to white blood cell counts in urine. Although, CEA levels were elevated in the poorly-differentiated group and the advanced stage group compared to the well-differentiated and early stage groups, the values were positive in only 12 out of 52 cases (23.1%). These values seemed to be low compared to other reports. beta 2-MG levels increased significantly in the poorly-differentiated and advanced stage groups. However, most cases in the above groups were complicated with pyelonephritis or renal impairment. It is suggested that the urinary beta 2-MG secretion from cancer itself is not so significant.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Assessment of urinary ferritin, CEA and beta 2-MG determinations in patients with urinary tract malignancies]. 637 12

The prevalence of bacteriuria was studied in a population sample of women aged 38-60. Significant (greater than or equal to 100 000 bacteria/ml of the same species in two consecutive specimens) or "probable" bacteriuria (greater than or equal to 100 000 in the first and 20 000-90 000 bacteria/ml of the same organism in the second specimen) were found in 5% of the women, increasing from 3.5% in women aged 38 to 8.6% in women aged 60. Escherichia coli predominated (90% of those with significant bacteriuria), and 91% of the Escherichia coli strains were sensitive to sulphonamides. About half of the women who were non-bacteriuric after short-term treatment had one or more recurrent urinary tract infections during a two-year follow-up period. Serum creatinine and urine concentrating capacity did not differentiate women with significant or "probable" bacteriuria from the others. Pathological radiological changes were found in 17% of bacteriuric women who were submitted to i.v. pyelography. When re-examined six years after the first study, 23% of initially bacteriuric and 5% of initially non-bacteriuric women had bacteriuria. Patients with renal lesions have been followed for ten years, but none of them has developed progressive renal impairment. Three women with chronic pyelonephritis and acute pyelonephritic attacks in the past were discovered when screening the concentrating capacity in this population sample, but they were non-bacteriuric when screening for bacteriuria. A study of this kind must be conducted over many years before valid conclusions can be drawn.
 ...
PMID:Bacteriuria in a population sample of women. Prevalence, characteristics, results of treatment, and prognosis. 746 10


1 2 3 Next >>