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)

The genitourinary tract is well recognized as a route through which bacteria could gain access to the blood circulation. Under some circumstances, metastatic infections may occur in distant organs, including endogenous endophthalmitis. Xanthogranulomatous pyelonephritis (XGP) is an unusual variant of chronic pyelonephritis. It most often occurs in middle-aged women who frequently have a history of recurrent urinary tract infections combined with obstruction and a kidney of poor function. We reported an unusual case of urinary tract infection in a non-nephrolithiasis and non-obstructive urinary tract complicated by Klebsiella pneumoniae endogenous endophthalmitis and developed XGP in two months.
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PMID:Unusual clinical presentation of Klebsiella pneumoniae induced endogenous endophthalmitis and xanthogranulomatous pyelonephritis in a non-nephrolithiasis and non-obstructive urinary tract. 1238 Sep 13

The aim of the study was to determine frequency of infectious-inflammatory complications regarding the duration of transcutaneous nephrolithotripsy (TCNL). Two groups of nephrolithiasis patients were compared. Group 1 consisted of 37 nephrolithiasis patients aged 20 to 78 years (15 males, 22 females). Size of the concrements ranged from 1.8 to 4.9 cm. They underwent contact lithotripsy performed by an ultrasound lithotriptor. Group 2 consisted of 22 patients aged 34 to 74 years (11 males and 11 females). Nephroliths were 2.0 to 8.5 cm in size. Group 2 patients underwent combined contact pneumatic and ultrasound lithotripsy on a novel Swiss LithoClast Master unit. Elimination of the nephroliths was observed in 27 (72.9%) patients of group 2 and in 19 (86.3%) patients of group 2. Residual calculi were detected in 10 (27%) patients of group 1. Surgery lasted 66 to 140 min (mean 81.2) and 40 to 120 min (mean 58.5 min) in groups 1 and 2, respectively. Pyelonephritis activity was registered in 24 (77.4%) and 3 (13.6%) patients, respectively. Thus, in percutaneous lithotripsy of large stones, frequency of inflammatory complications depends not only on technical faults and initial bacteriuria, but also on the duration of the operation. If surgical intervention took more than 60 min, frequency of the infectious-inflammatory complications increased 1.6-fold. Utilization of the lithotriptor Swiss LithoClast Master raises efficiency, accelerates destruction and evacuation of stones.
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PMID:[Results of transcutaneous nephrolithotripsy using the combined lithotriptor "2 in 1" "Swiss Lithoclast Master"]. 1240 77

Lipids were studied in 150 patients with nephrolithiasis, calculous pyelonephritis; enzymes, LPO products, phospholipase in 111 patients; vitamins A and E in 136 patients, vitamins B2, B6 and PP in 146 patients in the course of the disease, at admission and after treatment. In acute purulent and aggravated chronic calculous pyelonephritis lysophospholipids levels rose manifolds. Activation of LPO products, phospholipase, organ-specific enzymes is closely associated with low provision of vitamins A, E, B2, B6, PP. Deficiency of these vitamins ranged from 76.8 to 94.6% in acute purulent calculous pyelonephritis in all the patients.
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PMID:[Structural-functional damage to cellular membranes in deficiency of vitamins A, E, B2, B6, PP in children with calculous pyelonephritis]. 1262 65

Increasing prevalence of diabetes mellitus and rising patient life expectancy are causing an accumulation of urologic late complications-despite or due to steadily improving medical health care. The prevalence of diabetic cystopathy (impaired bladder sensation, increased bladder capacity, sometimes accompanied by voiding difficulties and residual urine) is 25% in non-insulin-dependent diabetics and 48% in insulin-dependent diabetics. Autonomic and peripheral neuropathy lead to detrusor hyposensitivity, and chronic overstretching of the bladder causes myogenic detrusor hypocontractility. Since diabetic cystopathy often develops insidiously and asymptomatically, prevention of secondary complications such as recurrent urinary tract infections, vesicorenal reflux, nephrolithiasis, and pyelonephritis requires the urologist's full attention as well as early and repeated urodynamic diagnostics. Comorbidities can lead to a variety of urodynamic findings. Therapeutic options are generally conservative (timed voiding, micturition training, CIC, pharmacotherapy) and should be part of an integrated interdisciplinary health care approach since undiscovered complications involving non-urologic organ systems create a higher long-term socioeconomic burden than preventive support provided by other specialists.
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PMID:[Diabetes mellitus and bladder function. What should be considered?]. 1466 81

Clinical trials of the generator EMSE 220F XXP were conducted on the lithotriptor Dornie C" in the Research Institute of Urology from September 2203 to January 2004. Extracorporeal lithotripsy (ECL) was made in 158 patients (66 women and 92 men, age 11-89 years) with different clinical forms of nephrolithiasis. The analysis of nephrolith fragmentation showed high disintegration power of the generator in all nephrolithiasis forms (97.4%). Maximal energy intensity in ECL of nephrolithis was under 7 units, of ureterolithis--10 units. The number of additional sessions averaged 11.4%, mean Edose was 49.2 J. Complications of early postoperative period was detected in 4 (2.5%) patients. In two of them (1.3%) subcapsular hematomas 180 cm3 in size were detected. The other two patients developed exacerbation of pyelonephritis early after operation. It was managed conservatively. Thus, EMSE 220F-XXP is a novel, highly effective source of generation of shock-wave impulses providing finely divided fragmentation of uroliths in 97.4% cases. A mean Edose 49.2 J effectively destructs urinary concrements of any location with a minimal risk of postoperative complications. Maximal intensity regimes should be used carefully with consideration of a high risk of traumatic complications.
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PMID:[New approach to improving efficacy and objective assessment of the extracorporeal lithotripsy]. 1571 21

Emphysematous pyelonephritis is a rare, but potentially lethal, possible sequela of nephrolithiasis, occurring most commonly in diabetic patients. The diagnosis of emphysematous pyelonephritis relies on the radiologic finding of gas in the renal parenchyma. We present the case of a patient with sarcoidosis, diabetes, and obstructing, gas-containing ureteral stones. Gas-containing renal stones are exceedingly rare, but have been linked to serious renal infections. The case management and a brief review of the published reports follow. We propose that gas-containing stones be considered evidence of emphysematous pyelonephritis in certain clinical settings.
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PMID:Gas-containing renal stones. 1707 Mar 81

Urinary tract calculi have been reported to account for between 1 in 1,000 and 1 in 7,600 hospital admissions in children in the USA. The annual incidence of urolithiasis in patients older than 10 years is 109 per 100,000 of the population in men and 36 per 100,000 of the population in women in Minnesota. The use of various medications is considered to be one of the etiologic factors of nephrolithiasis. Ceftriaxone is a widely used third-generation cephalosporin that is generally considered very safe, but complications such as biliary pseudolithiasis, and rarely, nephrolithiasis have been reported in children. There is limited information about urolithiasis as a side effect of ceftriaxone. The aim of this study was evaluation of the incidence of nephrolithiasis following ceftriaxone therapy in children. This quasi-experimental before and after study was conducted in Mofid Children's Hospital between 2003 and 2005. All patients were treated with 75 mg/kg intravenous ceftriaxone. Diagnosis of pyelonephritis was based on standard criteria. The first renal ultrasonography was performed on the first or second day of admission and was repeated on the last day of treatment. We also evaluated complicated patients for the third time with renal ultrasonography 3 months after treatment. Stone-forming patients underwent metabolic kidney stone risk factor evaluation. We evaluated 284 patients with pyelonephritis, 185 girls and 99 boys. The first ultrasonography was normal in all of our patients. On the second ultrasonography renal stones were reported in 4 out of 284 cases (1.4% and CI=0.96-1.83%). Underlying metabolic risk factors could not be identified in stone-forming patients. Follow-up ultrasonography 3 months later was normal. The results of our study suggest that ceftriaxone-treated patients may be at an increased risk of kidney stone formation. Stones passed spontaneously in all affected patients so the use of this effective drug can be safely continued. Close monitoring of ceftriaxone-treated patients with regard to kidney stone formation is recommended.
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PMID:Ceftriaxone associated nephrolithiasis: a prospective study in 284 children. 1722 43

Nephrolithiasis has rarely been reported in marine mammals. During 2004 and 2005, two cases of nephrolithiasis were diagnosed during routine necropsy examination, one in a northern elephant seal (Mirounga angustirostris) and one in a California sea lion (Zalophus californianus). Nephroliths were found throughout both kidneys during necropsy examination, varying in size from 1-10 mm in diameter in the northern elephant seal and from 1-15 mm in diameter in the California sea lion. Necropsy and histopathology revealed nephroliths in association with renal pelvic dilation and pyelonephritis in both animals. In addition, hydronephrosis was noted in the sea lion. Nephroliths were composed of uric acid and ammonium urate in the northern elephant seal and of ammonium urate in the California sea lion. The underlying disease leading to nephrolith formation was not determined; however, it is hypothesized that unknown metabolic derangements due to morphologic or physiologic differences may have played a role. This is the first report of urate nephrolithiasis in the California sea lion and northern elephant seal.
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PMID:Urate nephrolithiasis in a northern elephant seal (Mirounga angustirostris) and a California sea lion (Zalophus californianus). 1746 85

Immunomicrobiological examination was made of 656 urine and 71 blood samples from 71 patients with chronic pyelonephritis and coral nephrolithiasis. Bacteriuria in blood agar was quantified in colony-forming cells (CFC) in 1 ml of the urine. Identification of the bacterial strains was made by conventional methods. Blood samples were examined for phagocytic activity (PA) of neutrophils and phagocytic index (PI) in incomplete (30 min) and complete (2 hours) variants (S.aureus-209P), levels of IgA, IgM, IgG (in IU/ml), complement (CH50), T- and B-lymphocytes and 0-cells. Opportunistic bacteria (OB) in titer from Ig 2 to Ig 5 CFC/ml and more were identified in 428 (65.25%) samples. OB monocultures prevailed (48.6%). In exacerbation of the disease the majority of the examinees (73.0%) showed deficiency of both cellular and humoral components of antiinfection resistance system (AIRS). First-line defense against bacterial invasion was impaired as shown by incomplete neutrophil digestion in 62.0% of examinees. Among patients with humoral immunodeficiency, those with low IgM were the minority (45.0%). T-RFC and B-RFC deficiency (in 68.0 and 52.0%, respectively), low levels of IgG and IgA (66.0 and 73.0% cases, respectively) indicated deficiency of immunocompetent cells and their functional activity. The study of the AIRS established significance of its components for early and significant diagnosis of calculous pyelonephritis. Pyelonephritis in nephrolithiasis runs with deficiency of both cellular and humoral components of AIRS.
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PMID:[Some current aspects of diagnosis of calculous pyelonephritis]. 1747 91

Milk of calcium is a viscous colloidal suspension of calcium carbonate, calcium phosphate, or calcium oxalate, or a mixture of these compounds. The calcific material gravitates to the dependent portion of a cystic cavity. Crescent- or hemisphere-shaped calcium density with a sharp horizontal upper border at the milk of calcium-clear fluid interface confirms the diagnosis. Bilateral milk of calcium in the renal pelvis or in dilated calyces is very rare and has not been reported in patients with spinal cord injury. A 63-year-old male patient with T-10 paraplegia presented with recurrent urinary tract infections. X-ray of the kidneys, taken with the vertical beam while the patient lay supine, revealed a poorly defined opacity overlying the lower pole of the right kidney. Findings on ultrasonography of the kidneys were interpreted as a large, staghorn-type calculus in the dilated lower pole calyx of the right kidney. Because x-ray of the kidneys showed a poorly defined opacity overlying the lower pole of the right kidney, milk of calcium was suspected, and computed tomography (CT) of the kidneys was performed. Calcific debris with horizontal layering in the lower pole calyces of both kidneys was seen; this confirmed the diagnosis of milk of calcium. A 62-year-old female patient with C-7 tetraplegia underwent ileal conduit urinary diversion. Subsequently, she developed calculi in the right kidney, which were treated with shock wave lithotripsy. Follow-up x-ray revealed faintly opaque shadows with indistinct margins in the region of both kidneys. Intravenous urography showed cortical thinning at the upper poles and blunting of the calyces, suggestive of chronic pyelonephritis. The right renal pelvis was bulky, and bilateral renal calculi were diagnosed during ultrasonography; however, the presence of faintly radio-opaque shadows with indistinct margins raised suspicions of renal milk of calcium. A CT scan of the kidneys, which was performed in the supine and subsequently in the prone position, revealed gravity-dependent layering of calcific material in the pelves of both kidneys and in the midpole calyces of the right kidney, thus confirming the diagnosis of milk of calcium. In conclusion, CT scan of the kidneys confirmed the diagnosis of bilateral renal milk of calcium, a very rare entity in patients with spinal cord injury. Awareness of typical and unique features of milk of calcium during imaging enables physicians to recognize renal milk of calcium and to differentiate it from nephrolithiasis, thereby avoiding unwarranted interventions such as shock wave lithotripsy or endoscopic procedures.
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PMID:Bilateral renal milk of calcium masquerading as nephrolithiasis in patients with spinal cord injury. 1766 Jan 62


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