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)

In order to determine the pathogenic responsibility of Escherichia coli adhesins (ADHs) in urinary infections (UI), 2,000 different patients suffering different clinical urinary and male sexual gland infections were monitored. The ADHs were determined by agglutination techniques with human and guinea-pig red blood cells, Candida albicans and Saccharomyces cerevisiae cells and latex sensitized with GAL-GAL. In uncomplicated UIs, the possession of ADH is the main invasion mechanism for E. coli. The rate of E. coli ADH strains is very high (89%) in acute cases (727 of 818 cases: 310 of 362 cystitis; 104 of 113 recidivant cystitis; 120 of 126 pyelonephritis; 158 of 173 prostatitis, and 34 of 43 orchiepididymitis) and rare (10%) in asymptomatic or chronic cases (24 of 235 cases: 14 of 148 bacteriurias; 8 of 74 prostatitis, and 2 of 13 orchiepididymitis). A close relation is established between the presence of ADH and clinical symptoms. 90% (218 of 242) of acute cases with systemic symptoms are due to MR-type ADH strains, especially the P subtype. 71% (409 of 576) of acute cases with local symptoms are due to MS-type ADH strains. In complicated UIs the expression of ADH is not an essential condition for the invasion of the urinary apparatus. It has been strongly suggested that males are significantly more resistant to UI, both in the tract and parenchyma, than women. It can be deduced that the underlying disease is more liable to UI the lower the adherence level shown by isolated strains. Thus catheters, reflux and neurogenic bladder are, by far, more aggressive alterations than the prostatic adenoma, vesical tumor or lithiasis.
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PMID:Frequency and distribution of uropathogenic Escherichia coli adhesins: a clinical correlation over 2,000 cases. 168 Jun 92

One thousand five hundred strains obtained from patients suffering from different clinical forms of urinary infections (UI) and dependent glands have been studied with the aim of establishing the pathogenic responsibility of E. coli adhesion protein (ADH) in urinary infections (UI). ADH were determined using agglutination techniques with guinea pig and human red cells, C. albicans and S. cerevisiae spores and GAL-GAL sensitized latex. In non complicated UI, the presence of ADH is the main invasion mechanism for E. coli. The frequency of adherent strains is very high (569/648) in acute cases (207/247 cystitis + 69/98 recurrent cystitis + 108/114 pyelonephritis + 140/154 prostatitis + 28/35 orchyepidimitis and scarce (14/184) in asymptomatic or chronic cases (6/107 bacteriurias + 7/67 prostatitis + 1/10 orchyepidimitis). A close relationship is established between the presence of ADH and clinical symptoms. The acute cases with general symptoms are caused in 85% of cases (188/216) by strains with ADH type MR specially subtype P. The acute cases with local symptoms (only urinary syndrome) are caused in 77% of cases (297/387) by strains with ADH type Ms. In complicated UI the expression of adhesion proteins does not constitute and essential requisite in order to invade the urinary tract. It is suggested that males are significantly more resistant the females to UI both parenchymal and urinary tract. It is deduced that underlying factors are more predisposing to UI the smaller the adherence rate of isolated strains is. Thus, reflux and neurogenic bladder probes are by far more aggressive alterations than prostatic adenoma, bladder tumor and lithiasis.
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PMID:[The role of E. coli adhesins in the pathogenesis of urinary infection]. 168 74

Based on analysis of 309 transurethral [correction of transureteral] surgeries performed on patients with various diseases (prostatic adenoma, prostatic carcinoma, vesical tumors, urethral stenosis, cervical sclerosis) the authors scrutinized various complications: intraoperative (hemorrhages, vesical perforations) and postoperative ones. The most common postoperative complications were acute pyelonephritis, (5.82 per cent), dysuria (3.88), urethral stenosis (2.91 per cent). Immediate and long-term postsurgical hemorrhages were documented in 4.2 per cent and enuresis in 1.94 per cent of the patients. Certain prophylactic measures were considered. The duration of surgery was found to be correlated with the incidence of postoperative complications and it should not exceed 30-49 min. The mortality rate was 1.29 per cent.
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PMID:[The complications of transurethral operations (an analysis of 5-year results)]. 169 37

It is a description of a new technique of putting a removable purse-string hemostatic stitch on the prostatic adenoma bed. Four stitches are made with a double catgut thread. The loop of the thread encircles the ureteral catheter introduced into the urethral tube. Upon tightening the purse, loose thread ends are connected with the urethral tube and fastened, the tube is tracted. Postoperative drop irrigation of the bladder with antiseptic drugs proceeds through the ureteral catheter. The purse-string suture is taken out when the catheter is removed from the urethral drainage at postoperative hour 20-24. The bladder is sutured tightly using double-row buried purse-string gut stitches. A total of 143 patients underwent surgery according to the technique of whom 70% had aggravating chronic cysto-pyelonephritis, 17.5% suffered from urolithiasis, 72% from cardiac diseases and 30% of respiratory disorders. 28% of the patients combined prostatic adenoma with chronic prostatis. 38 patients (26.5%) needed blood transfusions. Mean stay in hospital after one-stage adenomectomy made up 16.4 days at stage I-II of the disease, after delayed adenomectomy 19 days, after two-stage adenomectomy 21.8 days. Two patients died (1.37%).
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PMID:[The hemostatic pursestring suture in adenomectomy of the prostate]. 175 21

Outcomes of radical surgery for prostatic adenoma have been analyzed for 426 patients divided into 3 groups. Group 1 included 160 patients subjected to urgent adenomectomy for acute urine retention, group 2 comprised 166 patients with severe intercurrent diseases subjected to one- and two-stage radical surgery, group 3 of 100 patients was free of intercurrent diseases. Urgent and delayed (within 72 hours and 5-10 days, respectively) radical adenomectomies are thought valid in management of acute urinary retention in patients with prostatic adenoma. Adequate preoperative preparation in deficient circulation, diabetes mellitus and other preexisting or concurrent diseases increased by 20-30% indications to the operation. Good outcomes were reported in 90%, 81.4% and 94% of patients from group 1, 2 and 3, respectively. 98.7% of 388 patients avoided suprapubic fistula and resumed natural urination. Only 1.3% of patients were discharged with cystostomy drainage of the bladder because of urethral stricture, urethrorectal fistula, renal failure and pyelonephritis. The differential approach provided good outcomes in 87.6% of seriously ill patients in overall hospital lethality 8.9%. The majority of the lethal outcomes resulted from purulent pyelonephritis (71%). The rest cases were due to acute affections of circulation, respiration and digestion.
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PMID:[Therapeutic tactics and results of prostatic adenomectomy in the presence of aggravating factors]. 747 27

Basing on the results obtained in 380 patients, the efficacy of radical surgery of prostatic adenoma was studied in 3 groups of patients: group 1 (136 patients) underwent urgent adenomectomy because of acute urine retention; group 2 (153 patients) with severe concomitant diseases underwent one or two-stage adenomectomy; group 3 (92 patients) without clinically manifested somatic pathology. The author shows practical significance of urgent (within 72 hours) and delayed (within 5-10 days) radical adenomectomies in surgery of patients with acute urine retention. Long-term preoperative therapy of circulatory disorders and diabetes mellitus allowed performance of radical adenomectomy in additional 20-30% of group 2 patients. Positive outcomes were achieved in 88.2%, 80.4%, 93.4% of patients from groups 1, 2 and 3, respectively. Urination recovered in 98.5% of those operated on. Hospital lethality was 9.7%. Its cause was mainly purulent pyelonephritis (70.3%), the rest lethal outcomes occurred due to circulatory, respiratory and gastrointestinal diseases.
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PMID:[The characteristics of the surgical procedure in patients with the complications of prostatic adenoma and severe concomitant diseases]. 750 50

Such wide-spread urological diseases as nephrolithiasis and prostatic adenoma requiring surgical management are often associated with chronic infection or inflammation (pyelonephritis, prostatitis, adenomitis). Relevant antiinflammatory treatment as a rule is conducted after the patient hospitalization which may induce unwanted emotional stress, occasional hospital infection, additional material expenditures. The authors have the experience of bactericidal and antiinflammatory treatment of the kidneys (143 patients with nephrolithiasis) and prostate (287 patients with adenoma) in the outpatient setting. Three-stage system of the patients' care is recommended: district outpatient clinic-consultative outpatient department of the Research Urological Center-Hospital of the above Center. Such an approach noticeably improved the treatment outcomes: the frequency of inflammatory postoperative complications reduced 2-fold, no more lethal outcomes occurred, the duration of the hospital stay decreased two-fold. The authors suggest to introduce the above three-stage system of pre- and posthospital outpatient antiinfectious and antiinflammatory treatment of nephrolithiasis-affected kidney and prostate in adenoma into the practice of all national, regional and local urological centers.
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PMID:[The preoperative anti-inflammatory and postoperative therapy of patients with calculous pyelonephritis and prostatic adenoma with chronic prostatitis under outpatient polyclinic conditions]. 753 81

61 patients suffering from chronic pyelonephritis in the stage of active inflammation associated with either urolithiasis (67.4%) or prostatic adenoma (32.6%) were divided into three groups. Group 1 received conventional antibacterial treatment, group 2 conventional treatment + local laser radiation (LLR), group 3 received combined therapy including intravascular laser irradiation of blood (IVLIB). The treatments efficacy was controlled by urine seeding for microflora and its sensitivity to antibiotics, by immunological supervision. The patients were found to have immunological abnormalities in the form of cellular and humoral immunity suppression, neutrophil phagocytic hypoactivity, elevated levels of medium-molecular peptides nonresponsive to standard antibacterial therapy. Adjuvant use of LLR improved humoral immunity and reduced total urine bacterial count. LLR replacement for IVLIB resulted in a complete regression of immunological shifts and more pronounced reduction of urinary bacterial contamination.
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PMID:[The potentials of local and intravascular laser irradiation for eliminating the immunological disorders in patients with chronic pyelonephritis]. 754 Mar 38

The examination and surgical treatment were performed in 34 kidney recipients (22 males and 12 females aged 16-65 years) with different urological diseases admitted to the urological clinic of M. F. Vladimirsky Moscow Region Research Clinical Institute in 1992-2007 3 weeks to 15 years after kidney transplantation. Most of the patients had urolithiasis, prostatic adenoma, some patients had renal cyst, implanted kidney tumor, tumor of the arteriosclerotic kidneys, posterior urethra stricture, posterior urethra valve. The recipients with such urological diseases as chronic pyelonephritis, vesicoureteral reflux, chronic prostatitis, chronic cystitis received conservative treatment outpatiently. Extracorporeal lithotripsy (ELT) was made in 12 patients (each patient, except one, was exposed to 2 sessions, one patient--3)--a total of 27 sessions. After the first ELT session fragments of the concrements (mean size 2-5 mm in diameter) evacuated spontaneously. Transurethral (retrograde) x-ray-endoscopic operations for removal of the transplanted kidney uroliths were not conducted as the newly created ostium in the upper part of the urinary bladder made it impossible to use a retrograde approach for elimination of the concrements. Kidney recipients with prostatic adenoma (2 and 5 years after transplantation) in 3 cases were subjected to scheduled TUR because of manifest obstructive symptoms. Four patients with AUR undergoing TUR showed intraoperative tissue hemorrhage as the operation was conducted during anticoagulant and anti-platelet therapy used early (3 months to 2 months after the transplantation. In view of this, TUR lasted longer as adequate hemostasis was needed. Urethral nitinol stenting was made in one patient with AUR and prostatic size over 60 cm3, TUR was made 4 months later. Thus, low invasive surgical interventions in kidney recipients with urological diseases have changed routive approaches to treatment of such patients consisting in open surgery which was often cancelled because of contraindications. ELT is a basic method of treatment of the transplant's uroliths, in other cases different endourologic interventions are used. Prostatic adenoma is treated, as a rule, surgically (TUR of the prostate).
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PMID:[Current trends in the treatment of urological patients with transplanted kidney]. 1952 68

The study of efficacy and safety of the drug vitaprost plus (rectal suppositories) in its use for prevention of infectious-inflammatory complications after transurethral resection (TUR) of the prostate for adenoma included 55 male surgical patients with prostatic adenoma (PA). The patients were randomized into two groups matched by age, symptoms and clinical data. The control group consisted of 20 patients (group 1), the study group--of 35 patients (group 2). TUR of the prostate was made in both groups, but patients of group 2 were given additional prophylactic treatment--vitaprost plus, one suppository before going to bed 2 days before surgery and for 8 days after TUR, the course lasted for 10 days. Postoperative blood and urine samples showed inflammatory changes more often in group 1, free of infection bacterial tests were more often in group 2. Renal microcirculation in group 1 after TUR evidenced for functional depression on perfusion intensity and renal ischemia and congestion. These changes persisted on postoperative day 8, being a potential cause of renal inflammation and ascending pyelonephritis. Group 2 patients exhibited insignificant postoperative microcirculatory disorders in the kidneys and were not registered on postoperative day 8. Infectious-inflammatory complications in group 1 patients were registered much more frequently than in group 2 patients. Thus, vitaprost plus can be recommended for prophylaxis of infectious-inflammatory complications of TUR in PA patients.
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PMID:[Administration of vitaprost plus for prevention of infectious-inflammatory complications of transurethral prostatic resection in patients with prostatic adenoma]. 2206 44


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