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Target Concepts:
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Query: UMLS:C0034186 (
pyelonephritis
)
6,144
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Recent studies have suggested that long-term lithium treatment reduces the high mortality rates of recurrent mood disorders in patients selected for and compliant with treatment at specialized lithium clinics. Whether lithium also generally reduces mortality in this diagnostic category under less select treatment conditions is a question of vital public health interest. The impact of prophylactic lithium on mortality was studied in a complete population of 362 unselected patients with DSM-III-R diagnoses of mood disorders or schizoaffective disorder, hospitalized at least once between 1970 and 1977 and treated with lithium for a minimum of one year. The patients were followed until 1991 or until date of death. The final analyses included 3911 patient years with lithium and, because of temporary or permanent discontinuations, 1274 patient years without lithium prophylaxis. A total of 129 deaths were recorded, compared with the 60.7 deaths that would normally be expected in the general population, yielding a Standard Mortality Ratio (SMR) of 2.1, significantly different from 1.0 (p < 0.001, 95% confidence limits 1.8-2.5). The relative risk of death was 1.7 times higher (p < 0.01, 95% confidence limits 1.2-2.6) during periods off lithium than during periods on lithium. The relative risk of
suicide
was 4.8 times higher off lithium than on lithium (p < 0.02, 95% confidence limits 1.1-12.6). Suicide, pneumonia,
pyelonephritis
, and, unexpectedly, pulmonary embolism contributed to the excess mortality both on and off lithium.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Mortality in recurrent mood disorders during periods on and off lithium. A complete population study in 362 patients. 774 44
Escherichia coli strains causing acute
pyelonephritis
often express multiple fimbrial types and haemolysin, which may contribute to their ability to adhere to, and interact with, kidney epithelial cells. Strain CFT073, a pap+, sfa+, pil+, hly+
pyelonephritis
strain, previously established as virulent in the CBA mouse model of ascending urinary tract infection and cytotoxic for cultured human renal epithelial cells, was selected for construction of isogenic strains. From a gene bank of this strain, two distinct copies of the pap operon were isolated. The two P-fimbrial determinants were subcloned into pCVD442, a positive selection
suicide
vector containing the sacB gene of Bacillus subtilis. Deletion mutations were introduced into each of the two constructs, within papEFG of one operon and papDEFG of the other. Suicide vectors carrying pap deletions were mobilized from E. coli SM10 lambda pir into CFT073 (NalR) and cointegrates were passaged on non-selective medium. The first pap mutation was identified by screening a Southern blot of DNA from sucrose-resistant colonies using a papEFG probe. This mutant retained the MRHA+ phenotype since a second functional copy of pap was still present. A double pap-deletion mutant, UPEC76, confirmed by Southern blotting, was unable to agglutinate human type O erythrocytes or alpha Gal(1-4)beta Gal-coated latex beads. CBA mice (N = 100) were challenged transurethrally with 10(5), 10(6), 10(7), or 10(9) cfu of strains CFT073 or UPEC76. After one week, quantitative cultures of urine, bladder, and kidney were done and histologic changes were examined. No substantive differences in organism concentration or histological findings between parent and mutant were detected in urine, bladder, or kidney at any challenge concentration. We conclude that adherence by P fimbriae of uropathogenic E. coli strain CFT073 plays only a subtle role in the development of acute
pyelonephritis
in the CBA mouse model.
...
PMID:Isogenic P-fimbrial deletion mutants of pyelonephritogenic Escherichia coli: the role of alpha Gal(1-4) beta Gal binding in virulence of a wild-type strain. 796 11