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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute gestational pyelonephritis infrequently leads to nonhydrostatic permeability pulmonary edema known clinically as acute respiratory distress syndrome (ARDS). In this form of ARDS, sepsis is considered the primary cause of pulmonary dysfunction. Decreases in colloid osmotic pressure, plasma fibronectin, and arterial oxygen saturation are associated with a worsening prognosis in septic conditions. We sought to investigate the changes in these parameters with acute gestational pyelonephritis to gain insight into the factors that may place the patient at risk for sepsis-related morbidity. Colloid osmotic pressure, plasma fibronectin, and arterial oxygen saturation via pulse oximetry were prospectively measured during the inpatient treatment of 17 pregnant patients with acute gestational pyelonephritis. All three parameters achieved their nadir within 24 hours of hospitalization and the initiation of therapy. Although no patient developed significant pulmonary dysfunction, we believe that patient susceptibility for pulmonary edema and general morbidity could be maximal in the first 24 hours after therapy. Future studies using a larger number of patients may identify one or more of these laboratory parameters as helpful in identifying gravid patients who are at risk of developing gestational ARDS.
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PMID:Acute gestational pyelonephritis: the impact on colloid osmotic pressure, plasma fibronectin, and arterial oxygen saturation. 202 86

Fibronectin levels were measured by enzyme immunoassay in 68 patients with pyelonephritis and 10 patients with chronic cystitis. The patients with chronic cystitis, acute and chronic non-obstructive pyelonephritis exhibited significantly high average blood fibronectin levels, whereas those with chronic obstructive pyelonephritis displayed the levels slightly different from those observed in healthy individuals. Hypofibronectinemia was detected in 23.3% of patients with chronic pyelonephritis. Preincubation of the neutrophils isolated from pyelonephritis patients with fibronectin increased the initially low phagocytic capacity without enhancing their metabolic activity. In experimental pyelonephritis, administration of exogenous fibronectin was demonstrated to contribute to a rapid bacterial elimination from the kidneys, to decrease the intensity of an inflammatory response, to prevent renal histostructural lesions, to enhance the functional activity of immunocompetent cells and to stabilize their membranes. The findings may serve the basis for using fibronectin in clinical practice as a promising agent to treat pyelonephritis.
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PMID:[Fibronectin and its significance in pyelonephritis]. 794 Nov 52

Staphylococcus aureus remains a prominent cause of community- and hospital-acquired infection. This study reviewed 162 cases of S. aureus infection occurring in 120 adults who were hospitalized at a Veterans Affairs Medical Center and referred for consultation to the Infectious Disease Service. There were 37 cases of skin and soft tissue infection, 5 pyomyositis, 34 osteomyelitis, 13 septic arthritis, 19 pneumonia, 3 empyema, 5 pyelonephritis, 37 vascular infection, 3 epidural abscess, and 6 miscellaneous infections. Bacteremia was documented in 56 of 119 (47%) cases in which blood cultures were obtained, indicating the serious nature of the infections in many cases. Staphylococcus aureus is widely prevalent in healthy persons. Given its ubiquity and the capacity to cause a broad array of infections, an effective host response must play an important role in preventing infection. This host response is immunologically nonspecific, in that it depends upon the effectiveness of mechanical barriers to invasion and, once invasion takes place, the interaction of PMN, complement, and antibody that is probably present in serum of all immunologically competent adults rather than sensitization of B or T lymphocytes by any identifiable antigens specific to S. aureus. Analysis of the present cases calls attention to S. aureus as an opportunistic pathogen, 1 that only infrequently causes serious infection in otherwise healthy persons. Nearly every patient in this series had 1 or more medical condition thought to predispose to infection; 279 such conditions were identified, representing an average of 2.3 per person. A break in the natural barrier to infection was also present in the majority of cases, for example, trauma, wound, or pre-existing decubitus ulcer in skin and soft tissue infections; endotracheal tube in pneumonia; and a catheter bypassing urethra or skin in urinary and vascular infections, respectively. The tendency for patients to be infected with S. aureus repeatedly (mean number of infections, 1.4 per patient) reflects the chronicity of many predisposing factors and, perhaps, of colonization as well. Staphylococcus aureus has a special predilection to cause infections involving prosthetic devices, perhaps related to its affinity for fibronectin, laminin, and other serum proteins that can mediate attachment to foreign material; 46 of 162 (28%) infections were associated with the presence of a foreign body. Such infections are difficult to eradicate with antibiotic therapy alone, perhaps because of a change in the metabolic state of adherent bacteria, and removal of the foreign body is generally required for cure.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The current spectrum of Staphylococcus aureus infection in a tertiary care hospital. 804 Dec 42

Adult male rats were subjected to pyelonephritis by direct kidney intramedullary injection of 0.1 ml saline suspension of 10(5) E. coli. Animals were killed at intervals of 4, 10, 15, 30 and 60 days. Half of each kidney and bladder were cultured in proper bacteriologic media to demonstrate the existence of infection. The other halves were submitted to light microscopy and ultrastructural studies. Immunofluorescence methods were used for the study of connective matrix components, at the initial stage of the inflammatory process (4, 10 and 15 days). Infection was documented by bacteriologic, gross and microscopic findings in all groups following inoculation, and it lasted up to two months. Following the acute inflammatory reaction, fibronectin and type III collagen were deposited in the interstitium of kidneys. Small amounts of type I collagen were found later. Type IV collagen appeared in small quantities, associated with collapse of structures containing basement membranes. Fibronectin became concentrated in re-activated foci. The subsequent scarring and associated focal renal atrophy depended upon the extension of the acute lesion.
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PMID:Dynamics of connective matrix deposition in acute experimental E. coli pyelonephritis in rats. 808 88

The treatment of 120 patients with acute purulent pyelonephritis (APP) brought about the following results. 86% patients given standard therapy showed deterioration of their condition, DIC syndrome and inflammatory process were not cured, pyoinflammatory process in the kidney continued. On the contrary, 84.1% patients on combined conservative treatment improved: DIC syndrome and active inflammation relieved, fibronectin content, IgA, IgM and IgG levels rose. Ultrasonic examination and dopplerography indicated that combined conservative therapy including cryoprecipitate arrested development of a purulent focus in the kidney, reestablished intraorganic circulation. Mean stay in hospital was 13.9 days.
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PMID:[Use of cryoprecipitate in combined therapy of acute purulent pyelonephritis]. 1615 47