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Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Of 291 patients who received renal allotransplants in 1964-74, 94 patients developed 121 bacteremic episodes within the first 6 months after transplantation. The death rate was 38%. The bacteremic episodes occurred mainly during the first 2-3 months after transplantation. In 65% of the episodes bacteremia was secondary to urinary tract infections. The bacteria fourn were most often gram-negative rods such as Escherichia coli, Klebsiella and Proteus. Predisposing factors were ureteral complications such as leakage or necrosis of the ureter, leucopenia, immunosuppression, and source of the kidney. The frequency of bacteremia was the same in patients with infectious and non-infectious primary renal disease.
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PMID:Bacteremia after renal transplantation. 33 58

A 64-year-old woman presented with retroperitoneal lymphoma metastatic to the left ureter. Lymphoma was not diagnosed and her clinical course was not fully explained until after surgery. The lack of superficial lymphoma delayed diagnosis and therefore prevented effective treatment. Her situation became unmanageable when it was complicated by bacteremia (E coli) and fungemia (Candida albicans).
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PMID:Metastatic lymphoma in the ureter complicated by bacteremia and fungemia. 37 Oct 14

Extracorporeal shock-wave lithotripsy (ESWL) has been accepted as the method of choice for most upper urinary tract calculi. However, in cases of stones in the lower ureter, ureteroscopic procedures have generally been preferred. Using the Dornier HM3 lithotriptor with modifications in the patient's position, we were able to successfully treat 155 unselected cases of lower ureteral calculi. The average stone size was 9.6 mm (range 5-23 mm). One hundred forty-three patients had stones located below the lower margin of the sacroiliac joint. These patients were placed in a supine position. The stones were visualized radiologically without use of a ureteral catheter in 78 percent of the patients; in 22 percent a ureteral catheter was inserted prior to ESWL to aid in stone localization. In 145 patients (94%) treatment was completed in one session; 10 patients (6%) required two sessions. Of the patients, 38 percent were free of stones one day after ESWL; 97 percent became stone free within three months, and only 3 patients required endoscopic manipulation, after ESWL. Twelve patients had stones in the midureter overlying the sacroileum. They were placed in the prone position, and the calculi were visualized with the aid of a ureteral catheter. All these patients became free of stones one month after treatment. There were no significant treatment-related complications except for bacteremia in 1 case. In view of the remarkable efficacy, negligible complication rate, and shorter hospital stay as compared to ureteroscopic stone manipulations, we recommend high energy ESWL as the primary monotherapy of mid and lower ureteral stones.
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PMID:Extracorporeal shock-wave lithotripsy (ESWL) monotherapy for stones in lower ureter. 150 48

Renal and ureteral calculi are treated primarily using extracorporeal lithotripsy, with percutaneous nephrostolithotomy retaining an important role for the treatment of large stones and complex situations. Aspects of pretherapy evaluation are reviewed. The vast majority of calculi 5 mm or less in diameter in the mid and lower ureter will pass spontaneously; in patients with acute ureteral obstruction, lower-osmolar nonionic contrast for urography caused as much discomfort as conventional high-osmolar contrast. Treatment planning for extracorporeal lithotripsy has changed in that internal stenting is no longer routinely recommended. Milk-of-calcium and calyceal diverticular stones respond poorly to extracorporeal lithotripsy. The access route used for percutaneous stone removal varies among investigators. Some advocate an intercostal approach for up to one third of patients; substantial complications occur with placement of a track above the 11th rib. Sepsis develops after percutaneous nephrostomy in up to 21% of patients, but the risk of sepsis can be decreased significantly by the administration of antibiotics during and after the procedure. Complications of extracorporeal lithotripsy include renal hematoma (especially if the patient is hypertensive or is taking aspirin), regional organ injury, and bacteremia. Although originally feared to occur frequently, hypertension occurring after or caused by extracorporeal lithotripsy was not confirmed to be a major problem. The incidence in a 2-year postlithotripsy follow-up was no greater than that for control subjects.
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PMID:Radiology and treatment of urinary tract stone disease. 155 85

Extracorporeal shock wave lithotripsy (ESWL) using a Therasonic lithotripter was performed on 30 patients with urinary tract calculi between July, 1989 and February, 1990. The results obtained in 31 cases (one patient had bilateral renal stones) were presented. There were 22 inpatients and 8 outpatients in this series. The stone location was: renal pelvis in 15 cases, renal calyces in 10 cases, parenchyma or diverticulum of renal calyces in 3 cases, ureteropelvic junction in 1 case, and upper ureter in 2 cases. Sixteen cases (52%) became stone-free and residual stones (less than or equal to 4 mm) remained in 9 cases (overall effective rate 81%) at one month after the treatment. There were no serious complications including bacteremia and renal hematoma. We concluded that Therasonic lithotripter is useful in the management of upper urinary tract calculi.
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PMID:[Clinical application of Therasonic lithotripsy treatment system for upper urinary tract calculi]. 223 4

Renal calculi are a well documented although uncommon complication of kidney transplantation and may be associated with significant morbidity in this immunosuppressed population with a single functioning kidney. We describe a patient who presented with 2 episodes of staphylococcal bacteremia associated with a ureteral structure and struvite calculi involving the calices, renal pelvis and proximal ureter of a cadaveric renal allograft. The patient was treated successfully with a combination of extracorporeal shock wave lithotripsy, percutaneous extraction and balloon dilation of the ureteral stricture. Renal transplant function was not altered postoperatively. In selected cases shock wave lithotripsy can be used as effective adjunctive therapy in a renal allograft harboring stones.
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PMID:Combination extracorporeal shock wave lithotripsy and percutaneous extraction of calculi in a renal allograft. 327 38

Retrograde pyelonephritis was produced in rats by introducing into the bladder a small refluxing inoculum of Escherichia coli that would enter the renal pelvis but not the blood stream. At the same time the left ureter was partially obstructed for 18 hours. This model differs from previous attempts to produce E coli pyelonephritis with large (0.6 ml) volumes infused into the bladder, because such large volumes cause bacteremia and hematogeneous pyelonephritis. Since retrograde E coli pyelonephritis in patients is not accompanied by positive blood cultures, the model described in this report is believed to accurately mimic human pyelonephritis and to allow a realistic approach to the study of immunity against retrograde infection in the urinary tract.
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PMID:Immunization against retrograde pyelonephritis. I. Production of an experimental model of severe ascending Escherichia coli pyelonephritis without bacteremia in rats. 459 Jun 45

During a two-year period (1966 to 1968) 70 patients were admitted to the Renal Transplantation Unit at St Mary's Hospital and 22 (31%) developed bacteraemia. Eighteen of the 25 episodes of bacteraemia occurred after transplantation and seven before. The typical clinical syndrome was uncommon and was only seen in 32% of cases. The presence of shock was not recognizable in the majority of patients probably because they were already receiving steroid therapy. The commonest infecting organism was Ps. aeruginosa (nine cases) and Gram-negative bacilli accounted for 72% of the bacteraemias. Staph. aureus was isolated in five patients.A likely source of the infecting organism was found in 80% of cases and the commonest source was the urinary tract. Serious complications were present in 13 episodes of bacteraemia, and these were peritonitis before transplantation, necrosis of the donor ureter, and severe rejection or polar infarction in the donor kidney after transplantation. Bacteraemia due to Gram-negative bacilli was associated with complications in 61% of cases. Ps. aeruginosa was almost invariably isolated from complicated cases though Esch. coli was only seen in simple cases. Antibiotic treatment was successful in 64% of cases but the cure rate was higher (86%) before transplantation than after transplantation (55%). Although the presence of complications did not affect the cure rate in Gram-positive bacteraemia, the cure rate in complicated Gram-negative bacteraemias was poor and associated with a mortality of over 70%. Patients receiving human cadaveric renal transplants are susceptible to all kinds of bacterial infection including bacteraemia, and the results of antibiotic treatment are dependent on both the nature of the infecting organism and the presence of serious underlying complications.
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PMID:Bacteraemia in patients receiving human cadaveric renal transplants. 499 2

The previously described experimental model implying ligature of the left ureter in the rat has been used in continued experiments. The present experiments intended to saturate the reticuloendothelial system with dead E. coli, and thereby produce a possible increase in the seeding of bacteria into the experimental locus minoris resistentiae. The results indicate that usage of organic material as E. coli may also stimulate the RES system. Most probably, the incidence of experimental infections in the left ureter is influenced upon by 2 main variables: the size of the experimental bacteremia and the current state of host defence mechanisms.
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PMID:Continued experimental study on the pathogenesis of sporadic bacteriuria in the rat. II. 676 62

Situations which can be considered at risk for infective endocarditis are those causing a bacteremia, which is necessary for the development of an endocarditis. Such situations can be identified by clinical studies evaluating the rate at which a bacteremia occurs after some procedures or because of lesions, then the risk of endocarditis after such a bacteremia. Without considering preexisting cardiac lesion and age, some situations seem to be at risk of subsequent endocarditis: acute bacterial infection for which antibiotherapy is necessary; procedures involving the mouth with the exception of superficial caries and bloodless supragingival prosthetic preparations; oesophageal dilatation, laser endo-oesophageal procedures, sclerosis of oesophageal varices; colonoscopy and sigmoidoscopy for cancer lesions, gastrointestinal procedures on a potentially infected gastrointestinal tract (cholecystectomy, colectomy...); tonsillectomy and adenoidectomy; naso-tracheal intubation; instrumental procedures involving the ureter or kidney, and prostatic or urinary tract biopsies and surgery; procedures performed on infected skin. In cardiac patients at high risk, in addition to the above retrograde cholangiography, colonoscopy and rectosigmoidoscopy, lithotripsy. In these situations the risk of endocarditis is probably linked to the rate of bacteremia, the size of inoculum, and the bacteria, compared with spontaneous bacteremia without any procedure, where the inoculum is low and bacteria is considered as non pathogenic. A prophylaxis has to be discussed in such situations, which are probably involved in less than 10% of endocarditis.
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PMID:[Situations and procedures with risk of bacterial endocarditis (intracardiac surgery excluded)]. 802 96


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