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Sample records for acute urinary retention

  1. Acute Urinary Retention and Obstipation: A Rare Cause…

    Abraham, Viju Joseph; Peacock, Mark; Kim J Mammen

    2012-01-01

    Tailgut cysts are rare congenital anomalies, believed to be remnants of the primitive embryonic hindgut. In addition to causing genitourinary and bowel obstructive symptoms, they have been reported to harbour occult adenocarcinoma. Varying positions of a tailgut cyst with respect to the rectum have also been reported in literature. We present a rare presentation of this disease vis a vis obstipation and acute urinary retention in a 70 year old man.

  2. Acute urinary retention and obstipation: a rare cause….

    Abraham, Viju Joseph; Peacock, Mark; Mammen, Kim J

    2013-02-01

    Tailgut cysts are rare congenital anomalies, believed to be remnants of the primitive embryonic hindgut. In addition to causing genitourinary and bowel obstructive symptoms, they have been reported to harbour occult adenocarcinoma. Varying positions of a tailgut cyst with respect to the rectum have also been reported in literature. We present a rare presentation of this disease vis a vis obstipation and acute urinary retention in a 70 year old man. PMID:24426394

  3. A Rare Cause of Acute Urinary Retention: Retroperitoneal Ganglioneuroma and Concurrent Mediastineal Schwannoma

    Salih Budak

    2013-04-01

    Full Text Available The underlying prior cause at the old male patients refered with acute urinary retention is frequently benign prostatic hypertrophy and urethral pathologies. Acute urinary retention can develop with obstruction as well as neurogenic causes. Neurogenic tumors develops from the cells which takes its origin from the neural crest and they can be seen every neural tissue. In this study rarely seen retroperitoneal ganglioneuroma which causes acute urinary retention and coexisting asymptomatic mediastineal schwannoma case is presented.

  4. Urinary retention secondary to acute vasculitic penile swelling in a pediatric patient.

    Farkas, Nicholas; Black, John; Gupta, Ashish

    2016-03-01

    Acute urinary retention secondary to vasculitic penile swelling in children is extremely rare. Henoch-Schönlein purpura is a self-limiting IgA-mediated cutaneous vasculitis, which can cause soft tissue edema. Acute urinary retention requires urgent intervention to prevent obstructive uropathy. Suprapubic catheterization provides an effective management strategy in the emergency setting. PMID:27014447

  5. Management outcome of acute urinary retention: model of prediction.

    Daly, Padraig

    2012-01-31

    OBJECTIVES: To assess for predictors of outcome in patients presenting with acute urinary retention (AUR). METHODS: A study was performed in our unit to evaluate trial without catheter (TWOC) and successive management. We assessed for predictors of surgical or medical management, which included: age, volume drained at time of catheterisation, cause of retention, serum creatinine, success of trial of voiding, co-morbidities, prostate-specific antigen (PSA) and prostate size on digital rectal examination (DRE). RESULTS: 72 men were entered into the study over an 18-month period: 27 had a successful first TWOC, 20 patients had a second TWOC, and 6 were successful. In total, 31 of the 33 patients with a successful TWOC remained on alpha-blockers without a further episode of AUR within a minimum of 6 months\\' follow-up. Patients failing TWOC were managed by transurethral resection of the prostate (n = 22), long-term catheterisation (n = 15) or prostatic stents (n = 3), and 1 patient died prior to intervention. Three predictors were significant on multivariate analysis: PSA (>2.9 ng\\/ml), prostate size on DRE (large) and volume drained at time of catheterisation (>or=1,000 ml). CONCLUSION: Patients with elevated PSA (>2.9 ng\\/ml), a large prostate size on DRE and a volume drained at time of catheterisation >1,000 ml are best managed by surgical intervention, while those with volumes drained at time of catheterisation of <1,000 ml, a PSA

  6. Acute urinary retention in a pre-school girl with constipation

    Guillermo A. Ariza Traslaviña

    2015-12-01

    Full Text Available Objective: To report a case of a preschool girl who developed acute urinary retention associated with constipation. Case description: A girl aged six years old presented a 24 h history of inability to urinate. She was went twice to the emergency room during this period. In the first admission, 12 h after the onset of the symptoms, she presented abdominal pain and acute urinary retention. After the drainage by urinary catheterization of 300 mL of clear urine, she presented relief of the symptoms and, as urinalysis had no change, the patient was discharged home. Twelve hours after the first visit, she returned to the emergency room complaining about the same symptoms. At physical examination, there was only a palpable and distended bladder up to the umbilicus with no other abnormalities. Again, a urinary catheterization was performed, which drained 450 mL of clear urine, with immediate relief of the symptoms. Urinalysis and urine culture had no abnormalities. During the anamnesis, the diagnosis of constipation was considered and a plain abdominal radiography was performed, which identified large amount of feces throughout the colon (fecal retention. An enema with a 12% glycerin solution was prescribed for three days. During follow-up, the child used laxatives and dietary modifications, this contributed to the resolution of the constipation. There were no other episodes of urinary retention after 6 months of follow-up. Comments: Acute urinary retention in children is a rare phenomenon and constipation should be considered as a cause.

  7. Recurrence of urinary retention secondary to retroverted gravid uterus

    Shunji Suzuki

    2009-01-01

    Full Text Available Background: Although urinary retention caused by the retroverted gravid uterus is uncommon, acute urinary retention is an emergency condition. Cases: We present here two cases of acute urinary retention at 12 weeks′ gestation secondary to retroverted gravid uterus. Although some preventive measures were suggested to the patients, recurrences of urinary retention occurred during the following 2-3 weeks and in their next pregnancies. Conclusion: In cases that urinary retention due to retroverted gravid uterus once occurred, we have to pay attention to the recurrence of urinary retention during the next pregnancies. (Suzuki S, Ono S, Satomi M. Recurrence of urinary retention secondary to retroverted gravid uterus

  8. Recurrence of urinary retention secondary to retroverted gravid uterus

    Shuichi Ono

    2009-07-01

    Full Text Available Background: Although urinary retention caused by the retroverted gravid uterus is uncommon, acute urinary retention is an emergency condition. Cases: We present here two cases of acute urinary retention at 12 weeks’ gestation secondary to retroverted gravid uterus. Although some preventive measures were suggested to the patients, recurrences of urinary retention occurred during the following 2-3 weeks and in their next pregnancies. Conclusion: In cases that urinary retention due to retroverted gravid uterus once occurred, we have to pay attention to the recurrence of urinary retention during the next pregnancies.

  9. Risk factors for acute urinary retention requiring temporary intermittent catheterization after prostate brachytherapy: a prospective study

    Purpose: We prospectively investigated prognostic factors for men undergoing transperineal radioactive seed implantation for prostate cancer at the University of Washington. Methods and Materials: Between February and April, 1998, 62 consecutive unselected patients were prospectively followed after brachytherapy for early-stage prostate adenocarcinoma. Pretreatment variables included age, American Urological Association (AUA) score, uroflowimetry, and prostate volume by ultrasound. Nonrandomized variables included hormonal therapy, seed type, and use of pelvic radiotherapy. Patients were contacted by phone at one week postoperatively and at one-month intervals thereafter. Follow-up continued until all patients provided the date of last catheterization. Results: Urinary retention rate at one week was 34% (21 of 63 patients). At one month, 29%; at three months, 18%; and at six months, 10%. Preoperative flow rate and post-void residual did not predict for retention (p=.48 and p=.58). Use of alpha blockers, hormonal therapy, type of seed (103Pd or 1251), or external beam radiotherapy had no impact on risk of retention at any followup point. Preimplant volume and AUA score predicted for retention on univariate analysis, but on multivariate analysis only postimplant volume remained significant (p=.02) for predicting retention risk and duration. Conclusion: Patients with large prostate size (>36 g) and higher AUA score (>10) appear to be at greater risk of risk of retention as well as duration of retention as defined in our study. Further investigation will be needed to clarify the risk of urinary retention for men undergoing brachytherapy

  10. [Acute urinary retention: a few simple rules for a successful catheterization].

    Birkhäuser, Frédéric D; Studer, Urs E

    2015-01-01

    Acute urinary retention is a common emergency condition in elderly men. Transurethral and suprapubic catheterization are easy and safe procedures provided that a few simple rules are followed. Primarily, a transurethral catheter is placed if there is no urethral injury or stricture. Local anaesthesia of the urethra up to the sphincter region and a well-stretched penis warrant an atraumatic insertion of the catheter into the bladder. The use of a thick catheter with a round tip or of a catheter with a bended tip under rectal guidance facilitate the insertion of the catheter in difficult conditions. Alternatively, a suprapubic catheterization can be performed provided that no contraindication such as history or suspicion of transitional cell carcinoma is present. Optimal interventional conditions using ultrasound-guidance are mandatory in patients after abdominal surgery and with hemorrhagic diathesis in view of a safe and straight-forward placement of the suprapubic catheterization. In case of persistent bleeding after insertion of a suprapubic catheter, the suprapubic catheter should be replaced by one with a balloon blocked and kept under tension for several minutes. PMID:25533254

  11. The burden of prolonged indwelling catheter after acute urinary retention in Ikeja – Lagos, Nigeria

    Uzodimma Charles C

    2007-09-01

    Full Text Available Abstract Background Acute urinary retention (AUR is a common urological problem. We have observed a growing list of patients on indwelling bladder catheter awaiting surgery after AUR. This study was aimed at identifying the health, financial and quality of life (QoL implications of prolonged use of indwelling catheter in these patients Methods We review the side-effects, QoL and cost of changing an indwelling catheter among patients who were on the waiting list for definitive surgery after AUR. All the 62 patients who presented to weekly catheter clinic for change of the indwelling catheter were recruited over a 3 – week period into the study. Results The mean age of the patients was 57.5 years and the mean catheter use time was 23 months. The aetiology of AUR was BPH in 40 (64% and urethral trauma in 16 (28.4% of the patients. The common side effects of prolonged catheterization included urethral/suprapubic pain, bleeding per urethram, loss of dignity, loss of job or being out of school, lack of sexual intercourse, pericatheter leakage of urine and recurrent urinary tract infection. The cost of change of the indwelling catheter to the patient each time ranged from 460.00 – 2500.00 Naira (averaged 789.67 Naira. The total annual cost for the change of indwelling catheter after AUR in our catheter clinic was estimated to be 7,350,000.00 Naira (58,800 US dollars with 1,890,000.00 Naira (15,120 US dollars being the cost borne by the patients per annum and the rest being government subsidy. Fifty-three (85.5% patients described that they were unhappy. There was a significant correlation between QoL and the presence of pain (p = 0.015 and bleeding (p = 0.042 associated with the presence of an indwelling catheter. Conclusion The need to have an indwelling catheter for a prolonged period after AUR is a painful experience and associated with several side-effects. This has a significant negative effect on the patients' QoL and constitutes a

  12. Pretreatment Nomogram to Predict the Risk of Acute Urinary Retention After I-125 Prostate Brachytherapy

    Purpose: Acute urinary retention (AUR) after iodine-125 (I-125) prostate brachytherapy negatively influences long-term quality of life and therefore should be prevented. We aimed to develop a nomogram to preoperatively predict the risk of AUR. Methods: Using the preoperative data of 714 consecutive patients who underwent I-125 prostate brachytherapy between 2005 and 2008 at our department, we modeled the probability of AUR. Multivariate logistic regression analysis was used to assess the predictive ability of a set of pretreatment predictors and the additional value of a new risk factor (the extent of prostate protrusion into the bladder). The performance of the final model was assessed with calibration and discrimination measures. Results: Of the 714 patients, 57 patients (8.0%) developed AUR after implantation. Multivariate analysis showed that the combination of prostate volume, IPSS score, neoadjuvant hormonal treatment and the extent of prostate protrusion contribute to the prediction of AUR. The discriminative value (receiver operator characteristic area, ROC) of the basic model (including prostate volume, International Prostate Symptom Score, and neoadjuvant hormonal treatment) to predict the development of AUR was 0.70. The addition of prostate protrusion significantly increased the discriminative power of the model (ROC 0.82). Calibration of this final model was good. The nomogram showed that among patients with a low sum score (35 points), the risk of AUR was more than 20%. Conclusion: This nomogram is a useful tool for physicians to predict the risk of AUR after I-125 prostate brachytherapy. The nomogram can aid in individualized treatment decision-making and patient counseling.

  13. The Impact of Acute Urinary Retention After Iodine-125 Prostate Brachytherapy on Health-Related Quality of Life

    Purpose: To evaluate the impact of acute urinary retention (AUR) in patients treated with 125I prostate brachytherapy on short- and long-term health-related quality of life (HRQOL); and to assess whether pretreatment HRQOL has additional value in the prediction of AUR. Methods and Materials: For 127 patients treated with 125I brachytherapy for localized prostate cancer between December 2000 and June 2003, toxicity and HRQOL data were prospectively collected. Patients received a HRQOL questionnaire at five time points: before and 1 month, 6 months, 1 year, and 6 years after treatment. The questionnaire included the RAND-36 generic health survey, the cancer-specific European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30), the tumor-specific EORTC prostate cancer module (EORTC QLQ-PR25), and the American Urological Association (AUA) symptom index. Results: Of 127 patients, 13 (10.2%) developed AUR. Patients with AUR had a significantly worse urinary QOL at all time points compared with patients without AUR. The mean difference over time (6 years) between both groups for the EORTC QLQ-PR25 urinary symptom score was 13.0 points (p < 0.001) and for the AUA urinary symptom score was 15.7 points (p = 0.001). Global QOL scores (EORTC QLQ-C30) over time for patients who developed AUR were significantly worse compared with patients without AUR (mean difference 6.7 points; p = 0.043). In multivariate logistic regression analysis, pretreatment International Prostate Symptom Score (p = 0.004) and neoadjuvant hormonal treatment (p = 0.034) were predictors of AUR. Quality of life did not have added predictive value. Conclusion: Acute urinary retention after prostate brachytherapy has a significant negative impact on patient's HRQOL up to 6 years after treatment, in terms of both global QOL measures and urinary symptom scores. Furthermore, our results suggest limited value of pretreatment HRQOL measures for the prediction of AUR.

  14. Symptomatic benign prostatic hyperplasia: the role of 5-alpha-reductase inhibitors in the prevention of acute urinary retention and surgical therapy

    Norma Marigliano; Domenico Galasso

    2012-01-01

    Benign prostatic hyperplasia (BPH) is a disease that affects over 50% of males aged 50 years or older. In men aged >80 years, the incidence is 90%. BPH occurs in 9-25% of males aged 40 to 79 years. Fifty percent of patients with BPH are symptomatic. The symptoms include reduced urinary flow, nocturia, defective bladder emptying, urinary hesitancy, and dysuria. Disease progression can be associated with acute urinary retention (AUR). Prostatic obstruction includes mechanical and dynam...

  15. Acute urinary retention in a 23-year-old woman with mild encephalopathy with a reversible splenial lesion: a case report

    Isobe Hideyuki

    2011-04-01

    Full Text Available Abstract Introduction Patients with clinically mild encephalitis/encephalopathy with a reversible splenial lesion present with relatively mild central nervous system disturbances. Although the exact etiology of the condition remains poorly understood, it is thought to be associated with infective agents. We present a case of a patient with mild encephalitis/encephalopathy with a reversible splenial lesion, who had the unusual feature of acute urinary retention. Case presentation A 23-year-old Japanese woman developed mild confusion, gait ataxia, and urinary retention seven days after onset of fever and headache. Magnetic resonance imaging demonstrated T2 prolongation in the splenium of the corpus callosum and bilateral cerebral white matter. These magnetic resonance imaging abnormalities disappeared two weeks later, and all of the symptoms resolved completely within four weeks. Except for the presence of acute urinary retention (due to underactive detrusor without hyper-reflexia, the clinical and radiologic features of our patient were consistent with those of previously reported patients with mild encephalitis/encephalopathy with a reversible splenial lesion. To the best of our knowledge, this is the first report of acute urinary retention recognized in a patient with mild encephalitis/encephalopathy with a reversible splenial lesion. Conclusion Our findings suggest that mild encephalitis/encephalopathy with a reversible splenial lesion can be associated with impaired bladder function and indicate that acute urinary retention in this benign disorder should be treated immediately to avoid bladder injury.

  16. The effect of immediate surgical bipolar plasmakinetic transurethral resection of the prostate on prostatic hyperplasia with acute urinary retention

    He, Le-Ye; Zhang, Yi-Chuan; He, Jing-Liang; Li, Liu-Xun; Wang, Yong; Tang, Jin; Tan, Jing; Zhong, Kuangbaio; Tang, Yu-Xin; Long, Zhi

    2016-01-01

    In the present study, we evaluated the safety and efficacy of immediate surgical bipolar plasmakinetic transurethral resection of the prostate (PK-TURP) for patients with benign prostatic hyperplasia (BPH) with acute urinary retention (AUR). We conducted a retrospective analysis of clinical data of BPH patients who received PK-TURP. A total of 1126 BPH patients were divided into AUR (n = 348) and non-AUR groups (n = 778). After the urethral catheters were removed, the urine white blood cell (WBC) count in the AUR group significantly increased compared with the non-AUR group (P urination, and maximal urinary flow rate. The duration of hospitalization of the AUR group was longer than that of the non-AUR group (P < 0.001). A total of 87.1% (303/348) patients in the AUR group and 84.1% (654/778) patients in the non-AUR group completed all of the postoperative follow-up visits. The incidence of urinary tract infection in the AUR group within 3 months after surgery was significantly higher than that in the non-AUR group (P < 0.01). The incidence of temporary urinary incontinence in the AUR group did not exhibit significant difference. During 3–12 months after surgery, there were no significant differences in major complications between the two groups. Multivariate regression analyses showed that age, postvoid residual, maximal urinary flow rate, diabetes, and hypertension, but not the presence of AUR, were independent predictors of IPSS post-PK-TURP. In conclusion, immediate PK-TURP surgery on patients accompanied by AUR was safe and effective. PMID:26178398

  17. Urinary retention and acute kidney injury in a tetraplegic patient using condom catheter after partying: a preventable complication

    Vaidyanathan S

    2015-10-01

    Full Text Available Subramanian Vaidyanathan,1 Fahed Selmi,1 Peter L Hughes,2 Gurpreet Singh,3 Bakul M Soni11Regional Spinal Injuries Centre, 2Department of Radiology, 3Department of Urology, Southport and Formby District General Hospital, Town Lane, Southport, UKBackground: Spinal cord injury patients, who manage their bladder using a condom catheter, are at risk of developing urine retention when they consume large volumes of alcoholic drinks within a short period of time.Case presentation: A male tetraplegic patient had been managing satisfactorily penile sheath drainage for 8 years. He went out socializing during which he consumed large volumes of alcohol but did not take any recreational drugs. The following morning, he noticed distension of the lower abdomen and passed urine in dribbles. He then developed a temperature and became unwell. He was seen by district nurses and a doctor, who prescribed antibiotics. He continued to feel unwell. After 8 days, he referred himself to a spinal unit at Regional Spinal Injuries Centre, Southport. The blood test results showed the following: blood urea: 19.8 mmol/L; creatinine: 172 µmol/L; and C-reactive protein: 336.4 mg/L. Urethral catheterization led to immediate drainage of 1,400 mL of urine. A computed tomography scan revealed an enlarged, swollen left kidney, indicating acute bacterial nephritis. He was prescribed intravenous fluids and Meropenem. Creatinine decreased to 46 µmol/L.Conclusion: Spinal cord injury patients using condom catheters should be made aware of the risk of urine retention when they consume large amounts of alcoholic drinks in a short period of time. Patients and caregivers should be informed to consider intermittent catheterizations for 24–48 hours or insert indwelling urethral catheter when planning for an evening out.Keywords: spinal cord injury, tetraplegia, neuropathic urinary bladder, acute kidney injury 

  18. Symptomatic benign prostatic hyperplasia: the role of 5-alpha-reductase inhibitors in the prevention of acute urinary retention and surgical therapy

    Norma Marigliano

    2012-01-01

    Full Text Available Benign prostatic hyperplasia (BPH is a disease that affects over 50% of males aged 50 years or older. In men aged >80 years, the incidence is 90%. BPH occurs in 9-25% of males aged 40 to 79 years. Fifty percent of patients with BPH are symptomatic. The symptoms include reduced urinary flow, nocturia, defective bladder emptying, urinary hesitancy, and dysuria. Disease progression can be associated with acute urinary retention (AUR. Prostatic obstruction includes mechanical and dynamic components, the latter mediated by alpha-muscarinic receptors. Treatment with alpha-1-blockers (alfuzosin, doxazosin, tamsulosin, and terazosin leads to rapid amelioration of symptoms and urinary flow, usually within one or two weeks. The 5-alpha reductase inhibitors (5-ARIs are “disease-modifying drugs.” They control the growth of the prostate by blocking the conversion of testosterone into dihydrotestosterone (DHT. Finasteride is a 5–ARI that is selective for type 2 receptors. Dutasteride is a powerful inhibitor of both 5- alpha reductase isoforms (type 1 and 2 and produces more complete suppression of DHT synthesis than finasteride. Dutasteride also has a much longer half-life than finasteride (five weeks versus five to six hours. The authors review the results of clinical trials involving finasteride and dutasteride, with and without alpha-1-blockers, highlighting the important role of dutasteride in improving acute urinary retention and eliminating the need for surgical therapy.

  19. Urinary Retention Associated with Atomoxetine Use: A Case Report

    Nilfer Sahin

    2016-02-01

    Full Text Available Atomoxetine is a well-studied non-stimulant treatment agent, and is also the first-choice non-stimulant drug for the conventional treatment of Attention Deficit Hyperactivity Disorder owing to its effectiveness and tolerability. Urinary retention is a type of urological emergency that is associated with the inability to urinate despite the bladder being full and a strong urge to urinate. It is known that urinary retention can also develop due to the use of anticholinergic drugs. In this manuscript, we present a 12-year-old male case who developed acute urinary retention in the period following atomoxetine treatment.

  20. Photoselective vaporization of the prostate with the 120W lithium triborate laser for the treatment of acute urinary retention

    Chung AS

    2012-06-01

    Full Text Available Amanda SJ Chung, Henry H WooSydney Adventist Hospital Clinical School, University of Sydney, Sydney, New South Wales, AustraliaPurpose: Whilst photoselective vaporization of the prostate (PVP is used to treat benign prostatic hyperplasia, there is little reported about its performance in urinary retention. The objective of this study is to evaluate the efficacy and safety of GreenLight™ high performance system 120W lithium triborate laser (American Medical Systems, Inc, Minnetonka, MN PVP in men with urinary retention.Patients and methods: Retrospective analysis of data of all men in urinary retention who underwent treatment with the 120W lithium triborate laser PVP by a single surgeon from November 2006 to July 2010 was performed (n = 78, median age 71 years (interquartile range, 64–80, median prostate volume 91 mL (interquartile range, 58–121. Perioperative outcomes and functional outcomes at baseline, and at 3 and 12 months post-operation were examined.Results: Patients managed preoperatively by urethral catheterization (n = 61 and suprapubic catheterization (n = 5 were of greater age (by 8.2 years, P < 0.05 and higher American Society of Anesthesiologists scores (P = 0.000, Fisher’s exact test mid P than patients managed by intermittent self-catheterization (n = 12, but there was no difference in outcomes. There were three Clavien grade III, two Clavien grade IV, and no Clavien grade V complications. There were also no blood transfusions. Fifty-three men (68% voided successfully post-PVP and went home catheter-free within 24 hours. At 3 months, 62 out of 64 evaluable men (97% were voiding well without needing any form of catheterization. At 3 months and 12 months, median International Prostate Symptom Score was 7 and 6; International Prostate Symptom Score Quality of Life Index 1 and 1; peak urinary flow 19 and 22 mL/sec; and post-void ultrasound measured residual urine volume 52 and 60 mL, respectively.Conclusion: PVP for urinary

  1. Simultaneous Transurethral Resection of Prostate and Prostate Needle Biopsy in Patients with Acute Urinary Retention and Elevated Prostate Specific Antigen Levels

    Yen-Ta Chen

    2009-08-01

    Full Text Available Background: To evaluate the safety and accuracy of simultaneous transrectal ultrasonography (TRUS-guided prostate biopsy and transurethral resection of prostate(TURP, patients with acute urinary retention (AUR who underwent simultaneous prostate biopsy and TURP were compared with those treated byTURP alone.Methods: From July 2000 to Jun 2004, 21 patients older than 70 years with AUR wereincluded in each group. Patients with elevated prostate specific antigen(PSA levels (> 4 ng/ml underwent TURP and TRUS-guided biopsy simultaneously (group I, while those with normal PSA levels (< 4 ng/ml receivedTURP alone (group II. The average ages of group I and group II patientswere 72.4 and 72.5 years.Results: In group I, 4 patients (19% were diagnosed with prostate cancer; 2 hadmetastasis and received hormone therapy; and 1 had localized cancer andwas treated with brachytherapy. An 82-year-old patient with localized canceropted for watchful waiting. Compared to group II, patients in group I did notshow aggregated morbidity, such as prolonged hospital stay, hematuria, orfever.Conclusion: Simultaneous TURP and TRUS-guided biopsy in healthy AUR patients doesnot increase the risk of morbidity. Furthermore, with this approach patientscan recover from the stress of AUR and have a definite diagnosis of theircondition.

  2. Acute Urinary Tract Obstruction

    Aleksic Djordje

    2015-09-01

    Full Text Available The kidneys are paired organs with the primary function of helping to remove toxins from the body and regulate water balance. They are vital to survival. After urine is produced in the kidneys, it must pass into the bladder, where it can be stored before being eliminated from the body through the urethra. Urinary tract obstruction is a common problem encountered by urologists, primary care physicians, and emergency medicine physicians. Urine can become obstructed at any point in this pathway. There are three groups of urinary tract obstructions: 1 obstruction of the urinary tract lumen; 2 obstruction of the urinary tract wall; and 3 extrinsic obstruction, which can press on the urinary tract lumen. An obstruction can be present from birth or develop later in life. The most common causes of obstruction include stones, strictures, tumours, and bladder dysfunction. These obstructions may result in the hydronephrosis of one or both kidneys, which, if left untreated, may lead to the deterioration of renal function. The goal of an initial treatment of urinary tract obstruction is to remove the obstruction. Later, we treat the cause that led to the obstruction. The bottom line is that all efforts should be made to preserve kidney function to avoid the need for dialysis or renal transplantation.

  3. Acute urine retention induced by ceftriaxone

    Kamal F Akl

    2011-01-01

    Full Text Available Ceftriaxone is known to cause biliary pseudolithiasis and, rarely, nephrolithiasis. When used in neonates receiving intravenous calcium, fatal lung and kidney calcifications occur. There is no satisfactory explanation for the pseudolithiasis, and the mechanism of stone formation remains unknown. Herein, we report a child with acute urinary retention (AUR secondary to ceftriaxone therapy. The AUR developed on the second hospital day. The urinary excretion of uric acid was elevated. In retrospect, there was a positive paternal family history of gout and stones. A positive family history of gout or stones is a pointer to the possibility of AUR or urolithiasis in patients on treatment with ceftriaxone. If urinary symptoms develop, it is worth checking for crystalluria. This will avoid many unnecessary investigations and procedures.

  4. Urinary trypsinogen-2 dipstick in acute pancreatitis

    Andersen, Anders Møller; Novovic, Srdan; Ersbøll, Annette Kjaer;

    2010-01-01

    In acute pancreatitis (AP), rapid diagnosis and early treatment are of importance for clinical outcome. Urinary trypsinogen-2 has been suggested as a promising diagnostic marker; however, studies using the urinary trypsinogen-2 dipstick test (UTDT) have provided varying results.......In acute pancreatitis (AP), rapid diagnosis and early treatment are of importance for clinical outcome. Urinary trypsinogen-2 has been suggested as a promising diagnostic marker; however, studies using the urinary trypsinogen-2 dipstick test (UTDT) have provided varying results....

  5. Persistent postpartum urinary retention following vaginal delivery: a rare complication in obstetrics practice

    Amrita Chaurasia

    2013-06-01

    Full Text Available Postpartum urinary retention occurs in 10-15% of women and is likely to be multifactorial in origin. Long labour, epidural analgesia, instrumental delivery, nulliparity, significant vaginal and perineal laceration or a previous history of voiding difficulty are risk factors for altered voiding parameters. Previous literatures have defined two types of urinary retention, first, overt retention and the other covert variety. Overt variety represents the acute retention while covert variety is of subacute in nature. Being subacute in nature, it damages the detrusors slowly. Sometimes the damage is so much so that it may take substantial time to recover or may not recover at all and the patient may have lifelong detrusor hypotonia with persistent urinary retention, requiring lifelong intermittent self-catheterization. This badly affects her personal as well as social wellbeing and also poses her for recurrent urinary tract infection. Here, we report a case of 25 yrs old, 36 weeks primigravida having persistent postpartum urinary retention following vaginal delivery, Who was enough fortunate to have recovery of detrusors. But, still it took 3-4 weeks for complete recovery of the urinary bladder. [Int J Reprod Contracept Obstet Gynecol 2013; 2(3.000: 475-477

  6. Urinary Retention Associated with Atomoxetine Use: A Case Report

    Nilfer Sahin

    2016-01-01

    Atomoxetine is a well-studied non-stimulant treatment agent, and is also the first-choice non-stimulant drug for the conventional treatment of Attention Deficit Hyperactivity Disorder owing to its effectiveness and tolerability. Urinary retention is a type of urological emergency that is associated with the inability to urinate despite the bladder being full and a strong urge to urinate. It is known that urinary retention can also develop due to the use of anticholinergic drugs. In this manus...

  7. Penile Cancer Presenting With Acute Urinary Retantion: Case Report

    Kazan, Ercan; Amasyalı, Akın Soner; Manav, Alper Nesip; Akkurt, Abdullah; Çuhacı, Nil; EROL, Haluk

    2015-01-01

    Penile cancer is a rare malignancy in our country. Phimosis, poor hygiene and smoking are major risk factors for penile cancer. Penile cancer in men have a strong correlation with human papillomavirus (HPV) infection. Penile cancer is rare in circumcised men, particularly if they are circumcised as newborns. Penile cancer is usually asymptomatic and physical examination is essential for diagnosis. We report a case of penile cancer whose first symptom was acute urinary retention (AUR) and revi...

  8. Can release of urinary retention trigger abdominal aortic aneurysm rupture?

    Luhmann, Andreas; Powell-Bowns, Matilda; Elseedawy, Emad

    2013-01-01

    Only 50% of abdominal aortic aneurysms present with the classic triad of hypotension, back pain and a pulsatile abdominal mass. This variability in symptoms can delay diagnosis and treatment. We present the case of a patient presenting with a unique combination of symptoms suggesting that decompression of urinary retention can lead to abdominal aortic aneurysm rupture. PMID:24964430

  9. URINARY INCONTINENCE IN ACUTE PSYCHOSIS

    Choudhury, S.; Augustine, M.

    1993-01-01

    SUMMARY A prospective two year study of consecutive admissions (n=984) to a psychiatry ward revealed that the incidence of temporary urinary incontinence in psychiatric patients without delirium or dementia was 1.63% (n=l6). When compared with controls (n=64) the incontinent patients were more often psychotic, gave a history of childhood enuresis and a past history of temporary incontinence during psychosis. Compared with psychotic controls (n=26), incontinent patients (n=16) had been exposed...

  10. Retención de orina en un paciente inmunocompetente: mielitis transversa aguda Urinary retention in immunocompetent patient: acute transverse myelitis

    M.V. Villaverde

    2011-12-01

    Full Text Available Bajo el término de mielitis transversa aguda (MTA se engloba un grupo heterogéneo de enfermedades con el nexo común de producir una lesión focal inflamatoria de la médula espinal de instauración brusca. El conocimiento de la MTA se está viendo modificado constantemente con el advenimiento de nuevas técnicas diagnósticas y teorías sobre su origen inmunológico. La responsabilidad de realizar un diagnóstico precoz, recae principalmente en el ámbito de la Atención Primaria y debe fundamentarse siempre en la realización de una detallada historia clínica asociada a una exploración neurológica minuciosa. El correcto manejo de la situación clínica una vez detectada, precisará de una derivación urgente al hospital de referencia, para ser evaluado y tratado de forma temprana por equipos multidisciplinares. Es de vital importancia la intervención precoz en muchas de estas patologías, ya que mejora el pronóstico de estos pacientes y disminuye considerablemente las secuelas.A heterogeneous group of diseases is included under the term acute transverse myelitis (ATM; these have the common factor of producing an inflammatory focal injury of the spinal cord in an acute form. Understanding of ATM is being constantly improved with the arrival of new diagnostic techniques and theories about its immune origin. Responsibility for making an early diagnosis lies primarily in the field of primary care and must always be based on the completion of a detailed clinical report together with a thorough neurological examination. Once detected, correct handling of the clinical situation will require an urgent referral to a hospital for evaluation and treatment at an early stage by multidisciplinary teams. Early intervention in many of these diseases is vital, because it improves the prognosis of these patients and significantly reduces injuries.

  11. Prevention and management of postoperative urinary retention after urogynecologic surgery

    Geller EJ

    2014-08-01

    Full Text Available Elizabeth J Geller Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Abstract: Postoperative urinary retention (POUR is a frequent consequence of gynecologic surgery, especially with surgical correction of urinary incontinence and pelvic organ prolapse. Estimates of retention rates after pelvic surgery range from 2.5%–43%. While there is no standard definition for POUR, it is characterized by impaired bladder emptying, with an elevation in the volume of retained urine. The key to management of POUR is early identification. All patients undergoing pelvic surgery, especially for the correction of incontinence or prolapse, should have an assessment of voiding function prior to discharge. There are several ways to assess voiding function – the gold standard is by measuring a postvoid residual. Management of POUR is fairly straightforward. The goal is to decompress the bladder to avoid long-term damage to bladder integrity and function. The decision regarding when to discontinue catheter-assisted bladder drainage in the postoperative period can be assessed in an ongoing fashion by measurement of postvoid residual. The rate of prolonged POUR beyond 4 weeks is low, and therefore most retention can be expected to resolve spontaneously within 4–6 weeks. When POUR does not resolve spontaneously, more active management may be required. Techniques include urethral dilation, sling stretching, sling incision, partial sling resection, and urethrolysis. While some risk of POUR is inevitable, there are risk factors that are modifiable. Patients that are at higher risk – either due to the procedures being performed or their clinical risk factors – should be counseled regarding the risks and management options for POUR prior to their surgery. Although POUR is a serious condition that can have serious consequences if left untreated, it

  12. Risk factors for urinary retention after vaginal hysterectomy for pelvic organ prolapse

    Chong, Chul; Kim, Hye Sung; Suh, Dong Hoon

    2016-01-01

    Objective To evaluate the risk factors for postoperative urinary retention in women who underwent vaginal hysterectomy for symptomatic pelvic organ prolapse. Methods The medical records of 221 women who underwent vaginal hysterectomy with anterior and posterior colporrhapy were reviewed. Urinary retention after catheter removal was defined as the presence of at least one of the following three conditions: 1) failure of first voiding trial necessitating catheterization, 2) first residual urine volume after self-voiding ≥150 mL, and 3) Foley catheter re-insertion. Results Urinary retention occurred in 60 women (27.1%). Multivariate and receiver operating characteristic curve analysis revealed that age (>63 years) and early postoperative day of catheter removal (day 1) was independent predictor for postoperative urinary retention. The incidence of urinary retention was significantly higher in women who removed indwelling catheter at day 1 (35.2%) than those at day 2 (12.0%, P=0.024), or day 3 (21.3%, P=0.044), but was similar to those at day 4 (25.0%, P=0.420). In women ≤63 years, urinary retention rate was not associated with the time of catheter removal after surgery; however, in women >63 years, the rate was significantly higher in day 1 removal group than day 2 to 4 removal group. Conclusion Age and postoperative day of catheter removal appear to be associated with postoperative urinary retention in women undergoing vaginal hysterectomy for pelvic organ prolapse. Keeping urinary catheter in situ at least for one day after vaginal prolapse surgery could be recommended, especially, in women older than 63 years. PMID:27004205

  13. Decline in urinary retention incidence in 805 patients after prostate brachytherapy: The effect of learning curve?

    Purpose: To evaluate the incidence and factors predictive of acute urinary retention (AUR) in 805 consecutive patients treated with prostate brachytherapy monotherapy and to examine the possible effect of a learning curve. Methods and Materials: Between July 1998 and November 2002, 805 patients were treated with prostate brachytherapy. Low-risk patients (Gleason Score (GS) ≤6; prostate specific antigen (PSA) ≤10, and ≤ T2b [UICC 1997]) received implant alone. Patients with prostate volume of 50 cc or more, GS = 7, or PSA = 10 to 15 received 6 months of androgen suppression (AS) with brachytherapy. Patient, treatment, and dosimetric factors examined include baseline prostate symptom score (IPSS), diabetes, vascular disease, PSA, Gleason score, clinical stage, AS, ultrasound planning target volume (PUTV), postimplant prostate volume (obtained with 'Day 30' postimplant CT), CT:PUTV ratio (surrogate for postimplant edema), number of seeds, number of needles, number of seeds per needle, dosimetric parameters (V100, V150, and D90), date of implant (learning curve), and implanting oncologists. Univariate and multivariate analyses were carried out. Results: Acute urinary retention in the first 200 patients was 17% vs. 6.3% in the most recently treated 200 patients (p = 0.002). Overall AUR was 12.7%, and prolonged urinary obstruction incidence (>20 days) was 5%. On multivariate analysis, factors predictive of any AUR include baseline IPSS (p = 20 days) on multivariate analysis include IPSS (p < 0.01), number of needles (p < 0.001), diabetes mellitus (p = 0.048), and CT:PUTV ratio (p < 0.001) Conclusion: Over the years, our AUR rate has fallen significantly (from 17% to 6.3%). On multivariate analysis, highly significant factors include IPSS, PUTV, CT:PUTV ratio (i.e., degree of prostate edema), and order of implant (learning curve). Over the course of the program, we have deliberately reduced the number of needles and OR time per patient, which have potentially

  14. Incidence of postoperative urinary retention after pelvic organ prolapse surgery in Cipto Mangunkusumo National General Hospital

    Tyas Priyatini

    2015-01-01

    Full Text Available Background: After vaginal delivery, every woman has 50% risk for pelvic organ prolapse (POP. The lifetime risk for a woman to undergo surgical treatment for POP was 11%, with the incidence of postoperative urinary retention (POUR after POP surgery of 2%-43%. The aim of our study is to identify the incidence of POUR after POP surgery in Cipto Mangunkusumo National General Hospital (RSCM and the risk factors.Methods: Medical records of 124 women undergoing pelvic prolapse surgery between 2010 and 2013 were analyzed. The incidence of POUR and the risk factors were identified by performing univariate and bivariate analysis using chi-Square test and its alternative with using SPSS 20.0. Independent variables include age, body mass index (BMI, parity, degree of prolapse, type of surgery technique, type of anesthesia, type of suture material, amount of intra-operative blood loss, and duration of surgery. POUR defined as urine residual volume more than 100cc.Results: The incidence of urinary retention after pelvic prolapse surgery was 29%. There was no correlation between age, BMI, parity, degree of prolapse, type of surgery technique, anesthesia, suture, intra-operative blood loss, duration of surgery, and the occurrence of urinary retention after pelvic organ prolapse surgery.Conclusion: The incidence of urinary retention after pelvic organ prolapse surgery was 29%. There was no correlation between the risk factors and the occurrence of urinary retention after pelvic organ prolapse surgery.

  15. “Vanishing Penis” and Urinary Retention due to Locally Destructive Penile Cancer

    Petros Sountoulides; Athanasios Bantis; Ioannis Zachos; Irene Asouhidou; Athanasios Pantazakos

    2009-01-01

    Penile carcinomas are relatively rare. They usually arise from precancerous lesions and present in the form of ulcerative or exophytic tumors. They rarely give rise to urinary symptoms and complications, and are usually easy to diagnose. We present a case of an 82-year-old man with chronic urinary retention due to urethral dissemination by a locally destructive penile lesion. The penis was literally “vanished” by the lesion down to the level of the pubic bone without, interestingly, having sp...

  16. Dysuria, Urinary Retention, and Inguinal Pain as Manifestation of Sacral Bannwarth Syndrome

    Finsterer, Josef; Dauth, Johannes; Angel, Kurt; Markowicz, Mateusz

    2015-01-01

    Only few cases with sacral radiculitis due to infection with Borrelia burgdorferi leading to neurogenic urinary dysfunction have been reported. A 57-year-old male developed urethral pain and urinary retention, requiring permanent catheterization. Extensive urological investigations did not reveal a specific cause, which was why neurogenic bladder dysfunction was suspected. Neurologic exam revealed only mildly reduced tendon reflexes. Cerebral and spinal MRI were noninformative. CSF investigat...

  17. The role of imaging in adult acute urinary tract infection

    Webb, J.A.W. [Diagnostic Radiology Department, St. Bartholomew`s Hospital, West Smithfield, London EC1A 7BE (United Kingdom)

    1997-08-01

    Imaging is required in only a minority of patients with urinary tract infection. Some patients who present with severe loin pain are imaged because ureteric colic is suspected. If urinary tract infection does not respond normally to antibiotics, imaging is undertaken to check for evidence of renal obstuction or sepsis. Finally, after the acute infection has been treated, imaging is required in some patients to check for factors pre-disposing to renal damage or to relapsing or recurrent infection. This review discusses the appropriate choice of imaging technique to use in each clinical situation and summarises the expected findings. (orig.). With 15 figs., 1 tab.

  18. The role of imaging in adult acute urinary tract infection

    Imaging is required in only a minority of patients with urinary tract infection. Some patients who present with severe loin pain are imaged because ureteric colic is suspected. If urinary tract infection does not respond normally to antibiotics, imaging is undertaken to check for evidence of renal obstuction or sepsis. Finally, after the acute infection has been treated, imaging is required in some patients to check for factors pre-disposing to renal damage or to relapsing or recurrent infection. This review discusses the appropriate choice of imaging technique to use in each clinical situation and summarises the expected findings. (orig.). With 15 figs., 1 tab

  19. Probing the urinary proteome of severe acute pancreatitis

    Flint, Richard S.; Phillips, Anthony R.J.; Farrant, Glenn J.; Mckay, Duncan; Buchanan, Christina M.; Cooper, Garth S.J.; Windsor, John A.

    2007-01-01

    Background. Proteinuria is a characteristic feature of severe acute pancreatitis (SAP) that may allow unique insights into AP pathophysiology. This study used a proteomic approach to differentiate the abundant urinary proteins in AP patients. Materials and methods. Urine samples were prospectively collected from 4 groups (5 SAP, 10 mild gallstone AP, 7 mild alcohol AP, 7 controls). Reverse-phase high-performance liquid chromatography (RP-HPLC) and matrix-assisted laser desorption/ionization t...

  20. Incidence of postoperative urinary retention after pelvic organ prolapse surgery in Cipto Mangunkusumo National General Hospital

    Tyas Priyatini; Joan M. Sari

    2015-01-01

    Background: After vaginal delivery, every woman has 50% risk for pelvic organ prolapse (POP). The lifetime risk for a woman to undergo surgical treatment for POP was 11%, with the incidence of postoperative urinary retention (POUR) after POP surgery of 2%-43%. The aim of our study is to identify the incidence of POUR after POP surgery in Cipto Mangunkusumo National General Hospital (RSCM) and the risk factors.Methods: Medical records of 124 women undergoing pelvic prolapse surgery between 201...

  1. Improved bladder emptying in urinary retention by electrical stimulation of pudendal afferents

    Peng, Chih-Wei; Chen, Jia-Jin Jason; Cheng, Chen-Li; Grill, Warren M.

    2008-06-01

    Urinary retention is the inability to empty the bladder completely, and may result from bladder hypocontractility, increases in outlet resistance or both. Chronic urinary retention can lead to several urological complications and is often refractory to pharmacologic, behavioral and surgical treatments. We sought to determine whether electrical stimulation of sensory fibers in the pudendal nerve could engage an augmenting reflex and thereby improve bladder emptying in an animal model of urinary retention. We measured the efficiency of bladder emptying with and without concomitant electrical stimulation of pudendal nerve afferents in urethane-anesthetized rats. Voiding efficiency (VE = voided volume/initial volume) was reduced from 72 ± 7% to 29 ± 7% following unilateral transection of the sensory branch of the pudendal nerve (UST) and from 70 ± 5% to 18 ± 4% following bilateral transection (BST). Unilateral electrical stimulation of the proximal transected sensory pudendal nerve during distention-evoked voiding contractions significantly improved VE. Low-intensity stimulation at frequencies of 1-50 Hz increased VE to 40-51% following UST and to 39-49% following BST, while high-intensity stimulation was ineffective at increasing VE. The increase in VE was mediated by increases in the duration of distention-evoked voiding bladder contractions, rather than increases in contraction amplitude. These results are consistent with an essential role for pudendal sensory feedback in efficient bladder emptying, and raise the possibility that electrical activation of pudendal nerve afferents may provide a new approach to restore efficient bladder emptying in persons with urinary retention.

  2. Management of urinary retention in an austere environment: suprapubic catheter placement.

    Smith, Christopher P; Sorrells, Andrew; Coburn, Michael

    2010-01-01

    Urinary retention is a true urologic emergency. First-line treatment with a transurethral catheter can and will fail. SOF medics need a reliable and durable method to resolve this problem using a minimal amount of resources and time. Current SOF Medical Handbook guidance for the management of unsuccessful urethral catheterization is inadequate. This article and accompanying video link, functions as a starting point for incorporating suprapubic tube placement in the training regimen and therapeutic armamentarium of SOF medical personnel. PMID:21049433

  3. Varicella zoster virus infection causing urinary retention in a child with HIV infection

    G S Wessels; C. F. Heyns

    2012-01-01

    An 11-year-old boy receiving antiretroviral therapy for HIV infection and antibacterial therapy for pulmonary tuberculosis presented with urinary retention due to varicella zoster virus infection involving the sacral nerves, confirmed on serological testing. The perineum over dermatomes S2 - S4 on the left was involved with a vesicular and superficially erosive rash. A transurethral catheter was inserted and the patient was treated with acyclovir (300 mg 6-hourly for 5 days). At follow-up 4 w...

  4. A case of Tailgut Cyst presented to the emergency department due to urinary retention

    ERYİĞİT, Umut; ÇEBİ, Nilay; Karaca, Yunus; KEHA KURT, Nurbanu; GÜNDÜZ, Abdülkadir

    2015-01-01

    Tailgut cysts are infrequent tumors in the presacral area and most presacral tumors in the literature are single-case, these tumors constitute 1/40.000 of applications to hospital. A 27-year-old male presented to the emergency department with urinary and fecal retention. Abdominal pain and swelling had persisted for a week. At physical examination the abdomen was swollen and distended. Rectal examination revealed a mass exerting external pressure on the inferior wall of the anal canal. Comput...

  5. The acquisition and retention of urinary catheterisation skills using surgical simulator devices: teaching method or student traits

    Waters, Peadar S.; McVeigh, Terri; Kelly, Brian D; Flaherty, Gerard T; Devitt, Dara; Barry, Kevin; Kerin, Michael J.

    2014-01-01

    Background The acquisition of procedural skills is an essential component of learning for medical trainees. The objective of this study was to assess which teaching method of performing urinary catheterisation is associated with most efficient procedural skill acquisition and retention. We evaluated factors affecting acquisition and retention of skills when using simulators as adjuncts to medical training. Methods Forty-two second year medical students were taught urinary catheter insertion u...

  6. [Acute cardiovascular disease and job retention].

    Fantoni-Quinton, Sophie; Tellart, Anne-Sophie; Cambier-Langrand, Evodie; Fassier, Jean Baptiste; Mounier-Vehier, Claire

    2016-05-01

    Since it allows a better quality of life, return to work must be considered ever since the early stages of the health care pathway following a cardiovascular disease. Seeing the occupational physician beforehand, so as to anticipate the return to work, is crucial. Dialogue between cardiologists, general practitioners and occupational physician, still observing medical confidentiality, must allow a better quality of return to work. Being recognized as a handicapped worker is a key element in the prevention of socio-professional exclusion. Even when dealing with long sick leave, permanent functional injuries or job loss, guiding the patients towards the appropriate person can improve return to work and job retention in the long term. PMID:27021479

  7. Pivmecillinam for the treatment of acute uncomplicated urinary infection.

    Nicolle, L E

    1999-12-01

    Pivmecillinam is a beta-lactam antimicrobial marketed almost two decades ago. It has been used widely for the treatment of acute cystitis in selected areas of the world, particularly in Scandinavia. With increasing resistance of community Escherichia coli isolates to trimethoprim and trimethoprim/sulphamethoxazole, as previously observed for ampicillin and sulphonamides, reassessment of empiric antimicrobial regimens for acute uncomplicated urinary infection is necessary. Thus, it is timely to revisit the role of pivmecillinam for the treatment of acute cystitis. Clinical studies document the efficacy of this antimicrobial with short course therapy for acute cystitis, and clinical practice in countries where it has been used for many years confirms its efficacy and tolerability. If this agent were more widely used for empiric treatment for acute cystitis, use of antimicrobials such as the quinolones might be avoided. Further trials to define the comparative efficacy of pivmecillinam with other antimicrobials, and further studies of community resistance in E. coli isolates to this agent are needed. PMID:10692756

  8. A Clinical Nurse Specialist-Directed Initiative to Reduce Postoperative Urinary Retention in Spinal Surgery Patients.

    Hoke, Nicole; Bradway, Christine

    2016-08-01

    : Postoperative urinary retention (POUR) is the inability to void when the bladder is full after surgery. It is a common complication in postoperative patients, especially in patients undergoing spinal surgery. At our institution, patients who were discharged from the postanesthesia care unit (PACU) to the inpatient surgical unit typically had bladder distention and a bladder volume of more than 450 mL. In an effort to address this situation, an interprofessional group of advanced practice RNs and physicians formed a team, reviewed the existing literature, examined the PACU nursing practice guideline for evaluating and managing POUR, and devised a quality improvement (QI) project to raise the PACU nursing staff's awareness of the potential for POUR among postoperative patients and to develop an updated nursing practice algorithm for the evaluation and management of POUR in spinal surgery patients. A description of the QI process, including the revised algorithm and pre- and postintervention results, is reported here. In the preintervention group (n = 42), 19 indwelling urinary catheterizations were documented in patient records; no use of intermittent catheterization was documented. In the postintervention group (n = 43), seven indwelling urinary catheterizations were documented in patient records; the use of intermittent catheterization was documented in 11. As a result of our intervention, we decreased the number of indwelling urinary catheters inserted in the PACU, and supported the PACU nursing staff in more frequent and appropriate use of intermittent catheterization in patients undergoing spinal surgery. PMID:27466926

  9. “Vanishing Penis” and Urinary Retention due to Locally Destructive Penile Cancer

    Petros Sountoulides

    2009-01-01

    Full Text Available Penile carcinomas are relatively rare. They usually arise from precancerous lesions and present in the form of ulcerative or exophytic tumors. They rarely give rise to urinary symptoms and complications, and are usually easy to diagnose. We present a case of an 82-year-old man with chronic urinary retention due to urethral dissemination by a locally destructive penile lesion. The penis was literally “vanished” by the lesion down to the level of the pubic bone without, interestingly, having spread to the local lymph nodes or given rise to distant metastases. A temporary suprapubic catheter was placed, followed by a perineal urethrostomy in order to reverse the established renal failure.

  10. Varicella zoster virus infection causing urinary retention in a child with HIV infection

    G S Wessels

    2012-11-01

    Full Text Available An 11-year-old boy receiving antiretroviral therapy for HIV infection and antibacterial therapy for pulmonary tuberculosis presented with urinary retention due to varicella zoster virus infection involving the sacral nerves, confirmed on serological testing. The perineum over dermatomes S2 - S4 on the left was involved with a vesicular and superficially erosive rash. A transurethral catheter was inserted and the patient was treated with acyclovir (300 mg 6-hourly for 5 days. At follow-up 4 weeks later, the perineal skin lesions had healed, the catheter was removed and the patient was able to pass urine.

  11. Urinary Retention

    ... Research Training & Career Development Grant programs for students, postdocs, and faculty Research at NIDDK Labs, faculty, and ... diabetes, digestive and liver diseases, kidney diseases, weight control and nutrition, urologic diseases, endocrine and metabolic diseases, ...

  12. Urinary Retention

    ... The technician performs the bladder ultrasound in a health care provider’s office, a radiology center, or a hospital, and a radiologist—a doctor who specializes in medical imaging—interprets ...

  13. Urinary Retention

    ... scarring after an injury to the penis or perineum, or surgery for benign prostatic hyperplasia and prostate ... and sometimes the areas around the prostate. The perineum is the area between the anus and the ...

  14. Use of diclofenac sodium post milligan-morgan hemorrhoidectomy reduces the risk of post-operative urinary retention

    To investigate the effects of a single dose of diclofenac-sodium suppository on urinary retention in patients undergoing Milligan-Morgan-hemorrhoidectomy. Methodology: A total of 186 patients with 3rd and 4th degree hemorrhoids undergoing Milligan-Morgan-hemorrhoidectomy were recruited in the study. All were randomly assigned into group-A or group-B with a total of 93 patients in each group. Rectal diclofenac-sodium suppository (100mg) was given to group-B, whereas group-A was given a placebo at the end of Milligan-Morgan hemorrhoidectomy. Frequency of urinary retention was determined in first 24 hours postoperatively. Data were analyzed using SPSS version 16 and Minitab. Results: Mean age of the patients was 35.83±11.16 years. 153 (82.3%) patients were males whereas 33 (17.7%) were females, with male to female ratio being 4.6:1. In group A, urinary retention was recorded in 15 patients (16.1%), while in group B, 5 patients (5.4%) developed urinary retention (p=0.03). Conclusion: Placement of rectal diclofenac suppository at the end of hemorrhoidectomy was effective in reducing urinary retention. (author)

  15. Warm Needling Moxibustion at Zhongji (CV 3) and Zusanli (ST 36) for Urinary Retention after Gynecological Surgery

    Song Xiao-lin; Yu Xin

    2014-01-01

    Objective:To observe the clinical effect of warm needling moxibustion at Zhongji (CV 3) and Zusanli (ST 36) in treatment of urinary retention after gynecological surgery. Methods: Forty patients with urinary retention after gynecological surgery were randomly divided into two groups by the randomized method, 20 cases in each group. Patients in the treatment group were treated by warm needling moxibustion at Zhongji (CV 3) and Zusanli (ST 36). Patients in the control group were treated by inductive urination. The therapeutic effects of the two groups were observed after one course of treatment. Results:The total effective rate was 95.0%in the treatment group and 70.0% in the control group. The difference in the total effective rate between the two groups was statistically significant (P Conclusion: Warm needling moxibustion at Zhongji (CV 3) and Zusanli (ST 36) is more effective than inductive urination in treating urinary retention after gynecological surgery.

  16. Acute gross sterile pyuria after oral ciprofloxacin treatment of urinary tract infection

    Pathoom Sukkaromdee; Viroj Wiwanitkit

    2016-01-01

    The sterile pyuria is an interesting problem in urology. Acute gross sterile pyuria is not a common clinical problem and is difficult to make a correct diagnosis. Here, the authors reported a case of acute gross sterile pyuria after oral ciprofloxacin treatment of urinary tract infection. The patient developed problem after complete course of 7-day acute upper urinary tract treatment. The patient was observed with cloudy whitish urine that had never seen before. The urinalysis showed sterile pyuria. This case was treated by conservative method and the problem was resolved within 7 days.

  17. Acupuncture for Chronic Urinary Retention due to Spinal Cord Injury: A Systematic Review

    Jia Wang

    2016-01-01

    Full Text Available No systematic review has been published on the use of acupuncture for the treatment of chronic urinary retention (CUR due to spinal cord injury (SCI. The aim of this review was to assess the effectiveness and safety of acupuncture for CUR due to SCI. Three randomized controlled trials (RCTs including 334 patients with CUR due to SCI were included. Meta-analysis showed that acupuncture plus rehabilitation training was much better than rehabilitation training alone in decreasing postvoid residual (PVR urine volume (MD −109.44, 95% CI −156.53 to −62.35. Likewise, a combination of acupuncture and aseptic intermittent catheterization was better than aseptic intermittent catheterization alone in improving response rates (RR 1.23, 95% CI 1.10 to 1.38. No severe adverse events were reported. In conclusion, acupuncture as a complementary therapy may have a potential effect in CUR due to SCI in decreasing PVR and improving bladder voiding. Additionally, acupuncture may be safe in treating CUR caused by SCI. However, due to the lack of high quality RCTs, we could not draw any definitive conclusions. More well-designed RCTs are needed to provide strong evidence.

  18. Acupuncture for Chronic Urinary Retention due to Spinal Cord Injury: A Systematic Review.

    Wang, Jia; Zhai, Yanbing; Wu, Jiani; Zhao, Shitong; Zhou, Jing; Liu, Zhishun

    2016-01-01

    No systematic review has been published on the use of acupuncture for the treatment of chronic urinary retention (CUR) due to spinal cord injury (SCI). The aim of this review was to assess the effectiveness and safety of acupuncture for CUR due to SCI. Three randomized controlled trials (RCTs) including 334 patients with CUR due to SCI were included. Meta-analysis showed that acupuncture plus rehabilitation training was much better than rehabilitation training alone in decreasing postvoid residual (PVR) urine volume (MD -109.44, 95% CI -156.53 to -62.35). Likewise, a combination of acupuncture and aseptic intermittent catheterization was better than aseptic intermittent catheterization alone in improving response rates (RR 1.23, 95% CI 1.10 to 1.38). No severe adverse events were reported. In conclusion, acupuncture as a complementary therapy may have a potential effect in CUR due to SCI in decreasing PVR and improving bladder voiding. Additionally, acupuncture may be safe in treating CUR caused by SCI. However, due to the lack of high quality RCTs, we could not draw any definitive conclusions. More well-designed RCTs are needed to provide strong evidence. PMID:27190542

  19. Empiric antibiotic therapy in acute uncomplicated urinary tract infections and fluoroquinolone resistance: a prospective observational study

    Düzgün Nurşen; Altunsoy Adalet; Aypak Cenk

    2009-01-01

    Abstract Background The aims of this study were to determine the antimicrobial susceptibility patterns of urinary isolates from community acquired acute uncomplicated urinary tract infections (uUTI) and to evaluate which antibiotics were empirically prescribed in the outpatient management of uUTI. Methods Among the patients which were admitted to outpatient clinics of Ankara University Medical Faculty, Ibni-Sina Hospital during 2005-2006, a total of 429 women between the age of 18 and 65 year...

  20. Increased incidence of acute kidney injury with aprotinin use during cardiac surgery detected with urinary NGAL

    Wagener, G.; Gubitosa, G.; Wang, S.;

    2008-01-01

    BACKGROUND: Use of aprotinin has been associated with acute kidney injury after cardiac surgery. Neutrophil gelatinase-associated lipocalin (NGAL) is a novel, very sensitive marker for renal injury. Urinary NGAL may be able to detect renal injury caused by aprotinin. This study determined if the...... use of aprotinin is associated with an increased incidence of acute kidney injury and increased levels of urinary NGAL. METHODS: In this prospective, observational study 369 patients undergoing cardiac surgery were enrolled. 205 patients received aprotinin and 164 received epsilon amino-caproic acid...... intraoperatively. Urinary NGAL was measured before and immediately after cardiac surgery and 3, 18 and 24 h later. The association of aprotinin use with the incidence of acute kidney injury (increase of serum creatinine >0.5 mg/dl) and NGAL levels was determined using logistic and linear regression models. RESULTS...

  1. Prostaglandin synthetase inhibition with indomethacin rectal suppositories in the treatment of acute and chronic urinary calculus obstruction.

    Al-Waili, N S

    1986-03-01

    The effect of indomethacin suppositories on both acute urinary colic and urinary calculus, resistant or refractory to conventional therapy with analgesics and spasmolytics was investigated. Fifty-five patients with acute urinary colic refractory to treatment with repeated injections of antispasmodics and analgesics had dramatic or complete pain relief after receiving indomethacin suppositories (100 mg) (P less than 0.01). Fifteen of the 55 patients passed urinary stones within 30 days of treatment with indomethacin. Three out of 30 other patients with renal or ureteric stones were treated with indomethacin suppositories (100 mg) twice daily. Twenty-one of the 30 patients passed their stones within 30 days of treatment. It is concluded that indomethacin suppositories can relieve acute urinary colic resistant to treatment with analgesic/antispasmodic drugs, and facilitate expulsion of urinary calculi. The mechanism of action of indomethacin is discussed in terms of its analgesic and anti-inflammatory effects and its prostaglandin synthesis inhibition. PMID:3720020

  2. A rare benign genitourinary tumor in a Japanese male: urinary retention owing to aggressive angiomyxoma of the prostate

    Hayakazu Nakazawa

    2010-03-01

    Full Text Available Close examination of a 67-year-old Japanese man, who complained of persistent nocturia, revealed that a semitransparent polypoid tumor had developed from the bladder neck to the prostatic urethra obstructing the internal urethral meatus, which resulted in excessive urinary retention and post-renal dysfunction. The tumor was resected by a transurethral procedure and a pathological examination of specimens revealed aggressive angiomyxoma (AAM of the prostate. AAM usually develops in the intrapelvic and perineal organs of females. So far as we know, this is the second case of primary prostatic AAM reported in the English literature, and is the first case where the patient encountered urethral obstruction.

  3. The Reason, Prevention and Treatment of Postpartum Urinary Retention%产后尿潴留的病因、预防及处理

    熊婕

    2015-01-01

    Objective To explore the etiology, prevention and treatment of postpartum urinary retention.Methods From January 2012 to December 2012, 32 cases of postpartum urine retention patients were analyzed, and research the causes of urinary retention occur ed, provided prevention and treatment scheme for medical work.Results The causes of postpartum urinary retention mainly include:①psychological factors;②mechanical damage;③drug ef ect;④stimulus placing a urinary catheter;⑤urinary tract infections;⑥other factors, etc.Conclusion Early detection of urinary retention symptoms, active intervention treatment, can reduce the occur ence of urinary retention and reduce maternal pain.%目的:探讨产后尿潴留的病因、预防及处理。方法对2012年1月~2013年12月32例产后尿潴留患者进行分析,研究尿潴留发生的病因,为医护工作提供预防及处理方案。结果引起产后尿潴留的原因主要有:①心理因素;②机械损伤;③药物影响;④留置尿管刺激;⑤泌尿系统感染;⑥其他因素等。结论及早发现尿潴留症状,积极干预处理,可减少尿潴留的发生,减轻产妇的痛苦。

  4. Urinary neutrophil gelatinase-associated lipocalin and acute kidney injury after cardiac surgery

    Wagener, G.; Gubitosa, G.; Wang, S.;

    2008-01-01

    BACKGROUND: Neutrophil gelatinase-associated lipocalin (NGAL) is proposed as an early marker of kidney injury. We report the association of urinary NGAL with indexes of intraoperative renal hypoperfusion (cardiopulmonary bypass time and aortic cross-clamp time) and acute kidney injury (AKI) after...... cardiopulmonary bypass time and aortic cross-clamp time to predict AKI were 0.592 (95% CI, 0.518 to 0.666) and 0.593 (95% CI, 0.523 to 0.665), respectively. LIMITATIONS: Limited sensitivity of changes in serum creatinine levels for kidney injury. CONCLUSIONS: Urinary NGAL has limited diagnostic accuracy to...

  5. STUDY OF FOSFOMYCIN TROMETAMOL IN ACUTE LOWER URINARY TRACT INFECTIONS

    Preetkamal

    2016-04-01

    Full Text Available OBJECTIVES To evaluate the efficacy of single oral dose of Fosfomycin Trometamol (FT in patients of uncomplicated lower urinary tract infections. METHODS One hundred women between 18-65 years’ age group with uncomplicated Urinary Tract Infection (UTI with culture positive for E. coli and Enterococcus were enrolled in this prospective study. Patients with culture positive for E. coli and Enterococcus and with in-vitro susceptibility to Fosfomycin Trometamol (FT as tested by Kirby-Bauer disc diffusion method were given single oral dose of Fosfomycin trometamol, i.e. 3 g. These patients were followed up for clinical and bacteriological cure and any adverse effects. RESULTS The incidence of E. coli infection was 86% and Enterococcus infection was 14%; 78% of E. coli isolates were susceptible to FT with 22% being resistant; 86% of Enterococcus isolates were susceptible to FT with 14% being resistant. Incidence of adverse effects of FT was only 2%. CONCLUSIONS Fosfomycin trometamol might be considered as a promising single dose oral antibiotic for uncomplicated UTI due to E. coli and Enterococcus spp.

  6. Gamma-variate plasma clearance versus urinary plasma clearance of (51) Cr-EDTA in patients with cirrhosis with and without fluid retention

    Fuglsang, Stefan; Henriksen, Ulrik L; Hansen, Hanne B;

    2016-01-01

    In patients with fluid retention, the plasma clearance of (51) Cr-EDTA (Clexp obtained by multiexponential fit) may overestimate the glomerular filtration rate (GFR). The present study was undertaken to compare a gamma-variate plasma clearance (Clgv) with the urinary plasma clearance of (51) Cr......-EDTA (Clu ) in patients with cirrhosis with and without fluid retention. A total of 81 patients with cirrhosis (22 without fluid retention, 59 with ascites) received a quantitative intravenous injection of (51) Cr-EDTA followed by plasma and quantitative urinary samples for 5 h. Clgv was determined from the...... injected dose relative to the plasma concentration-time area, obtained by a gamma-variate iterative fit. Clexp and Clu were determined by standard technique. In patients without fluid retention, Clgv , Clexp and Clu were closely similar. The difference between Clgv and Clu (Clgv - Clu = ΔCl) was mean -0...

  7. Urinary liver-type fatty acid-binding protein predicts adverse outcomes in acute kidney injury

    Ferguson, Michael A.; Vaidya, Vishal S.; Waikar, Sushrut S.; Collings, Fitz B.; Sunderland, Kelsey E.; Gioules, Costas J.; Bonventre, Joseph V.

    2009-01-01

    Acute kidney injury (AKI) is a common condition with significant associated morbidity and mortality. The insensitivity and non-specificity of traditional markers of renal dysfunction prevent timely diagnosis, estimation of the severity of renal injury, and the administration of possible therapeutic agents. Here, we determine the prognostic ability of urinary liver-type fatty acid-binding protein (L-FABP), and further characterize its sensitivity and specificity as a biomarker of AKI. Initial ...

  8. Surveillance of acute community acquired urinary tract bacterial infections

    Sibanarayan Rath; Rabindra N. Padhy

    2015-01-01

    Objective: To record the antibiotic resistance of community acquired uropathogens over a period of 24 months (May 2011-April 2012). Methods: Urine samples from patients of outpatient department (OPD) were used for isolating urinary tract infection (UTI)-causing bacteria that were cultured on suitable selective media and identified by biochemical tests. Their antibiograms were ascertained by Kirby-Bauer’s disc diffusion method, using 17 antibiotics of 5 different classes. Results: From 2137 urine samples 1332 strains of pathogenic bacteria belonging to 11 species were isolated. Two Gram-positives, Staphylococcus aureus and Enterococcus faecalis and nine Gram-negatives, Acinetobacter baumannii, Citrobacter sp., Escherichia coli, Enterobacter aerogenes, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris and Pseudomonas aeruginosa were isolated. Both S. aureus and E. faecalis were vancomycin resistant, and resistant-strains of all pathogens increased in each 6-month period of study. Particularly, all Gram-negatives were resistant to nitrofurantoin and co-trimoxazole, the most preferred antibiotics of empiric therapy for UTI, but were moderately resistant to gentamicin, ampicillin, amoxyclav, ofloxacin and gatifloxacin. Most Gram-negatives produced extended spectrum β-lactamase. Conclusions: It was concluded that periodic surveillance of pathogens is an essential corollary in effective health management in any country, as empiric therapy is a common/essential practice in effective clinical management.

  9. Drug-induced acute tubulointerstitial nephritis: a case with elevated urinary cadmium.

    Subat-Dezulović, Mirna; Slavić, Irena; Rozmanić, Vojko; Persić, Mladen; Medjimurec, Branka; Sćukanec-Spoljar, Mira

    2002-05-01

    Acute tubulointerstitial nephritis (ATIN) has many different causes, but is most frequently caused by drugs. We report a 13-year-old vegetarian girl with drug-induced ATIN, confirmed by renal biopsy, and simultaneous occurrence of elevated urinary cadmium. Four weeks prior to admission she had been treated with antibiotics and acetaminophen for respiratory infection, and remaining febrile, was treated with different "home-made" herbal mixtures. She presented with acute non-oliguric renal failure, tubular dysfunction, and sterile pyuria, but without skin rash or edema. Laboratory data showed a raised erythrocyte sedimentation rate, normal white blood count with eosinophilia, and a serum creatinine of 245 micromol/l. Urinalysis was remarkable for glycosuria, tubular proteinuria, and elevated beta(2)-microglobulin and N-acetyl-beta-D-glucosaminidase excretion. Immunoserological tests characteristic of acute glomerulonephritis and systemic diseases were negative. She was treated with steroids and her renal function improved. Follow-up analyses disclosed normal urinary cadmium and enzyme excretion within 6 months. Heavy metal analysis of herbal preparations that she had taken confirmed the presence of cadmium, but within approved concentrations. In conclusion, elevated urinary cadmium in the case of drug-induced ATIN may be assumed to be an accidental finding. However, consumption of different herbs containing cadmium and cadmium-induced nephro-toxicity could be the reason for such serious renal damage. PMID:12042900

  10. Acute urinary toxicity following transperineal prostate brachytherapy using a modified Quimby loading method

    Purpose: To examine the acute urinary toxicity following transperineal prostate implant using a modified Quimby loading method with regard to time course, severity, and factors that may be associated with a higher incidence of morbidity. Methods and Materials: One hundred thirty-nine patients with prostate adenocarcinoma treated with brachytherapy from 1997 through 1999 had follow-up records available for review. Patients considered for definitive brachytherapy alone included those with prostate specific antigen (PSA) ≤6, Gleason score (GS) ≤6, clinical stage 6, PSA>6, or Stage>T2a were treated with external beam radiation therapy followed by brachytherapy boost. Sources were loaded according to a modified Quimby method. At each follow-up, toxicity was graded based on a modified RTOG urinary toxicity scale. Results: Acute urinary toxicity occurred in 88%. Grade I toxicity was reported in 23%, grade II in 45%, and grade III in 20%, with 14% requiring prolonged (greater than 1 week) intermittent or indwelling catheterization. Overall median duration of symptoms was 12 months. There was no difference in duration of symptoms between patients treated with I-125 or Pd-103 sources (p=0.71). After adjusting for GS and PSA, multivariate logistic regression analysis showed higher incidence of grade 3 toxicity in patients with larger prostate volumes (p=0.002), and those with more seeds implanted (p<0.001). Higher incidence of prolonged catheterization was found in patients receiving brachytherapy alone (p=0.01), with larger prostate volumes (p=0.01), and those with more seeds implanted (p<0.001). Conclusion: Interstitial brachytherapy for prostate cancer leads to a high incidence of acute urinary toxicity, most of which is mild to moderate in severity. A prolonged need for catheterization can occur in some patients. Patients receiving brachytherapy alone, those with prostate volumes greater than 30 cc, and those implanted with a greater number of seeds have the highest

  11. Nursing Experience of Urinary Retention after Cesarean Section%浅谈产科术后尿潴留的护理研究

    张亚伟

    2014-01-01

    Obstetric operation after catheter removal due to various causes of dysuria cause urinary retention, if processing is undeserved, prone to urinary tract infections, the clinical brought great suf ering to the patients. The nursing problems of urinary retention after cesarean section, talk about understanding yourself.%产科手术拔除尿管后常因各种原因引起排尿困难导致尿潴留,如处理不当容易发生泌尿系统感染,临床上给患者带来极大的痛苦。本文就剖宫产术后尿潴留的护理问题,谈一下自己的体会。

  12. A Rare Cause of Acute Abdomen: Urinary Bladder Rupture due to Foley Catheter

    Ömer Engin

    2013-07-01

    Full Text Available Urinary bladder rupture is usually found due to blunt or penetrating traumas and iatrogenic injuries, and spontaneous intraperitoneal perforation is very rare. 57 years old male patient was consulted to general surgery department due to abdominal pain, nausia-vomiting and fever. He had Diabetes Mellitus, Multiple Sclerosis, Leriche Syndrome and operation for benign prostatic hypertrophy 5 years ago on his medical history which the case catheterised him urinary bladder himself frequently in nonsterile conditions. He did not care about sterility. On physical examination, suprapubic defence and rebound was noted more prominently on right lower quadrant. He was taken to operating room with the diagnosis of acute abdomen. On exploration, infection was seen on all layers of the whole urinary bladder, abscess formation and necrosis causing a microperforation which is detected by methylene blue was also present. Intraabdominal abscess drainage, cystostomy and primary suturing of the urinary bladder was performed. Patient died due to sepsis at the 9.th post operative day.

  13. The Effect of Acute Exercise on Consolidation and Retention of Motor Memory

    Skriver, Kasper Christen

    There is substantial evidence that a single bout of exercise can improve cognitive functions and retention of certain types of declarative memory. However, it is unclear if a similar effect can be demonstrated when coupling physical activity with the acquisition and retention of a motor skill...... as effectively as running. Our research suggests that norepinephrine, lactate and brain-derived neurotrophic factor might be involved in mediating the effect of exercise on motor memory. Overall, the results imply that exercise can be applied to facilitate long-term retention of motor memory........ Hence, the overall aim of the present thesis was to investigate the relationship between acute exercise and motor memory, with special interest in investigating if exercise performed after motor skill learning could improve skill retention. Study I was designed to assess if a single bout of exercise...

  14. Significant upper urinary tract hematuria as a rare complication of high-pressure chronic retention of urine following decompression: a case report

    Naranji Ishvar

    2012-08-01

    Full Text Available Abstract Introduction Hematuria has been described following bladder drainage in 2% to 16% of high-pressure chronic urinary retention treatments by decompression and is generally self-limiting. We describe a case of significant bilateral upper urinary tract hematuria following drainage of high-pressure chronic retention. To the best of our knowledge, the only similar case reported in the literature was in 1944. Case presentation An 82-year-old Caucasian man was referred to our department with nocturnal enuresis and a palpable bladder. He was catheterized, produced a residual volume of 2900mL, and ended up becoming oliguric. Following investigations, he had bilateral nephrostomies. He was discharged 18 days after presentation. Conclusions Clinicians should keep in mind the presentation discussed in this case report to be able to swiftly manage this extremely rare complication of decompression in patients with high-pressure chronic retention.

  15. 99mTc-DMSA scintigraphy in acute urinary tract infection in children

    24 children with symptomatic urinary tract infection (UTI) underwent systematically ultrasound studies (US) and 99mTc-DMSA renal scans. Among the 15 patients considered as acute pyelonephritis (APN) on clinical grounds, the scan was abnormal in 12 cases, in contrast with only 1 abnormal scan in the clinical subgroup of the lower UTI. Among the 10 abnormal scans that were repeated later on, 6 did completely normalize. US showed only once a parenchymal appearance suggestive for APN. Our findings suggest that the DMSA scan has to be considered at present as the most sensitive imaging technique for the detection of APN. (orig.)

  16. Total plasma clearance versus urinary plasma clearance of (51)Cr-EDTA in patients with cirrhosis with and without fluid retention

    Henriksen, Ulrik Lütken; Hansen, Hanne B; Ring-Larsen, Helmer;

    2015-01-01

    Abstract Background and aim. In patients with fluid retention, the total plasma clearance of (51)Cr-EDTA (ClP) may overestimate the glomerular filtration rate (GFR). The present study was therefore undertaken in order to compare ClP with the urinary plasma clearance of (51)Cr-EDTA (ClU) in patients...... with cirrhosis with and without fluid retention. Material and methods. A total of 136 patients with cirrhosis (24 without fluid retention, 112 with ascites) received a quantitative intravenous injection of (51)Cr-EDTA followed by plasma and quantitative urinary samples for 5 hours. ClP was determined...... from the injected dose relative to the plasma concentration-time area, extrapolated to infinity. ClU was determined as urinary excretion relative to the plasma concentration-time area up to voiding. Results. In patients without fluid retention, the difference between ClP and ClU (ClP - ClU = ClΔ) was...

  17. Urinary proteomic shotgun approach for identification of potential acute rejection biomarkers in renal transplant recipients

    2012-01-01

    Background Acute rejection (AR) episodes in renal transplant recipients are suspected when plasma creatinine is elevated and other potential causes out ruled. Graft biopsies are however needed for definite diagnosis. Non-invasive AR-biomarkers is an unmet clinical need. The urinary proteome is an interesting source in the search for such a biomarker in this population. Methods In this proof of principle study, serial urine samples in the early post transplant phase from 6 patients with biopsy verified acute rejections and 6 age-matched controls without clinical signs of rejection were analyzed by shotgun proteomics. Results Eleven proteins fulfilled predefined criteria for regulation in association with AR. They presented detectable regulation already several days before clinical suspicion of AR (increased plasma creatinine). The regulated proteins could be grouped by their biological function; proteins related to growth and proteins related to immune response. Growth-related proteins (IGFBP7, Vasorin, EGF and Galectin-3-binding protein) were significantly up-regulated in association with AR (P = 0.03) while proteins related to immune response (MASP2, C3, CD59, Ceruloplasmin, PiGR and CD74) tended to be up-regulated ( P = 0.13). Conclusion The use of shotgun proteomics provides a robust and sensitive method for identification of potentially predictive urinary biomarkers of AR. Further validation of the current findings is needed to establish their potential clinical role with regards to clinical AR diagnosis. Trial registration ClinicalTrials.gov number NCT00139009 PMID:23369437

  18. Efficacy of selective alpha-1 blocker therapy in the treatment of acute urinary symptoms during radiotherapy for localized prostate cancer

    Purpose: To determine the efficacy of an alpha-1 adrenoreceptor blocking agent for acute urinary symptoms in patients treated with radiotherapy for localized prostate cancer. Methods and Materials: Between 1987 and 1995, 743 patients with clinically localized prostate cancer were treated with 3D-CRT. A total of 275 (37%) patients developed Grade 2 acute urinary symptoms as defined by the RTOG morbidity scoring system. Terazosin hydrochloride (THC), a selective alpha-1 adrenoceptor blocking agent, was given to 119 (43%) patients for treatment of their urinary symptoms, whereas nonsteroidal anti-inflammatory medications (NSAID) were administered to 71 patients (26%). Thirty-one patients (11%) were treated with other medications, and 54 (20%) did not seek pharmacologic intervention for their urinary symptoms. Patients were monitored weekly to assess changes in urinary urgency, frequency, and nocturia. Results: Treatment with THC resulted in a significant resolution of urinary symptoms in 79 of 119 patients (66%), while 26 (22%) had moderate improvement, and 14 (12%) had minimal to no response to this drug. In contrast, only 11 of 71 (16%) of the patients treated with NSAIDs experienced significant symptom relief, 20 (28%) had moderate improvement, and 40 (56%) had minimal to no response. The difference in the significant symptomatic improvement between THC and NSAID therapy (66% vs. 16%) was highly significant (p < 0.001). For patients treated with THC, a higher likelihood of significant symptom relief was observed in patients who did not receive neoadjuvant androgen ablation (p = 0.04) and in those who were younger than 65 years of age (p = 0.02). Conclusion: Alpha-1 selective adrenoceptor blocking agents are effective in ameliorating the acute urinary symptoms in patients receiving radiotherapy for localized prostate cancer. Although this was not a randomized prospective study, the data suggest that NSAIDs were less effective in relieving radiation-induced urinary

  19. Identification of novel translational urinary biomarkers for acetaminophen-induced acute liver injury using proteomic profiling in mice

    Swelm, R.P.L. van; Laarakkers, J.M.M.; Kuur, E.C. van der; Morava, E.; Wevers, R A; Augustijn, K.D.; Touw, D.J.; Sandel, M.H.; Masereeuw, R.; Russel, F. G. M.

    2012-01-01

    Drug-induced liver injury (DILI) is the leading cause of acute liver failure. Currently, no adequate predictive biomarkers for DILI are available. This study describes a translational approach using proteomic profiling for the identification of urinary proteins related to acute liver injury induced by acetaminophen (APAP). Mice were given a single intraperitoneal dose of APAP (0-350 mg/kg bw) followed by 24 h urine collection. Doses of >/=275 mg/kg bw APAP resulted in hepatic centrilobular...

  20. Identification of Novel Translational Urinary Biomarkers for Acetaminophen-Induced Acute Liver Injury Using Proteomic Profiling in Mice

    2012-01-01

    Drug-induced liver injury (DILI) is the leading cause of acute liver failure. Currently, no adequate predictive biomarkers for DILI are available. This study describes a translational approach using proteomic profiling for the identification of urinary proteins related to acute liver injury induced by acetaminophen (APAP). Mice were given a single intraperitoneal dose of APAP (0–350 mg/kg bw) followed by 24 h urine collection. Doses of ≥275 mg/kg bw APAP resulted in hepatic centrilobular necr...

  1. Diagnosis and treatment of melamine-associated urinary calculus complicated with acute renal failure in infants and young children

    SUN Ning; JIANG Ye-ping; FENG Dong-chuan; ZHANG Rui-feng; ZHU Xiao-yu; XIAO Hong-zhan; SHEN Ying; SUN Qiang; LI Xu-ran; JIA Li-qun; ZHANG Gui-ju; ZHANG Wei-ping; CHEN Zhi; FAN Jian-feng

    2009-01-01

    Background Infants in some areas of China developed urinary lithiasis after being fed with powdered milk that was tainted with melamine in 2008 and very small proportion of the infants developed acute renal failure caused by urinary tract calculus obstruction. The aim of this article was to summarize clinical characteristics, diagnosis and treatment of infants with urinary calculus and acute renal failure developed after being fed with melamine tainted formula milk.Methods Data of infant patients with urinary calculus and acute renal failure due to melamine tainted formula milk admitted to the Beijing Children's Hospital Affiliated to the Capital Medical University and the Xuzhou Children's Hospital in 2008 were used to analyze the epidemiological characteristics, clinical manifestations, imaging features as well as effects of 4 types of therapies.Results All the 34 infants with urinary calculus were complicated with acute renal failure, their blood urea nitrogen (BUN) was (24.1±8.2) mmol/L and creatinine (CO was (384.2±901.2) μmol/L. The chemical analysis on the urinary calculus sampled from 15 of the infants showed that the calculus contained melamine and acidum uricum. The time needed for the four types of therapies for returning Cr to normal was (3.5±1.9) days for cystoscopy group, (2.7±1.1) days for lithotomy group, (3.8±2.3) days for dialysis group, and (2.7±1.6) days for medical treatment group, which had no statistically significant difference (P=0.508). Renal failure of all the 34 infants was relieved within 1 to 7 days, averaging (3.00±1.78) days.Conclusions Melamine tainted formula milk may cause urinary calculus and obstructive acute renal failure. It is suggested that firstly the patients with urinary calculus complicated with acute renal failure should be treated with dialysis or medication to correct electrolyte disturbance, in particular hyperkalemia, and then relieve the obstruction with available medical and surgical methods as soon as

  2. Urinary biomarkers TIMP-2 and IGFBP7 early predict acute kidney injury after major surgery.

    Ivan Gocze

    Full Text Available To assess the ability of the urinary biomarkers IGFBP7 (insulin-like growth factor-binding protein 7 and TIMP-2 (tissue inhibitor of metalloproteinase 2 to early predict acute kidney injury (AKI in high-risk surgical patients.Postoperative AKI is associated with an increase in short and long-term mortality. Using IGFBP7 and TIMP-2 for early detection of cellular kidney injury, thus allowing the early initiation of renal protection measures, may represent a new concept of evaluating renal function.In this prospective study, urinary [TIMP-2]×[IGFBP7] was measured in surgical patients at high risk for AKI. A predefined cut-off value of [TIMP-2]×[IGFBP7] >0.3 was used for assessing diagnostic accuracy. Perioperative characteristics were evaluated, and ROC analyses as well as logistic regression models of risk assessment were calculated with and without a [TIMP-2]×[IGFBP7] test.107 patients were included in the study, of whom 45 (42% developed AKI. The highest median values of biomarker were detected in septic, transplant and patients after hepatic surgery (1.24 vs 0.45 vs 0.47 ng/l²/1000. The area under receiving operating characteristic curve (AUC for the risk of any AKI was 0.85, for early use of RRT 0.83 and for 28-day mortality 0.77. In a multivariable model with established perioperative risk factors, the [TIMP-2]×[IGFBP7] test was the strongest predictor of AKI and significantly improved the risk assessment (p<0.001.Urinary [TIMP-2]×[IGFBP7] test sufficiently detect patients with risk of AKI after major non-cardiac surgery. Due to its rapid responsiveness it extends the time frame for intervention to prevent development of AKI.

  3. Sub-nephrotoxic cisplatin sensitizes rats to acute renal failure and increases urinary excretion of fumarylacetoacetase.

    Vicente-Vicente, Laura; Sánchez-Juanes, Fernando; García-Sánchez, Omar; Blanco-Gozalo, Víctor; Pescador, Moisés; Sevilla, María A; González-Buitrago, José Manuel; López-Hernández, Francisco J; López-Novoa, José Miguel; Morales, Ana Isabel

    2015-04-16

    Nephrotoxicity limits the therapeutic efficacy of the antineoplastic drug cisplatin. Due to dosage adjustment and appropriate monitoring, most therapeutic courses with cisplatin produce no or minimal kidney damage. However, we studied whether even sub-nephrotoxic dosage of cisplatin poses a potential risk for the kidneys by predisposing to acute kidney injury (AKI), specifically by lowering the toxicity threshold for a second nephrotoxin. With this purpose rats were treated with a single sub-nephrotoxic dosage of cisplatin (3mg/kg, i.p.) and after two days, with a sub-nephrotoxic regime of gentamicin (50mg/kg/day, during 6 days, i.p.). Control groups received only one of the drugs or the vehicle. Renal function and renal histology were monitored throughout the experiment. Cisplatin treatment did not cause any relevant functional or histological alterations in the kidneys. Rats treated with cisplatin and gentamicin, but not those under single treatments, developed an overt renal failure characterized by both renal dysfunction and massive tubular necrosis. In addition, the urinary excretion of fumarylacetoacetase was increased in cisplatin-treated animals at subtoxic doses, which might be exploited as a cisplatin-induced predisposition marker. In fact, the urinary level of fumarylacetoacetase prior to the second nephrotoxin correlated with the level of AKI triggered by gentamicin in predisposed animals. PMID:25677510

  4. Urinary tract analgesics for the treatment of patients with acute cystitis: where is the clinical evidence?

    Pergialiotis, Vassilis; Arnos, Pantelis; Mavros, Michael N; Pitsouni, Eleni; Athanasiou, Stavros; Falagas, Matthew E

    2012-08-01

    Acute cystitis is one of the most common health-related problems in the female population. Over the last few decades, a number of drugs labeled as 'urinary tract analgesics' were released; these are available over the counter and are gaining widespread resonance among the North American population. The main representatives of this class of drugs are phenazopyridine and methenamine hippurate. Methenamine's efficacy and side effects have been well studied in a recent systematic review. On the other hand, in contrast to its widespread use, the published clinical evidence regarding phenazopyridine's effectiveness and safety is scarce. In addition, consumers (potentially patients) appear to ignore the limitations of this kind of treatment. In this article, concerns regarding the use of over-the-counter uroanalgesics, with a focus on the relevant clinical evidence, are discussed. PMID:23030327

  5. A prospective study of children with first acute sumptomatic E.coli urinary tract infections

    Between 1985 and 1987 102 children, age 0-14 years, presented with a first acute symptomatic E. coli urinary tract infection. Investigations included early 99mtechnetium dimercaptosuccinic acid (DMSA) scan, ultrasonography, micturating cysto-urethrography and indirect voiding radionuclide cystography using 99mTc DTPA. Follow-up DMSA scan was carried out after 6 months. Twenty-one of 102 of initial DMSA studies showed diminished uptake of radionuclide and 12 showed cortical scarring. Twenty-nine patients had significant vesicoureteral relux. The finding of diminished uptake on the initial scan was significantly associated with fever, systemic upset, length of symptoms and a peripheral blood leucocytosis. In addition the finding was associated with fever and loin pain in the older child. Both diminished uptake and scarring were more common in refluxing kidney units. We propose that, in children with UTI, diminished uptake on early DMSA scan localises infection in the renal parenchyma

  6. Comparison of pivmecillinam and cephalexin in acute uncomplicated urinary tract infection.

    Menday, A P

    2000-01-01

    The clinical and bacteriological efficacy of a 3-day course of pivmecillinam, 200 mg three times daily, was compared with that of a 7-day course of cephalexin, 250 mg four times daily, in 216 patients with a bacteriologically confirmed, acute, uncomplicated, urinary tract infection. Both treatments were similarly effective. Clinical cure or improvement was obtained in 95.3% of patients given pivmecillinam and in 93.6% of patients given cephalexin. Bacteriological success was achieved in 89.7 and 81.7% patients taking pivmecillinam or cephalexin, respectively. Eradication rates for Escherichia coli were 90.1% for pivmecillinam and 80.6% for cephalexin. Both treatments were well tolerated. This study has confirmed that a 3-day course of pivmecillinam is effective and well tolerated in uncomplicated cystitis. PMID:10724022

  7. Urinary proteomic shotgun approach for identification of potential acute rejection biomarkers in renal transplant recipients

    Loftheim Håvard

    2012-08-01

    Full Text Available Abstract Background Acute rejection (AR episodes in renal transplant recipients are suspected when plasma creatinine is elevated and other potential causes out ruled. Graft biopsies are however needed for definite diagnosis. Non-invasive AR-biomarkers is an unmet clinical need. The urinary proteome is an interesting source in the search for such a biomarker in this population. Methods In this proof of principle study, serial urine samples in the early post transplant phase from 6 patients with biopsy verified acute rejections and 6 age-matched controls without clinical signs of rejection were analyzed by shotgun proteomics. Results Eleven proteins fulfilled predefined criteria for regulation in association with AR. They presented detectable regulation already several days before clinical suspicion of AR (increased plasma creatinine. The regulated proteins could be grouped by their biological function; proteins related to growth and proteins related to immune response. Growth-related proteins (IGFBP7, Vasorin, EGF and Galectin-3-binding protein were significantly up-regulated in association with AR (P = 0.03 while proteins related to immune response (MASP2, C3, CD59, Ceruloplasmin, PiGR and CD74 tended to be up-regulated ( P = 0.13. Conclusion The use of shotgun proteomics provides a robust and sensitive method for identification of potentially predictive urinary biomarkers of AR. Further validation of the current findings is needed to establish their potential clinical role with regards to clinical AR diagnosis. Trial registration ClinicalTrials.gov number NCT00139009

  8. Implant quality and acute urinary toxicity with 125I permanent seed implantation for clinically localized prostate cancer. Results of the first 30 patients treated at PMCC

    It is widely recognized that a steep learning curve exists for departments initiating a prostate low-dose radiation (LDR) implant service. Appropriate team credentialing, willingness to accept mentoring and attention toward ongoing QA initiatives are required to ensure that both clinical and dosimetric endpoints consistently achieve standards deemed appropriate. The department of urological services began a prostate seed service in 4/2002. All participating staff were suitably trained in Seattle, Washington with unit protocols based on standard trans-rectal sonographic pre-planning, modified peripheral loading, prescription dose 145Gy and 4 week CT based post implant dosimetry. Patient eligibility paralleled federal medicare guidelines with men presenting with favorable risk disease, gland volumes 15ml/sec) considered potential candidates. a) Presenting Demographics: (n=30) Median age 62 (41-73), T stage 1c:2a:2b:2c = 18:10:1:1, Median PSA 6.3ng/ ml (5.1ng/ml - 11.1ng/ml), Median IPSS 5 (0-12), Mean Qmax 18ml/s (10ml/s -35ml/s).; b) Acute toxicity: No significant peri-procedural complications. One patient developed urinary retention day 3 and was successfully trialed day 10. All patients experienced some degree of sub-acute urinary irritation although three patients followed for at least 12 months have returned to their baseline level of functioning. c) Post implant Dosimetry: Median D90 139Gy (104Gy - 190Gy). 3 Patients received a D90 < 90% with one at 104Gy receiving additional 'top-up' external beam radiation (20Gy). A definable improvement in implant quality was observed over the 12 month study interval. Although acute toxicity was considered acceptable, patients do experience a sub-acute period of low grade albeit persistent urinary irritation and need to be cautioned appropriately. A high level of implant quality was achieved in the majority of patients. Despite 5 years HDR brachytherapy experience, considerable refinement in technique and approach was

  9. Monitoring of Urinary L-Type Fatty Acid-Binding Protein Predicts Histological Severity of Acute Kidney Injury

    Negishi, Kousuke; Noiri, Eisei; DOI, Kent; Maeda-Mamiya, Rui; Sugaya, Takeshi; Portilla, Didier; Fujita, Toshiro

    2009-01-01

    The present study aimed to evaluate whether levels of urinary L-type fatty acid-binding protein (L-FABP) could be used to monitor histological injury in acute kidney injury (AKI) induced by cis-platinum (CP) injection and ischemia reperfusion (IR). Different degrees of AKI severity were induced by several renal insults (CP dose and ischemia time) in human L-FABP transgenic mice. Renal histological injury scores increased with both CP dose and ischemic time. In CP-induced AKI, urinary L-FABP l...

  10. Urinary 1-hydroxypyrene is associated with oxidative stress and inflammatory biomarkers in acute Myocardial Infarction.

    Freitas, Fernando; Brucker, Natália; Durgante, Juliano; Bubols, Guilherme; Bulcão, Rachel; Moro, Angela; Charão, Mariele; Baierle, Marília; Nascimento, Sabrina; Gauer, Bruna; Sauer, Elisa; Zimmer, Marcelo; Thiesen, Flávia; Castro, Iran; Saldiva, Paulo; Garcia, Solange C

    2014-09-01

    Several studies have associated exposure to environmental pollutants, especially polycyclic aromatic hydrocarbons (PAHs), with the development of cardiovascular diseases. Considering that 1-hydroxypyrene (1-OHP) is the major biomarker of exposure to pyrenes, the purpose of this study was to evaluate the potential association between 1-OHP and oxidative stress/inflammatory biomarkers in patients who had suffered an acute myocardial infarction (AMI). After adopting the exclusion criteria, 58 post-infarction patients and 41 controls were sub-divided into smokers and non-smokers. Urinary 1-OHP, hematological and biochemical parameters, oxidative stress biomarkers (MDA, SOD, CAT, GPx and exogenous antioxidants) and the inflammatory biomarker (hs-CRP) were analyzed. 1-OHP levels were increased in post-infarct patients compared to controls (p < 0.05) and were correlated to MDA (r = 0.426, p < 0.01), CAT (r = 0.474, p < 0.001) and β-carotene (r = -0.309; p < 0.05) in non-smokers. Furthermore, post-infarction patients had elevated hs-CRP, MDA, CAT and GPx levels compared to controls for both smokers and non-smokers. Besides, β-carotene levels and SOD activity were decreased in post-infarction patients. In summary, our findings indicate that the exposure to pyrenes was associated to lipid damage and alterations of endogenous and exogenous antioxidants, demonstrating that PAHs contribute to oxidative stress and are associated to acute myocardial infarction. PMID:25257356

  11. Urinary 1-Hydroxypyrene is Associated with Oxidative Stress and Inflammatory Biomarkers in Acute Myocardial Infarction

    Fernando Freitas

    2014-09-01

    Full Text Available Several studies have associated exposure to environmental pollutants, especially polycyclic aromatic hydrocarbons (PAHs, with the development of cardiovascular diseases. Considering that 1-hydroxypyrene (1-OHP is the major biomarker of exposure to pyrenes, the purpose of this study was to evaluate the potential association between 1-OHP and oxidative stress/inflammatory biomarkers in patients who had suffered an acute myocardial infarction (AMI. After adopting the exclusion criteria, 58 post-infarction patients and 41 controls were sub-divided into smokers and non-smokers. Urinary 1-OHP, hematological and biochemical parameters, oxidative stress biomarkers (MDA, SOD, CAT, GPx and exogenous antioxidants and the inflammatory biomarker (hs-CRP were analyzed. 1-OHP levels were increased in post-infarct patients compared to controls (p < 0.05 and were correlated to MDA (r = 0.426, p < 0.01, CAT (r = 0.474, p < 0.001 and β-carotene (r = −0.309; p < 0.05 in non-smokers. Furthermore, post-infarction patients had elevated hs-CRP, MDA, CAT and GPx levels compared to controls for both smokers and non-smokers. Besides, β-carotene levels and SOD activity were decreased in post-infarction patients. In summary, our findings indicate that the exposure to pyrenes was associated to lipid damage and alterations of endogenous and exogenous antioxidants, demonstrating that PAHs contribute to oxidative stress and are associated to acute myocardial infarction.

  12. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) of urinary protein in acute kidney injury.

    Suhail, Sufi M; Woo, K T; Tan, H K; Wong, K S

    2011-07-01

    Recent experimental and clinical studies have shown the importance of urinary proteomics in acute kidney injury (AKI). We analyzed the protein in urine of patients with clinical AKI using sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) for its diagnostic value, and followed them up for 40 months to evaluate prognosis. Urine from 31 consecutive cases of AKI was analyzed with SDS-PAGE to determine the low, middle and high molecular weight proteins. Fractional excretion of sodium (FENa) was estimated from serum and urine creatinine and sodium (Na). The cases were followed-up for 40 months from the end of the recruitment of study cases. Glomerular protein was higher in the hematuria group when compared with the non-hematuria group (P <0.04) and in the AKI group than in the acute on chronic renal failure (AKI-on-CRF) group (P <0.002). Tubular protein was higher in the AKI-on-CRF group (P <0.003) than in the AKI group. Tubular protein correlated with FENa in groups with diabetes mellitus (DM), AKI-on-CRF, and without hematuria (P <0.03, P <0.02 and P <0.004, respectively). Pattern of protein did not differ between groups with and without DM and clinical acute tubular necrosis (ATN). At the end of 40 months follow-up, category with predominantly glomerular protein progressed to chronic renal failure (CRF) or end-stage renal failure in higher proportion (P <0.05). In clinical AKI, we observed that glomerular protein dominated in cases with glomerular insult, as indicated by hematuria. Tubular protein was common in the study cases with CRF, DM and cases without hematuria. This indicates tubulo-interstitial injury for AKI in these cases. Patients with predominantly glomerular protein had an adverse outcome. PMID:21743220

  13. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE of urinary protein in acute kidney injury

    Sufi M Suhail

    2011-01-01

    Full Text Available Recent experimental and clinical studies have shown the importance of urinary proteomics in acute kidney injury (AKI. We analyzed the protein in urine of patients with clinical AKI using sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE for its diagnostic value, and followed them up for 40 months to evaluate prognosis. Urine from 31 consecutive cases of AKI was analyzed with SDS-PAGE to determine the low, middle and high molecular weight proteins. Fractional excretion of sodium (FENa was estimated from serum and urine creatinine and sodium (Na. The cases were followed-up for 40 months from the end of the recruitment of study cases. Glomerular protein was higher in the hematuria group when compared with the non-hematuria group (P <0.04 and in the AKI group than in the acute on chronic renal failure (AKI-on-CRF group (P <0.002. Tubular protein was higher in the AKI-on-CRF group (P <0.003 than in the AKI group. Tubular protein correlated with FENa in groups with diabetes mellitus (DM, AKI-on-CRF, and without hematuria (P <0.03, P <0.02 and P <0.004, respectively. Pattern of protein did not differ between groups with and without DM and clinical acute tubular necrosis (ATN. At the end of 40 months follow-up, category with predominantly glomerular protein progressed to chronic renal failure (CRF or end-stage renal failure in higher proportion (P <0.05. In clinical AKI, we observed that glomerular protein dominated in cases with glomerular insult, as indicated by hematuria. Tubular protein was common in the study cases with CRF, DM and cases without hematuria. This indicates tubulo-interstitial injury for AKI in these cases. Patients with predominantly glomerular protein had an adverse outcome.

  14. Empiric antibiotic therapy in acute uncomplicated urinary tract infections and fluoroquinolone resistance: a prospective observational study

    Düzgün Nurşen

    2009-10-01

    Full Text Available Abstract Background The aims of this study were to determine the antimicrobial susceptibility patterns of urinary isolates from community acquired acute uncomplicated urinary tract infections (uUTI and to evaluate which antibiotics were empirically prescribed in the outpatient management of uUTI. Methods Among the patients which were admitted to outpatient clinics of Ankara University Medical Faculty, Ibni-Sina Hospital during 2005-2006, a total of 429 women between the age of 18 and 65 years old who were clinically diagnosed with uUTI and to whom prescribed empirical antibiotics were enrolled in this prospective observational study. Patients' demographical data, urine culture results, resistance rates to antimicrobial agents and prescribed empiric antimicrobial therapy were analyzed. Results Totally 390 (90.9% patients among all study population were requested for urine culture by their physicians. 150 (38.5% of these urine cultures were positive. The most common isolated uropathogen was Escherichia coli (E. coli (71.3%. The variations of uropathogens according to age and menopause status were not significantly different. The resistance rates of E. coli isolates for ampicillin, ampicillin-sulbactam, amoxicillin-clavulonate, cefuroxime, ceftriaxone, fluoroquinolones (FQ, co-trimoxazole (TMP-SMX and gentamicin were 55.1%, 32.7%, 32.7%, 23.4%, 15.9%, 25.2%, 41.1%, 6.1% respectively. FQ were the most common prescribed antibiotics (77.9% (P P Conclusion Empirical use of FQ in uUTI should be discouraged because of increased antimicrobial resistance rates.

  15. Renal and urinary levels of endothelial protein C receptor correlate with acute renal allograft rejection.

    Lionel Lattenist

    Full Text Available The Endothelial Protein C Receptor (EPCR is expressed on leukocytes, on endothelium of large blood vessels and to a lesser extent on capillaries. Membrane bound EPCR plays an important role in the activation of protein C which has anticoagulant, anti-inflammatory and cytoprotective effects. After cleavage by a protease EPCR is also found as a soluble protein. Acute rejection of kidney allografts can be divided in T-cell-mediated rejection (TCMR and antibody-mediated (ABMR rejection. The latter is characterized by strong activation of coagulation. Currently no reliable non-invasive biomarkers are available to monitor rejection. Renal biopsies were available from 81 renal transplant patients (33 without rejection, 26 TCMR and 22 ABMR, we had access to mRNA material, matched plasma and urine samples for a portion of this cohort. Renal EPCR expression was assessed by RT-PCR and immunostaining. Plasma and urine sEPCR levels were measured by ELISA. ABMR patients showed higher levels of EPCR mRNA than TCMR patients. EPCR expression on glomeruli was significantly elevated in ABMR patients than in TCMR or control patients. In the peritubular capillaries EPCR expression was higher in ABMR patients than in control patients. EPCR expression was higher in tubules and arteries of rejection patients than in control patients. Plasma sEPCR levels did not differ. Urine sEPCR levels were more elevated in the ABMR group than in patients with TCMR or without rejection. ROC analysis demonstrated that urinary sEPCR is appropriate to discriminate between ABMR patients and TCMR or control patients. We conclude that urinary sEPCR could be a novel non-invasive biomarker of antibody mediated rejection in renal transplantation.

  16. Development of clinical practice guidelines for urinary continence care of adult stroke survivors in acute and rehabilitation settings.

    Fisher, Andrea R

    2014-01-01

    This study developed evidence-based clinical practice guidelines for the urinary continence care of adult stroke survivors in acute and rehabilitation settings. The research team conducted a comprehensive review of the literature on urinary continence interventions and outcomes. The team then developed a set of recommendations outlined in the resulting clinical practice guidelines titled Clinical Practice Guidelines (CPGs) for the Urinary Continence Care of Stroke Survivors in Acute and Rehabilitation Settings. The evaluation of the CPGs consisted of a two-part assessment and pilot implementation. An expert panel of 25 local and regional experts in stroke and continence care assessed the proposed CPGs. This assessment consisted of two stages: a) evaluating the guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) Instrument (http://www. agreetrust.org); and, b) conducting focus groups to identify barriers and facilitators to the implementation of the guidelines using the Ottawa Model of Research Use (OMRU). Results from the expert panel assessments/feedback contributed to the refinement of the CPGs as well as identification and construction of implementation strategies. Two sites conducted a three-month pilot implementation of three recommendations from the CPGs as selected by each site. The two inpatient sites were a rehabilitation setting and a mixed acute and rehabilitation setting. The implementation of the CPGs included the development of learning strategies tailored to the needs of each site and in addition to the creation of an online self-learning portal. This study assessed nurses' knowledge, attitudes, and beliefs regarding urinary continence challenges using a survey before and after the pilot. Chart reviews before and after the pilot implementation audited the nurses' urinary continence practices for patients and uptake of the selected guidelines' recommendations. Study findings suggested the implementation of the CPGs

  17. Prediction of the severity of acute pancreatitis on admission by urinary trypsinogen activation peptide: A meta-analysis

    Wei Huang; Kiran Altaf; Tao Jin; Jun-Jie Xiong; Li Wen; Javed, Muhammad A; Marianne Johnstone; Ping Xue; Halloran, Christopher M; Qing Xia

    2013-01-01

    AIM: To undertake a meta-analysis on the value of urinary trypsinogen activation peptide (uTAP) in predicting severity of acute pancreatitis on admission. METHODS: Major databases including Medline, Embase, Science Citation Index Expanded and the Cochrane Central Register of Controlled Trials in the Cochrane Library were searched to identify all relevant studies from January 1990 to January 2013. Pooled sensitivity, specificity and the diagnostic odds ratios (DORs) with 95%CI were calculated ...

  18. Prognostic value of the acute DMSA scan in hospitalized children with urinary tract infection

    Hashemian H

    2008-12-01

    Full Text Available "nBackground: Urinary Tract Infection (UTI is one of the major etiological factors of permanent kidney impairment, resulting in renal scarring and severe and pernicious side effects, such as arterial hypertension and renal failure. The purpose of this study was to clarify the impression of renal parenchyma involvement by first UTI (on the basis of acute DMSA scan and vesicoureteral reflux (VUR-on the basis of VCUG/ RNC on the renal scar formation (on the basis of late DMSA scan. "nMethods: Children diagnosed with their first UTI at the Children's Hospital Medical Center, Tehran, Iran, were evaluated. For each patient, we recorded age, sex, results of VCUG/RNCs and acute DMSA scan, as well as those of a late DMSA scan performed 4-6 months later. The results of acute and late DMSA scans were compared along with the results of VCUG/RNCs. "nResults: This study included a total of 103 children, of whom 16 (15.5% were boys and 87 (84.5% were girls. The mean age was 27.2±27.7 months. The frequency of renal scars in kidneys with mild (28.6%, 8.7% and moderate (33.3%, 18.2% pyelonephritis with or without VUR was not significantly different, while the frequency of renal scars in kidneys with severe pyelonephritis (84.6%, 23.1% in the presence of VUR was significantly higher than non-refluxing kidneys with severe pyelonephritis (p=0.005. Furthermore, the frequency of renal scars in refluxing kidneys increased significantly with the severity of pyelonephritis (normal 8.3%, mild 28.6%, moderate 33.3%, and severe 84.6%; p=0.001. This pattern was not significant in non-refluxing kidneys (0%, 10.3%, 18.2%, and 23.1%, respectively; p=0.062. "nConclusion: The present study indicates that the incidence of renal scarring increases with pyelonephritis severity in patients with VUR. Furthermore, we can estimate the risk of renal scar formation from the results of acute DMSA scan and VCUG/RNC.

  19. Three days of pivmecillinam or norfloxacin for treatment of acute uncomplicated urinary infection in women.

    Nicolle, L E; Madsen, K S; Debeeck, G O; Blochlinger, E; Borrild, N; Bru, J P; Mckinnon, C; O'Doherty, B; Spiegel, W; Van Balen, F A M; Menday, P

    2002-01-01

    Pivmecillinam is a unique beta-lactam antimicrobial that has been used for the treatment of acute uncomplicated urinary infection for > 20 y. Since this agent was introduced, the quinolone antimicrobials have become widely used for the same indication. This study compared the efficacy of a 3-d regimen of pivmecillinam 400 mg b.i.d. with norfloxacin 400 mg b.i.d. Women aged between 18 and 65 y presenting with symptoms of acute cystitis of pivmecillinam and 471 to receive norfloxacin. In each group, 30% of women had negative urine cultures prior to therapy. Bacteriologic cure at early post-therapy follow-up was achieved in 222/298 (75%) pivmecillinam patients and 276/302 (91%) norfloxacin patients [p pivmecillinam and 425/442 (96%) who received norfloxacin (p = 0.39; 95% CI 1.5-3.9). Early post-therapy (11 +/- 2 d) clinical cure was achieved in 360/437 women (82%) who received pivmecillinam and 381/433 (88%) who received norfloxacin (p = 0.019; 95% CI 0.9-10.3). In women aged pivmecillinam and 299/340 (88%) for norfloxacin (p = 0.11; 95% CI 1.0-9.4). Adverse effects were similar for both regimens, and there was no evidence of the emergence of organisms of increasing resistance with therapy. Short-course therapy with norfloxacin was superior to that with pivmecillinam in terms of bacteriologic outcome, although differences in clinical outcome were less marked. In conclusion, short-course therapy with pivmecillinam is an effective empirical treatment for pre-menopausal women. PMID:12195873

  20. Cefixime versus trimethoprim/sulfamethoxazole in treatment of patients with acute, uncomplicated lower urinary tract infections.

    Cox, C E

    1989-11-01

    One hundred six patients with acute, uncomplicated lower urinary tract infections participated in a randomized study that compared cefixime (one 400-mg tablet once daily) with trimethoprim (160 mg)/sulfamethoxazole (800 mg) (one tablet every 12 hours). Two cefixime recipients and 3 patients given trimethoprim/sulfamethoxazole had courses that were not evaluable for efficacy. At five to nine days post-therapy, 98 percent of the patients in each treatment group had clinical cure and bacteriologic eradication. At four to six weeks post-therapy, 87 percent (34/39) of the cefixime-treated patients and 83 percent (33/40) of those given trimethoprim/sulfamethoxazole had clinical cure and 90 percent (35/39) and 93 percent (37/40) of the patients in the respective treatment groups had bacteriologic eradication. Adverse clinical experiences or changes in the results of laboratory tests were few. Thus, a once-daily dose of cefixime was as safe and as effective as a twice-daily regimen of trimethoprim/sulfamethoxazole. PMID:2683326

  1. Tritiated water retention on maize and beans after an acute contamination

    Although tritium is released in large quantities into environment by nuclear industries and peaceful radioisotope utilization, its behavior is not well known. The International Atomic Energy Agency is sponsoring an international study group to obtain more information about tritiated water (HTO) behavior in different ecological systems. This paper presents the studies made on corn and beans after an acute application of tritiated water during their early stages of growth on an experimental field. Sampling and radiochemical analytical methods of tritium and its behaviour on that plants during their growth cycle are outlined. It is shown that the tritiated water retention plot has at least two components, with effective half lifes of about 10 and 100 days for corn, and 8 and 40 days for beans. (author)

  2. Urinary albumin excretion and history of acute myocardial infarction in a cross-sectional population study of 2,613 individuals

    Jensen, J S; Borch-Johnsen, K; Feldt-Rasmussen, B;

    1997-01-01

    BACKGROUND: Preliminary studies have suggested that microalbuminuria--a slightly increased urinary excretion of albumin--is a risk factor for atherosclerosis. The aim of this study was to examine whether an association exists between urinary excretion of albumin and a history of acute myocardial...... measurement of urinary albumin excretion rate, acquisition of information regarding previous acute myocardial infarction (verified by the Danish Hospital Register) and tobacco and alcohol consumption, 12-lead resting electrocardiogram, and measurement of blood pressure, body mass index, waist:hip ratio......, plasma concentrations of total cholesterol, HDL cholesterol and fibrinogen, serum albumin concentration and glomerular filtration rate. RESULTS: Among the participants, 3.6% presented with a history of acute myocardial infarction. There was a positive association between urinary albumin excretion rate...

  3. Fifty-one cases of urinary retention treated by warm needle moxibustion and massage%温针灸配合按摩治疗尿潴留51例

    阎翠兰

    2011-01-01

    @@ Urinary retention is a common urological emergency.Sometimes multi-line tube catheterization is used to treat this urological emergency condition.In this instance, multi-line tube catheterization is considered to be a fast and helpful method, yet it does not treat the root cause.In addition, acupuncture therapy is another unique way used to treat this medical condition, but it is less helpful than the method of thermal acupuncture and massage therapy.therefore, the author used warm needle moxibustion and massage to treat urinary retention-urological emergency, and the report is as follows.

  4. Association of urinary mAlb, β2-m, NAG and KIM-1 with acute kidney injury after cardiac surgery

    Objective: To explore the relationship of urinary microalbumin (mAlb), β2-microglobulin (β2-m), N-acetyl-β-glucosaminidase (NAG) and kidney injury molecule-1 (KIM-1) with acute kidney injury (AKI) in patients after cardiac surgery by cardiopulmonary bypass. Methods: Ninety-one patients undergone cardiac surgery were divided into AKI group and non-AKI group according to the AKI criteria. The Scr, urinary mAlb, β2-m, NAG and KIM-1 levels were measured at different time points. Results: The urinary concentrations of mAlb, β2-m, NAG and KIM-1 at 18h after cardiac surgery in AKI patients were significantly higher than those in non-AKI patients. When mAlb, β2-m, NAG and KIM-1 were used simultaneously, the sensitivity, specificity, positive predictive value,negative predictive value, positive likelihood ratio, negative likelihood ratio and diagnostic accuracy were 84.38%, 90.16%, 81.81%, 91.66%, 9.5, 0.09, 90.10% respectively. Conclusion: Combined determination of urinary concentrations of mAlb, β2-m, NAG and KIM-1 at 18h after cardiac surgery were the early diagnostic markers for AKI, which were 30-54h prior to serum creatinine. (authors)

  5. Identification of novel translational urinary biomarkers for acetaminophen-induced acute liver injury using proteomic profiling in mice.

    van Swelm, Rachel P L; Laarakkers, Coby M M; van der Kuur, Ellen C; Morava-Kozicz, Eva; Wevers, Ron A; Augustijn, Kevin D; Touw, Daan J; Sandel, Maro H; Masereeuw, Rosalinde; Russel, Frans G M

    2012-01-01

    Drug-induced liver injury (DILI) is the leading cause of acute liver failure. Currently, no adequate predictive biomarkers for DILI are available. This study describes a translational approach using proteomic profiling for the identification of urinary proteins related to acute liver injury induced by acetaminophen (APAP). Mice were given a single intraperitoneal dose of APAP (0-350 mg/kg bw) followed by 24 h urine collection. Doses of ≥275 mg/kg bw APAP resulted in hepatic centrilobular necrosis and significantly elevated plasma alanine aminotransferase (ALT) values (pintoxication the presence of SOD1 and CA3, whereas both proteins were absent in control urine samples. Urinary concentrations of CaM were significantly increased and correlated well with plasma APAP concentrations (r = 0.97; p<0.0001) in human APAP intoxicants, who did not present with elevated plasma ALT levels. In conclusion, using this urinary proteomics approach we demonstrate CA3, SOD1 and, most importantly, CaM as potential human biomarkers for APAP-induced liver injury. PMID:23166697

  6. Contribution of Proteus mirabilis urease to persistence, urolithiasis, and acute pyelonephritis in a mouse model of ascending urinary tract infection.

    Johnson, D E; Russell, R G; Lockatell, C V; Zulty, J C; Warren, J W; Mobley, H L

    1993-07-01

    Proteus mirabilis, a significant cause of bacteriuria and acute pyelonephritis in humans, produces urease. This high-molecular-weight, multimeric, cytoplasmic enzyme hydrolyzes urea to ammonia and carbon dioxide. To assess the role of urease in colonization, urolithiasis, and acute pyelonephritis in an animal model of ascending urinary tract infection, we compared a uropathogenic strain of P. mirabilis with its isogenic urease-negative mutant, containing an insertion mutation within ureC, the gene encoding the large subunit of the enzyme. Mice challenged transurethrally with the parent strain developed significant bacteriuria and urinary stones. The urease-negative mutant had a 50% infective dose of 2.7 x 10(9) CFU, a value more than 1,000-fold greater than that of the parent strain (2.2 x 10(6) CFU). The urease-positive parent strain reached significantly higher concentrations and persisted significantly longer in the bladder and kidney than did the mutant. Indeed, in the kidney, the parent strain increased in concentration while the mutant concentration fell so that, by 1 week, the parent strain concentration was 10(6) times that of the mutant. Similarly, the urease-positive parent produced significantly more severe renal pathology than the mutant. The initial abnormalities were in and around the pelvis and consisted of acute inflammation and epithelial necrosis. By 1 week, pyelitis was more severe, crystals were seen in the pelvis, and acute pyelonephritis, with acute interstitial inflammation, tubular epithelial cell necrosis, and in some cases abscesses, had developed. By 2 weeks, more animals had renal abscesses and radial bands of fibrosis. We conclude that the urease of P. mirabilis is a critical virulence determinant for colonization, urolithiasis, and severe acute pyelonephritis. PMID:8514376

  7. Clinical significance of changes of urinary contents of albumin, IgG and β-microglobulin (β2-m) in patients with acute pancreatitis

    Objective: To investigate the cause and clinical significance of changes of urinary albumin, IgG and β2-m contents in patients with acute pancreatitis. Methods: Urinary contents of albumin IgG and β2-m (with RIA) as well as serum levels of BUN, creatinine (with biochemical methods) were determined in 89 patients with acute pancreatitis (severe 12, mild 27) and 30 controls. Results: Urinary concentrations of albumin, IgG and β2-m were significantly higher in patients with acute pancreatitis (both mild and severe type) than those in controls (P0.05). Differences between the urinary contents of these proteins in the two groups of acute pancreatitis patients (severe vs mild) were slight. Conclusion: Damage of renal function as shown by increase of urinary concentrations of albumin, IgG and β2-m could be demonstrated in patients with acute pancreatitis long before detection of any significant changes of serum BUN and creatinine levels, even in cases of mild pancreatitis. (authors)

  8. Urinary cystatin C is diagnostic of acute kidney injury and sepsis, and predicts mortality in the intensive care unit

    Nejat, Maryam; Pickering, John W; Walker, Robert J.; Westhuyzen, Justin; Shaw, Geoffrey M.; Frampton, Christopher M; Endre, Zoltán H

    2010-01-01

    Introduction To evaluate the utility of urinary cystatin C (uCysC) as a diagnostic marker of acute kidney injury (AKI) and sepsis, and predictor of mortality in critically ill patients. Methods This was a two-center, prospective AKI observational study and post hoc sepsis subgroup analysis of 444 general intensive care unit (ICU) patients. uCysC and plasma creatinine were measured at entry to the ICU. AKI was defined as a 50% or 0.3-mg/dL increase in plasma creatinine above baseline. Sepsis w...

  9. Diagnostic accuracy of early urinary index changes in differentiating transient from persistent acute kidney injury in critically ill patients: multicenter cohort study

    Pons, Bertrand; Lautrette, Alexandre; Oziel, Johanna; Dellamonica, Jean; Vermesch, Régine; Ezingeard, Eric; Mariat, Christophe; Bernardin, Gilles; Zeni, Fabrice; Cohen, Yves; Tardy, Bernard; Souweine, Bertrand; Vincent, François; Darmon, Michael

    2013-01-01

    Introduction Urinary indices have limited effectiveness in separating transient acute kidney injury (AKI) from persistent AKI in ICU patients. Their time-course may vary with the mechanism of AKI. The primary objective of this study was to evaluate the diagnostic value of changes over time of the usual urinary indices in separating transient AKI from persistent AKI. Methods An observational prospective multicenter study was performed in six ICUs involving 244 consecutive patients, including 9...

  10. Urinary Kidney Injury Molecule-1 (KIM-1 in Early Diagnosis of Acute Kidney Injury in Pediatric Critically Ill

    Irma Lestari Paramastuty

    2016-04-01

    Full Text Available Acute kidney injury (AKI often associated with a high hospital morbi-mortality rate in the intensive care unit patients. Kidney injury molecule-1 (KIM-1, has many characteristics of ideal biomarker for kidney injury. The aim of this study was to compared the temporal pattern of elevation urinary KIM-1 level following critically ill children with SCr as standart biomarker of AKI. Prospective analytic observational study was conducted during October to March 2014 in the Saiful Anwar General Hospital and Physiology Laboratory Brawijaya University. There were 13 critically ill as subjects. SCr and KIM-1 levels from all subjects were measured three times ( at admission, after 1st and 6th hour. Subjects were devided into AKI - non-AKI groups by SCr level and survivor - non survivor group at the and of the observations. Results showed that there were significantly increased levels of KIM-1 in the AKI and non-AKI and survivor-non survivor group at time point. However, we found that delta KIM-1 at time point increased significant in non AKI group and survivor group. KIM-1 at admission can diagnosed AKI in critically ill children. We conclude that urinary KIM-1 is a sensitive non-invasive biomarker to diagnosed acute kidney injury in critically ill children. Increase level of KIM-1 by time shows protective and good outcome in critically ill children.

  11. Influence factors of salt-sensitive hypertension and responses of blood pressure and urinary sodium and potassium excretion to acute oral saline loading among essential hypertensive patients

    刘叶舟

    2014-01-01

    Objective To explore the influence factors of saltsensitive hypertension and to observe changes of blood pressures and urinary sodium and potassium excretion in response to acute oral saline loading among essential hypertensive patients in China.Methods Essential hypertensive patients from Beijing Jinzhan second community were included in this study.Salt-sensitivity was determined via the improved Sullivan’s acute oral saline loading

  12. Identification of urinary microRNA biomarkers for detection of gentamicin-induced acute kidney injury in rats.

    Zhou, Xiaobing; Qu, Zhe; Zhu, Cong; Lin, Zhi; Huo, Yan; Wang, Xue; Wang, Jufeng; Li, Bo

    2016-07-01

    MicroRNAs (miRNAs) have been recently recognized as promising non-invasive biomarkers for detecting the organ injuries. To further understand the sensibility and reliability of miRNA measurements in urine sample for predicting drug-induced early nephrotoxicity, a global urinary miRNA expression analysis was performed in the rodent models with gentamicin-induced acute kidney injury (AKI). Male Wistar rats were daily administrated with gentamicin (0, 60, and 120 mg/kg) for up to 10 days by intraperitoneal injection, and the miRNA profiling of animal urine samples were subsequently analyzed using TaqMan(®) Array Rodent miRNA Cards. The results showed that four miRNAs (mmu-miR-138-5p, mmu-miR-1971, mmu-miR-218-1-3p, and rno-miR-489) were continuously increased in urine samples since day 4 after administration with gentamicin, which was not reflected by the standard markers such as serum creatinine (Cr) and urea nitrogen (BUN). Furthermore, other nine urinary miRNAs were increased in both 60 and 120 mg/kg groups on day 8. Receiver operator characteristics analysis demonstrated that the performance of these miRNAs with time- or dose-dependent increases were comparable to standard biomarkers (i.e. serum Cr and BUN), suggesting that the urinary miRNA panel can be used as potential biomarkers for the detection of gentamicin-induced AKI in rats. Moreover, the computer prediction analysis showed that these differentially expressed miRNAs were potentially targeted to many genes, which were mainly associated with the regulation of metabolic process and signaling. These data will improve the understanding and prediction of toxicology processes induced by nephrotoxicants. PMID:27074385

  13. Demographic data for urinary Acute Kidney Injury (AKI marker [IGFBP7]·[TIMP2] reference range determinations

    Nandkishor S. Chindarkar

    2015-12-01

    Full Text Available This data in brief describes characteristics of chronic stable comorbid patients who were included in reference range studies of [IGFBP7]·[TIMP-2] “Reference Intervals of Urinary Acute Kidney Injury (AKI Markers [IGFBP7]·[TIMP2] in Apparently Healthy Subjects and Chronic Comorbid Subjects without AKI” [1]. In order to determine the specificity of [IGFBP7]·[TIMP-2] for identifying patients at risk of developing AKI we studied a cohort with nine broad classification of disease who did not have AKI. Details regarding the population that was targeted for inclusion in the study are also described. Finally, we present data on the inclusion criteria for the healthy subjects used in this investigation to determine the reference range.

  14. A general practice evaluation of pivmecillinam given twice daily as a treatment for acute urinary tract infection.

    Skinner, J L; Venables, T L; Sheldon, M G

    1984-01-01

    In a multi-centre study in general practice, 292 female patients with acute urinary tract infection received a 5-day course of pivmecillinam at a dosage of either 200 mg or 400 mg twice-daily. Positive bacteriological cultures were obtained from 64 (31%) of 206 patients for whom bacteriological data was complete, and bacteriological cures were obtained in all 38 patients in the lower dose group and 22 (85%) of the 26 patients in the higher dose group. An equally good clinical response was seen with both treatments and the mean symptom score (maximum possible 15) was reduced from 7.46 to 0.73. Side-effects were reported for 7 (4%) patients in the lower dose group and 11 (10%) patients in the higher dose group. Two patients in each group ceased treatment due to nausea, which was the most frequently reported complaint. PMID:6504945

  15. Controlled randomized study comparing amoxycillin and pivmecillinam in adult out-patients presenting with symptoms of acute urinary tract infection.

    Bresky, B

    1977-07-01

    A comparative study of amoxycillin and pivmecillinam was performed on 298 out-patients with acute urinary tract infection, receiving either 375 mg amoxycillin three times daily or 400 mg pivmecillinam three times daily. The primary cure rate was 90% in the pivmecillinam group compared to 82% in the amoxycillin group. Resistant enterobacteriaceae emerged in approximately 5% of patients receiving amoxycillin but not after treatment with pivmecillinam. No serious side effects were observed in patients receiving picmecillinam and the tolerance was generally good. Upper gastrointestinal side effects were more frequent in the pivmecillinam group whereas lower gastrointestinal side effects predominated in the amoxycillin group. 200 mg pivmecillinam three times daily compared with 400 mg three times daily showed no differences in cure rate and side effects were lower (11% compared to 19%). PMID:330480

  16. Diagnosis and treatment of 30 cases of high altitude sickness combined with urinary retention%高原反应合并尿潴留30例报告

    董永超; 张俊; 徐越斌; 张斌; 马巍; 侯晓斌; 王养民

    2012-01-01

    Objective To explore the diagnosis and treatment of altitude sickness combined with urinary retention. Methods 30 cases of altitude sickness combined with urinary retention were treated from April 16th to 26th,2010.They were all male,The average age of them was 24 years (range,19 -38).All were the first time entering the high altitude area (3600 -5000 m) from low altitude area (600 - 1800 m ).The urinary frequency of 25 patients reduced from 8 to 10 times/d to 2 to 4 times/d,the urine output reduced from the 1500- 2400 ml/d to 600- 800 ml/d; the other 5 patients had no urine in 12 -18 h,even had no sense to urinate.26 patients also combined with altitude pulmonary edema and 4 combined with altitude cerebral edema.30 patients had double renal columns enlarged,21 cases had urinary protein ( + ~ ++ ). Results 30 patients were exported urine 300 -600 ml within 10 min,leaded to urine 1800 -2300ml in 12 h,returned to normal voiding after catheter removal in 18 -24 h. After comprehensive treatment such as oxygen,dehydration,diuretic,sedative,antispasmodic and anti-infection,22 cases who with chest tightness,shortness of breath,dyspnea,hemoptysis foam sputum,headache,vomiting and other symptoms of jet-like improved apparently after hospital admission within 1 hour.Their heart rate downed from 90 - 145beats/min to 68 -92 beats/min,respiration from 28 -45 times/min to 18 - 28 times/min,oxygen saturation from 48% - 84% to 92% - 100% ; 8 cases who with shortness of breath,palpitation and headache improved not obviously.After the antihypertensive treatment,their blood pressure was still high (systolic blood pressure 150 - 180 mm Hg,diastolic blood pressure 90 -110 mm Hg),oxygen saturation between 78% to 87%,so they were carried to rear area for further treatment.30 cases were all cured no death. Conclusions The high altitude urinary retention is reversible disease,which is often associated with high altitude pulmonary edema,altitude cerebral edema,acute

  17. Effects of disopyramide on detrusor muscle contraction: in vitro experiment and report of 3 cases with disopyramide-induced urinary retention.

    Gotoh, M; Kato, K; Saito, M; Kondo, A

    1987-01-01

    Three cases of disopyramide-induced urinary retention were reported and effects of disopyramide on agonist-induced contraction of detrusor muscle were studied in vitro. Muscle strips were obtained from rabbit bladder body and changes in isometric contraction of the strips were monitored. Acetylcholine, prostaglandin F2-alpha, potassium chloride, barium chloride, adenosine triphosphate and Ca2+ were used as agonists for detrusor muscle contraction. Disopyramide relaxed the contraction elicited by acetylcholine in normal Krebs solution, but exhibited no relaxing effect on contractions induced by prostaglandin F2-alpha, potassium chloride, barium chloride and adenosine triphosphate. In Ca2+-free Krebs solution, basal tension of the strips declined and spontaneous contractile activity was eliminated. Replenishment of 3 mM Ca2+ induced a slow contraction and redevelopment of spontaneous contraction of the strips. Pretreatment of the strips with disopyramide had no inhibitory effect on the Ca2+-induced contraction or on the spontaneous contractile activity in Ca2+-free solution. In normal Krebs solution, acetylcholine (10(-9)-10(-2)M) caused dose-dependent contractions of the detrusor muscle strips. Pretreatment of the strips with disopyramide (10(-5)-10(-3)M) dose-dependently inhibited the acetylcholine-induced contraction in a competitive way. The inhibitory effect of disopyramide on acetylcholine-induced contraction was less potent than that of atropine. We conclude that disopyramide may inhibit detrusor contractile activity mostly by its anticholinergic effect, resulting clinically in micturition disturbance. PMID:3482338

  18. Short-term effect of acute and repeated urinary bladder inflammation on thigmotactic behaviour in the laboratory rat

    Morland, Rosemary H; Novejarque, Amparo; Huang, Wenlong; Wodarski, Rachel; Denk, Franziska; Dawes, John D; Pheby, Tim; McMahon, Stephen B; Rice, Andrew SC

    2015-01-01

    Understanding the non-sensory components of the pain experience is crucial to developing effective treatments for pain conditions. Chronic pain is associated with increased incidence of anxio-depressive disorders, and patients often report feelings of vulnerability which can decrease quality of life. In animal models of pain, observation of behaviours such as thigmotaxis can be used to detect such affective disturbances by exploiting the influence of nociceptive stimuli on the innate behavioural conflict between exploration of a novel space and predator avoidance behaviour. This study investigates whether acute and repeated bladder inflammation in adult female Wistar rats increases thigmotactic behaviour in the open field paradigm, and aims to determine whether this correlates with activation in the central amygdala, as measured by c-Fos immunoreactivity. Additionally, up-regulation of inflammatory mediators in the urinary bladder was measured using RT-qPCR array featuring 92 transcripts to examine how local mediators change under experimental conditions. We found acute but not repeated turpentine inflammation of the bladder increased thigmotactic behaviour (decreased frequency of entry to the inner zone) in the open field paradigm, a result that was also observed in the catheter-only instrumentation group. Decreases in locomotor activity were also observed in both models in turpentine and instrumentation groups. No differences were observed in c-Fos activation, although a general increased in activation along the rostro-caudal axis was seen. Inflammatory mediator up-regulation was greatest following acute inflammation, with CCL12, CCL7, and IL-1β significantly up-regulated in both conditions when compared to naïve tissue. These results suggest that acute catheterisation, with or without turpentine inflammation, induces affective alterations detectable in the open field paradigm accompanied by up-regulation of multiple inflammatory mediators.

  19. Efficacy Observation on Electro-acupuncture Combined with Abdominal Massage for Urinary Retention following Spinal Cord Injury%电针结合腹部按摩治疗脊髓损伤性尿潴留疗效观察

    向慧竹; 贾海鹏; 李茜; 卢添娇

    2014-01-01

    Objective: To investigate the efficacy of electro-acupuncture combined with abdominal massage for urinary retention following spinal cord injury. Methods:27 cases of patients with urinary retention following spinal cord injury were all treated by electro-acupuncture combined with abdominal massage and observed the efficacy. Results: 14 cases were cured, 9 cases turned better and 4 cases invalid, the total effective rate was 85.18%. Conclusion:The treatment of electro-acupuncture combined with abdominal massage for urinary retention following spinal cord injury is safe and effective, deserves clinical promotion and application.%目的:探讨电针结合腹部按摩治疗脊髓损伤性尿潴留的疗效。方法:27例脊髓损伤性尿潴留患者均采用电针结合腹部按摩治疗,观察其临床疗效。结果:治愈14例,好转9例,无效4例,总有效率为85.18%。结论:针灸结合腹部按摩治疗脊髓损伤性尿潴留安全、有效,值得临床推广应用。

  20. Comparison of cefixime and co-trimoxazole in acute uncomplicated urinary tract infection. A double-blind general practice study.

    Levenstein, J; Summerfield, P J; Fourie, S; Brink, G; Michaelides, B; Murray, E; Naidoo, N

    1986-10-11

    Five hundred and twenty-eight patients with presumptive acute uncomplicated urinary tract infection (UTI) were randomly assigned to receive cefixime 400 mg once daily, cefixime 200 mg twice daily or co-trimoxazole 2 tablets twice a day for 10 days; 477 completed at least 5 days of therapy. Of the patients 342 (65%) had positive baseline urine cultures, yielding 353 pathogens. A microbiological response was determined for 280 pathogens (79%), eradication being observed in over 94% of isolates; 153 pathogens (43%) were sensitive to both cefixime and co-trimoxazole and eradication was observed in over 96% of cases. Clinical response correlated well with microbiological response. The incidence of diarrhoea and stool changes was higher (P less than 0.005) in the patients who received cefixime once daily than in the other groups. There was a significantly higher incidence of stool changes with cefixime twice daily than with co-trimoxazole (P less than 0.05), but these did not necessitate discontinuation of therapy. Nausea was commoner with co-trimoxazole (P less than 0.05). The majority of pathogens isolated were Escherichia coli, Proteus mirabilis and staphylococci. Approximately 24% of E. coli were resistant in vitro to co-trimoxazole (P less than 0.005). Cefixime 200 mg twice daily is an effective and safe alternative to co-trimoxazole in the management of acute uncomplicated UTI. PMID:3535127

  1. Clinical usefulness of urinary liver-type fatty-acid-binding protein as a perioperative marker of acute kidney injury in patients undergoing endovascular or open-abdominal aortic aneurysm repair

    Obata, Yumi; Kamijo-Ikemori, Atsuko; Ichikawa, Daisuke; Sugaya, Takeshi; Kimura, Kenjiro; Shibagaki, Yugo; Tateda, Takeshi

    2015-01-01

    Purpose Acute kidney injury (AKI) is common after cardiovascular surgery and is usually diagnosed on the basis of the serum creatinine (SCr) level and urinary output. However, SCr is of low sensitivity in patients with poor renal function. Because urinary liver-type fatty-acid-binding protein (L-FABP) reflects renal tubular injury, we evaluated whether perioperative changes in urinary L-FABP predict AKI in the context of abdominal aortic repair. Methods Study participants were 95 patients who...

  2. Predictive factors of renal scarring in children with acute urinary tract infection

    The purpose of this study was to evaluate the usefulness of 99mTc DMSA scintigraphy on the diagnosis of a renal scar in children with urinary tract infections. Eighty three patients were included in this study, who were diagnosed as the urinary tract infection on the basis of symptom, urinalysis and urine culture. 99mTc DMSA scintigraphy and voiding cystoureterography were performed within 7days before the treatment in all patients. We classified the scintigraphic findings as follow s : 1 ; a large hypoactive upper of lower pole. 2 ; a small hypoactive area. 3 ; single defect resulting in localized deformity of the outlines. 4 ; deformed outlines in a small or normal sized kidney. 5 ; multiple defects. 6 ; diffuse hypoactive kidney without regional impairment. Follow-up scintigraphy was done at least 6 months after the initial study. When the abnormality on the initial scintigraphy was not completely resolved on the follow-up scan, the lesion was defined as containing a scar. One hundred and fifteen renal units of 166 units(69.3%) showed abnormal findings on the DMSA scintigraphy. 65 units(56.5%) was diagnosed as containing renal scars in follow-up scintigraphies. Incidences of renal scar among renal units showing pattern 3, 4 and 5 on the initial scan was 75%, 78% and 78%, respectively. Whereas many of renal units showing 1, 2 and 6 pattern were recovered(65%, 76%, 50%). Sensitivity, specificity and accuracy of pattern-based DMSA scintigraphic findings on the diagnosis of renal scar was 76.9%, 85.1% and 81.9%, respectively. VUR was significantly associated with the renal scar when the initial DMSA shows unrecoverable findings(pattern 3, 4, 5). Odds ratio of the renal scar in a kidney showing unrecoverable initial scintigraphic findings was 19.1. Odds ratio in a kidney with mild or moderate-to-severe VUR was 3.5 and 14.4 respectively. In the urinary tract infection, renal scar was significantly developed in a kidney showing unrecoverable findings on the initial

  3. Comparison of pivmecillinam and cephradine in bacteriuria in pregnancy and in acute urinary tract infection.

    Brumfitt, W; Franklin, I; Hamilton-Miller, J; Anderson, F

    1979-01-01

    48 non-pregnant domiciliary patients referred by general practitioners and 50 pregnant women were treated for bacteriuria with either 500 mg cephradine or 400 mg pivmecillinam every 6 h for 7 days. In the pregnant women, cure rates were over 90% after 2 weeks for both compounds, and after 6 weeks were 86% for cephradine and 78% for pivmecillinam. Cure rates in the non-pregnant were 83% for cephradine and 95% for pivmecillinam at 6 weeks. Seven patients (3 given cephradine, 4 given pivmecillinam) stopped treatment due to side-effects. Overall, side-effects (many of which were trivial) were more common in patients treated with cephradine (51%) than in those receiving pivmecillinam (33%). It is concluded that both drugs are highly effective in these two common types of urinary infection. PMID:231299

  4. Eearly diagnostic value of urinary NGAL in acute kidney injury in critically ill patients

    徐兴凯

    2013-01-01

    Objective To estimate the predictive value of neutrophil gelatinase-associated lipocalin in urine (uNGAL) for detection of acute kidney injury (AKI) in the intensive care unit (ICU) critically ill patients.Methods A total of 110 patients from the ICU of three general hospitals were enrolled in the study.The patients were adults

  5. Understanding of Nursing Diabetes Complicated with Neurogenic Retention of Urine and Urinary Tract Mycotic Infection%糖尿病合并神经源性尿潴留、泌尿道真菌感染的护理体会

    李柳芳; 顾华英; 巫织娥; 蔡秀英

    2002-01-01

    To treat patients with diabetic nearogenie bladder and neurogenic retention of urine by treating diabetes and evacuatingneurogenic retention of urine and restoring the function of the bladder. When the disease is complicated with urinary tract mycotic infection,the nursing become more important for the treatment.

  6. Urinary Obstruction in Prostate Cancer Patients From the Dutch Trial (68 Gy vs. 78 Gy): Relationships With Local Dose, Acute Effects, and Baseline Characteristics

    Purpose: To investigate the relationship between late urinary obstruction and the details of the dose distribution of irradiated prostate cancer patients, taking into account their baseline symptoms and acute complaints. Patients and Methods: We selected patients from the Dutch multicenter trial randomized between 68 Gy and 78 Gy, for whom toxicity data and dose data were available (n = 557). The absolute dose surface parameters of the delineated bladder were calculated. Next, we constructed three-dimensional dose maps of the area around the prostate, providing an approximate identification of the corresponding anatomic locations. The dose difference maps were constructed by subtracting the mean dose maps of the patients with and without late urinary obstruction. Selected local dose points were analyzed using Cox regression analysis. Results: Urinary obstruction was scored for 40 patients, including 19 of 296 patients who received 68-72 Gy and 21 of 261 patients who received 76-78 Gy. A total of 19 events occurred within 2 years after irradiation and 21 events after 2 years. The bladder surface receiving ≥80 Gy predicted (p <.01) the occurrence of obstruction within 2 years. The dose difference map indicated highly significant differences in the bladder neck situated in the trigonal region (p < .001) that were especially predictive of obstruction after 2 years and of the diagnosis of bladder neck obstruction. Baseline complaints and transurethral resection of the prostate and acute complaints were mainly predictive for obstruction within 2 years. Conclusion: Relatively early events of urinary obstruction were associated with urinary problems existing before RT, acute toxicity, previous transurethral resection of the prostate, and hotspots in the bladder. Events after 2 years were associated with the local dose in the trigonal area.

  7. Diagnostic accuracy of urinary neutrophil gelatinase-associated lipocalin in patients with septic acute kidney injury

    Patel, Munna

    2016-01-01

    Munna Lal Patel,1 Rekha Sachan,2 Radhey Shyam,3 Satish Kumar,1 Ritul Kamal,4 Arvind Misra1 1Department of Medicine, 2Department of Obstetrics & Gynaecology, 3Department of Geriatric Intensive Care Unit, King George Medical University, 4Epidemiology Division, Council of Scientific and Industrial Research (CSIR-IITR), Indian Institute of Toxicology Research, Lucknow, Uttar Pradesh, India Background: Sepsis is the most common cause of acute kidney injury (AKI). Very few studies have inve...

  8. Urinary 1-Hydroxypyrene is Associated with Oxidative Stress and Inflammatory Biomarkers in Acute Myocardial Infarction

    Fernando Freitas; Natália Brucker; Juliano Durgante; Guilherme Bubols; Rachel Bulcão; Angela Moro; Mariele Charão; Marília Baierle; Sabrina Nascimento; Bruna Gauer; Elisa Sauer; Marcelo Zimmer; Flávia Thiesen; Iran Castro; Paulo Saldiva

    2014-01-01

    Several studies have associated exposure to environmental pollutants, especially polycyclic aromatic hydrocarbons (PAHs), with the development of cardiovascular diseases. Considering that 1-hydroxypyrene (1-OHP) is the major biomarker of exposure to pyrenes, the purpose of this study was to evaluate the potential association between 1-OHP and oxidative stress/inflammatory biomarkers in patients who had suffered an acute myocardial infarction (AMI). After adopting the exclusion criteria, 58 po...

  9. Functional evaluation of the urinary tract by duplex Doppler ultrasonography in patients with acute renal colic

    Sayani R; Ali M.; Shazlee K; Hamid RS; Hamid K

    2011-01-01

    Raza Sayani1, Muhammad Ali1, Kashif Shazlee2, Rana Shoaib Hamid1, Kamran Hamid21Radiology Department, Aga Khan University Hospital, 2Radiology Department, Ziauddin Hospital, Karachi, PakistanPurpose: To determine the role of duplex Doppler ultrasonography (DDU) in patients with acute unilateral renal obstruction.Subjects and methods: A total of 161 patients with suspected renal colic due to urolithiasis were evaluated by DDU followed by intravenous urography (IVU). The mean intra-arterial res...

  10. Urinary L-FABP predicts poor outcomes in critically ill patients with early acute kidney injury

    Parr, Sharidan K.; Clark, Amanda J.; Bian, Aihua; Shintani, Ayumi; Wickersham, Nancy E.; Ware, Lorraine B.; Ikizler, T. Alp; Siew, Edward D.

    2014-01-01

    Biomarker studies for early detection of acute kidney injury (AKI) have been limited by non-selective testing and uncertainties in using small changes in serum creatinine as a reference standard. Here we examine the ability of urine L-type fatty acid binding protein (L-FABP), neutrophil gelatinase-associated lipocalin (NGAL), Interleukin-18 (IL-18), and Kidney Injury Moledule-1 (KIM-1) to predict injury progression, dialysis, or death within 7 days in critically ill adults with early AKI. Of ...

  11. Is urinary 5-HIAA determination a valuable method in diagnosis of acute appendicitis in children?

    Ozel S

    2006-01-01

    Full Text Available The aim of the study is to investigate the significance of spot urine 5-hydroxyindoleacetic acid (5-HIAA levels in patients admitted with the suspicion of acute appendicitis. Seventy-one patients with the mean age of 9.4±2.9 years, who were admitted to our pediatric surgery clinic between August 2002 and March 2004 with the complaints of abdominal pain were evaluated prospectively. Additionally spot urine samples were collected from 34 healthy children for control. 5-HIAA was detected from the urine samples in all children with high-performance liquid chromatography (HPLC method. The results were analyzed with one way analysis of variance (ANOVA, post hoc Tukey HSD test and receiver operating characteristic (ROC curve. After the clinical follow-up appendicitis was detected in 40 patients and abdominal pain was found to be due to causes other than appendicitis in 31 patients. Results were found to be correlative with the final diagnosis in all patients. The mean 5-HIAA levels were 2.5±1.8 µmol/dl in healthy children, whereas 9±5 µmol/dl in nonappendicitis and 18.9±17.8 µmol/dl in appendicitis patients, respectively. The difference between the patients with acute appendicitis and the other two groups were statistically significant ( P = 0.001. For a value of 8.9 µmol/dl, this test was found to be 70% sensitive and 67% specific according to the ROC curve. 5-HIAA significantly rises in pediatric acute appendicitis. However, due to high values of SD and relatively low sensitivity and specificity, this test seems to have limited diagnostic power as a single parameter in childhood acute appendicitis.

  12. Assessing glomerular filtration rate (GFR) in critically ill patients with acute kidney injury - true GFR versus urinary creatinine clearance and estimating equations

    Bragadottir, Gudrun; Redfors, Bengt; Ricksten, Sven-Erik

    2013-01-01

    Introduction Estimation of kidney function in critically ill patients with acute kidney injury (AKI), is important for appropriate dosing of drugs and adjustment of therapeutic strategies, but challenging due to fluctuations in kidney function, creatinine metabolism and fluid balance. Data on the agreement between estimating and gold standard methods to assess glomerular filtration rate (GFR) in early AKI are lacking. We evaluated the agreement of urinary creatinine clearance (CrCl) and three...

  13. Urinary chitinase 3-like protein 1 for early diagnosis of acute kidney injury: a prospective cohort study in adult critically ill patients

    De Loor, Jorien; Decruyenaere, Johan; Demeyere, Kristel; Nuytinck, Lieve; Hoste, Eric AJ; Meyer, Evelyne

    2016-01-01

    Background Acute kidney injury (AKI) occurs frequently and adversely affects patient and kidney outcomes, especially when its severity increases from stage 1 to stages 2 or 3. Early interventions may counteract such deterioration, but this requires early detection. Our aim was to evaluate whether the novel renal damage biomarker urinary chitinase 3-like protein 1 (UCHI3L1) can detect AKI stage ≥2 more early than serum creatinine and urine output, using the respective Kidney Disease | Improvin...

  14. Urinary Tissue Inhibitor of Metalloproteinase-2 (TIMP-2) • Insulin-Like Growth Factor-Binding Protein 7 (IGFBP7) Predicts Adverse Outcome in Pediatric Acute Kidney Injury

    Westhoff, Jens H.; Tönshoff, Burkhard; Waldherr, Sina; Pöschl, Johannes; Teufel, Ulrike; Westhoff, Timm H.; Fichtner, Alexander

    2015-01-01

    Background The G1 cell cycle inhibitors tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) have been identified as promising biomarkers for the prediction of adverse outcomes including renal replacement therapy (RRT) and mortality in critically ill adult patients who develop acute kidney injury (AKI). However, the prognostic value of urinary TIMP-2 and IGFBP7 in neonatal and pediatric AKI for adverse outcome has not been investigated yet...

  15. Diagnostic accuracy on the management of acute paediatric urinary tract infection in a general paediatric unit

    Fahisham Taib; Bakht Jamal

    2015-01-01

    Objective: To ascertain diagnostic accuracy of paediatric urinary tract infection (UTI) in a general paediatric unit of a district hospital. Methods: Retrospective case note review and comparing to the final computerised database of Human in-Patient Enquiry (HIPE) at Portiuncula Hospital, Galway, Ireland. All children from 0-16 years of age with the diagnosis of UTI were enrolled within the 3 year study period. The information was first retrieved from HIPE system to capture list of patients. Case notes revision was followed to extract data under standardized pro-forma for demography, accuracy of diagnosis, treatment instituted and investigation ordered. Patients’ data was reviewed according to updated definition. Results: There were 85 cases treated for UTI during the 3 year period, and only 45 cases were considered as genuine UTI according to diagnostic criteria. Out of 45 cases, 16 cases were considered as suspected UTI cases. Escherichia coli was noted to be the commonest organism. Cephradine has been used as the first line treatment as per local guideline;however, different antibiotic regimes were based on physician’s preferences. The sensitivity of the current method of UTI diagnosis remained at 64%when comparing final diagnosis in the HIPE system. Conclusions: UTI can be difficult to accurately diagnosis in certain clinical cases. Decisions made should be individualized and tailored according to clinical suspicion and presentation of the patients. Improvement to ensure accurate diagnosis is vital to ensure correct data capture in the HIPE system thus giving valuable information and resource for future care.

  16. Nalidixic acid and pivmecillinam for treatment of acute lower urinary tract infections.

    Hovelius, B; Mårdh, P A; Nygaard-Pedersen, L; Wathne, B

    1985-11-01

    Women, 15-45 years of age, with symptoms of lower urinary tract infection (UTI) were randomly treated with nalidixic acid (1 g X 3) or pivmecillinam (200-400 mg X 3) for three or seven days, respectively. Therapeutic failure, relapse, or reinfection occurred among 18% of 82 women, even though the isolated strains of gram-negative rods in these patients were susceptible in vitro to the antibiotics used. Therapeutic failure, i.e. no effect or at best only a minor effect on the symptoms, was registered in 10 of 13 cases of UTI caused by Staphylococcus saprophyticus and treated with nalidixic acid, which was consistent with the high minimum inhibitory concentrations (MIC) (128-512 micrograms/ml) of this antibiotic. S. saprophyticus was isolated in 9 of 12 patients during treatment with nalidixic acid. On the other hand, pivmecillinam therapy was clinically effective in 16 of 18 patients with UTI caused by S. saprophyticus, even though the MIC of mecillinam to these strains was considerably higher (8-64 micrograms/ml) than that vis-à-vis gram-negative rods. Thus the clinical effect of pivmecillinam was significantly better than that of nalidixic acid in cases of UTI caused by S. saprophyticus. The organism was not isolated from 14 patients receiving pivmecillinam therapy. PMID:4081404

  17. Precursor T-Cell acute lymphoblastic leukemia/lymphoma with rare presentation in the urinary bladder

    Alexander Pham

    2011-10-01

    Full Text Available We present the 16th reported case of Acute Lymphoblastic Leukemia (ALL with involvement in the bladder. Our patient was a 22 yearold man with T-cell ALL with a mediastinal mass. He received hyperfractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone (HyperCVAD with mediastinal radiation. Prior to starting maintenance, he relapsed in the bladder and marrow. He received a nelarabine- based induction regimen and achieved remission. This was followed by an unrelated 11/12 HLA-matched myeloablative allogeneic stem cell transplant. He is in complete remission for the past 409 days.

  18. Symptomatic vaginal candidiasis after pivmecillinam and norfloxacin treatment of acute uncomplicated lower urinary tract infection.

    Menday, A P

    2002-10-01

    The comparative incidence of symptomatic vaginal candidiasis associated with pivmecillinam and norfloxacin treatment in women with acute symptomatic uncomplicated UTI was determined in two randomised, double-blind, clinical trials. Adverse events reported following general enquiry were reviewed. Presence of Candida vaginitis was based upon the specification as such by investigators, the presence of specific symptoms such as genital pruritus and/or the prescription of specific anti Candida therapy. The incidences of Candida vaginitis were as follows; Study 1 pivmecillinam 200 mg tid for 7 days 13 (4.6%), pivmecillinam 200 mg bid for 7 days 7 (2.4%), pivmecillinam 400 mg bid for 3 days 6 (2.1%) and placebo 6 (2.1%), P=0.19. Study 2 pivmecillinam 400 mg bid for 3 days 7 (1.5%), norfloxacin 400 mg bid for 3 days 20 (4.3%), P=0.016. The incidence of Candida vaginitis in women with acute symptomatic uncomplicated UTI given 3 days treatment with pivmecillinam 400 mg bid is similar to that seen with placebo and is significantly less than the incidence with norfloxacin 400 mg bid for 3 days. PMID:12385688

  19. Arabin cerclage pessary as a treatment of an acute urinary retention in a pregnant woman with uterine prolapse.

    Martínez-Varea, Alicia; Nohales-Alfonso, Francisco; Diago Almela, Vicente José; Perales-Marín, Alfredo

    2013-01-01

    A 35-year-old gravida 7, para 1, and abortus 5 female with hypogastric pain and inability to void urine after 14 + 3 weeks of amenorrhea was examined in the emergency department. One year before, a uterine prolapse had been diagnosed in another hospital. Examination showed a uterine prolapse grade 2 with palpable bladder. The patient was unable to void urine. After a manual reduction of the uterine prolapse, the patient underwent an emergency catheterization for bladder drainage. A Hodge pessary (size 70) was placed, which led to spontaneous micturitions. Due to the persistence of the symptoms the following day, Hodge pessary was replaced by an Arabin cerclage pessary. Although the pessary could be removed from the beginning of the second trimester, due to the uterine prolapse as a predisposing factor in the patient and the uncomplicated progression of pregnancy, it was decided to maintain it in our patient. Therefore, Arabin cerclage pessary allowed a successful pregnancy outcome and was not associated with threatened preterm delivery or vaginal infection. PMID:23936698

  20. Arabin Cerclage Pessary as a Treatment of an Acute Urinary Retention in a Pregnant Woman with Uterine Prolapse

    Alicia Martínez-Varea

    2013-01-01

    Full Text Available A 35-year-old gravida 7, para 1, and abortus 5 female with hypogastric pain and inability to void urine after 14 + 3 weeks of amenorrhea was examined in the emergency department. One year before, a uterine prolapse had been diagnosed in another hospital. Examination showed a uterine prolapse grade 2 with palpable bladder. The patient was unable to void urine. After a manual reduction of the uterine prolapse, the patient underwent an emergency catheterization for bladder drainage. A Hodge pessary (size 70 was placed, which led to spontaneous micturitions. Due to the persistence of the symptoms the following day, Hodge pessary was replaced by an Arabin cerclage pessary. Although the pessary could be removed from the beginning of the second trimester, due to the uterine prolapse as a predisposing factor in the patient and the uncomplicated progression of pregnancy, it was decided to maintain it in our patient. Therefore, Arabin cerclage pessary allowed a successful pregnancy outcome and was not associated with threatened preterm delivery or vaginal infection.

  1. Functional evaluation of the urinary tract by duplex Doppler ultrasonography in patients with acute renal colic

    Sayani R

    2011-12-01

    Full Text Available Raza Sayani1, Muhammad Ali1, Kashif Shazlee2, Rana Shoaib Hamid1, Kamran Hamid21Radiology Department, Aga Khan University Hospital, 2Radiology Department, Ziauddin Hospital, Karachi, PakistanPurpose: To determine the role of duplex Doppler ultrasonography (DDU in patients with acute unilateral renal obstruction.Subjects and methods: A total of 161 patients with suspected renal colic due to urolithiasis were evaluated by DDU followed by intravenous urography (IVU. The mean intra-arterial resistive index (RI and the difference of mean resistive index between both kidneys (delta RI were determined for each person. An RI value of ≥0.70 and a delta RI value of ≥0.06 were taken as the discriminatory threshold for obstruction. IVU results were considered the “reference standard” against which renal DDU findings were compared.Results: IVU showed both kidneys to be normal in 51 patients and with unilateral ureteric obstruction in 110 patients. The mean RI for obstructed kidneys was 0.67 (0.048, which was significantly higher (P-value < 0.05 than a mean RI of contralateral normal kidneys 0.59 (0.04. The mean delta RI in patients with unilateral ureteric obstruction was significantly higher than that in patients with normal kidneys, at 0.076 (0.03 and 0.03 (0.05, respectively. In patients with complete obstruction, sensitivity of RI and delta RI were 77.5% and 92.5% with a specificity of 84.3% and 90.1%, respectively. In patients with partial obstruction, the sensitivity of these values was 22.8% and 62.8% with a specificity of 84.3% and 90.1%.Conclusion: Delta RI is more sensitive and specific than RI in acute renal obstruction. However, due to relatively low sensitivity for detection of partial obstruction, DDU cannot replace IVU as the standard imaging technique.Keywords: renal colic, Doppler ultrasonography, resistive index

  2. Urinary Tract Effects After Multifocal Nonthermal Irreversible Electroporation of the Kidney: Acute and Chronic Monitoring by Magnetic Resonance Imaging, Intravenous Urography and Urinary Cytology

    Purpose: The nonthermal irreversible electroporation (NTIRE) is a novel potential ablation modality for renal masses. The aim of this study was the first evaluation of NTIRE’s effects on the renal urine-collecting system using intravenous urography (IVU) and urinary cytology in addition to histology and magnetic resonance imaging (MRI). Methods: Eight percutaneous NTIRE ablations of the renal parenchyma, including the calyxes or pelvis, were performed in three male swine. MRI, IVU, histology, and urinary cytology follow-ups were performed within the first 28 days after treatment. Results: MRI and histological analysis demonstrated a localized necrosis 7 days and a localized scarification of the renal parenchyma with complete destruction 28 days after NTIRE. The urine-collecting system was preserved and showed urothelial regeneration. IVU and MRI showed an unaltered normal morphology of the renal calyxes, pelvis, and ureter. A new urinary cytology phenomenon featured a temporary degeneration by individual vacuolization of detached transitional epithelium cells within the first 3 days after NTIRE. Conclusions: This first urographical, urine-cytological, and MRI evaluation after porcine kidney NTIRE shows multifocal parenchyma destruction while protecting the involved urine-collecting system with regenerated urothelial tissue. NTIRE could be used as a targeted ablation method of centrally located renal masses.

  3. Urinary Tract Effects After Multifocal Nonthermal Irreversible Electroporation of the Kidney: Acute and Chronic Monitoring by Magnetic Resonance Imaging, Intravenous Urography and Urinary Cytology

    Wendler, Johann Jakob, E-mail: johann.wendler@med.ovgu.de [University of Magdeburg, Department of Urology (Germany); Pech, Maciej [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Porsch, Markus; Janitzky, Andreas [University of Magdeburg, Department of Urology (Germany); Fischbach, Frank [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Buhtz, Peter; Vogler, Klaus [University of Magdeburg, Institute of Pathology (Germany); Huehne, Sarah [University of Magdeburg, Department of Urology (Germany); Borucki, Katrin [University of Magdeburg, Institute of Clinical Chemistry (Germany); Strang, Christof [University of Magdeburg, Department of Anaesthesiology (Germany); Mahnkopf, Dirk [Institute of Medical Technology and Research (Germany); Ricke, Jens [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Liehr, Uwe-Bernd [University of Magdeburg, Department of Urology (Germany)

    2012-08-15

    Purpose: The nonthermal irreversible electroporation (NTIRE) is a novel potential ablation modality for renal masses. The aim of this study was the first evaluation of NTIRE's effects on the renal urine-collecting system using intravenous urography (IVU) and urinary cytology in addition to histology and magnetic resonance imaging (MRI). Methods: Eight percutaneous NTIRE ablations of the renal parenchyma, including the calyxes or pelvis, were performed in three male swine. MRI, IVU, histology, and urinary cytology follow-ups were performed within the first 28 days after treatment. Results: MRI and histological analysis demonstrated a localized necrosis 7 days and a localized scarification of the renal parenchyma with complete destruction 28 days after NTIRE. The urine-collecting system was preserved and showed urothelial regeneration. IVU and MRI showed an unaltered normal morphology of the renal calyxes, pelvis, and ureter. A new urinary cytology phenomenon featured a temporary degeneration by individual vacuolization of detached transitional epithelium cells within the first 3 days after NTIRE. Conclusions: This first urographical, urine-cytological, and MRI evaluation after porcine kidney NTIRE shows multifocal parenchyma destruction while protecting the involved urine-collecting system with regenerated urothelial tissue. NTIRE could be used as a targeted ablation method of centrally located renal masses.

  4. Potential mechanisms for acute health effects and lung retention of inhaled particles of different origin

    Klepczynska Nyström, Anna

    2012-01-01

    Background: Environmental particle exposure is known to have negative health effects. There is limited knowledge about how size and origin of particles influence these effects. There is also little known regarding the fate of ultrafine particles (particles in nanosize;< 100 nanometers in diameter) after being inhaled. Aim: The main objective of this thesis was to study acute health effects in humans and their potential underlying mechanisms, resulting from exposure to particles of different o...

  5. Urinary L-FABP predicts poor outcomes in critically ill patients with early acute kidney injury.

    Parr, Sharidan K; Clark, Amanda J; Bian, Aihua; Shintani, Ayumi K; Wickersham, Nancy E; Ware, Lorraine B; Ikizler, T Alp; Siew, Edward D

    2015-03-01

    Biomarker studies for early detection of acute kidney injury (AKI) have been limited by nonselective testing and uncertainties in using small changes in serum creatinine as a reference standard. Here we examine the ability of urine L-type fatty acid-binding protein (L-FABP), neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), and kidney injury molecule-1 (KIM-1) to predict injury progression, dialysis, or death within 7 days in critically ill adults with early AKI. Of 152 patients with known baseline creatinine examined, 36 experienced the composite outcome. Urine L-FABP demonstrated an area under the receiver-operating characteristic curve (AUC-ROC) of 0.79 (95% confidence interval 0.70-0.86), which improved to 0.82 (95% confidence interval 0.75-0.90) when added to the clinical model (AUC-ROC of 0.74). Urine NGAL, IL-18, and KIM-1 had AUC-ROCs of 0.65, 0.64, and 0.62, respectively, but did not significantly improve discrimination of the clinical model. The category-free net reclassification index improved with urine L-FABP (total net reclassification index for nonevents 31.0%) and urine NGAL (total net reclassification index for events 33.3%). However, only urine L-FABP significantly improved the integrated discrimination index. Thus, modest early changes in serum creatinine can help target biomarker measurement for determining prognosis with urine L-FABP, providing independent and additive prognostic information when combined with clinical predictors. PMID:25229339

  6. Relationships between bladder dose–volume/surface histograms and acute urinary toxicity after radiotherapy for prostate cancer

    Background and purpose: DUE01 is an observational study aimed at developing predictive models of genito-urinary toxicity of patients treated for prostate cancer with conventional (1.8–2 Gy/fr, CONV) or moderate hypo-fractionation (2.35–2.7 Gy/fr, HYPO). The current analysis focused on the relationship between bladder DVH/DSH and the risk of International Prostate Symptoms Score (IPSS) ⩾ 15/20 at the end of radiotherapy. Materials and methods: Planning and relevant clinical parameters were prospectively collected, including DVH/DSH, LQ-corrected (DVHc/DSHc) and weekly (DVHw/DSHw) histograms. Best parameters were selected by the differences between patients with/without IPSS ⩾ 15/20 at the end of radiotherapy. Logistic uni- and backward multi-variable (MVA) analyses were performed. Results: Data of 247 patients were available (CONV: 116, HYPO: 131). Absolute DVHw/DSHw and DVHc/DSHc predicted the risk of IPSS ⩾ 15 at the end of radiotherapy (n = 77/247); an MVA model including baseline IPSS, anti-hypertensive, T stage, the absolute surface receiving ⩾8.5 Gy/week and ⩾12.5 Gy/week was developed (AUC = 0.78, 95% CI: 0.72–0.83). Similar AUC values were found if replacing DSHw with DVHw/DVHc/DSHc parameters. The impact of dose–volume/surface parameters remained when excluding patients with baseline IPSS ⩾ 15 and in HYPO. IPSS ⩾ 20 at the end of radiotherapy (n = 27/247) was mainly correlated to baseline IPSS and T stage. Conclusions: Although the baseline IPSS was the main predictor, constraining v8.5w < 56 cc and v12.5w < 5 cc may significantly reduce acute GU toxicity

  7. Rapid detection of acute kidney injury by urinary neutrophil gelatinase-associated lipocalin after cardiopulmonary bypass surgery

    Objective: To determine the accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in early detection of acute kidney injury (AKI) after cardiopulmonary bypass (CPB) surgery by comparing with serum creatinine. Study Design: Descriptive study. Place and Duration of Study: Department of Chemical Pathology and Endocrinology, AFIP in collaboration with AFIC/ NIHD, Rawalpindi, from April to December 2011. Methodology: Eighty eight patients undergoing CPB surgery in AFIC/NIHD were included by consecutive sampling. Blood samples of subjects for serum creatinine analysis were drawn pre-operatively, 4 h, 24 h and 48 h after CPB surgery. Spot urine samples for NGAL were collected at 4 h after CPB surgery. Urine samples were analyzed on Abbott ARCHITECT i2000SR analyzer whereas serum creatinine samples were measured on Beckman UniCel DxC 600 Synchron Clinical System. Results: Out of 88 patients, 11 (13%) cases developed AKI 4 h postoperatively. Urinary NGAL increased markedly at 4 h postoperatively as compared to serum creatinine which showed rise at 24 - 48 h after cardiac surgery. Analysis of urine NGAL at a cutoff value of 87 ng/ml showed area under the curve of 0.91 [95% confidence interval (CI) 0.83 - 0.96] with sensitivity of 90.9% (95% CI 58.7 - 98.5) and specificity of 98.7% (95% CI 92.9-99.8). There was a positive correlation of 4 h urine NGAL and serum delta creatinine at 48 h, which was statistically significant (rs = 0.33, p = 0.001). Conclusion: The study demonstrated that levels of urine NGAL in patients suffering from AKI increased significantly at 4 h as compared to serum creatinine levels. Urine NGAL is an early predictive biomarker of AKI after CPB. (author)

  8. NASA Astronaut Urinary Conditions Associated with Spaceflight

    Law, Jennifer; Cole, Richard; Young, Millennia H.; Mason, Sara

    2016-01-01

    INTRODUCTION: Spaceflight is associated with many factors which may promote kidney stone formation, urinary retention, and/or Urinary Tract Infection (UTI). According to ISS mission predictions supplied by NASA's Integrated Medical Model, kidney stone is the second and sepsis (urosepsis as primary driver) the third most likely reason for emergent medical evacuation from the International Space Station (ISS). METHODS: Inflight and postflight medical records of NASA astronauts were reviewed for urinary retention, UTI and kidney stones during Mercury, Gemini, Apollo, Mir, Shuttle, and ISS expeditions 1-38. RESULTS: NASA astronauts have had 7 cases of kidney stones in the 12 months after flight. Three of these cases occurred within 90 to 180 days after landing and one of the seven cases occurred in the first 90 days after flight. There have been a total of 16 cases (0.018 events per person-flights) of urinary retention during flight. The event rates per mission are nearly identical between Shuttle and ISS flights (0.019 vs 0.021 events per person-flights). In 12 of the 16 cases, astronauts had taken at least one space motion sickness medication. Upon further analysis, it was determined that the odds of developing urinary retention in spaceflight is 3 times higher among astronauts who took promethazine. The female to male odds ratio for inflight urinary retention is 11:14. An astronaut with urinary retention is 25 times more likely to have a UTI with a 17% infection rate per mission. There have been 9 reported UTIs during spaceflight. DISCUSSION: It is unclear if spaceflight carries an increased post-flight risk of kidney stones. Regarding urinary retention, the female to male odds ratio is higher during flight compared to the general population where older males comprise almost all cases due to prostatic hypertrophy. This female prevalence in spaceflight is even more concerning given the fact that there have been many more males in space than females. Terrestrial

  9. Predicting acute uncomplicated urinary tract infection in women: a systematic review of the diagnostic accuracy of symptoms and signs

    van de Laar Floris A

    2010-10-01

    Full Text Available Abstract Background Acute urinary tract infections (UTI are one of the most common bacterial infections among women presenting to primary care. However, there is a lack of consensus regarding the optimal reference standard threshold for diagnosing UTI. The objective of this systematic review is to determine the diagnostic accuracy of symptoms and signs in women presenting with suspected UTI, across three different reference standards (102 or 103 or 105 CFU/ml. We also examine the diagnostic value of individual symptoms and signs combined with dipstick test results in terms of clinical decision making. Methods Searches were performed through PubMed (1966 to April 2010, EMBASE (1973 to April 2010, Cochrane library (1973 to April 2010, Google scholar and reference checking. Studies that assessed the diagnostic accuracy of symptoms and signs of an uncomplicated UTI using a urine culture from a clean-catch or catherised urine specimen as the reference standard, with a reference standard of at least ≥ 102 CFU/ml were included. Synthesised data from a high quality systematic review were used regarding dipstick results. Studies were combined using a bivariate random effects model. Results Sixteen studies incorporating 3,711 patients are included. The weighted prior probability of UTI varies across diagnostic threshold, 65.1% at ≥ 102 CFU/ml; 55.4% at ≥ 103 CFU/ml and 44.8% at ≥ 102 CFU/ml ≥ 105 CFU/ml. Six symptoms are identified as useful diagnostic symptoms when a threshold of ≥ 102 CFU/ml is the reference standard. Presence of dysuria (+LR 1.30 95% CI 1.20-1.41, frequency (+LR 1.10 95% CI 1.04-1.16, hematuria (+LR 1.72 95%CI 1.30-2.27, nocturia (+LR 1.30 95% CI 1.08-1.56 and urgency (+LR 1.22 95% CI 1.11-1.34 all increase the probability of UTI. The presence of vaginal discharge (+LR 0.65 95% CI 0.51-0.83 decreases the probability of UTI. Presence of hematuria has the highest diagnostic utility, raising the post-test probability of UTI to

  10. Predicting acute uncomplicated urinary tract infection in women: a systematic review of the diagnostic accuracy of symptoms and signs

    Giesen, Leonie GM

    2010-10-24

    Abstract Background Acute urinary tract infections (UTI) are one of the most common bacterial infections among women presenting to primary care. However, there is a lack of consensus regarding the optimal reference standard threshold for diagnosing UTI. The objective of this systematic review is to determine the diagnostic accuracy of symptoms and signs in women presenting with suspected UTI, across three different reference standards (102 or 103 or 105 CFU\\/ml). We also examine the diagnostic value of individual symptoms and signs combined with dipstick test results in terms of clinical decision making. Methods Searches were performed through PubMed (1966 to April 2010), EMBASE (1973 to April 2010), Cochrane library (1973 to April 2010), Google scholar and reference checking. Studies that assessed the diagnostic accuracy of symptoms and signs of an uncomplicated UTI using a urine culture from a clean-catch or catherised urine specimen as the reference standard, with a reference standard of at least ≥ 102 CFU\\/ml were included. Synthesised data from a high quality systematic review were used regarding dipstick results. Studies were combined using a bivariate random effects model. Results Sixteen studies incorporating 3,711 patients are included. The weighted prior probability of UTI varies across diagnostic threshold, 65.1% at ≥ 102 CFU\\/ml; 55.4% at ≥ 103 CFU\\/ml and 44.8% at ≥ 102 CFU\\/ml ≥ 105 CFU\\/ml. Six symptoms are identified as useful diagnostic symptoms when a threshold of ≥ 102 CFU\\/ml is the reference standard. Presence of dysuria (+LR 1.30 95% CI 1.20-1.41), frequency (+LR 1.10 95% CI 1.04-1.16), hematuria (+LR 1.72 95%CI 1.30-2.27), nocturia (+LR 1.30 95% CI 1.08-1.56) and urgency (+LR 1.22 95% CI 1.11-1.34) all increase the probability of UTI. The presence of vaginal discharge (+LR 0.65 95% CI 0.51-0.83) decreases the probability of UTI. Presence of hematuria has the highest diagnostic utility, raising the post-test probability of

  11. Urinary albumin excretion in hospitalized patients with acute myocardial infarction. Prevalence of microalbuminuria and correlation to left ventricle wall thickness

    Taskiran, M; Feldt-Rasmussen, B; Jensen, G B;

    1998-01-01

    risk factors. One-hundred-and-twenty-six patients and 56 healthy controls matched for age and sex were studied. The albumin/creatinine concentration ratio in morning urine specimens was calculated as an index of the albumin excretion. Microalbuminuria was defined as a urinary albumin...

  12. Evaluation of the nitrite and leukocyte esterase activity tests for the diagnosis of acute symptomatic urinary tract infection in men.

    Koeijers, J.J.; Kessels, A.G.H.; Nys, S.; Bartelds, A.; Donker, G.; Stobberingh, E.; Verbon, A.

    2007-01-01

    For 422 male patients with symptoms indicative of a urinary tract infection, nitrite and leukocyte esterase activity dipstick test results were compared with results of culture of urine samples. The positive predictive value of a positive nitrite test result was 96%. Addition of results of the leuko

  13. [Urinary complications after anorectal surgery].

    Iusuf, T; Sârbu, V; Cristache, C; Popescu, R; Botea, F; Panait, L

    2000-01-01

    The prevalence of urinary complications after various anorectal operations was studied in a group of 273 patients. The overall prevalence of urinary complications was 26.7%; most of these complications affected men between 41 and 50, mainly after hemorrhoidectomy. In 10.6% of patients, bladder catheterization was needed. These urinary complications result from nervous reflexes originating from the anus and determined by the operative trauma and/or rectal distinction. In the treatment of these urinary complications, the role of the muses is essential for reassuring the patients. Parasympathomimetic drugs are often efficient. Urinary catheterization must be delayed until the 18th hour. Fluid restriction may be useful to prevent urinary retention. PMID:14870531

  14. Randomized, controlled trial of a 10-day course of amifloxacin versus trimethoprim-sulfamethoxazole in the treatment of acute, uncomplicated urinary tract infection. Amifloxacin Multi-Center Trial Group.

    Boyko, E. J.; Iravani, A; Silverman, M H; Schelling, D J; Wright, R A

    1990-01-01

    We conducted a randomized controlled trial of orally administered amifloxacin versus trimethoprimsulfamethoxazole (TMP-SMX) as treatments of acute uncomplicated urinary tract infection in women. Amifloxacin at a dosage of 200 mg twice a day appeared as safe and effective as TMP-SMX, but amifloxacin at 400 mg twice a day tended to cause adverse events more frequently than did TMP-SMX.

  15. Urinary KIM-1, NGAL and L-FABP for the diagnosis of AKI in patients with acute coronary syndrome or heart failure undergoing coronary angiography.

    Torregrosa, Isidro; Montoliu, Carmina; Urios, Amparo; Andrés-Costa, María Jesús; Giménez-Garzó, Carla; Juan, Isabel; Puchades, María Jesús; Blasco, María Luisa; Carratalá, Arturo; Sanjuán, Rafael; Miguel, Alfonso

    2015-11-01

    Acute kidney injury (AKI) is a common complication after coronary angiography. Early biomarkers of this disease are needed since increase in serum creatinine levels is a late marker. To assess the usefulness of urinary kidney injury molecule-1 (uKIM-1), neutrophil gelatinase-associated lipocalin (uNGAL) and liver-type fatty acid-binding protein (uL-FABP) for early detection of AKI in these patients, comparing their performance with another group of cardiac surgery patients. Biomarkers were measured in 193 patients, 12 h after intervention. In the ROC analysis, AUC for KIM-1, NGAL and L-FABP was 0.713, 0.958 and 0.642, respectively, in the coronary angiography group, and 0.716, 0.916 and 0.743 in the cardiac surgery group. Urinary KIM-1 12 h after intervention is predictive of AKI in adult patients undergoing coronary angiography, but NGAL shows higher sensitivity and specificity. L-FABP provides inferior discrimination for AKI than KIM-1 or NGAL in contrast to its performance after cardiac surgery. This is the first study showing the predictive capacity of KIM-1 for AKI after coronary angiography. Further studies are still needed to answer relevant questions about the clinical utility of biomarkers for AKI in different clinical settings. PMID:24989970

  16. Hemagglutination and biofilm formation as virulence markers of uropathogenic Escherichia coli in acute urinary tract infections and urolithiasis

    Maheswari, Uma B.; Palvai, Sunitha; Anuradha, Pattepu Rajalingam; Kammili, Nagamani

    2013-01-01

    Introduction: Urinary tract infections (UTI) are a major public health concern in developing countries. Most UTIs are caused by E. coli, accounting for up to 90% of community-acquired UTIs (CAUTI). Recurrent UTI is considered as a major risk factor for urolithiasis. Virulence factors like adhesins and biofilm have been extensively studied by authors on UPEC isolated from recurrent UTI. The studies on isolates from infection stones in kidney are scanty. In a prospective study, we aimed to dete...

  17. Urinary Tissue Inhibitor of Metalloproteinase-2 (TIMP-2) • Insulin-Like Growth Factor-Binding Protein 7 (IGFBP7) Predicts Adverse Outcome in Pediatric Acute Kidney Injury

    Westhoff, Jens H.; Tönshoff, Burkhard; Waldherr, Sina; Pöschl, Johannes; Teufel, Ulrike; Westhoff, Timm H.; Fichtner, Alexander

    2015-01-01

    Background The G1 cell cycle inhibitors tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) have been identified as promising biomarkers for the prediction of adverse outcomes including renal replacement therapy (RRT) and mortality in critically ill adult patients who develop acute kidney injury (AKI). However, the prognostic value of urinary TIMP-2 and IGFBP7 in neonatal and pediatric AKI for adverse outcome has not been investigated yet. Methods The product of the urinary concentration of TIMP-2 and IGFBP7 ([TIMP-2]•[IGFBP7]) was assessed by a commercially available immunoassay (NephroCheck™) in a prospective cohort study in 133 subjects aged 0–18 years including 46 patients with established AKI according to pRIFLE criteria, 27 patients without AKI (non-AKI group I) and 60 apparently healthy neonates and children (non-AKI group II). AKI etiologies were: dehydration/hypovolemia (n = 7), hemodynamic instability (n = 7), perinatal asphyxia (n = 9), septic shock (n = 7), typical hemolytic-uremic syndrome (HUS; n = 5), interstitial nephritis (n = 5), vasculitis (n = 4), nephrotoxic injury (n = 1) and renal vein thrombosis (n = 1). Results When AKI patients were classified into pRIFLE criteria, 6/46 (13%) patients fulfilled the criteria for the category “Risk”, 13/46 (28%) for “Injury”, 26/46 (57%) for “Failure” and 1/46 (2%) for “Loss”. Patients in the “Failure” stage had a median 3.7-fold higher urinary [TIMP-2]•[IGFBP7] compared to non-AKI subjects (P<0.001). When analyzed for AKI etiology, highest [TIMP-2]•[IGFBP7] values were found in patients with septic shock (P<0.001 vs. non-AKI I+II). Receiver operating characteristic (ROC) curve analyses in the AKI group revealed good performance of [TIMP-2]•[IGFBP7] in predicting 30-day (area under the curve (AUC) 0.79; 95% CI, 0.61–0.97) and 3-month mortality (AUC 0.84; 95% CI, 0.67–0.99) and moderate performance in predicting RRT

  18. Acute Transverse Myelitis (Ascending Myelitis) as the Initial Manifestation of Japanese Encephalitis: A Rare Presentation

    Varshney Ankur Nandan; Kumar Nilesh; Behera Dibyaranjan; Tiwari Ashutosh; Anand Ravi; Anand Arvind

    2013-01-01

    Japanese encephalitis, an inflammatory brain disease prevalent in Southeast Asia, usually presented with fever, headache, convulsions, brain stem signs with pyramidal and extrapyramidal features, and altered sensorium. Acute transverse myelitis, as the initial manifestation of Japanese encephalitis, is an unusual manifestation and is seldom reported. We hereby report a case of 13-year-old adolescent boy who presented to us with fever and acute onset paraparesis with urinary retention initiall...

  19. 综合护理干预配合推拿按摩对产后尿潴留的预防效果观察%Prevention effect observation of comprehensive nursing intervention combined with massage on postpartum urinary retention

    贺晓敏; 刘倩; 王玲; 罗丹

    2015-01-01

    目的:探讨综合护理干预配合推拿按摩对产后尿潴留的预防效果。方法将76例顺产分娩的初产妇分为对照组(常规护理)和干预组(常规护理+综合干预)各38例,观察2组首次排尿时间、尿潴留发生率以及产后出血量。结果干预组首次排尿时间为(4.4±0.7)h,其中73.7%(28/38)的产妇在4 h内自行排便,尿潴留发生率2.6%(1/38),低于对照组的7.9%(3/38),2组首次排尿情况差异有统计学意义(P<0.05)。干预组产后出血量少于对照组,差异有统计学意义(P<0.01)。结论在常规护理的基础上配合中医按摩推拿能够促进产妇尽早排尿,降低尿潴留发生率,减少产后出血量。%ObjectiveTo explore the effect of comprehensive nursing intervention in prevention of postpartum urinary retention.Methods76 cases of normal labor primiparae were divided into control group(routine nursing)and intervention group(routine nursing + comprehensive intervention)with 38 cases respectively,the first micturition time and the amount of postpartum hemorrhage of two groups were observed.ResultsThe first micturition time of intervention group was 4.4+0.7h,and 73.7%(28/38)of which were self-bowel within 4h,urinary retention rate of 2.6%(1/38),which was lower than that of the control group 7.9%(3/38),the first urination time between two groups had statistical significance difference(P<0.05).The postpartum hemorrhage amount in intervention group was less than the control group(P<0.01).ConclusionTreated with TCM massage on the basis of routine nursing for postpartum maternal,it can promote maternal self-urination,decrease the incidence of urinary retention and reduce the amount of postpartum hemorrhage.

  20. Searching for biomarkers of acute rejection in renal transplant recipients : development and optimization of a urinary proteomic approach

    2011-01-01

    In Paper I a method for sample preparation of urinary proteins was developed and optimized. The main steps were desalting/enrichment by cut-off centrifugation (5 kDa), albumin depletion and tryptic digestion followed by 2D-LC-MS. Emphasize was put on maximizing protein recovery and improving downstream compatibility. A 2D-separation approach combining ZIC-HILIC and RP was also tested and gave a separation system with a high degree of orthogonality. Finally, the suitability of the method was a...

  1. Relation between blaTEM, blaSHV and blaCTX-M genes and acute urinary tract infections

    Sima Sadat Seyedjavadi; Mehdi Goudarzi; Fattaneh Sabzehali

    2016-01-01

    Objective: To survey the frequency of blaTEM, blaSHV and blaCTX-M genotypes in extended-spectrum b-lactamase (ESBL)-producing Escherichia coli (E. coli) isolated from hospitalized patients with urinary tract infection and the determination of their antibiotic resistance patterns. Methods: During 11-month study, 100 ESBL-producing E. coli were collected from 330 patients who met the definition of urinary tract infection. The phenotypic identification of ESBL was confirmed by double disk synergy test and combined disk diffusion test. In vitro, susceptibility to ESBL isolates than 14 antimicrobial agents was performed by Kirby-Bauer disk diffusion method. The frequency of blaTEM, blaSHV and blaCTX-M ESBL-producing E. coli was assessed by PCR method. Results: The frequency of ESBL-producing E. coli was 40.8%. In vitro, susceptibility to ESBL-producing E. coli showed that the majority of isolates were highly susceptible to amikacin (74%) and imipenem (91%). The rates of resistance to other antibiotics varied from 33% to 96%. Through 100 tested isolates, the prevalence of blaTEM, blaSHV and blaCTX-M genes was determined to be 67%, 45% and 74% respectively. In comparison with other bla genes, the frequency of blaCTX-M was strikingly high. Conclusions: Due to the increase of E. coli with multiple ESBL genes, continuous sur-veillance in order to use appropriate antibiotics and the control of infections is necessary.

  2. A newly developed kit for the measurement of urinary liver-type fatty acid-binding protein as a biomarker for acute kidney injury in patients with critical care.

    Sato, Ryo; Suzuki, Yasushi; Takahashi, Gaku; Kojika, Masahiro; Inoue, Yoshihiro; Endo, Shigeatsu

    2015-03-01

    In recent years, it has been reported that the urinary level of Liver-type fatty acid-binding protein (L-FABP) serves as a useful biomarker for diagnosing acute kidney injury (AKI) or sepsis complicated by AKI. However, because the urinary level of L-FABP is currently measured by enzyme-linked immunosorbent assay (ELISA), several days may elapse before the results of the measurement become available. We have newly developed a simplified kit, the Dip-test, for measuring the urinary level of L-FABP. The Dip-test was measured at 80 measurement points (22 points in noninfectious disease, 13 points in SIRS, 20 points in infectious disease, and 25 points in sepsis) in 20 patients. The urinary L-FABP levels as determined by ELISA in relation to the results of the Dip-test were as follows: 10.10 ± 12.85 ng/ml in patients with a negative Dip-test ([-] group), 41.93 ± 50.51 ng/ml in patients with a ± test ([±] group), 70.36 ± 73.70 ng/ml in patients with a positive test ([+] group), 1048.96 ± 2117.68 ng/ml in patients with a 2 + test ([2+] group), and 23,571.55 ± 21,737.45 ng/ml in patients with a 3 + test ([3+] group). The following tendency was noted: the stronger the positive Dip-test reaction, the higher the urinary L-FABP level. Multigroup comparison revealed a significant differences in the urinary L-FABP levels between the Dip-test (-) group and each of the other groups. In this study, the usefulness of the Dip-test, our newly developed simplified kit for measuring the urinary L-FABP level, is suggested. PMID:25499195

  3. Acute Bacterial Prostatitis: Diagnosis and Management.

    Coker, Timothy J; Dierfeldt, Daniel M

    2016-01-15

    Acute bacterial prostatitis is an acute infection of the prostate gland that causes pelvic pain and urinary tract symptoms, such as dysuria, urinary frequency, and urinary retention, and may lead to systemic symptoms, such as fevers, chills, nausea, emesis, and malaise. Although the true incidence is unknown, acute bacterial prostatitis is estimated to comprise approximately 10% of all cases of prostatitis. Most acute bacterial prostatitis infections are community acquired, but some occur after transurethral manipulation procedures, such as urethral catheterization and cystoscopy, or after transrectal prostate biopsy. The physical examination should include abdominal, genital, and digital rectal examination to assess for a tender, enlarged, or boggy prostate. Diagnosis is predominantly made based on history and physical examination, but may be aided by urinalysis. Urine cultures should be obtained in all patients who are suspected of having acute bacterial prostatitis to determine the responsible bacteria and its antibiotic sensitivity pattern. Additional laboratory studies can be obtained based on risk factors and severity of illness. Radiography is typically unnecessary. Most patients can be treated as outpatients with oral antibiotics and supportive measures. Hospitalization and broad-spectrum intravenous antibiotics should be considered in patients who are systemically ill, unable to voluntarily urinate, unable to tolerate oral intake, or have risk factors for antibiotic resistance. Typical antibiotic regimens include ceftriaxone and doxycycline, ciprofloxacin, and piperacillin/tazobactam. The risk of nosocomial bacterial prostatitis can be reduced by using antibiotics, such as ciprofloxacin, before transrectal prostate biopsy. PMID:26926407

  4. Systemic and Urinary Neutrophil Gelatinase-Associated Lipocalins Are Poor Predictors of Acute Kidney Injury in Unselected Critically Ill Patients

    Annick A. Royakkers; Catherine S. Bouman; Stassen, Pauline M.; Joke C. Korevaar; Binnekade, Jan M.; Willem van de Hoek; Kuiper, Michael A; Spronk, Peter E.; Schultz, Marcus J

    2012-01-01

    Background. Neutrophil gelatinase-associated lipocalin (NGAL) in serum and urine have been suggested as potential early predictive biological markers of acute kidney injury (AKI) in selected critically ill patients. Methods. We performed a secondary analysis of a multicenter prospective observational cohort study of unselected critically ill patients. Results. The analysis included 140 patients, including 57 patients who did not develop AKI, 31 patients who developed AKI, and 52 patients with...

  5. Systemic and urinary neutrophil gelatinase-associated lipocalins are poor predictors of acute kidney injury in unselected critically ill patients.

    Royakkers, A.A.; Bouman, C.S.; Stassen, P.M.; Korevaar, J.C.; Binnekade, J.M.; van der Hoek, W.; Kuiper, M A; Spronk, P.E.; Schultz, M.J.

    2012-01-01

    Background. Neutrophil gelatinase-associated lipocalin (NGAL) in serum and urine have been suggested as potential early predictive biological markers of acute kidney injury (AKI) in selected critically ill patients. Methods. We performed a secondary analysis of a multicenter prospective observational cohort study of unselected critically ill patients. Results. The analysis included 140 patients, including 57 patients who did not develop AKI, 31 patients who developed AKI, and 52 patients with...

  6. The prevalence of O serogroups of Escherichia coli strains causing acute urinary tract infection in children in Iran

    Fatemeh Emamghorashi

    2011-01-01

    Full Text Available The aim of present study was to determine the prevalence of O serogroups of Escherichia coli (E. coli strains that cause community-acquired urinary tract infections (UTI in children. In this study, 96 children with UTI referred to two Jahrom University-affiliated Hospitals in Iran were enrolled, during the period from August 2005 to August 2006. Drug sensitivity was tested by disk diffusion method and serotyping done by slide agglutination method. A total of 96 E. coli strains were isolated from urine samples of the study children whose age ranged from one month to 14 years. Cystitis was diagnosed in 49.2% and pyelonephritis in 50.8% of the study patients. Maximum drug resistance was seen with ampicilin (80.2% and the least with imipenem (1.1%. The most common type of O antigen was O1 (12.2%. There was significant correlation between the presence of O antigens and sensitivity to nalidixic acid and gentamicin (P < 0.05. This is the first report of E. coli serotyping in children with UTI from the south of Iran and their relation to antibiotic resistance and clinical presentation. Further studies from other parts of Iran and on other serotypes are recommended.

  7. Role of Tc99m-dimercaptosuccinic acid (DMSA) in diagnosis of acute urinary tract infection (UTI) in Sudanese children patients

    Pediatric nuclear medicine, in order to survive, must be innovative in finding ways of competing with other pediatric imaging studies for better health care. In this study a group of thirty-one patients with urinary tract infection confirmed by clinical investigation, (fever, pain, ....ect), laboratory investigation (RBC and pus cell)and urine culture, were evaluate by nuclear medicine study. The aim of the study was to compare the diagnostic value of cortical scintigraphy using Tc99m dimercaptosuccinic acid (Tc99m-DMSA), with two other routine investigations; the intravenous urographic (IVU), and ultrasonography (US), for diagnosis of renal parenchymal abnormality in children. The Tc99m-DMSA renal scan was utilized as the gold standard test for renal involvement. All patients had Tc99m-DMSA renal scan, and US, and only 22 patients had contrast IVU. The Tc99m-DMSA renal scan showed abnormality renal scanning in about 94% of patients, US abnormalities were detected in about 81% of patient, while the IVU detected defects in about 87%. Because the prevalence of upper UTI in children is high, Tc99m-DMSA renal scan is undoubtedly the available tool for pediatriacicians as a guide in giving appropriate antibiotic therapy and to prevent further renal damage. The study concludes that, the renal cortical scintigraphy with Tc99m-DMSA has been reported to be a useful children diagnostic study of acute parenchymal renal infections, moreover, is presently the method of choice to detect acute parenchymal infection. (Author)

  8. Retention, distribution, and excretion of 239PuO2 particles labeled with 169Yb in the Rhesus monkey after a single acute inhalation exposure

    Sixteen Rhesus monkeys were exposed to a high fired 239PuO2 aerosol labeled with 169Yb, and retention, distribution, and excretion patterns were determined. After an early rapid clearance phase, which had a half-life of less than one day, the remaining plutonium was retained in the lungs with a half-life that appeared to be greater than 500 days. By 30 days after exposure, 99 percent of the 239Pu in the body was in the lungs. At this time, 6 to 10 percent of the 169Yb burden was in the carcass and skeleton suggesting that there was dissociation of some 169Yb from the particles. The remaining 169Yb activity was in the lungs. There was little 239Pu in the liver, bone, or lymph nodes. The particulate material was cleared rapidly from the gastrointestinal and upper respiratory tracts and appeared in feces over the first four days. The level of 239Pu in feces returned to background by six days. Urinary excretion of 239Pu reached a peak by 8 to 10 days and then remained at a constant rate throughout the remainder of the experiment. These data are useful in calculating radiation dose to a variety of organs and relating this dose to the appearance of late effects from inhaled alpha-emitting particles. (U.S.)

  9. Value of comprehensive renal ultrasound in children with acute urinary tract infection for assessment of renal involvement: comparison with DMSA scintigraphy and final diagnosis

    The aim of this study was to evaluate the value of comprehensive renal ultrasound (US), i.e., combining greyscale US and amplitude-coded color Doppler sonography (aCDS), for assessment of urinary tract infection (UTI) in infants and children, compared to (1) 99mTc DMSA scintigraphy and (2) final diagnosis. Two hundred eighty-seven children with UTI underwent renal comprehensive US and DMSA scintigraphy. The results were compared with regard to their reliability to diagnose renal involvement, using (1) DMSA scintigraphy and (2) final diagnosis as the gold standard. Sixty-seven children clinically had renal involvement. Sensitivity increased from 84.1% using only aCDS to 92.1% for the combined US approach, using DMSA scintigraphy as the reference standard. When correlated with the final diagnosis, sensitivity for DMSA scintigraphy was 92.5%; sensitivity for comprehensive US was 94.0%. Our data demonstrate an increasing sensitivity using the combination of renal greyscale US supplemented by aCDS for differentiation of upper from lower UTI. Sensitivity for DMSA and comprehensive US was similar for both methods compared to the final diagnosis. Comprehensive US should gain a more important role in the imaging algorithm of children with acute UTI, thereby reducing the radiation burden. (orig.)

  10. Role of 99mTc-DMSA in the diagnosis of acute Pyelonephritis in children with urinary tract infection. Based on 114 cases

    Objective: To evaluate the use fullness of the renal scintigraphy with 99mTc-DMSA in the diagnosis of acute pyelonephritis in children with urinary tract infection (UTI), in comparison with intravenous urography (IVU), renal ultrasonography and voiding cystourethrogram. Material and Methods: One hundred and fourteen children with suspected UTI in the first episode. The isotopic technique consisted of administration 2-4 mCi ( 74-148 MBq) 99mTc-DMSA i.v. obtaining posterior and left and right posterior obliques views with pinhole collimator; and posterior and anterior views with parallel hole collimator, after 2-4 hours. Results: The overall sensitivity and specificity for the renal scintigraphy with 99mTc-DMSA was 90 % and 95 % respectively. In renal ultrasonography was 52 % and 86 % respectively. In voiding cystourethrogram was 30 % and 90 % respectively. And in IVU was 30 % and 91 % respectively. Conclusion: We consider renal scintigraphy with 99mTc-DMSA, the first method in the evaluation of UTI, with better sensitivity and specificity than renal ultrasonography, voiding cystourethrogram and IVU

  11. Pediatric urinary tract infection

    Acute urinary tract infection (UTI) is an important cause of morbidity in children and may be complicated by congenital urinary tract abnormalities of a functional or anatomic nature which, predispose to recurrent UTI's that in turn may lead to renal failure and hypertension. Early radiologic and ultrasonographic investigations may reveal these anatomic anomalies in particular because the urinary tract, specifically in children, is not readily accessible to adequate clinical examinations Excretory urography (EU) has been considered as the 'gold standard' of upper urinary tract visualization, while the voiding cystourethrogram (VCUG) was thought to be the preferential method of imaging of the lower urinary tract. Recently, major technical advances have altered this commonly accepted diagnostic workup. Although ultrasonography, radio-nuclide scanning and urodynamics have become important contributors to the understanding of pathophysiology of UTI's their value and place in assessment of the sequence of imaging has not been comprehensively studied. This thesis deals about the optimization of the choice and the order of the different imaging techniques used in the evaluation of children, younger than six year with UTI. (author). 243 refs.; 23 figs.; 8 tabs

  12. Which are risk factors developing renal cortical defects on 99mTc-DMSA scintigraphy in children with acute urinary tract infections?

    To determine (1) the relationship between the cortical defects seen on 99''mTc-DMSA renal scans and age, and (2) the presence and degree of vesicoureteral reflux, and then to depict the risk factors for cortical defects in children with acute urinary tract infection (UTI). Furthermore, to assess the diagnostic value of VCUG in predicting a defect on 99mTc-DMSA renal scans. We studied 134 kidneys in 67 children aged 15 days-10 years (M:F =3D 39:28) in whom symptomatic UTI was present. In all these children, both DMSA renal scans and voiding cystourethrography (VCUG) were performed. Scanning took place within 7 days of diagnosis and VCUG was performed after one month of diagnosis. Scintigraphic findings were graded according to the extent and number of cortical defects. We evaluated the relationships between the cortical defects seen on DMSA scans and age, and the grade of vesicoureteral reflux. The diagnostic value of VCUG in predicting cortical defects was analysed. The prevalence of cortical defects was greater in patients older than two years (38/54, 70%) than in those aged less than two (38/80, 48%). The frequency of cortical defects was related to vesicoureteral reflux (p less than 0.05) and grade of reflux (p less than 0.05). As this latter increased, the extent of cortical defects also increased (p less than 0.05), and DMSA scans revealed the presence of these in 76 of the 134 kidneys (57%) with acute UTI. In 30 of these 76 (39.5%), VCUG demonstrated the presence of vesicoureteral reflex. On the other hand, vesicoureteral reflex was found in 36 of the 134 kidneys (27%), and in 30 of these 36 (83%), cortical defects were noted. The sensitivity of VCUG in predicting cortical defect was 39.5%, while specificity was 89.7%. The positive predictive value for defects was 83.3%, and the negative predictive value was 53.1%. The relative risk of cortical defect in the presence of vesicoureteral reflux was 1.78. Renal cortical defects are significantly related to age

  13. Which are risk factors developing renal cortical defects on {sup 99m}Tc-DMSA scintigraphy in children with acute urinary tract infections?

    Moon, Seong Won; Lim, Gye Yeon; Jang, Hae Suk; Lee, Eun Ja; Sohn, Hyung Sun; Hahn, Sung Tae [The Catholic University, Seoul (Korea, Republic of)

    2000-04-01

    To determine (1) the relationship between the cortical defects seen on {sup 99}''mTc-DMSA renal scans and age, and (2) the presence and degree of vesicoureteral reflux, and then to depict the risk factors for cortical defects in children with acute urinary tract infection (UTI). Furthermore, to assess the diagnostic value of VCUG in predicting a defect on {sup 99m}Tc-DMSA renal scans. We studied 134 kidneys in 67 children aged 15 days-10 years (M:F =3D 39:28) in whom symptomatic UTI was present. In all these children, both DMSA renal scans and voiding cystourethrography (VCUG) were performed. Scanning took place within 7 days of diagnosis and VCUG was performed after one month of diagnosis. Scintigraphic findings were graded according to the extent and number of cortical defects. We evaluated the relationships between the cortical defects seen on DMSA scans and age, and the grade of vesicoureteral reflux. The diagnostic value of VCUG in predicting cortical defects was analysed. The prevalence of cortical defects was greater in patients older than two years (38/54, 70%) than in those aged less than two (38/80, 48%). The frequency of cortical defects was related to vesicoureteral reflux (p less than 0.05) and grade of reflux (p less than 0.05). As this latter increased, the extent of cortical defects also increased (p less than 0.05), and DMSA scans revealed the presence of these in 76 of the 134 kidneys (57%) with acute UTI. In 30 of these 76 (39.5%), VCUG demonstrated the presence of vesicoureteral reflex. On the other hand, vesicoureteral reflex was found in 36 of the 134 kidneys (27%), and in 30 of these 36 (83%), cortical defects were noted. The sensitivity of VCUG in predicting cortical defect was 39.5%, while specificity was 89.7%. The positive predictive value for defects was 83.3%, and the negative predictive value was 53.1%. The relative risk of cortical defect in the presence of vesicoureteral reflux was 1.78. Renal cortical defects are

  14. Urinary flavonoid excretion and risk of acute coronary syndrome in a nested case-control study123

    Bredsdorff, Lea; Obel, Tina; Dethlefsen, Claus; Tjønneland, Anne; Schmidt, Erik B; Rasmussen, Salka E; Overvad, Kim

    2013-01-01

    Background: Epidemiologic studies have suggested that a higher intake of flavonoids may be associated with lower risk of ischemic heart disease. However, the traditional estimation of flavonoid intake by using dietary assessment methods is affected by subjective measures. Objective: We examined...... whether the objective measurement of dietary flavonoids excreted in urine is associated with lower risk of acute coronary syndrome (ACS). Design: A case-control study was nested in the Danish Diet, Cancer and Health cohort study. Cases were identified in participants who had received a first-time ACS...... diagnosis in the Danish National Patient Registry after the time of enrollment into the Diet, Cancer and Health study. The excretion of 10 flavonoids, which represent 5 subclasses, was measured in spot urine samples by using liquid chromatography–mass spectrometry. Results: A total of 393 eligible cases...

  15. Urinary flavonoid excretion and risk of acute coronary syndrome in a nested case-control study123

    Bredsdorff, Lea; Obel, Tina; Dethlefsen, Claus; Tjønneland, Anne; Schmidt, Erik B; Rasmussen, Salka E; Overvad, Kim

    2013-01-01

    diagnosis in the Danish National Patient Registry after the time of enrollment into the Diet, Cancer and Health study. The excretion of 10 flavonoids, which represent 5 subclasses, was measured in spot urine samples by using liquid chromatography–mass spectrometry. Results: A total of 393 eligible cases......Background: Epidemiologic studies have suggested that a higher intake of flavonoids may be associated with lower risk of ischemic heart disease. However, the traditional estimation of flavonoid intake by using dietary assessment methods is affected by subjective measures. Objective: We examined...... whether the objective measurement of dietary flavonoids excreted in urine is associated with lower risk of acute coronary syndrome (ACS). Design: A case-control study was nested in the Danish Diet, Cancer and Health cohort study. Cases were identified in participants who had received a first-time ACS...

  16. In-vivo comparison of the acute retention of stem cell derivatives and fibroblasts after intramyocardial transplantation in the mouse model

    Lang, Cajetan; David, Robert [University of Rostock, Reference and Translation Center for Cardiac Stem Cell Therapy (RTC), Rostock (Germany); Lehner, Sebastian; Todica, Andrei; Boening, Guido; Zacherl, Mathias; Bartenstein, Peter [University of Munich, Department of Nuclear Medicine, Ludwig-Maximilians, Munich (Germany); Franz, Wolfgang-Michael [University of Innsbruck, Department of Cardiology, Innbruck (Austria); Krause, Bernd Joachim [University of Rostock, Department of Nuclear Medicine, Rostock (Germany); Hacker, Marcus [Medical University of Vienna, Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Wien (Austria)

    2014-12-15

    Various strategies have been applied to increase the engraftment of an intramyocardial cell transplant (Tx) to treat ischemic myocardium. Thereby, co-transplanted fibroblasts (FB) improve the long-term survival of stem cell derivatives (SCD) in a murine model of myocardial infarction. For therapeutic use, the time frame in which FB exert putative supportive effects needs to be identified. Therefore, we tracked the biodistribution and retention of SCD and FB in vivo using highly sensitive positron emission tomography (PET) imaging. Murine [{sup 18} F]-fluorodeoxyglucose (FDG) labeled SCD and FB were transplanted after left anterior descending artery (LAD) ligation into the border zone of the ischemic area in female C57BL/6 mice. Cardiac retention and biodistribution during the initial 2 h after injection were measured via PET imaging. Massive initial cell loss occurred independently of the cell type. Thereby, FB were retained slightly, yet significantly better than SCD until 60 min post-injection (7.5 ± 1.7 vs. 5.2 ± 0.7 % ID at 25 min and 7.0 ± 1.5 vs. 4.8 ± 0.8 % ID at 60 min). Thereafter, a fraction of ∝5 % that withstood the massive initial washout remained at the site of injection independently of the applied cell type (120 min, SCD vs. FB P = 0.64). Most of the lost cells were detected in the lungs (∝30 % ID). We were able to quantitatively define the retention and biodistribution of different cell types via PET imaging in a mouse model after intramyocardial Tx. The utmost accuracy was achieved through this cell- and organ-specific approach by correcting PET data for cellular FDG efflux. Thereby, we observed a massive initial cell loss of ∝95 %, causing low rates of long-term engraftment for both SCD and FB. We conclude that FB are not privileged compared to SCD regarding their acute retention kinetics, and therefore exert their beneficial effects at a later time point. (orig.)

  17. In-vivo comparison of the acute retention of stem cell derivatives and fibroblasts after intramyocardial transplantation in the mouse model

    Various strategies have been applied to increase the engraftment of an intramyocardial cell transplant (Tx) to treat ischemic myocardium. Thereby, co-transplanted fibroblasts (FB) improve the long-term survival of stem cell derivatives (SCD) in a murine model of myocardial infarction. For therapeutic use, the time frame in which FB exert putative supportive effects needs to be identified. Therefore, we tracked the biodistribution and retention of SCD and FB in vivo using highly sensitive positron emission tomography (PET) imaging. Murine [18 F]-fluorodeoxyglucose (FDG) labeled SCD and FB were transplanted after left anterior descending artery (LAD) ligation into the border zone of the ischemic area in female C57BL/6 mice. Cardiac retention and biodistribution during the initial 2 h after injection were measured via PET imaging. Massive initial cell loss occurred independently of the cell type. Thereby, FB were retained slightly, yet significantly better than SCD until 60 min post-injection (7.5 ± 1.7 vs. 5.2 ± 0.7 % ID at 25 min and 7.0 ± 1.5 vs. 4.8 ± 0.8 % ID at 60 min). Thereafter, a fraction of ∝5 % that withstood the massive initial washout remained at the site of injection independently of the applied cell type (120 min, SCD vs. FB P = 0.64). Most of the lost cells were detected in the lungs (∝30 % ID). We were able to quantitatively define the retention and biodistribution of different cell types via PET imaging in a mouse model after intramyocardial Tx. The utmost accuracy was achieved through this cell- and organ-specific approach by correcting PET data for cellular FDG efflux. Thereby, we observed a massive initial cell loss of ∝95 %, causing low rates of long-term engraftment for both SCD and FB. We conclude that FB are not privileged compared to SCD regarding their acute retention kinetics, and therefore exert their beneficial effects at a later time point. (orig.)

  18. Prevalence of acute pyelonephritis and incidence of renal scarring in children under the age of two with urinary tract infection evaluated by 99mTc-DMSA renal scintigraphy: the experience of a university hospital

    Objective: To calculate the frequencies of acute pyelonephritis and renal scarring in patients under the age of two, with first episode of urinary tract infection in a Brazilian university hospital, comparing with data reported in the international literature. Materials and Methods: Scintigraphic reports of children less than two years old submitted to 99mTc-DMSA renal scintigraphy in a university hospital in Rio Grande do Sul between 2006 and 2009 were reviewed to investigate acute pyelonephritis/renal scarring. Additionally, the presence of vesicoureteral reflux, early use of antibiotics, and comorbidities were investigated on electronic records. The sample size calculation was based on a systematic review study and obtained a minimum of 147 patients. Patients whose electronic records were not available were excluded. Results: One hundred and fifty-seven children met the inclusion criteria; among them 48 had acute pyelonephritis and 8 of these had renal scars. Neither age nor sex presented any significant association with acute pyelonephritis (p = 0.405 and p = 0.124, respectively). No statistical significance was observed in the association between vesicoureteral reflux and acute pyelonephritis (p = 1.0) and other comorbidities (p = 0.470), and in relation to early use of antibiotics with acute pyelonephritis (p = 0.130) and renal scarring (p = 0.720). Conclusion: The frequencies found in the present study for acute pyelonephritis/renal scarring are in agreement with the results reported by most studies in the literature. (author)

  19. Prevalence of acute pyelonephritis and incidence of renal scarring in children under the age of two with urinary tract infection evaluated by {sup 99m}Tc-DMSA renal scintigraphy: the experience of a university hospital

    Berdichevski, Eduardo Herz; Vilas, Eduardo Rosito de, E-mail: duduberdi@hotmail.com [Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, RS (Brazil). Hospital Sao Lucas. Service of Medicine; Mattos, Silvia Gelpi; Bezerra, Sofia; Baldisserotto, Matteo [Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, RS (Brazil). Faculdade de Medicina

    2013-01-15

    Objective: To calculate the frequencies of acute pyelonephritis and renal scarring in patients under the age of two, with first episode of urinary tract infection in a Brazilian university hospital, comparing with data reported in the international literature. Materials and Methods: Scintigraphic reports of children less than two years old submitted to {sup 99m}Tc-DMSA renal scintigraphy in a university hospital in Rio Grande do Sul between 2006 and 2009 were reviewed to investigate acute pyelonephritis/renal scarring. Additionally, the presence of vesicoureteral reflux, early use of antibiotics, and comorbidities were investigated on electronic records. The sample size calculation was based on a systematic review study and obtained a minimum of 147 patients. Patients whose electronic records were not available were excluded. Results: One hundred and fifty-seven children met the inclusion criteria; among them 48 had acute pyelonephritis and 8 of these had renal scars. Neither age nor sex presented any significant association with acute pyelonephritis (p = 0.405 and p = 0.124, respectively). No statistical significance was observed in the association between vesicoureteral reflux and acute pyelonephritis (p = 1.0) and other comorbidities (p = 0.470), and in relation to early use of antibiotics with acute pyelonephritis (p = 0.130) and renal scarring (p = 0.720). Conclusion: The frequencies found in the present study for acute pyelonephritis/renal scarring are in agreement with the results reported by most studies in the literature. (author)

  20. Detection of Drug-Induced Acute Kidney Injury in Humans Using Urinary KIM-1, miR-21, -200c, and -423.

    Pavkovic, Mira; Robinson-Cohen, Cassianne; Chua, Alicia S; Nicoara, Oana; Cárdenas-González, Mariana; Bijol, Vanesa; Ramachandran, Krithika; Hampson, Lucy; Pirmohamed, Munir; Antoine, Daniel J; Frendl, Gyorgy; Himmelfarb, Jonathan; Waikar, Sushrut S; Vaidya, Vishal S

    2016-07-01

    Drug-induced acute kidney injury (AKI) is often encountered in hospitalized patients. Although serum creatinine (SCr) is still routinely used for assessing AKI, it is known to be insensitive and nonspecific. Therefore, our objective was to evaluate kidney injury molecule 1 (KIM-1) in conjunction with microRNA (miR)-21, -200c, and -423 as urinary biomarkers for drug-induced AKI in humans. In a cross-sectional cohort of patients (n = 135) with acetaminophen (APAP) overdose, all 4 biomarkers were significantly (P SCr increase) but also in APAP-OD patients without clinical diagnosis of AKI compared with healthy volunteers. In a longitudinal cohort of patients with malignant mesothelioma receiving intraoperative cisplatin (Cp) therapy (n = 108) the 4 biomarkers increased significantly (P < .0014) over time after Cp administration, but could not be used to distinguish patients with or without AKI. Evidence for human proximal tubular epithelial cells (HPTECs) being the source of miRNAs in urine was obtained first, by in situ hybridization based confirmation of increase in miR-21 expression in the kidney sections of AKI patients and second, by increased levels of miR-21, -200c, and -423 in the medium of cultured HPTECs treated with Cp and 4-aminophenol (APAP degradation product). Target prediction analysis revealed 1102 mRNA targets of miR-21, -200c, and -423 that are associated with pathways perturbed in diverse pathological kidney conditions. In summary, we report noninvasive detection of AKI in humans by combining the sensitivity of KIM-1 along with mechanistic potentials of miR-21, -200c, and -423. PMID:27122240

  1. Urinary Bladder

    ... to the symphysis pubis, and below the parietal peritoneum . The size and shape of the urinary bladder ... outer layer of the bladder wall is parietal peritoneum. In all other regions, the outer layer is ...

  2. 鞘内注射误用碳酸氢钠注射液为溶媒致下肢麻木、高热及尿潴留%Lower extremity numbness, fever, and urinary retention due to misuse of sodium bicarbonate for intrathecal injection

    郭敏; 张文; 席亚明

    2013-01-01

    1例61岁男性急性淋巴细胞白血病患者行化疗药物鞘内注射,因医生配药时拿错药物,误将5%碳酸氢钠注射液用作化疗药物溶媒.鞘内注射完毕后患者即出现下肢麻木,继之出现寒战、高热(体温最高40.1℃)、大汗、血压升高(190~210/106~110 mm Hg,1 mm Hg=0.133 kPa)、心率增快(170~ 180次/min)、尿潴留.给予甲泼尼龙、甘露醇静脉滴注,同时给予补液及导尿等处理.4h后患者体温、血压、心率恢复正常,6h后下肢麻木消失,12 h后可自行排尿.随访1周,患者未再出现类似症状.%A 61-year-old male patient with acute lymphoblastic leukemia received intrathecal injection of chemotherapy drugs.A doctor in charge took mistakenly the 5% sodium bicarbonate injection as solvent.After intrathecal injection,the patient presented lower limbs numbness,followed by chills,fever (peak temperature 40.1 ℃),sweating,elevated blood pressure (190-210/106-110 mm Hg),increased heart rate (170-180 beats/min),and urinary retention.The patient was given an Ⅳ infusion of methylprednisolone and mannitol,and at the same time,fluid supplement and urethral catheterization were given.The patient's temperature,blood pressure,and heart rate returned to normal 4 hours later,numbness of lower limbs disappeared 6 hours later,and urinated on himself 12 hours later.There was no similar symptoms recurrence at one-week follow up.

  3. Characteristics of regional sympathetic dysfunction in acutely ischemic myocardium assessed by {sup 123}I-metaiodobenzylguanidine imaging. Impairment of myocardial norepinephrine uptake or retention

    Ishida, Yoshio; Hirose, Yoshiaki [National Cardiovascular Center, Suita, Osaka (Japan); Maeno, Masakazu [and others

    1995-07-01

    To characterize regional cardiac sympathetic dysfunction due to myocardial ischemia, we examined {sup 123}I-metaiodobenzylguanidine (MIBG) myocardial distribution of initial 15-min and 4-hr delayed SPECT images in 14 patients with recent myocardial infarction (MI), 25 patients with vasospastic angina which was angiographically proven with elgonovine maleate (Gp VSAP) and 16 patients with chest pain syndrome and normal CAG findings (Gp CP). In those with MI, the study was serially done at 2 weeks after (Gp MI-1) and at 3 months after the onset of MI (Gp MI-2). We estimated regional tracer uptake in 20 segments of tomographic images by using a 4-point scoring system (0=normal, 1=mild, 2=moderate, 3=severe reduction) and calculated the total defect score (IDS). In all patients with MI, the area of reduced MIBG uptake was more extensive than the {sup 201}Tl perfusion defect in the acute stage (Gp MI-1) indicating the presence of viable but denervated myocardial tissue. Also, the MIBG defect was persistently observed from initial (TDS: 24{+-}13) to delayed imaging (TDS: 26{+-}12). However, in the chronic stage (Gp MI-2), the initial MIBG uptake improved (TDS: 18 {+-}9) but the delayed uptake remained almost the same (TDS: 22{+-}10) indicating high washout of MIBG from the ischemic myocardium. Fourteen in Gp VSAP and 14 in Gp CP showed the regional MIBG defect in the delayed image more extensively than in the initial image indicating high washout of MIBG in the involved myocardial regions. These results suggest that neuronal uptake of MIBG is impaired in the acute stage of MI although neuronal retention of MIBG is predominantly impaired in the chronic stage of MI or in Gps VSAP and CP. (author).

  4. The management of the congenital anterior urethral diverticula with calculi which is the cause of acute urinary retention (Globe vesicale): A case report

    Pirinççi, Necip; Geçit, İlhan; Güneş, Mustafa; Taken, Kerem; Tanık, Serhat; Ceylan, Kadir

    2013-01-01

      Abstract. Congenital urethral diverticula with calculi has a low incidence as reported in the literature. Congenital diverticula have been seen % 10-20 in all urethral diverticula. The etiology of urethral stones are urethra and bladder stones, urethral diverticula, foreign matters, urethral stenosis and urethral trauma. Management of treatment urethral stones is surgery and endoscopy. Our case was a three years old boy who referred to our clinic due to globe vesicale. Diagnosis was perform...

  5. Retención de orina en un paciente inmunocompetente: mielitis transversa aguda Urinary retention in immunocompetent patient: acute transverse myelitis

    M.V. Villaverde; C. López Canales; F. Gutiérrez Moreno; A. Martínez Hernández; Vela, P.

    2011-01-01

    Bajo el término de mielitis transversa aguda (MTA) se engloba un grupo heterogéneo de enfermedades con el nexo común de producir una lesión focal inflamatoria de la médula espinal de instauración brusca. El conocimiento de la MTA se está viendo modificado constantemente con el advenimiento de nuevas técnicas diagnósticas y teorías sobre su origen inmunológico. La responsabilidad de realizar un diagnóstico precoz, recae principalmente en el ámbito de la Atención Primaria y debe fundamentarse s...

  6. Urinary Tract Infections In Pregnancy

    N Sivalingam; Loh KY

    2007-01-01

    Urinary tract infections frequently affect pregnant mothers. This problem causes significant morbidity and healthcare expenditure. Three common clinical manifestations of UTIs in pregnancy are: asymptomatic bacteriuria, acute cystitis and acute pyelonephritis. Escherichia coli remains the most frequent organism isolated in UTIs. All pregnant mothers should be screened for UTIs in pregnancy and antibiotics should be commenced without delay. Urine culture and sensitivity is the gold standard in...

  7. The innate immune response during urinary tract infection and pyelonephritis

    Spencer, John David; Schwaderer, Andrew L.; Becknell, Brian; Watson, Joshua; Hains, David S.

    2013-01-01

    Despite its proximity to the fecal flora, the urinary tract is considered sterile. The precise mechanisms by which the urinary tract maintains sterility are not well understood. Host immune responses are critically important in the antimicrobial defense of the urinary tract. During recent years, considerable advances have been made in our understanding of the mechanisms underlying immune homeostasis of the kidney and urinary tract. Dysfunctions in these immune mechanisms may result in acute d...

  8. Urinary Diversion

    ... of wastes and extra fluid. In order for normal urination to occur, all body parts in the urinary tract need to work together in the correct order. Kidneys. The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below ...

  9. Acute Kidney Injury Induced by Systemic Inflammatory Response Syndrome is an Avid and Persistent Sodium-Retaining State

    Daniel Vitorio; Alexandre Toledo Maciel

    2014-01-01

    Acute kidney injury (AKI) is a frequent complication of the systemic inflammatory response syndrome (SIRS), which is triggered by many conditions in the intensive care unit, including different types of circulatory shock. One under-recognized characteristic of the SIRS-induced AKI is its avidity for sodium retention, with progressive decreases in urinary sodium concentration (NaU) and its fractional excretion (FENa). This phenomenon occurs in parallel with increases in serum creatinine, being...

  10. Dosimetric coverage of the prostate, normal tissue sparing, and acute toxicity with high-dose-rate brachytherapy for large prostate volumes

    Purpose: to evaluate dosimetric coverage of the prostate, normal tissue sparing, and acute toxicity with HDR brachytherapy for large prostate volumes. Materials and methods: one hundred and two prostate cancer patients with prostate volumes >50 mL (range: 5-29 mL) were treated with high-dose-rate (HDR) brachytherapy ± intensity modulated radiation therapy (IMRT) to 4,500 cGy in 25 daily fractions between 2009 and 2013. HDR brachytherapy monotherapy doses consisted of two 1,350-1,400 cGy fractions separated by 2-3 weeks, and HDR brachytherapy boost doses consisted of two 950-1,150 cGy fractions separated by 4 weeks. Twelve of 32 (38%) unfavorable intermediate risk, high risk, and very high risk patients received androgen deprivation therapy. Acute toxicity was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4. Results: median follow-up was 14 months. Dosimetric goals were achieved in over 90% of cases. Three of 102 (3%) patients developed Grade 2 acute proctitis. No variables were significantly associated with Grade 2 acute proctitis. Seventeen of 102 (17%) patients developed Grade 2 acute urinary retention. American Urological Association (AUA) symptom score was the only variable significantly associated with Grade 2 acute urinary retention (p-0.04). There was no ≥ Grade 3 acute toxicity. Conclusions: dosimetric coverage of the prostate and normal tissue sparing were adequate in patients with prostate volumes >50 mL. Higher pre-treatment AUA symptom scores increased the relative risk of Grade 2 acute urinary retention. However, the overall incidence of acute toxicity was acceptable in patients with large prostate volumes. (author)

  11. Dosimetric coverage of the prostate, normal tissue sparing, and acute toxicity with high-dose-rate brachytherapy for large prostate volumes

    Yang, George; Strom, Tobin J.; Shrinath, Kushagra; Mellon, Eric A.; Fernandez, Daniel C.; Biagioli, Matthew C. [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (United States); Wilder, Richard B., E-mail: mcbiagioli@yahoo.com [Cancer Treatment Centers of America, Newnan, GA (United States)

    2015-05-15

    Purpose: to evaluate dosimetric coverage of the prostate, normal tissue sparing, and acute toxicity with HDR brachytherapy for large prostate volumes. Materials and methods: one hundred and two prostate cancer patients with prostate volumes >50 mL (range: 5-29 mL) were treated with high-dose-rate (HDR) brachytherapy ± intensity modulated radiation therapy (IMRT) to 4,500 cGy in 25 daily fractions between 2009 and 2013. HDR brachytherapy monotherapy doses consisted of two 1,350-1,400 cGy fractions separated by 2-3 weeks, and HDR brachytherapy boost doses consisted of two 950-1,150 cGy fractions separated by 4 weeks. Twelve of 32 (38%) unfavorable intermediate risk, high risk, and very high risk patients received androgen deprivation therapy. Acute toxicity was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4. Results: median follow-up was 14 months. Dosimetric goals were achieved in over 90% of cases. Three of 102 (3%) patients developed Grade 2 acute proctitis. No variables were significantly associated with Grade 2 acute proctitis. Seventeen of 102 (17%) patients developed Grade 2 acute urinary retention. American Urological Association (AUA) symptom score was the only variable significantly associated with Grade 2 acute urinary retention (p-0.04). There was no ≥ Grade 3 acute toxicity. Conclusions: dosimetric coverage of the prostate and normal tissue sparing were adequate in patients with prostate volumes >50 mL. Higher pre-treatment AUA symptom scores increased the relative risk of Grade 2 acute urinary retention. However, the overall incidence of acute toxicity was acceptable in patients with large prostate volumes. (author)

  12. The association of urinary sediment with severity in patients with acute kidney injury%急性肾损伤患者尿沉渣评分与肾损伤严重程度的关系

    陈昕; 刘琦; 刘进

    2015-01-01

    ObjectiveTo investigate the association of urinary sediment scoring system created on the basis of the number of renal tubular epithelial cells and granular casts with the severity of acute kidney injury. Methods Of 60 patients consulted for AKI, fresh morning urine was examined by two experts with phase-contrast microscopy, who did not know clinical information, counting the number of renal tubular epithelial cells and granular casts, scored on the basis of urinary sediment grading system, staged AKI on the base of the RIFLE standard, the worsening of AKI was progressing to higher AKI network stage, dialysis, or death. The association of score of urinary sediment with worsening of AKI was investigated, then the difference between worsening group with not worsening group was compared, the relationship of score of urinary sediment and the risk factors of worsening in AKI were analyzed by Logistic regression analysis. ResultsThe urinary sediment scores were lowest in those with stage 1 and highest in stage 3 of AKI (0.72±0.64vs. 1.36±0.97,P<0.05). 40% patients experienced worsening of AKI, the urinary sediment scores of worsening group were significantly higher than that of not worsening group (1.88±0.74vs.0.52±0.56,P<0.05). Multivariate stepwise Logistic regression analysis showed that the urinary sediment scores and serum creatinine were the independent risk factors of AKI worsening. ConclusionThe urinary sediment score may be a useful tool to predict worsening of AKI.%目的:探讨以肾小管上皮细胞及颗粒管型为基础建立的尿沉渣评分系统与急性肾损伤(AKI)病变严重程度的关系。方法60例AKI患者,取晨尿由专人双盲用相差显微镜计数肾小管上皮细胞及颗粒管型,依据尿沉渣评分系统予以评分,依据RIFLE[危险(risk)、损伤(injury)、衰竭(loss)、丧失(failur)、终末期肾脏病(end-stage kidney disease)]标准修改方案进行AKI分期,以AKI的分期加重

  13. Fosfomycin tromethamine as second agent for the treatment of acute, uncomplicated urinary tract infections in adult female patients in The Netherlands?

    Knottnerus, B.J.; Nys, S.; Riet, G. ter; Donker, G.; Geerlings, S.E.; Stobberingh, E.

    2008-01-01

    BACKGROUND: Uncomplicated urinary tract infections (UTIs) are common among female patients. According to the national guidelines of the Dutch College of General Practitioners (GPs), the drugs of first and second choice as therapy for UTIs are nitrofurantoin and trimethoprim with resistance percentag

  14. Retention Catheterization Causes Analysis and Prevention of Urinary Tract Infection%保留导尿造成尿路感染的原因分析与预防

    刘志红

    2014-01-01

    导尿和留置尿管是基础临床护理基本常用的技术操作之,导尿和留置尿管操作不当也是引起尿路感染的主要危险因素,文献报道在医院感染中尿路感染占40%,尿路感染治疗不及时可引起严重并发症因此,降低医院感染,控制留置尿管患者尿路感染至关重要。观察留置导尿与尿路感染的相关因素,严格掌握导尿指征,有效控制和预防留置导尿患者尿路感染的发生,正确的操作和置管后的护理,合理使用抗生素,缩短留置导尿时间是有效减少尿路逆行感染的重要措施。我们必须以严谨的态度和科学的方法进行操作和护理,同时对留置尿管患者尿路感染进行原因分析,并找出预防措施。%Catheterization and indwelling catheter is the basis for clinical nursing basic common technical operation, urethral catheterization and catheterization improper operation is caused by the main risk factors of urinary tract infection, urinary tract infection accounted for 40% of reported in nosocomial infection, not timely treatment can lead to serious complications and urinary tract infection, nosocomial infection, control indwel ing catheter in patients with urinary tract infection is very important. Factors associated with urinary tract infection of catheter indwel ing, strictly grasp the indications for catheterization, ef ective prevention and control of indwel ing urethral catheterization occurred urinary tract infection patients, the correct operation and after catheter nursing, the rational use of antibiotics, shorten the indwel ing catheter time is ef ectively an important measure to reduce urinary tract infections. We must carry out the operation and nursing method of at itude and scientific analysis, at the same time of indwelling catheter patients with urinary tract infection and to find out the cause, prevention measures.

  15. Postoperative urinary retention: evaluation of patients using opioids analgesic Retención urinaria post-operatoria: evaluación de pacientes en tratamiento analgésico con opioides Retenção urinária pós-operatória: avaliação de pacientes em uso de analgesia com opióides

    Maria do Carmo Barretto de Carvalho Fernandes

    2007-04-01

    Full Text Available The study aimed to determine the occurrence of urinary retention in patients using opioid analgesic and to describe the method used for vesical relief. A prospective and consecutive series of 1,316 patients undergoing surgery from September 1999 to April 2003 and using opioids post surgery were studied. From the 1,136 patients, 594 did not use urinary catheters pre-surgery. From these 594 patients, 128 (22% suffered post operative urinary retention. Urinary retention was significantly related to the use of continuous epidural analgesia (p=0.009. About 69% of patients experiencing urinary retention post surgery returned to spontaneous micturition following a single catheterization. The incidence found of urinary retention was similar to the literature, more frequent in men who received continuous epidural analgesia. The findings suggest orientation and careful nursing team observation of post operative micturition, emphasizing the intermittent aseptically catheterization for urinary retention in order to prevent potential complications of the urinary tract.Los objetivos de este estudio fueron determinar la incidencia de retención urinaria post-operatoria en pacientes que se encontraban en uso de analgésicos opioides, así como describir el método utilizado en el vaciado vesical. Se trata de una serie prospectiva y consecutiva de 1.316 pacientes quirúrgicos, estudiados de septiembre de 1999 a abril de 2003. De ellos, 594 pacientes no usaron cateterismo de demora en el pre-operatorio. Así mismo, 128 pacientes de este grupo presentó retención urinaria, con una incidencia del 22% (128/594. Hubo una asociación estadísticamente significativa entre la ocurrencia de retención urinaria y el uso de analgesia epidural continua (p=0,009. El 69% de los pacientes presentó una micción espontánea luego de haber realizado apenas un cateterismo. La incidencia de retención urinaria encontrada es semejante a la descrita en la literatura, siendo m

  16. Meningitis-retention Syndrome; A Case Report.

    Ishii, Gen; Hata, Kenichi; Aoki, Soichiro; Suzuki, Masayasu; Kimura, Takahiro; Egawa, Shin

    2016-05-01

    We report a case of meningitis-retention syndrome followed by urodynamic tests. A 48-year-old man was admitted to the hospital for an undiagnosed fever with headache and urinary retention. Aseptic meningitis was suspected according to cerebrospinal fluid analyses, and urodynamic test showed an underactive detrusor, leading to inadequate contraction of the bladder on voiding in spite of a normal sensation during bladder filling. Clean intermittent self-catheterization was required temporarily, but normal urinary voiding without the need for medication was restored in 2 weeks after discharge from the hospital, when urodynamic tests showed normal contractility of the bladder during voiding. PMID:27175342

  17. Scintigraphy findings in children presenting the first febrile infection of urinary tract

    Urinary tract infection (UTI) is one of the more frequent bacterial infections in childhood. The aim of present research was to know the acute phase renal alterations of the first febrile infection of urinary tract

  18. Long-term urinary function after transperineal brachytherapy for patients with large prostate glands

    Purpose: To summarize longer-term postbrachytherapy morbidity in patients with prostate glands >50 cm3. Methods and Materials: From 1997 to 1998, 33 patients with a transrectal ultrasound-based prostate volume >50 cm3 were treated at the University of Washington by 125I (144 Gy) or 103Pd (115 Gy) implantation for prostate carcinoma. These 33 patients comprised 7% of the total implant patient population. Twelve patients were treated with neoadjuvant androgen ablation before implantation. The 125I source strength ranged from 0.34 to 0.5 mCi and the 103Pd source strength ranged from 1.1 to 1.4 mCi (pre-NIST-99). The total number of sources implanted was 94-223 (median 155). Despite the typical implant-related volume increase, the postimplant CT-defined prostate volumes were generally well-covered by the prescription isodose (median coverage 92%, range 80-100%). The preimplant urinary obstructive symptoms were quantified by the criteria of the American Urological Association. Results: Of the 33 patients, 12 developed acute postimplant urinary retention, all presenting within 24 h of implantation. Patients who developed postimplant retention lasting >1 week were generally treated with intermittent self-catheterization. By 1 month, 85% of patients were catheter free. By 1 year, only 1 patient (4%) remained in urinary retention; the remainder of cases had resolved spontaneously. With follow-up of 1.7-2.6 years, the last American Urological Association scores were higher than the pretreatment scores in 15 patients and lower in 7 patients. No patient developed permanent urinary incontinence. Long-term changes in the American Urological Association scores were unrelated to whether the patient had been in urinary retention after implantation. Two patients developed rectal fistulas; they had preimplant transrectal ultrasound prostate volumes of 53 and 59 cm3, in the low range for this group of patients. No other patient had persistent rectal bleeding suggestive of clinically

  19. A rare cause of acute abdominal pain: Herlyn-Werner-Wunderlich syndrome.

    Aydin, Ramazan; Ozdemir, Ayse Zehra; Ozturk, Bahadir; Bilgici, Meltem Ceyhan; Tosun, Migraci

    2014-01-01

    Herlyn-Werner-Wunderlich (HWW) syndrome is a rare müllerian duct anomaly with uterus didelphys, unilateral obstructed hemivagina, and ipsilateral renal agenesis. Patients with this syndrome generally present after menarche with pelvic pain and mass and, rarely, primary infertility in later years. Strong suspicion and knowledge of this syndrome are mandatory for an accurate diagnosis. A 14-year-old female patient presented with acute retention of urine and abdominopelvic pain. Her condition was diagnosed with the use ultrasonography and magnetic resonance imaging as a case of HWW syndrome. She was treated with vaginal hemiseptal resection. The HWW syndrome should be considered among the differential diagnoses in girls with renal anomalies presenting with pelvic mass, symptoms of acute abdominal pain, and acute urinary retention. PMID:24378860

  20. Antibiotic susceptibility and imaging findings of the causative microorganisms responsible for acute urinary tract infection in children: a five-year single center study

    Ji Eun Yoon; Wun Kon Kim; Jin Seok Lee; Kyeong-Seob Shin; Tae-Sun Ha

    2011-01-01

    Purpose : We studied the differences in the antibiotic susceptibilities of the microorganisms that causeing urinary tract infections (UTI) in children to obtain useful information on appropriate drug selection for childhood UTI. Methods : We retrospectively analyzed the antibiotic susceptibilities of 429 microorganisms isolated from 900 patients diagnosed with UTI in the Department of Pediatrics, Chungbuk National University Hospital, from 2003 to 2008. Results : The most common causative mic...

  1. Urinary incontinence - injectable implant

    ... repair; ISD repair; Injectable bulking agents for stress urinary incontinence ... Blaivas JM, Gormley EA, et al. Female Stress Urinary Incontinence Update Panel of the American Urological Association Education ...

  2. Short-term effect of acute and repeated urinary bladder inflammation on thigmotactic behaviour in the laboratory rat [v1; ref status: indexed, http://f1000r.es/56e

    Rosemary H Morland

    2015-05-01

    Full Text Available Understanding the non-sensory components of the pain experience is crucial to developing effective treatments for pain conditions. Chronic pain is associated with increased incidence of anxio-depressive disorders, and patients often report feelings of vulnerability which can decrease quality of life. In animal models of pain, observation of behaviours such as thigmotaxis can be used to detect such affective disturbances by exploiting the influence of nociceptive stimuli on the innate behavioural conflict between exploration of a novel space and predator avoidance behaviour. This study investigates whether acute and repeated bladder inflammation in adult female Wistar rats increases thigmotactic behaviour in the open field paradigm, and aims to determine whether this correlates with activation in the central amygdala, as measured by c-Fos immunoreactivity. Additionally, up-regulation of inflammatory mediators in the urinary bladder was measured using RT-qPCR array featuring 92 transcripts to examine how local mediators change under experimental conditions. We found acute but not repeated turpentine inflammation of the bladder increased thigmotactic behaviour (decreased frequency of entry to the inner zone in the open field paradigm, a result that was also observed in the catheter-only instrumentation group. Decreases in locomotor activity were also observed in both models in turpentine and instrumentation groups. No differences were observed in c-Fos activation, although a general increased in activation along the rostro-caudal axis was seen. Inflammatory mediator up-regulation was greatest following acute inflammation, with CCL12, CCL7, and IL-1β significantly up-regulated in both conditions when compared to naïve tissue. These results suggest that acute catheterisation, with or without turpentine inflammation, induces affective alterations detectable in the open field paradigm accompanied by up-regulation of multiple inflammatory mediators.

  3. Effects of comprehensive rehabilitation treatment on female patients with urinary retention in diabetic cystopathy%综合康复治疗对女性糖尿病性膀胱合并尿潴留患者的临床观察

    王磊; 钱余; 姜洋; 吴蓉蓉; 张盛波; 李岷星; 张渝梅

    2014-01-01

    Objective:To observe the effects of comprehensive rehabilitation treatment on female patients with urinary retention in dia-betic cystopathy.Methods:51 female cases with urinary retention in diabetic cystopathy were divided into experimental group(31 cases) and control group(20 cases) , all cases received Oral administration of pyridostigmine bromide 、controlling blood sugar and urinary tract infection,In addition, 31 patients of experimental group were gave comprehensive rehabilitation treatment,which including intramuscular injection of mouse nerve growth factors、intermittent clamp catheters 、bladder exercise plans and running bladder voiding function train-ing,etc.Results:During the 4-weeks of follow-up:at the first 2-weeks intervention,9 patiens restored automatic micturition, and 12 patiens restored automatic micturition after the second 2-weeks intervention in experimental group, the total effective rate was 67.7%.8 patiens restored automatic micturition in control group, the total effective rate was 40%.From the result of follow-up, the efficacy of two groups was significant (p<0.05).Conclusion:The comprehensive rehabilitation treatment on female patients with urinary retention in DCP might be efective .%目的:探讨综合康复治疗对女性糖尿病性膀胱合并尿潴留患者的临床应用效果。方法:共51例女性糖尿病性膀胱合并尿潴留患者,通过口服溴吡斯的明,控制血糖和尿路感染后,随机分实验组31例和对照组20例,实验组采取2周为1个疗程的综合康复治疗:肌注鼠神经生长因子、盆底膀胱锻炼计划及间歇夹管等治疗,拔除导尿管观察患者排尿情况,若患者不能自主排尿,再进行第2疗程治疗,观察患者能否拔导尿管恢复自主排尿。结果:实验组9例患者在第1疗程结束后,拔除导尿管恢复自主排尿,12例患者在第2疗程结束后拔除导尿管能自主排尿,拔管成功率为67.7%;对照组4

  4. Urinary Calprotectin and Posttransplant Renal Allograft Injury

    Bistrup, Claus; Marcussen, Niels; Pagonas, Nikolaos; Seibert, Felix S.; Arndt, Robert; Zidek, Walter; Westhoff, Timm H.

    2014-01-01

    Objective Current methods do not predict the acute renal allograft injury immediately after kidney transplantation. We evaluated the diagnostic performance of urinary calprotectin for predicting immediate posttransplant allograft injury. Methods In a multicenter, prospective-cohort study of 144 incipient renal transplant recipients, we postoperatively measured urinary calprotectin using an enzyme-linked immunosorbent assay and estimated glomerular filtration rate (eGFR) after 4 weeks, 6 months, and 12 months. Results We observed a significant inverse association of urinary calprotectin concentrations and eGFR 4 weeks after transplantation (Spearman r = −0.33; P<0.001). Compared to the lowest quartile, patients in the highest quartile of urinary calprotectin had an increased risk for an eGFR less than 30 mL/min/1.73 m2 four weeks after transplantation (relative risk, 4.3; P<0.001; sensitivity, 0.92; 95% CI, 0.77 to 0.98; specificity, 0.48; 95% CI, 0.31 to 0.66). Higher urinary calprotectin concentrations predicted impaired kidney function 4 weeks after transplantation, as well as 6 months and 12 months after transplantation. When data were analyzed using the urinary calprotectin/creatinine-ratio similar results were obtained. Urinary calprotectin was superior to current use of absolute change of plasma creatinine to predict allograft function 12 months after transplantation. Urinary calprotectin predicted an increased risk both in transplants from living and deceased donors. Multivariate linear regression showed that higher urinary calprotectin concentrations and older donor age predicted lower eGFR four weeks, 6 months, and 12 months after transplantation. Conclusions Urinary calprotectin is an early, noninvasive predictor of immediate renal allograft injury after kidney transplantation. PMID:25402277

  5. Renal scintigraphy in children with first febrile urinary tract infection

    The urinary tract infection is one of the most frequent bacterial infections in the childhood. Two hundred eleven children diagnosed as first febrile urinary tract infection patients were studied and performed Tc-DMSA renal scintigraphy in the acute phase of infection. The results were correlated to the duration and intensity of the fever before the diagnosis, to the acute phase reactants (hemogram, erythrosedimentation and reactive-C protein) and to the results of imaging studies (renal ultrasound and mictional uretrocystography)

  6. Analysis of naltrexone urinary metabolites.

    Ventura, R; de la Torre, R; Segura, J

    1988-01-01

    A reversed-phase HPLC method using ion-pair formation has been developed for the simultaneous determination of naltrexone and three urinary metabolites. The extraction of the free and conjugated metabolites was studied by liquid-solid procedures using styrene-divinylbenzene copolymers (Amberlite XAD-2) and bonded octadecyl silica supports (ODS-silica). Optimum recovery was obtained with ODS-silica extraction using 25% acetonitrile in a 5 mM diammonium phosphate buffer pH 2.1 as elution solvent. The chromatographic behaviour of naltrexone metabolites and naloxone (internal standard) was examined by varying the mobile phase composition. Increments of both the diammonium phosphate buffer concentration and the percentage of organic solvent in the eluent decreases the retention of compounds in a non-linear manner. Increments of the dodecyl sulphate (counter-ion) concentration, increases the retention time. The method was applied to determine the urinary levels of major naltrexone metabolites in a volunteer receiving a 50 mg oral dose. This is the first method reported which permits the simultaneous quantitative determination of naltrexone and its metabolites, 6beta-naltrexol, naltrexone glucuronide and 6beta-naltrexol glucuronide, in urine. PMID:16867358

  7. Urinary calprotectin and posttransplant renal allograft injury

    Tepel, Martin; Borst, Christoffer; Bistrup, Claus;

    2014-01-01

    OBJECTIVE: Current methods do not predict the acute renal allograft injury immediately after kidney transplantation. We evaluated the diagnostic performance of urinary calprotectin for predicting immediate posttransplant allograft injury. METHODS: In a multicenter, prospective-cohort study of 144...... incipient renal transplant recipients, we postoperatively measured urinary calprotectin using an enzyme-linked immunosorbent assay and estimated glomerular filtration rate (eGFR) after 4 weeks, 6 months, and 12 months. RESULTS: We observed a significant inverse association of urinary calprotectin...... concentrations and eGFR 4 weeks after transplantation (Spearman r = -0.33; P<0.001). Compared to the lowest quartile, patients in the highest quartile of urinary calprotectin had an increased risk for an eGFR less than 30 mL/min/1.73 m2 four weeks after transplantation (relative risk, 4.3; P<0.001; sensitivity...

  8. The diagnosis of urinary tract infections in young children (DUTY: protocol for a diagnostic and prospective observational study to derive and validate a clinical algorithm for the diagnosis of UTI in children presenting to primary care with an acute illness

    Downing Harriet

    2012-07-01

    Full Text Available Abstract Background Urinary tract infection (UTI is common in children, and may cause serious illness and recurrent symptoms. However, obtaining a urine sample from young children in primary care is challenging and not feasible for large numbers. Evidence regarding the predictive value of symptoms, signs and urinalysis for UTI in young children is urgently needed to help primary care clinicians better identify children who should be investigated for UTI. This paper describes the protocol for the Diagnosis of Urinary Tract infection in Young children (DUTY study. The overall study aim is to derive and validate a cost-effective clinical algorithm for the diagnosis of UTI in children presenting to primary care acutely unwell. Methods/design DUTY is a multicentre, diagnostic and prospective observational study aiming to recruit at least 7,000 children aged before their fifth birthday, being assessed in primary care for any acute, non-traumatic, illness of ≤ 28 days duration. Urine samples will be obtained from eligible consented children, and data collected on medical history and presenting symptoms and signs. Urine samples will be dipstick tested in general practice and sent for microbiological analysis. All children with culture positive urines and a random sample of children with urine culture results in other, non-positive categories will be followed up to record symptom duration and healthcare resource use. A diagnostic algorithm will be constructed and validated and an economic evaluation conducted. The primary outcome will be a validated diagnostic algorithm using a reference standard of a pure/predominant growth of at least >103, but usually >105 CFU/mL of one, but no more than two uropathogens. We will use logistic regression to identify the clinical predictors (i.e. demographic, medical history, presenting signs and symptoms and urine dipstick analysis results most strongly associated with a positive urine culture result. We will

  9. Best pharmacological practice: urinary tract infections.

    Nicolle, Lindsay

    2003-05-01

    Urinary tract infection is the most frequent bacterial infection. Acute uncomplicated urinary infection and acute non-obstructive pyelonephritis occur in young women with normal genitourinary tracts. Empirical short-course therapy is preferred for the management of acute cystitis, but evolving resistance requires continuing reassessment of optimal antimicrobial selection. Empirical trimethoprim or trimethoprim/sulfamethoxazole has been recommended, but increasing resistance to these agents suggests that pivmecillinam, nitrofurantoin and perhaps fosfomycin trometamol should be considered. Although flouroquinolones are effective as short-course therapy, widespread empirical use of these agents should be discouraged because of potential promotion of resistance. For acute non-obstructive pyelonephritis, flouroquinolones are the empirical oral treatment of choice, although urine culture results should direct continuing therapy. Complicated urinary tract infection occurs in men or women of all ages with underlying abnormalities of the genitourinary tract. Treatment of complicated urinary infection is individualised, taking into consideration the underlying abnormality and susceptibilities of the infecting organism. Asymptomatic bacteriuria should not be treated except in pregnant women, in patients prior to undergoing an invasive surgical procedure, or renal transplant recipients in the early postrenal transplant period. PMID:12739995

  10. Fosfomycin trometamol: a review of its use as a single-dose oral treatment for patients with acute lower urinary tract infections and pregnant women with asymptomatic bacteriuria.

    Keating, Gillian M

    2013-11-01

    Fosfomycin trometamol (fosfomycin tromethamine) [Monuril(®), Monurol(®), Monural(®)] is approved in numerous countries worldwide, mainly for the treatment of uncomplicated urinary tract infections (UTIs). Fosfomycin has good in vitro activity against common uropathogens, such as Escherichia coli (including extended-spectrum β-lactamase-producing E. coli), Proteus mirabilis, Klebsiella pneumoniae and Staphylococcus saprophyticus, and the susceptibility of uropathogens to fosfomycin has remained relatively stable over time. A single oral dose of fosfomycin trometamol 3 g (the approved dosage) achieves high concentrations in urine. Results of recent randomized trials indicate that single-dose fosfomycin trometamol had similar clinical and/or bacteriological efficacy to 3- to 7-day regimens of ciprofloxacin, norfloxacin, cotrimoxazole or nitrofurantoin in women with uncomplicated lower UTIs. In addition, single-dose fosfomycin trometamol had similar bacteriological efficacy to a 5-day course of cefuroxime axetil or a 7-day course of amoxicillin/clavulanic acid in pregnant women with asymptomatic bacteriuria, and similar clinical and/or bacteriological efficacy to a 5-day course of cefuroxime axetil or amoxicillin/clavulanic acid or a 3-day course of ceftibuten in pregnant women with a lower UTI. Single-dose fosfomycin trometamol was generally well tolerated, with gastrointestinal adverse events (e.g. diarrhoea, nausea) reported most commonly. In conclusion, single-dose fosfomycin trometamol is an important option for the first-line empirical treatment of uncomplicated lower UTIs. PMID:24202878

  11. Antibiotic susceptibility and imaging findings of the causative microorganisms responsible for acute urinary tract infection in children: a five-year single center study

    Ji Eun Yoon

    2011-02-01

    Full Text Available Purpose : We studied the differences in the antibiotic susceptibilities of the microorganisms that causeing urinary tract infections (UTI in children to obtain useful information on appropriate drug selection for childhood UTI. Methods : We retrospectively analyzed the antibiotic susceptibilities of 429 microorganisms isolated from 900 patients diagnosed with UTI in the Department of Pediatrics, Chungbuk National University Hospital, from 2003 to 2008. Results : The most common causative microorganisms for UTI were Escherichia coli (81.4%, Klebsiella pneumoniae (8.4%, Enterobacter spp. (1.7%, and Proteus spp. (0.4%. E. coli showed relatively high susceptibility as compared to imipenem (100%, amikacin (97.7%, aztreonam (97.9%, cefepime (97.7%, and ceftriaxone (97.1%, while it showed relatively low susceptibility to gentamicin (GM (79.0%, trimethoprim/sulfamethoxazole (TMP/SMX (68.7%, ampicillin/sulbactam (33.0%, and ampicillin (AMP (28.6%. There were no significant differences in the image findings for causative microorganisms. Conclusion : Gram-negative organisms showed high susceptibility to amikacin and third-generation cephalosporins, and low susceptibility to AMP, GM, and TMP/SMX. Therefore, the use of AMP or TMP/SMX as the first choice in empirical and prophylactic treatment of childhood UTI in Korea should be reconsidered and investigated further.

  12. Urinary Tract Infections (UTIs)

    Full Text Available ... Chronic Kidney Diseases Movie: Urinary System Your Urinary System Bedwetting ... Web site. Note: All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and ...

  13. [Male urinary incontinence

    Boer, TA de; Heesakkers, J.P.F.A.

    2008-01-01

    *Urinary incontinence in males is gaining increasingly more attention. *Male urinary incontinence can be classified as storage incontinence due to overactive bladder syndrome or stress incontinence due to urethral sphincter dysfunction. *Most patients benefit from the currently available treatment o

  14. Urinary Tract Infections (UTIs)

    Full Text Available ... Chronic Kidney Diseases Movie: Urinary System Your Urinary System Bedwetting ... of Use Visit the Nemours Web site. Note: All information on KidsHealth® is for educational purposes only. For ...

  15. Urinary tract infection - adults

    A urinary tract infection, or UTI, is an infection of the urinary tract. The infection can occur at different points in ... al. Diagnosis, prevention, and treatment of catheter-associated ... in adults: 2009 International Clinical Practice Guidelines from ...

  16. Urinary Tract Infections (UTIs)

    Full Text Available ... Español What Other Kids Are Reading Movie: Digestive System Winter Sports: Sledding, Skiing, Snowboarding, Skating Crushes What's ... Urinary Tract? Your urinary tract is actually a system made up of these main parts: two kidneys ...

  17. Urinary Tract Infections (UTIs)

    Full Text Available ... frye -tus), or a kidney infection, and it's serious because it can damage the kidneys and make ... For Parents MORE ON THIS TOPIC Chronic Kidney Diseases Movie: Urinary System Your Urinary System Bedwetting Contact ...

  18. Urinary Tract Infections (UTIs)

    Full Text Available ... in your urinary tract. Let's find out more. What Exactly Is a Urinary Tract? Your urinary tract is actually a system made up ... should see a doctor right away. previous continue What Will the Doctor Do? First, your doctor will ask you questions about your symptoms. ...

  19. Kidneys and Urinary Tract

    ... more common kidney and urinary tract problems include: Congenital problems of the urinary tract. As a fetus develops in the womb, any part of the urinary tract can grow to an abnormal size or in an abnormal ... congenital abnormalities (meaning abnormalities that exist at birth) is ...

  20. Urinary and Rectal Toxicity Profiles After Permanent Iodine-125 Implant Brachytherapy in Japanese Men: Nationwide J-POPS Multi-institutional Prospective Cohort Study

    Ohashi, Toshio, E-mail: ohashi@rad.med.keio.ac.jp [Keio University School of Medicine, Tokyo (Japan); Yorozu, Atsunori; Saito, Shiro [National Hospital Organization Tokyo Medical Center, Tokyo (Japan); Tanaka, Nobumichi [Nara Medical University School of Medicine, Nara (Japan); Katayama, Norihisa [Okayama University School of Medicine, Okayama (Japan); Kojima, Shinsuke; Maruo, Shinichiro; Kikuchi, Takashi [Translational Research Informatics Center, Hyogo (Japan); Dokiya, Takushi [Kyoundo Hospital, Tokyo (Japan); Fukushima, Masanori [Translational Research Informatics Center, Hyogo (Japan); Yamanaka, Hidetoshi [Institutes of Preventive Medicine, Kurosawa Hospital, Gunma (Japan)

    2015-09-01

    Purpose: To assess, in a nationwide multi-institutional cohort study begun in 2005 and in which 6927 subjects were enrolled by 2010, the urinary and rectal toxicity profiles of subjects who enrolled during the first 2 years, and evaluate the toxicity profiles for permanent seed implantation (PI) and a combination therapy with PI and external beam radiation therapy (EBRT). Methods and Materials: Baseline data for 2339 subjects out of 2354 patients were available for the analyses. Toxicities were evaluated using the National Cancer Institute's Common Terminology Criteria for Adverse Events, and the International Prostate Symptom Scores were recorded prospectively until 36 months after radiation therapy. Results: Grade 2+ acute urinary toxicities developed in 7.36% (172 of 2337) and grade 2+ acute rectal toxicities developed in 1.03% (24 of 2336) of the patients. Grade 2+ late urinary and rectal toxicities developed in 5.75% (133 of 2312) and 1.86% (43 of 2312) of the patients, respectively. A higher incidence of grade 2+ acute urinary toxicity occurred in the PI group than in the EBRT group (8.49% vs 3.66%; P<.01). Acute rectal toxicity outcomes were similar between the treatment groups. The 3-year cumulative incidence rates for grade 2+ late urinary toxicities were 6.04% versus 4.82% for the PI and the EBRT groups, respectively, with no significant differences between the treatment groups. The 3-year cumulative incidence rates for grade 2+ late rectal toxicities were 0.90% versus 5.01% (P<.01) for the PI and the EBRT groups, respectively. The mean of the postimplant International Prostate Symptom Score peaked at 3 months, but it decreased to a range that was within 2 points of the baseline score, which was observed in 1625 subjects (69.47%) at the 1-year follow-up assessment. Conclusions: The acute urinary toxicities observed were acceptable given the frequency and retention, and the late rectal toxicities were more favorable than those of other

  1. Urinary and Rectal Toxicity Profiles After Permanent Iodine-125 Implant Brachytherapy in Japanese Men: Nationwide J-POPS Multi-institutional Prospective Cohort Study

    Purpose: To assess, in a nationwide multi-institutional cohort study begun in 2005 and in which 6927 subjects were enrolled by 2010, the urinary and rectal toxicity profiles of subjects who enrolled during the first 2 years, and evaluate the toxicity profiles for permanent seed implantation (PI) and a combination therapy with PI and external beam radiation therapy (EBRT). Methods and Materials: Baseline data for 2339 subjects out of 2354 patients were available for the analyses. Toxicities were evaluated using the National Cancer Institute's Common Terminology Criteria for Adverse Events, and the International Prostate Symptom Scores were recorded prospectively until 36 months after radiation therapy. Results: Grade 2+ acute urinary toxicities developed in 7.36% (172 of 2337) and grade 2+ acute rectal toxicities developed in 1.03% (24 of 2336) of the patients. Grade 2+ late urinary and rectal toxicities developed in 5.75% (133 of 2312) and 1.86% (43 of 2312) of the patients, respectively. A higher incidence of grade 2+ acute urinary toxicity occurred in the PI group than in the EBRT group (8.49% vs 3.66%; P<.01). Acute rectal toxicity outcomes were similar between the treatment groups. The 3-year cumulative incidence rates for grade 2+ late urinary toxicities were 6.04% versus 4.82% for the PI and the EBRT groups, respectively, with no significant differences between the treatment groups. The 3-year cumulative incidence rates for grade 2+ late rectal toxicities were 0.90% versus 5.01% (P<.01) for the PI and the EBRT groups, respectively. The mean of the postimplant International Prostate Symptom Score peaked at 3 months, but it decreased to a range that was within 2 points of the baseline score, which was observed in 1625 subjects (69.47%) at the 1-year follow-up assessment. Conclusions: The acute urinary toxicities observed were acceptable given the frequency and retention, and the late rectal toxicities were more favorable than those of other

  2. Approach to urinary tract infections.

    Najar, M S; Saldanha, C L; Banday, K A

    2009-10-01

    Urinary tract infection (UTI) is the most common infection experienced by humans after respiratory and gastro-intestinal infections, and also the most common cause of both community-acquired and nosocomial infections for patients admitted to hospitals. For better management and prognosis, it is mandatory to know the possible site of infection, whether the infection is uncomplicated or complicated, re-infection or relapse, or treatment failure and its pathogenesis and risk factors. Asymptomatic bacteriuria is common in certain age groups and has different connotations. It needs to be treated and completely cured in pregnant women and preschool children. Reflux nephropathy in children could result in chronic kidney disease; otherwise, urinary tract infections do not play a major role in the pathogenesis of end-stage renal disease. Symptomatic urinary tract infections occur most commonly in women of child-bearing age. Cystitis predominates, but needs to be distinguished from acute urethral syndrome that affects both sexes and has a different management plan than UTIs. The prostatitis symptoms are much more common than bacterial prostatic infections. The treatment needs to be prolonged in bacterial prostatitis and as cure rates are not very high and relapses are common, the classification of prostatitis needs to be understood. The consensus conference convened by National Institute of Health added two more groups of patients, namely, chronic prostatitis/chronic pelvic pain syndrome and asymptomatic inflammatory prostatitis, in addition to acute and chronic bacterial prostatitis. Although white blood cells in urine signify inflammation, they do not always signify UTI. Quantitative cultures of urine provide definitive evidence of UTI. Imaging studies should be done 3-6 weeks after cure of acute infection to identify abnormalities predisposing to infection or renal damage or which may affect management. Treatment of cystitis in women should be a three-day course and if

  3. [Urinary infection in the pregnant woman].

    Delcroix, M; Zone, V; Cheront, C; Adam, M H; Duquesne, G; Noel, A M

    1994-05-01

    Urinary tract infections are common during pregnancy. When unrecognized, they can be responsible for complications such as threatened premature labour and impaired intra-uterine development. Detection and appropriate treatment are thus essential. This article reviews the pathophysiology of urinary tract infections during pregnancy and the three major entities involved--different but related to each other--are detailed (significant asymptomatic bacteriuria or SAB, acute cystitis and acute pyelonephritis), together with their specific treatment. SAB tends to persist during pregnancy, then leading in the absence of treatment to a potentially serious complication (acute pyelonephritis) in approximately one woman in five. SAB should be sought at the first prenatal visit by microscopic and bacteriological examination of a properly obtained urine specimen. Lower genital infections should also be sought and treated, without forgetting to remind the patient of preventive measures (adequate hygiene, sufficient urine output, post-coital micturition, regular bowel habit). PMID:8036390

  4. Prevalência e fatores preditivos de retenção urinária diagnosticada por ultrassonografia no período pós-anestésico imediato Prevalencia y factores predictivos de retención urinaria diagnosticada por ultrasonido en el período postanestésico inmediato Prevalence and predictive factors of urinary retention assessed by ultrasound in the immediate post-anesthetic period

    Adilson José Dal Mago

    2010-08-01

    factores independientes de previsión para su aparecimiento. MÉTODO: Doscientos cincuenta y siete pacientes admitidos en la SRPA fueron prospectivamente incluidos en el estudio. Las variables recolectadas incluyeron: edad, sexo, estado físico, local de la cirugía, tipo de anestesia, tiempos quirúrgico y anestésico, uso o no de opioides, volumen de fluidos administrados, e historial previo de síntomas urinarios. Las medidas del volumen vesical fueron realizadas por ultrasonido, en la entrada y en el alta de la SRPA. El criterio para caracterizar la retención urinaria fue el volumen vesical igual o mayor que 600 mL, asociado a la incapacidad de micción espontánea 30 minutos después del diagnóstico. Los análisis univariados y multivariados fueron utilizados para identificar los factores predictivos independientes. RESULTADOS: Ocurrió una retención urinaria en 19 pacientes (7,39%. Los factores predictivos independientes identificados fueron el volumen urinario igual o mayor que 360 mL en la admisión a la SRPA (Cui-cuadrado de Mantel-Haenszel (1 gl. = 18,76; p BACKGROUND AND OBJECTIVES: Urinary retention is a common condition in the post-anesthetic care unit (PACU. Vesical overdistension and consequent damage of the detrusor muscle of the urinary bladder represent situations that can be prevented. The ultrasound allows the reliable measurement of the urinary volume, determining the prevalence of postoperative vesical distension. The objective of the present study was to determine the prevalence of postoperative urinary retention and identify independent predictive factors. METHODS: Two-hundred and fifty-seven patients admitted to the PACU were included prospectively in this study. Parameters collected included: age, gender, physical status, site of surgery, type of anesthesia, time of the surgery and anesthesia, use of opioids, volume of fluids administered, and history of urinary symptoms. Vesical volumes were measured by ultrasound after admission and upon

  5. Native and contrast-radiographic examination of the urinary tract

    Govorčin Mira

    2005-01-01

    Full Text Available Introduction Plain x-rays and contrast urography are important for diagnosing urinary tract diseases. The first plain film of the urinary tract was made in 1896, and the first tests using contrasts started in 1904. Excretory urography has been used since 1930. Plain film of the urinary tract Plain films of the urinary tract are used in the kidney area, the area of the ureter and urinary bladder. They also show structures (lumbar and sacral spine and pelvis, muscles (m. iliopsoas as well as calculi. Excretory urography X-ray visualization of the urinary tract with contrast substances is intravenous urography. It is used for diagnosing diseases of the upper urinary system with symptoms such as: pain, colic, hydronephrosis, as well as acute cortical infections, urinary bladder tumors, etc. Retrograde urography Retrograde urography is a procedure recommended when either the pyelocalyx system or the ureter are not seen unilaterally or bilaterally. Cystography and urethrocystography Cystography is used to visualize the bladder. It is recommended in case of intravesical obstruction. Urethrocystography is a technique for investigation of the anterior and prostatic urethra as well as the neck of the urinary bladder. Conclusion Plain film of the urinary tract, excretory urography, retrograde pyelography, cystography and urethrocystography, used along with ultrasonography, computerized tomography and magnetic resonance, are useful diagnostic procedures which provide accurate diagnosis and effective treatment.

  6. The role of urinary peptidomics in kidney disease research.

    Klein, Julie; Bascands, Jean-Loup; Mischak, Harald; Schanstra, Joost P

    2016-03-01

    Urinary peptidomics focuses on endogenous urinary peptide content. Many studies now show the usefulness of this approach for the discovery and validation of biomarkers in kidney diseases that are as varied as chronic kidney disease, acute kidney injury, congenital anomalies of the kidney and the urinary tract, and polycystic kidney disease. Most studies focus on chronic kidney disease and demonstrate that urinary peptidome analysis can substantially contribute to early detection and stratification of patients with chronic kidney disease. A number of multicenter studies are ongoing that aim further validation in a clinical setting and broaden the applicability of urinary peptides. The association of urinary peptides with kidney disease also starts to deliver information on the pathophysiology of kidney disease with emphasis on extracellular matrix remodeling. Bioinformatic peptide centric tools have been developed that allow to model the changes in protease activity involved in kidney disease, based on the urinary peptidome content. A novel application of urinary peptidome analysis is the back-translation of results obtained in humans to animals for animal model validation and improvement of readout in these preclinical models. In conclusion, urinary peptidomics not only contribute to detection and stratification of kidney disease in the clinic, but might also create a new impulse in drug discovery through better insight in the pathophysiology of disease and optimized translatability of animal models. PMID:26880450

  7. Microdistribution and Long-Term Retention of 239Pu (NO3)4 in the Respiratory Tracts of an Acutely Exposed Plutonium Worker and Experimental Beagle Dogs

    Nielsen, Christopher E.; Wilson, Dulaney A.; Brooks, Antone L.; McCord, Stacey; Dagle, Gerald E.; James, Anthony C.; Tolmachev, Sergei Y.; Thrall, Brian D.; Morgan, William F.

    2012-11-01

    The long-term retention of inhaled soluble forms of plutonium raises concerns as to the potential health effects in persons working in nuclear energy or the nuclear weapons program. The distributions of long-term retained inhaled plutonium-nitrate [239Pu (NO3)4] deposited in the lungs of an accidentally exposed nuclear worker (Human Case 0269) and in the lungs of experimentally exposed beagle dogs with varying initial lung depositions were determined via autoradiographs of selected histological lung, lymph node, trachea, and nasal turbinate tissue sections. These studies showed that both the human and dogs had a non-uniform distribution of plutonium throughout the lung tissue. Fibrotic scar tissue effectively encapsulated a portion of the plutonium and prevented its clearance from the body or translocation to other tissues and diminished dose to organ parenchyma. Alpha radiation activity from deposited plutonium in Human Case 0269 was observed primarily along the sub-pleural regions while no alpha activity was seen in the tracheobronchial lymph nodes of this individual. However, relatively high activity levels in the tracheobronchial lymph nodes of the beagles indicated the lymphatic system was effective in clearing deposited plutonium from the lung tissues. In both the human case and beagle dogs, the appearance of retained plutonium within the respiratory tract was inconsistent with current biokinetic models of clearance for soluble forms of plutonium. Bound plutonium can have a marked effect on the dose to the lungs and subsequent radiation exposure has the potential increase in cancer risk.

  8. Urinary Tract Imaging

    Rowley, V. Allen

    1986-01-01

    This article reviews the current imaging investigations usually required in the work-up of common urinary tract problems such as urinary tract infection, colic, trauma, hematuria and renal failure. Radiological therapeutic techniques such as percutaneous nephrostomy for drainage of obstructed systems and percutaneous nephrolithotomy for treatment of renal calculi are briefly mentioned. The virtual elimination of percutaneous or open surgery for renal and upper urinary tract stones, resulting ...

  9. Continent Urinary Diversion

    Moon, Andrew; Vasdev, Nikhil; Thorpe, Andrew C

    2013-01-01

    We present a review on the current options for continent urinary diversion and their different indications on the basis of patient selection. In current clinical practice continent urinary diversion is being used world-wide in patients undergoing radical cystectomy and in severe cases of benign bladder pathologies. We also discuss the specific complications of continent urinary diversion and highlight the need to rigorously monitor these patients in the long- term specifically in terms of the...

  10. Managing retention.

    Carter, Tony

    2007-01-01

    To build this process it is necessary to consult customers for preferences, build familiarity and knowledge to build a relationship and conduct business in a customized fashion. The process takes every opportunity to build customer satisfaction with each customer contact. It is an important process to have, since customers today are more demanding, sophisticated, educated and comfortable speaking to the company as an equal (Belk, 2003). Customers have more customized expectations so they want to be reached as individuals (Raymond and Tanner, 1994). Also, a disproportionate search for new business is costly. The cost to cultivate new customers is more than maintaining existing customers (Cathcart, 1990). Other reasons that customer retention is necessary is because many unhappy customers will never buy again from a company that dissatisfied them and they will communicate their displeasure to other people. These dissatisfied customers may not even convey their displeasure but without saying anything just stop doing business with that company, which may keep them unaware for some time that there is any problem (Cathcart, 1990). PMID:18453139

  11. Elimination of biliary stones through the urinary tract: a complication of the laparoscopic cholecystectomy

    Castro Maurício Gustavo Bravim de

    1999-01-01

    Full Text Available The introduction and popularization of laparoscopic cholecystectomy has been accompanied with a considerable increase in perforation of gallbladder during this procedure (10%--32%, with the occurrence of intraperitoneal bile spillage and the consequent increase in the incidence of lost gallstones (0.2%--20%. Recently the complications associated with these stones have been documented in the literature. We report a rare complication occurring in an 81-year-old woman who underwent laparoscopic cholecystectomy and developed cutaneous fistula to the umbilicus and elimination of biliary stones through the urinary tract. During the cholecystectomy, the gall bladder was perforated, and bile and gallstones were spilled into the peritoneal cavity. Two months after the initial procedure there was exteriorization of fistula through the umbilicus, with intermittent elimination of biliary stones. After eleven months, acute urinary retention occurred due to biliary stones in the bladder, which were removed by cystoscopy. We conclude that efforts should be concentrated on avoiding the spillage of stones during the surgery, and that no rules exist for indicating a laparotomy simply to retrieve these lost gallstones.

  12. PREVALENCE OF URINARY TRACT INFECTION IN PREGNANT W OMEN

    Nawaz; Siddesh; Sirwar

    2012-01-01

    ABSTRACT: Urinary tract infection is one of the most frequen tly seen medical complications in pregnancy. UTI in pregnancy is an important concern, as it possesses risk of complications such as acute and chronic pyelonephritis, toxaemia, anaemi a, hypertension, intrauterine growth retardation and increased perinatal mortality. The detection of bacteriuria allows an approach to be made for the prevention of chronic urinary dis ease in ...

  13. Engineering out the risk for infection with urinary catheters.

    Maki, D G; Tambyah, P.A.

    2001-01-01

    Catheter-associated urinary tract infection (CAUTI) is the most common nosocomial infection. Each year, more than 1 million patients in U.S. acute-care hospitals and extended-care facilities acquire such an infection; the risk with short-term catheterization is 5% per day. CAUTI is the second most common cause of nosocomial bloodstream infection, and studies suggest that patients with CAUTI have an increased institutional death rate, unrelated to the development of urosepsis. Novel urinary ca...

  14. Effects of human urinary kallidinogenase in the treatment of acute cere-bral infarction%人尿激肽原酶治疗急性缺血性脑卒中的效果

    赵志斌

    2014-01-01

    Objective To evaluate the effects of human urinary kallidinogenase in the treatment of acute cerebral in-farction, in order to provide a better way for acute cerebral infarction treatment. Methods 120 patients with acute cere-bral infarction from December 2011 to December 2013 in the Central Hospital of Panjin City were selected and divided into two groups, each group had 60 cases. Patients in the control group were given treatment including reasonable se-lection of mannitol for reducing intracranial pressure, Aspirin for anti-platelet aggregation, prevention of complications, necessary nutritional support, rehabilitation therapy and other conventional treatment. Patients in the treatment group were given urinary kallidinogenase 0.15 PNAu joined in 250 mL of normal saline intravenously once a day for 14 d, on the basis of the control group. The treatment efficacy, neurological deficit score (NIHSS) before and after treatment, live ability after treatment, the recurrence and adverse reactions after treatment were observed in the two groups. Results In the treatment group 17 cases had cured, 31 cases had significant progress, 10 cases had progress, 2 cases had invalid, no one had deteriorate, the total effective rate was 96.67%; while in the control group, there were 12, 21, 8, 16 and 3 cases retrospectively, the total effective rate was 68.33%; the difference between the two groups in the total effective rate was statistically significant (P<0.05). After 14 days of treatment, NIHSS score [(7.06±3.64) scores] in the treat-ment group was significantly lower than that of before treatment [(15.03±5.77) scores] and the control group after treat-ment [(9.85±4.35) scores], the differences were statistically significant (P<0.05). After treatment activities of daily liv-ing score in the treatment group [(58.4±5.6) scores] was significantly higher than that of before treatment [(38.7±6.3) scores] and the control group after treatment [(43.3±5.4) scores], the differences

  15. Is urinary drainage necessary during continuous epidural analgesia after colonic resection?

    Basse, L; Werner, M; Kehlet, H

    2000-01-01

    . METHODS: This is a prospective, uncontrolled study with well-defined general anesthesia, postoperative analgesia, and nursing care programs in patients with a planned 2-day hospital stay, urinary catheter removal on the first postoperative morning, and epidural catheter removal on the second postoperative...... and, subsequently, for cystitis and left-sided epididymitis. Three patients had uncomplicated urinary infection. No patients had urological complaints at 30 days follow-up (95% confidence limit, 0% to 3.6%). CONCLUSION: The low incidence of urinary retention (9%) and urinary infection (4%) suggests...

  16. Bladder Dysfunction and Urinary Incontinence

    F. faizi

    2009-01-01

    . "nIn a healthy adult, the PMC functions as an on-off switch that is activated by stretch receptors in the bladder wall and is, in turn, modulated by inhibitory and excitatory neurologic influences from the brain. When the bladder is full, the stretch receptors are activated. The individual perceives the activation of the stretch receptors as the bladder being full, which signals a need to void. "nWhen an individual cannot find a bathroom nearby, the brain bombards the PMC with a multitude of inhibitory signals to prevent detrusor contractions. At the same time, an individual may actively contract the levator muscles to keep the external sphincter closed or initiate distracting techniques to suppress urination. "nThus, the voiding process requires coordination of both the ANS and somatic nervous system, which are in turn controlled by the PMC located in the brainstem. "nPathophysiology: "nIf a problem occurs within the nervous system, the entire voiding cycle is affected. Any part of the nervous system may be affected, including the brain, pons, spinal cord, sacral cord, and peripheral nerves. A dysfunctional voiding condition results in different symptoms, ranging from acute urinary retention to an overactive bladder or to a combination of both. "nUrinary incontinence results from a dysfunction of the bladder, the sphincter, or both. Bladder overactivity (spastic bladder is associated with the symptoms of urge incontinence, while sphincter underactivity (decreased resistance results in symptomatic stress incontinence. A combination of detrusor overactivity and sphincter underactivity may result in mixed symptoms. "nBrain lesion: "nLesions of the brain above the pons destroy the master control center, causing a complete loss of voiding control. The voiding reflexes of the lower urinary tract—the primitive voiding reflex—remain intact. Affected individuals show signs of urge incontinence, or spastic bladder (medically termed detrusor hyperreflexia or overactivity

  17. Urinary Tract Infections (UTIs)

    Full Text Available ... might have the feeling that you need to go to the bathroom all the time. And when you do, phew! Your pee smells bad. These changes occur because bacteria have caused an infection somewhere in your urinary tract. Let's find out more. What Exactly Is a Urinary ...

  18. Urinary Tract Infections

    ... can usually be found and treated before the kidneys become infected. If your doctor treats a urinary tract infection early and ... Tips on preventing urinary tract infections Drink plenty of water to flush out bacteria. Drinking cranberry juice may also help ...

  19. Urinary Tract Infections (UTIs)

    Full Text Available ... Dictionary of Medical Words En Español What Other Kids Are Reading Movie: Digestive System Winter Sports: Sledding, ... a Booger? Urinary Tract Infections (UTIs) KidsHealth > For Kids > Urinary Tract Infections (UTIs) Print A A A ...

  20. Place of non-contrast computed tomography for evaluation of flank pain and suspected urinary stone in emergency service

    İsmail Şalk

    2014-03-01

    Full Text Available Aim. With an intent to present our experience with the non-contrast computed tomography (CT during the work-up of patients admitted with acute urinary complaints in the emergency service, we reviewed our clinical and non-contrast CT imaging data of patients presented with flank pain and suspected urinary stone. Methods. Clinical and non-contrast CT with ultrasound examinations performed at our Emergency and Radiology Departments in 2011 were reviewed retrospectively in 102 adult urinary stone patients in acute conditions. Results. In 102 patients with suspected urinary stones, 95 had urinary stones detected with non-contrast CT. Ultrasonography provided helpful findings for the evaluation of calyceal dilatation and hydronephrosis. There was no specific side and level preference of urinary stones in the urinary tract. There was no hydronephrosis in for the percent of urinary stone patients. The BUN and creatinine levels in the patients with multiple urinary stones were higher than those in the patients with single urinary stones (p<0.05. Although single urinary stone was more common, overall there was no specific propensity of single and multiple urinary stones to kidney, ureter, and bladder. Conclusions. In this study, we attempted to reveal the efficacy of non-contrast CT during the diagnosis of urinary stones in patients presenting to the Emergency Department in acute conditions. According to our findings, non-contrast CT with ultrasound is diagnostic modality for patients with urinary stones in the Emergency Department. Further studies are needed to shed light on the long-term effects of the choice of this pathway on the clinicoradiologic diagnosis of urinary stone patients. According to our findings, non-contrast CT with ultrasound is diagnostic modality for patients with urinary stones in the Emergency Department. Further studies are needed to shed light on the long-term effects of the choice of this pathway on the outcome of urinary stone

  1. Transurethral convective water vapor as a treatment for lower urinary tract symptomatology due to benign prostatic hyperplasia using the Rezūm® system: evaluation of acute ablative capabilities in the human prostate

    Dixon CM

    2015-01-01

    Full Text Available Christopher M Dixon,1 Edwin Rijo Cedano,2 Lance A Mynderse,3 Thayne R Larson4 1Lenox Hill Hospital, New York, NY, USA; 2Department of Urology, Clinica Canela, La Romana, Dominican Republic; 3Department of Urology, Mayo Clinic, Rochester, MN, USA; 4Institute of Medical Research, Scottsdale, AZ, USA Background: The purpose of this study was to assess the acute ablative characteristics of transurethral convective water vapor (steam using the Rezūm® system in men with benign prostatic hyperplasia through histologic and radiographic studies. Methods: Seven patients were treated with transurethral intraprostatic injections of sterile steam under endoscopic visualization followed by previously scheduled adenectomies. The extirpated adenomas were grossly examined followed by whole mount sectioning and staining with triphenyl-tetrazolium chloride (TTC to evaluate thermal ablation. Histology was performed after hematoxylin and eosin staining on one prostate. After review of results from the first patient cohort, an additional 15 patients with clinical benign prostatic hyperplasia were treated followed by gadolinium-enhanced magnetic resonance imaging (MRI at one week. Results: In the first patient cohort, gross examination of TTC-stained tissue showed thermal ablation in the transition zone. In addition, there was a distinct interface between viable and necrotic prostatic parenchyma. Histopathologic examination revealed TTC staining-outlined necrotic versus viable tissue. Gadolinium-enhanced MRIs in the cohort of 15 patients demonstrated lesion defects in all patients at 1 week post-procedure. Coalesced lesions were noted with a mean (± standard deviation lesion volume of 9.6±8.5 cm3. The largest lesion volume was 35.1 cm3. Ablation using vapor was rapid and remained confined to the transition zone, consistent with the thermodynamic principles of convective thermal energy transfer. Conclusion: Thermal ablation was observed in all specimens. The

  2. Radiographic and ultrasonographic evaluation of the upper urinary tract diseases in dogs: 22 cases

    TEMİZSOYLU, Mustafa Doğa; BUMİN, Ali; KAYA, Mahir; ALKAN, Zeki

    2006-01-01

    The objectives of the present study were to describe the complementary use of radiography and ultrasonography in the diagnosis of upper urinary tract disorders in dogs, and to compare ultrasonographic findings with the survey and contrast radiographic findings in the evaluation of canine upper urinary tract diseases. The study materials were composed of 22 dogs of various breed, age, and sex with upper urinary tract diseases. Pyelonephritis (9 cases), acute renal failure (7 cases), policystic...

  3. Auditing urinary catheter care.

    Dailly, Sue

    Urinary catheters are the main cause of hospital-acquired urinary tract infections among inpatients. Healthcare staff can reduce the risk of patients developing an infection by ensuring they give evidence-based care and by removing the catheter as soon as it is no longer necessary. An audit conducted in a Hampshire hospital demonstrated there was poor documented evidence that best practice was being carried out. Therefore a urinary catheter assessment and monitoring tool was designed to promote best practice and produce clear evidence that care had been provided. PMID:22375340

  4. Origin of Urinary Oxalate

    Holmes, Ross P.; Knight, John; Assimos, Dean G.

    2007-04-01

    Urinary oxalate is mostly derived from the absorption of ingested oxalate and endogenous synthesis. The breakdown of vitamin C may also contribute small amounts to the urinary oxalate pool. The amount of oxalate absorbed is influenced by the oxalate content of the diet, the concentrations of divalent cations in the gut, the presence of oxalate-degrading organisms, transport characteristics of the intestinal epithelium, and other factors associated with the intestinal environment. Knowledge of pathways associated with endogenous oxalate synthesis is limited. Urinary oxalate excretion can be modified using strategies that limit dietary oxalate absorption and the ingestion of oxalogenic substrates such as hydroxyproline.

  5. Asymptomatic acute pyelonephritis as a cause of acute renal failure in the elderly.

    Woodrow, G; Patel, S.; Berman, P; Morgan, A G; Burden, R. P.

    1993-01-01

    Urinary tract infections in the elderly are common, often asymptomatic and usually benign. We report three patients who presented with acute renal failure due to acute pyelonephritis in the absence of clinical findings of infection or urinary tract obstruction. Blood and urine cultures grew Escherichia coli in two of the patients and in two patients renal biopsy confirmed acute pyogenic pyelonephritis. Antimicrobial therapy and haemodialysis led to improvement, though one patient subsequently...

  6. Unlocking the code: mining the urinary proteome after renal transplantation.

    Endre, Zoltan H; Fernando, Mangalee

    2016-06-01

    Diagnosis of transplant dysfunction usually requires kidney biopsy. Sidgel et al. compared urinary proteomics with matched kidney biopsies to develop a biomarker panel to differentiate acute rejection, BK viral nephropathy, and chronic allograft nephropathy. The results suggest that monitoring a panel of urinary peptides may ultimately facilitate noninvasive diagnosis and management of common transplant complications. PMID:27181772

  7. Urinary Tract Infections (UTIs)

    Full Text Available ... Urinary Tract Troubles Girls are more likely than boys to get a UTI. That's because their urethras are much shorter than boys' urethras. The shorter urethra means bacteria can get ...

  8. Pediatric Urinary Tract Infection

    SBA National Resource Center: 800-621-3141 Pediatric Urinary Tract Infections and Catheterization in Children with Neurogenic Bladder and Bowel Why is it important to begin urologic care in infancy and ...

  9. Reoperation for urinary incontinence

    Foss Hansen, Margrethe; Lose, Gunnar; Kesmodel, Ulrik Schiøler;

    2016-01-01

    BACKGROUND: The synthetic midurethral slings were introduced in the 1990s and were rapidly replaced the Burch colposuspension as the gold standard treatment for urinary incontinence. It has been reported that the retropubic midurethral tape has an objective and subjective cure rate of 85% at 5...... years of follow-up, but the rate of reoperation after retropubic midurethral tape at the long-term follow-up is less well described. The existing literature specifies an overall lifetime rate of reoperation of about 8-9% after an initial operation for urinary incontinence. There are, however......, conflicting statements about the risk of reoperation after specific surgical procedures for urinary incontinence. OBJECTIVE: The objective of the study was to describe the cumulative incidence of reoperation within a 5 year period after different types of surgical procedures for urinary incontinence based...

  10. Urinary incontinence - retropubic suspension

    ... or in your abdomen above your pubic bone (suprapubic catheter). The catheter is used to drain urine from ... Instructions Kegel exercises - self-care Self catheterization - female Suprapubic catheter care Urinary catheters - what to ask your doctor ...

  11. Urinary Tract Infections (UTIs)

    Full Text Available ... System Your Urinary System Bedwetting Contact ... Web site. Note: All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and ...

  12. Urinary Tract Infections (UTIs)

    Full Text Available ... Your pee smells bad. These changes occur because bacteria have caused an infection somewhere in your urinary ... shorter than boys' urethras. The shorter urethra means bacteria can get up into the bladder more easily ...

  13. Urinary Tract Infections (UTIs)

    Full Text Available ... a UTI. The doctor also can choose to send the urine sample to a lab for testing. ... Your Urinary System Bedwetting Contact Us Print Resources Send to a friend Reprint Guidelines Sign up for ...

  14. Urinary incontinence - injectable implant

    Injectable implants are injections of material into the urethra to help control urine leakage ( urinary incontinence ) caused by a ... into the tissue next to the sphincter. The implant procedure is usually done in the hospital. Or ...

  15. Urinary Tract Infections (UTIs)

    Full Text Available ... Problems of Grown Ups People, Places & Things That Help Feelings Q&A Movies & More Quizzes Kids' Dictionary ... ll never want to have one again! To help keep those bacteria out of your urinary tract, ...

  16. Concurrent acute disseminated encephalomyelitis and Guillain-Barré syndrome in a child

    Isha S Deshmukh

    2015-01-01

    Full Text Available Acute disseminated encephalomyelitis (ADEM and Guillain-Barrι syndrome (GBS are distinct demyelinating disorders that share an autoimmune pathogenesis and prior history of viral infection or vaccination. Our patient is a 10 years with acute flaccid paralysis, quadriparesis (lower limbs affected more than upper limbs, generalized areflexia and urinary retention. He had difficulty in speech and drooling of saliva. He also presented with raised intracranial pressure with papilledema; then bilateral optic neuritis developed during the later course of illness. Based on the temporal association and exclusion of alternative etiologies, diagnosis of the association between ADEM and GBS was made. Electro-diagnosis (electromyography-nerve conduction velocity and magnetic resonance imaging study supported our diagnosis. He improved remarkably after treatment with intravenous immunoglobulin and intravenous methylprednisolone.

  17. Acute pancreatitis

    Al Mofleh Ibrahim

    1997-01-01

    Full Text Available The past few years have witnessed a tremendous progress in our knowledge regarding the pathogenesis, diagnosis, prognostic evaluation and classification of acute pancreatitis. The role of ischemia, lysosomal enzymes, oxygen free radicals, polymorphnuclear cells-byproducts and inflammatory mediators in the pathogenesis of pancreatic necrosis and multiple organ failure has been emphasized. Furthermore, the recent knowledge about agents infecting pancreatic necrosis, routes of infection, bacteriological examination of fine needle aspirate and appropriate antibiotics have changed the concept of acute pancreatitis. New diagnostic tests such as rapid urinary trypsinogen-2 test and inflammatory mediators including polymorphnuclear elastase, C-reactive protein and interleukin-6 contribute to early diagnosis, prognostic evaluation and initiation of an appropriate therapy.

  18. Urinary catheterization in gynecological surgery: When should it be removed?

    Adly N.A. Fattah

    2013-08-01

    Full Text Available Background: The aim of this study was to determine the most appropriate time for urinary catheter removal following a gynecological surgery.Methods: Critical appraisal of clinical trial articles were conducted. It was aimed to answer our clinical question whether 24-hour postoperative urinary catheter removal is superior compared to other durations in avoiding postoperative urinary retention (PUR and urinary tract infection (UTI. The search was conducted on the Cochrane Library® and PubMed® using keywords “postoperative urinary retention”, “postoperative catheterization” and “urinary retention AND catheterization”. Reference lists of relevant articles were searched for other possibly relevant trials.Results: Seven articles were available as full text, then appraisals of six prospective RCTs involving 846 women underwent hysterectomy and vaginal prolapse surgery were performed finding at the re-catheterization and UTI rate. Subjects in earlier-removal groups were 3 to 4 times more likely to have re-catheterization (OR = 3.10-4.0 compared to later-removal groups, while they who have it removed on 5th day were 14 times more likely to develop UTI compared with immediate group (OR = 14.786, 95% CI 3.187- 68.595.Conclusion: The 24-hour catheterization policy in hysterectomy and vaginal prolapse surgery remains most appropriate although associated with an increased risk of re-catheterization. The removal of catheter before 24 hour (6 or 12 hour could be considered to be used as one of interventions in further RCT(s to find out the best duration which would result in lowest incidence in both of UTI and  PUR. (Med J Indones. 2013;22:183-8. doi: 10.13181/mji.v22i3.589Keywords: Catheter, hysterectomy, prolapse, urinary tract infection

  19. Fasting and Urinary Stones

    Ali Shamsa

    2013-01-01

    Introduction: Fasting is considered as one of the most important practices of Islam, and according to Prophet Mohammad, fasting is obligatory upon Muslims. The aim of this study is to evaluate the effects of fasting on urinary stones. Materials and Methods: Very few studies have been carried out on urinary stones and the effect of Ramadan fasting. The sources of the present study are Medline and articles presented by local and Muslim researchers. Meanwhile, since we are acquainted ...

  20. [Urinary tract infections].

    Hörl, W H

    2011-09-01

    Urinary tract infections occur very frequently in the community and in hospitalized patients and are mainly caused by Escherichia (E.) coli. Depending on virulence determinants of uropathogenic microorganisms and host-specific defense mechanisms, urinary tract infections can manifest as cystitis, pyelonephritis (bacterial interstitial nephritis), bacteremia or urosepsis. Uncomplicated urinary tract infections in otherwise healthy women should be treated for 3-7 days depending on the antibiotic therapy chosen, even if spontaneous remission rates of up to 40% have been reported. Antibiotics of the first choice for empirical treatment of uncomplicated urinary tract infection are fluoroquinolones, pivmecillinam and fosfomycin. A huge problem is the increasing antimicrobial resistance of uropathogenic microorganisms. Complicated urinary tract infections associated with anatomical and/or functional abnormalities of the urinary tract and/or comorbidities such as diabetes or immunosuppressive therapy, need longer antibiotic treatment (e.g. 10-14 days) as well as interdisciplinary diagnostic procedures. Treatment of community acquired urosepsis includes cephalosporins of the third generation, piperacillin/tazobactam or ciprofloxacin. For nosocomial urosepsis the combination with an aminoglycoside or a carbapenem is recommended. PMID:21850538

  1. Acute Autonomic, Sensory and Motor Neuropathy Associated with Meningoencephalitis

    Satoko Kinoshita

    2009-01-01

    Full Text Available We report the first case of acute autonomic, motor and sensory neuropathy (AASMN associated with meningoencephalitis. A 62-year-old man presented with fever, neck stiffness, and coma. Respiratory failure developed. Magnetic resonance images showed an abnormality in the medial temporal lobe. Cerebrospinal fluid analysis revealed pleocytosis with a high protein level. Intensive care gradually improved the consciousness level, but paralysis of the four extremities persisted. Nerve conduction studies revealed demyelinating sensory and motor polyneuropathy. Severe orthostatic hypotension, urinary retention, and constipation were also present. Clinical autonomic tests suggested both sympathetic and parasympathetic dysfunction. After intravenous immunoglobulin therapy, motor and sensory symptoms resolved rapidly; dysautonomia resolved gradually over the next 2 months. The response to immunological therapy and the presence of antecedent infection suggest that AASMN is a postinfectious, immune-mediated, autonomic, sensory and motor nervous system dysfunction.

  2. Virulence of Escherichia coli in relation to host factors in women with symptomatic urinary tract infection.

    Sandberg, T; Kaijser, B; Lidin-Janson, G; Lincoln, K; Orskov, F.; Orskov, I; Stokland, E.; Svanborg-Edén, C

    1988-01-01

    The relationship between bacterial characteristics and the severity of urinary tract infection in adults has not been clarified. In this study, Escherichia coli strains (n = 178) were prospectively collected from women with community-acquired urinary tract infection. The isolates were identified by O:K:H serotype and characterized for adherence, hemolysin production, and serum bactericidal resistance. The patients had acute pyelonephritis with or without complicating factors and acute cystiti...

  3. Significance of Urinary Proteome Pattern in Renal Allograft Recipients

    Suhail, Sufi M.

    2014-01-01

    Urinary proteomics is developing as a platform of urinary biomarkers of immense potential in recent years. The definition of urinary proteome in the context of renal allograft and characterization of different proteome patterns in various graft dysfunctions have led to the development of a distinct science of this noninvasive tool. Substantial numbers of studies have shown that different renal allograft disease states, both acute and chronic, could portray unique urinary proteome pattern enabling early diagnosis of graft dysfunction and proper manipulation of immunosuppressive strategy that could impact graft prognosis. The methodology of the urinary proteome is nonetheless not more complex than that of other sophisticated assays of conventional urinary protein analysis. Moreover, the need for a centralized database is also felt by the researchers as more and more studies have been presenting their results from different corners and as systems of organizing these newly emerging data being developed at international and national levels. In this context concept of urinary proteomics in renal allograft recipients would be of significant importance in clinical transplantation. PMID:24757556

  4. Significance of Urinary Proteome Pattern in Renal Allograft Recipients

    Sufi M. Suhail

    2014-01-01

    Full Text Available Urinary proteomics is developing as a platform of urinary biomarkers of immense potential in recent years. The definition of urinary proteome in the context of renal allograft and characterization of different proteome patterns in various graft dysfunctions have led to the development of a distinct science of this noninvasive tool. Substantial numbers of studies have shown that different renal allograft disease states, both acute and chronic, could portray unique urinary proteome pattern enabling early diagnosis of graft dysfunction and proper manipulation of immunosuppressive strategy that could impact graft prognosis. The methodology of the urinary proteome is nonetheless not more complex than that of other sophisticated assays of conventional urinary protein analysis. Moreover, the need for a centralized database is also felt by the researchers as more and more studies have been presenting their results from different corners and as systems of organizing these newly emerging data being developed at international and national levels. In this context concept of urinary proteomics in renal allograft recipients would be of significant importance in clinical transplantation.

  5. Radionuclide targeting with particular emphasis on urinary bladder carcinoma

    Sjöström, A

    2001-01-01

    primary bladder carcinoma tumours was investigated. Both receptors were expressed in the majority of metastases and primary tumours. Targeting the EGF receptor and/or HER-2 in urinary bladder carcinoma is an exciting new concept The incidence of urinary bladder carcinoma is increasing and many patients die every year of this disease despite assumed radical therapy. Thus, there is a need for improved methods of diagnosis and therapy. Radionuclide targeting is based on achieving specific delivery of radioactive nuclides to tumour cells with minimal damage to surrounding normal tissues. Two possible target structures are the epidermal growth factor (EGF) receptor and the related receptor HER-2. Cellular binding and retention of sup 1 sup 2 sup 5 I-EGF-dextran conjugates was investigated in two bladder carcinoma cell lines. The conjugate bound specifically to the EGF receptor with delayed maximum binding, limited intracellular degradation and prolonged cellular retention compared to sup 1 sup 2 sup 5 I-EGF. EGF w...

  6. Genome Sequence of Klebsiella pneumoniae Urinary Tract Isolate Top52

    Johnson, Jeremiah G.; Spurbeck, Rachel R.; Sandhu, Sukhinder K.; Matson, Jyl S.

    2014-01-01

    Klebsiella pneumoniae is a significant cause of nosocomial infections, including ventilator-associated pneumonias and catheter-associated urinary tract infections. K. pneumoniae strain TOP52 #1721 (Top52) was isolated from a woman presenting with acute cystitis and subsequently characterized using various murine models of infection. Here we present the genome sequence of K. pneumoniae Top52.

  7. Urinary Expression of Kidney Injury Markers in Renal Transplant Recipients

    Szeto, Cheuk-Chun; Kwan, Bonnie Ching-Ha; Lai, Ka-Bik; Lai, Fernand Mac-Moune; Chow, Kai-Ming; Wang, Gang; Luk, Cathy Choi-Wan; Li, Philip Kam-Tao

    2010-01-01

    Background and objectives: The outcome of renal transplantation after an episode of acute rejection is difficult to predict, even with an allograft biopsy. We examined whether urinary expression of specific biomarker mRNA could be used as a noninvasive prognostic marker in kidney transplant recipients.

  8. Remission of nephrotic syndrome diminishes urinary plasmin content and abolishes activation of ENaC

    Andersen, René F; Buhl, Kristian Bergholt; Jensen, Boye L.; Svenningsen, Per; Friis, Ulla Glenert; Jespersen, Bente; Rittig, Søren

    2013-01-01

    BACKGROUND: Urinary plasmin activates the epithelial Na(+) channel (ENaC) in vitro and may possibly be a mechanism of sodium retention in nephrotic syndrome (NS). This study used a paired design to test the hypothesis that remission of NS is associated with a decreased content of urinary plasmin......-503] μg/mmol in nephrotic urine versus 9.5 (95 % CI 8-12) μg/mmol at remission (p ...

  9. Fasting and Urinary Stones

    Ali Shamsa

    2013-11-01

    Full Text Available Introduction: Fasting is considered as one of the most important practices of Islam, and according to Prophet Mohammad, fasting is obligatory upon Muslims. The aim of this study is to evaluate the effects of fasting on urinary stones. Materials and Methods: Very few studies have been carried out on urinary stones and the effect of Ramadan fasting. The sources of the present study are Medline and articles presented by local and Muslim researchers. Meanwhile, since we are acquainted with three well-known researchers in the field of urology, we contacted them via email and asked for their professional opinions. Results: The results of studies about the relationship of urinary stones and their incidence in Ramadan are not alike, and are even sometimes contradictory. Some believe that increased incidence of urinary stones in Ramadan is related not to fasting, but to the rise of weather temperature in hot months, and an increase in humidity. Conclusion: Numerous biological and behavioral changes occur in people who fast in Ramadan and some researchers believe that urinary stone increases during this month.

  10. Fasting and urinary stones

    Ali Shamsa

    2013-12-01

    Full Text Available Introduction: Fasting is considered as one of the most important practices of Islam, and according to Prophet Mohammad, fasting is obligatory upon Muslims. The aim of this study is to evaluate the effects of fasting on urinary stones. Materials and Methods:Very few studies have been carried out on urinary stones and the effect of Ramadan fasting. The sources of the present study are Medline and articles presented by local and Muslim researchers. Meanwhile, since we are acquainted with three well-known researchers in the field  of urology, we contacted them via email and asked for their professional opinions. Results:The results of studies about the relationship of urinary stones and their incidence in Ramadan are not alike, and are even sometimes contradictory. Some believe that increased incidence of urinary stones in Ramadan is related not to fasting, but to the rise of weather temperature in hot months, and an increase in humidity. Conclusion: Numerous biological and behavioral changes occur in people who fast in Ramadan and some researchers believe that urinary stone increases during this month.

  11. Comparative analysis of clinical characters between acute focal bacterial nephritis and acute pylonephritis

    李湛

    2013-01-01

    Objective To improve standards of diagnosis and therapy for acute focal bacterial nephritis by comparing the characters of acute focal bacterial nephritis and acute pylonephritis.Methods Thirty-five patients of upper urinary tract infection whoever accepted ultrasongraphic and computed tomographic (CT) examinations in Beijing Hospital from January 2007 to January 2013 were studied retrospectively.Eighteen patients were diagnosed as acute focal bacterial nephritis (AFBN) according to CT imaging features,the other 17 patients were diagnosed as acute

  12. MedlinePlus: Urinary Incontinence

    ... Also in Spanish Stress incontinence Also in Spanish Suprapubic catheter care Also in Spanish Urge incontinence Also in ... catheterization - male Skin care and incontinence Stress incontinence Suprapubic catheter care Urge incontinence Urinary catheters Urinary catheters - what ...

  13. Urinary Tract Infections in Children

    ... Disease Organizations​​ . (PDF, 345 KB) Alternate Language URL Urinary Tract Infections in Children Page Content On this page: What ... Points to Remember Clinical Trials What is a urinary tract infection (UTI)? A UTI is an infection in the ...

  14. 尤瑞克林联合依达拉奉治疗中重度急性脑梗死的随机临床研究%Randomized clinical study of urinary kallidinogenase combined with edaravone treating moderate and severe acute cerebral infarction

    王展航

    2012-01-01

    Objective To explore the effect and safety of urinary kallidinogenase combined with edaravone in treating moderate and severe acute cerebral infarction.Methods 84 patients who had acute cerebral infarction were randomly divided into 2 groups,control group was given edaravone,treatment group was added urinary kallidinogenase based on control group,other conventional medical treatments were same.Results After 14 days treatment,the change of National Institute of Health stroke scale(NIHSS)and Activities of Daily Living(ADL)before and after the 14 days were compared.After the treatment,NIHSS of urinary kallidinogenase group and control group both improved (P < 0.01),urinary kallidinogenase group improved more significantly,and had significant difference compared with control group(P < 0.01).ADL level of the two groups both went up(P < 0.01),urinary kallidinogenase group went up more significantly,and had the significant difference compared with controlled group(P < 0.01).Conclusion Uri nary kallidinogenase could selectively expand ischemic vessel,open collateral circulation,and promote the formation of new vessels,if combined with edaravone treating moderate and severe acute cerebral infarction,it could significantly improve the neurological deficit,reduce disability rate and increase the safety.%目的 观察尤瑞克林联合依达拉奉治疗中重度急性脑梗死的有效性和安全性.方法 对84例急性脑梗死患者随机分为两组:对照组给予依达拉奉治疗,治疗组在对照组基础上再加尤瑞克林,其它内科常规治疗相同.结果 比较两组治疗14 d前后美国国立卫生院神经功能缺损评分(NIHSS)和日常生活能力(ADL)的变化.治疗后治疗组和对照组NIHSS评分均有改善(P<0.01),但治疗组改善更明显(P<0.01);两组ADL水平均较治疗前上升(P<0.01),但治疗组上升更明显(P<0.01).结论 尤瑞克林可选择性扩张缺血区血管,开放侧枝循环,促进新生血管形成,

  15. Urinary albumin in space missions

    Cirillo, Massimo; De Santo, Natale G; Heer, Martina;

    2002-01-01

    Proteinuria was hypothesized for space mission but research data are missing. Urinary albumin, as index of proteinuria, was analyzed in frozen urine samples collected by astronauts during space missions onboard MIR station and on ground (control). Urinary albumin was measured by a double antibody...... radioimmunoassay. On average, 24h urinary albumin was 27.4% lower in space than on ground; the difference was statistically significant. Low urinary albumin excretion could be another effect of exposure to weightlessness (microgravity)....

  16. Urinary Tract Infections (For Kids)

    Full Text Available ... Your pee smells bad. These changes occur because bacteria have caused an infection somewhere in your urinary tract. Let's ... near your body, especially when it's hot outside. Bacteria love to grow in warm, moist places. Gross! Reviewed by: T. Ernesto Figueroa, ... Diseases Movie: Urinary System Your Urinary System Bedwetting Contact ...

  17. Record Retention Practices among the Nation's “Most Wired” Hospitals

    Rinehart-Thompson, Laurie A.

    2008-01-01

    This exploratory study examined health record retention practices among health information management professionals in acute care general hospitals in the United States. A descriptive research design was used, and data were collected using a self-reporting survey. Respondents answered questions about record retention policies, the responsibility of health information professionals in policy administration, record retention periods, factors that determine retention periods, and other informati...

  18. Kidneys and urinary system

    Nuclear medicine studies, through primarily concerned with the functional aspects of the organ, can also provide useful information about the anatomy. An understanding of the anatomy and physiology of the kidneys and urinary system greatly helps in the interpretation of data from radionuclide studies

  19. Urinary Incontinence in Men

    ... of wastes and extra fluid. In order for normal urination to occur, all parts in the urinary tract need to work together in the correct order. Kidneys. The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below ...

  20. Increased urinary orosomucoid excretion

    Christiansen, M S; Iversen, K; Larsen, C T;

    2009-01-01

    OBJECTIVE: In a previous study, urinary orosomucoid excretion rate (UOER) independently predicted cardiovascular mortality in patients with type 2 diabetes. The aim of the present study was to determine whether increased UOER is associated with cardiovascular risk factors such as inflammation, im...

  1. Urinary Tract Infections.

    Plummer, Nancy; Michael, Nancy, Ed.

    This module on urinary tract infections is intended for use in inservice or continuing education programs for persons who administer medications in long-term care facilities. Instructor information, including teaching suggestions, and a listing of recommended audiovisual materials and their sources appear first. The module goal and objectives are…

  2. The early diagnostic value of urinary Sema3A for ICU adult patients with acute kidney injury%尿Sema3A对重症监护病房患者急性肾损伤的早期诊断价值

    田漫漫; 赵双平

    2015-01-01

    目的 探讨信号素3A (Sema3A)对成人重症监护病房急性肾损伤(AKI)的早期诊断价值及其与脓毒症的关系.方法 以中南大学湘雅医院重症医学科(ICU) 2013年7至12月预期入住ICU时间>24 h入ICU时未发生AKI年龄>18岁的患者为研究对象.记录患者一般临床资料,并每12 h收集血清、尿标本,用酶联免疫法检测尿Sema3A和中性粒细胞明胶酶相关脂质运载蛋白(NGAL).根据是否发生AKI分为AKI组和非AKI组,根据引起AKI的原因是否为脓毒症分为AKI脓毒症组、AKI非脓毒症组、非AKI脓毒症组、非AKI非脓毒症组.AKI组选取诊断AKI当时及前24h的标本,诊断AKI当时计为T(0)h,前面两个时间点分别计为T(-12)h、T(-24)h.非AKI组取入室后前3个时间点的标本,分别计为T(0)h、T(-12)h、T(-24)h.整理资料进行统计学分析.结果 AKI组尿Sema3A、尿NGAL较非AKI组高(P<0.05).AKI组尿Sema3A、尿NGAL浓度随时间变化有增高趋势,其中T(-24)h、T(-12)h分别与T(0)h比较差异有统计学意义.T(-24)h尿Sema3A、尿NGAL分别与血肌酐、APACHEⅡ呈正相关性.尿Sema3A以T(-12)h的AUC最大为0.885(95% CI 0.774 ~0.997,P<0.05);尿NGAL以T(-24)h的AUC最大为0.878(95% CI 0.788~0.993,P<0.05).脓毒症组与非脓毒症组Sema3A差异无统计学意义,而两组间NGAL差异有统计学意义.S-AKI组与非S-AKI组尿Sema3A差异无统计学意义,而两组之间的尿NGAL差异有统计学意义.尿Sema3A死亡组较生存组高(P<0.05)).结论 尿中Sema3A检测有助于AKI的早期诊断;尿中Sema3A浓度不受脓毒症影响,更有预测价值.%Objective To research the early diagnosis value of Semaphorin3A as a biaomarker on acute kidney injury(AKI) in adult intensive care unit(ICU),and explore the relationship between Sema3A and sepsis.Methods The objects of the study are patients who were enrolled from July 2013 to December 2013 in XiangYa Hospital ICU.After admission and study enrollment

  3. Urinary Stone Disease: Advancing Knowledge, Patient Care, and Population Health.

    Scales, Charles D; Tasian, Gregory E; Schwaderer, Andrew L; Goldfarb, David S; Star, Robert A; Kirkali, Ziya

    2016-07-01

    Expanding epidemiologic and physiologic data suggest that urinary stone disease is best conceptualized as a chronic metabolic condition punctuated by symptomatic, preventable stone events. These acute events herald substantial future chronic morbidity, including decreased bone mineral density, cardiovascular disease, and CKD. Urinary stone disease imposes a large and growing public health burden. In the United States, 1 in 11 individuals will experience a urinary stone in their lifetime. Given this high incidence and prevalence, urinary stone disease is one of the most expensive urologic conditions, with health care charges exceeding $10 billion annually. Patient care focuses on management of symptomatic stones rather than prevention; after three decades of innovation, procedural interventions are almost exclusively minimally invasive or noninvasive, and mortality is rare. Despite these advances, the prevalence of stone disease has nearly doubled over the past 15 years, likely secondary to dietary and health trends. The NIDDK recently convened a symposium to assess knowledge and treatment gaps to inform future urinary stone disease research. Reducing the public health burden of urinary stone disease will require key advances in understanding environmental, genetic, and other individual disease determinants; improving secondary prevention; and optimal population health strategies in an increasingly cost-conscious care environment. PMID:26964844

  4. [Urinary tract infections in pregnancy: when to treat, how to treat, and what to treat with].

    Kladenský, J

    2012-04-01

    Urinary tract infections (UTI) in pregnant women are a relatively frequent occurrence and the spectrum of these infections ranges from lower urinary tract disease (asymptomatic bacteriuria, acute cystitis) to upper urinary tract disease (acute pyelonephritis). Anatomical and functional changes in the urinary tract in pregnancy result in significantly higher susceptibility to progression of the infection from asymptomatic bacteriuria to the stage of acute pyelonephritis. Untreated asymptomatic bacteriuria in pregnancy leads, in as much as 40%, to the development of acute pyelonephritis with all the subsequent negative effects not only for the woman herself, but particularly for the fetus. Bacteriuria in pregnancy accounts for a significantly higher number of newborns with a low birth weight, low gestational age and higher neonatal mortality rate. Therefore, it is necessary to perform screening for bacteriuria in pregnant women and, when the finding is positive, to treat this bacteriuria. The selection of an appropriate antimicrobial agent to treat urinary tract infection in pregnancy is limited by the safety of a given drug not only for the woman, but particularly for the fetus. The article provides an overview of medications that can be safely used throughout the pregnancy or only in certain stages of pregnancy. The selection of an appropriate antibiotic should always be preceded by the result of urine culture. The article presents the principles and rules for treating asymptomatic bacteriuria, acute cystitis and acute pyelonephritis in pregnant women. PMID:22702077

  5. Role of suprapubic catheterization in retention of urine1

    Abrams, P H; Gaches, C G C; Green, N A; Shah, P J R; Ashken, M. H.

    1980-01-01

    One hundred and nine male patients took part in a randomized trial of elective suprapubic or urethral catheterization in retention of urine. The self-retaining trocar suprapubic catheter proved safe and reliable in trained hands and its use was associated with a low incidence of side effects. The suprapubic catheter when used to allow continuous flow resection appeared to lead to decreased blood loss and reduced resection time. No decrease in urinary infection rate over the period of hospital...

  6. Dynamics of Urinary Calprotectin after Renal Ischaemia

    Ebbing, Jan; Seibert, Felix S.; Pagonas, Nikolaos; Bauer, Frederic; Miller, Kurt; Kempkensteffen, Carsten; Günzel, Karsten; Bachmann, Alexander; Seifert, Hans H.; Rentsch, Cyrill A.; Ardelt, Peter; Wetterauer, Christian; Amico, Patrizia; Babel, Nina; Westhoff, Timm H.

    2016-01-01

    Background: Urinary calprotectin has been identified as a promising biomarker for acute kidney injury. To date, however, the time-dependent changes of this parameter during acute kidney injury remain elusive. The aim of the present work was to define the time-course of urinary calprotectin secretion after ischaemia/reperfusion-induced kidney injury in comparison to neutrophil gelatinase—associated lipocalin, thereby monitoring the extent of tubular damage in nephron sparing surgery for kidney tumours. Methods: The study population consisted of 42 patients. Thirty-two patients underwent either open or endoscopic nephron sparing surgery for kidney tumours. During the surgery, the renal arterial pedicle was clamped with a median ischaemic time of 13 minutes (interquartile range, 4.5–20.3 minutes) in 26 patients. Ten retro-peritoneoscopic living donor nephrectomy patients and 6 nephron sparing surgery patients in whom the renal artery was not clamped served as controls. Urinary calprotectin and neutrophil gelatinase—associated lipocalin concentrations were repeatedly measured by enzyme-linked immunosorbent assay and assessed according to renal function parameters. Results: Urinary concentrations of calprotectin and neutrophil gelatinase—associated lipocalin increased significantly after ischaemia/reperfusion injury, whereas concentrations remained unchanged after nephron sparing surgery without ischaemia/reperfusion injury and after kidney donation. Calprotectin and neutrophil gelatinase—associated lipocalin levels were significantly increased 2 and 8 hours, respectively, post-ischaemia. Both proteins reached maximal concentrations after 48 hours, followed by a subsequent persistent decrease. Maximal neutrophil gelatinase—associated lipocalin and calprotectin concentrations were 9-fold and 69-fold higher than their respective baseline values. The glomerular filtration rate was only transiently impaired at the first post-operative day after ischaemia

  7. Urinary Incontinence in Elderly

    N. S. Neki

    2016-01-01

    Full Text Available Urinary Incontinence (UI is dened any involuntary leakage of urine. It is twice as common in women as in men and affects at least 1 in 3 older women. It is not a normal result of aging. Rather it is a medical problem that is often curable and should be treated. Urine is stored in the bladder and emptied via the urethra. During urination, muscles of the bladder wall contract, forcing urine from the bladder into the urethra. Sphincter muscles surrounding the urethra relax thus releasing urine from the body. Incontinence occurs if bladder muscles suddenly contract or sphincter muscles are not strong enough to contain urine. The diagnosis of geriatric urinary incontinence includes evaluation for overow incontinence, functional incontinence and stress incontinence. The treatment goal should be realistic and aim to improve the patient's functional status and quality of life. Best treatment outcomes can only be achieved by a holistic treatment approach.

  8. Acute Legionella pneumophila infection masquerading as acute alcoholic hepatitis

    Hunter, Jonathan Michael; Chan, Julian; Reid, Angeline Louise; Tan, Chistopher

    2013-01-01

    A middle-aged man had deteriorated rapidly in hospital after being misdiagnosed with acute alcoholic hepatitis. Acute Legionnaires disease (Legionellosis) was subsequently diagnosed on rapid antigen urinary testing and further confirmed serologically. This led to appropriate antibiotic treatment and complete clinical resolution. Physicians caring for patients with alcohol-related liver disease should consider Legionella pneumophila in their differential diagnosis even with a paucity of respir...

  9. Neonatal Staphylococcus lugdunensis urinary tract infection.

    Hayakawa, Itaru; Hataya, Hiroshi; Yamanouchi, Hanako; Sakakibara, Hiroshi; Terakawa, Toshiro

    2015-08-01

    Staphylococcus lugdunensis is a known pathogen of infective endocarditis, but not of urinary tract infection. We report a previously healthy neonate without congenital anomalies of the kidney and urinary tract who developed urinary tract infection due to Staphylococcus lugdunensis, illustrating that Staphylococcus lugdunensis can cause urinary tract infection even in those with no urinary tract complications. PMID:26177232

  10. [Urinary tract infection in pregnancy].

    Duarte, Geraldo; Marcolin, Alessandra Cristina; Quintana, Silvana Maria; Cavalli, Ricardo Carvalho

    2008-02-01

    Several factors cause urinary tract infection (UTI) to be a relevant complication of the gestational period, aggravating both the maternal and perinatal prognosis. For many years, pregnancy has been considered to be a factor predisposing to all forms of UTI. Today, it is known that pregnancy, as an isolated event, is not responsible for a higher incidence of UTI, but that the anatomical and physiological changes imposed on the urinary tract by pregnancy predispose women with asymptomatic bacteriuria (AB) to become pregnant women with symptomatic UTI. AB affects 2 to 10% of all pregnant women and approximately 30% of these will develop pyelonephritis if not properly treated. However, a difficult-to-understand resistance against the identification of AB during this period is observed among prenatalists. The diagnosis of UTI is microbiological and it is based on two urine cultures presenting more than 10(5) colonies/mL urine of the same germ. Treatment is facilitated by the fact that it is based on an antibiogram, with no scientific foundation for the notion that a pre-established therapeutic scheme is an adequate measure. For the treatment of pyelonephritis, it is not possible to wait for the result of culture and previous knowledge of the resistance profile of the antibacterial agents available for the treatment of pregnant women would be the best measure. Another important variable is the use of an intravenous bactericidal antibiotic during the acute phase, with the possibility of oral administration at home after clinical improvement of the patient. At our hospital, the drug that best satisfies all of these requirements is cefuroxime, administered for 10-14 days. Third-generation cephalosporins do not exist in the oral form, all of them involving the inconvenience of parenteral administration. In view of their side effects, aminoglycosides are considered to be inadequate for administration to pregnant women. The inconsistent insinuation of contraindication of

  11. Diagnosis of urinary tract diseases

    Radiological exploration of the urinary tract has become highly sophisticated. The information provided by the new imaging techniques is extremely accurate and useful in the diagnosis and pretherapeutic assessment of most urinary tract diseases. Interventional radiology has given radiologists an important role in the treatment of some types of pathology. The authors describe the value of modern imaging and its different aspects in each of the principal branches of urinary tract pathology. viz.: tumours, obstructions, infections, vascular and prostatic diseases

  12. Acute Gynecologic Disorders.

    Donaldson, Carolyn K

    2015-11-01

    Premenopausal women with acute pelvic pain comprise a significant percentage of patients who present to the emergency room. Etiologies can be gynecologic, urologic, gastrointestinal, or vascular. Signs and symptoms are often nonspecific and overlapping. The choice of imaging modality is determined by the clinically suspected differential diagnosis. Ultrasound (US) is the preferred imaging modality for suspected obstetric or gynecologic disorders. CT is more useful when gastrointestinal or urinary tract pathology is likely. MR imaging is rarely used in the emergent setting, except to exclude appendicitis in pregnant women. This article presents a comprehensive review of imaging of acute gynecologic disorders. PMID:26526439

  13. A case of spontaneous rupture of the urinary bladder treated nonoperatively

    A 66-year-old female was admitted for abdominal pain. The patient had undergone a radical hysterectomy and had received postoperative irradiation for carcinoma of the uterus at 43 years of age, and a neurogenic bladder was diagnosed at 64 years of age. After admission, her symptoms improved with conservative treatment. One week after admission, she complained of severe acute abdominal pain. Abdominal CT showed a large amount of free fluid in the peritoneal cavity. The punctured ascitic fluid was slightly muddy. Peritonitis due to spontaneous rupture of the urinary bladder was suspected. The patient received nonsurgical treatment including intra-abdominal drainage and a urinary catheter. Cystography showed leakage of the contrast medium into the peritoneal cavity. After treatment, she did not have any symptoms, and she was discharged with an indwelling urinary catheter. Perforation of the urinary bladder should be considered in patients presenting with acute abdomen, particularly in those with previous histories of pelvic irradiation or neurogenic bladder. (author)

  14. Dose contribution from organically bound tritum after an acute tritiated water intake

    To assess the dose contribution from retained organically bound tritium (OBT), we have analyzed urinary excretion data from eight individuals who had an acute intake of tritiated water (HTO). The analysis of the bioassay data showed that the mean body water turnover half-time was 6.3 ± 1.0 d and 8.4 ± 1.9 d for the period of increased water and normal water intake respectively. The long term excretion of tritium was also observed, indicting the tritium incorporation and retention in the organic components of the soft tissues. A mathematical model is proposed to estimate the dose increases from the retained OBT by examining the kinetics of tritium excretion in urine. Based on the kinetics of tritium in urine, the average dose increase from the metabolized OBT was 6.2 ± 1.3% of the HTO dose. The uncertainty in the OBT dose estimates was calculated to be less than 50%

  15. Trans-obturator Tape in surgical treatment of urinary incontinence

    Ashrafi M

    2008-06-01

    Full Text Available Background: The aim of this study was to assess the efficacy and safety of a new minimally-invasive surgical procedure using trans-obturator Tape (TOT to treat female stress urinary incontinence.Methods: This clinical trial study was performed from 2003 to 2004 in the Gynecology Department of Imam Hospital, Vali-e-Asr, Tehran, Iran. A total of 35 women with stress urinary incontinence underwent the TOT procedure. All patients underwent pre-operative clinical examination, cough-stress test (full bladder, uroflowmetry and post-voiding residual volume assessment. Results: The mean age of patients was 50 years, ranging from 26 to 74 years, with an average urinary stress incontinence duration of six years. The mean time of follow-up was 14 months (at 1, 6, 12 and 24 months and the average duration of surgery was about 20 minutes. The perioperative complication rate was 9% with no vascular, nerve or bowel injuries. The rate of hemorrhagic side effects (spontaneously-absorbed hematoma and blood loss not requiring blood transfusion was 2.9%. Post-operative urinary retention and vaginal erosion occurred in one case each; the former was treated by intermittent self-catheterization. In total, 91.4% of patients were completely cured and 8.6% were improved without failure of treatment. Conclusions: The present study confirms the results obtained by Delorme and coworkers, and allows us to consider TOT as a safe, minimally invasive and efficient short-term surgical technique for the treatment of female stress urinary incontinence, alone or in combination with prolapse repair. Following this study, a randomized control trial is recommended to compare TOT with the gold standard surgery for women with urinary incontinence.

  16. Drug Retention Times

    Center for Human Reliability Studies

    2007-05-01

    The purpose of this monograph is to provide information on drug retention times in the human body. The information provided is based on plausible illegal drug use activities that might be engaged in by a recreational drug user.

  17. Drug Retention Times

    Center for Human Reliability Studies

    2007-05-01

    The purpose of this monograph is to provide information on drug retention times in the human body. The information provided is based on plausible illegal drug use activities that might be engaged in by a recreational drug user

  18. Liquid Effluent Retention Facility

    Federal Laboratory Consortium — The Liquid Effluent Retention Facility (LERF) is located in the central part of the Hanford Site. LERF is permitted by the State of Washington and has three liquid...

  19. Uptake, retention and excretion of strontium in man

    The absorption of strontium from the gastrointestinal tract is discussed in relation to the diet and the different components of a bread-milk diet. A brief review is given of the results obtained by using chelators and diets high in calcium in order to decrease the strontium absorption. The ratios of strontium to calcium in the different body compartments for adult man is discussed. The results of recent experimental work on normal man on a constant diet, are reviewed with particular reference to the urinary excretion and the retention of Sr85 contained in the experimental diet. The endogenous faecal excretion is also derived. These results are compared with those obtained from a single intravenous injection of radioactive strontium. For all the subjects the retention was obtained from whole-body counting using a pulse height analyser. The retention of the strontium in the skeleton is analysed and it is postulated that there are at least three degrees of binding of radioactive strontium with bone. In particular the retention several months after the dose and the relationship of this retention to the radiation dose to the skeleton from Sr90 is discussed. A formula is proposed for the evaluation of body retention of a radioactive dose of strontium from the radioactivity excreted in the urine. (author)

  20. KIDNEY AND URINARY TRACT

    2003-01-01

    11.1 Renal failure2003357 Acute-on-chronic renal failure. ZHANGLuxia(张路霞), et al. Renal Div, 1st Hosp, Peking U-niv,Beijing 100034 Chin J Nephrol 2003; 19(2):78 -80Objective: To investigate the incidence and clinico-pathological characteristics of acute-on-chronic renal failure (A/C). Methods: Clinical data from all patients diagnosed as A/C by clinical materials and renal biopsy for

  1. Inflammatory Hepatic Nodules Associated with Urinary Tract Infection in Two Pediatric Patients

    Kim, Ye Lim; Kim, Kyeong Ah; Lee, Chang Hee; Choi, Jae Woong; Lee, Jong Mee; Park, Cheol Min [Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2009-12-15

    Inflammatory nodule in the liver associated with acute urinary infection is an uncommon presentation. We recently experienced two pediatric patients, admitted for urinary tract infection, in whom a solitary hyperechoic nodule or multiple low echoic nodules in the liver were incidentally discovered. All patients complained of fever, and urine culture results were positive for Klebsiella, Streptococcus, and Escherichia coli. After receiving treatment with antibiotics, the hepatic nodules gradually decreased in size and completely disappeared

  2. Common errors in diagnosis and management of urinary tract infections: Microbiological aspects

    Bojić-Miličević Gordana; Mikov Momir; Dautović Radomir

    2005-01-01

    Introduction Urinary tract infections (UTI) are among the most common infectious diseases affecting all age groups, from infants to the elderly. The majority of these infections occur in otherwise healthy individuals who present with symptoms of acute uncomplicated bacterial cystitis or pyelonephritis. Certain patient populations with complicated conditions are at increased risk for acquiring infection or failing therapy. Forty to 50% of adult women have a history of at least one urinary trac...

  3. Inflammatory Hepatic Nodules Associated with Urinary Tract Infection in Two Pediatric Patients

    Inflammatory nodule in the liver associated with acute urinary infection is an uncommon presentation. We recently experienced two pediatric patients, admitted for urinary tract infection, in whom a solitary hyperechoic nodule or multiple low echoic nodules in the liver were incidentally discovered. All patients complained of fever, and urine culture results were positive for Klebsiella, Streptococcus, and Escherichia coli. After receiving treatment with antibiotics, the hepatic nodules gradually decreased in size and completely disappeared

  4. The Role of Urinary Liver-Type Fatty Acid-Binding Protein in Critically Ill Patients

    Cho, Eunjung; Yang, Ha Na; Jo, Sang-Kyung; Cho, Won-Yong; Kim, Hyoung-Kyu

    2013-01-01

    Although several urinary biomarkers have been validated as early diagnostic markers of acute kidney injury (AKI), their usefulness as outcome predictors is not well established. This study aimed to determine the diagnostic and prognostic abilities of urinary liver-type fatty acid-binding protein (L-FABP) in heterogeneous critically ill patients. We prospectively collected data on patients admitted to medical and surgical intensive care units (ICUs) from July 2010 to June 2011. Urine neutrophi...

  5. Urinary extracellular microvesicles: isolation methods and prospects for urinary proteome.

    Wang, Danqi; Sun, Wei

    2014-08-01

    Extracellular microvesicles (EVs) are membranous vesicles, which are released from diverse cells. These EVs have also been found in a wide range of body fluids. The cargo of EVs, including proteins, lipids, carbohydrates, and nucleic acids, can be stably preserved in EVs. Researchers have found that EVs can mediate intercellular communication by shuttling the cargo components. Therefore, EVs can be used for the identification of disease-specific biomarkers. As one class of EVs, urinary exosomes can reflect the status of the renal system. Moreover, urinary exosome analysis can minimize the interference of high abundant proteins in the whole urine sample. Therefore, urinary exosomes have gained much attention in recent years. In this review, we present a comprehensive summary of urinary exosome studies in recent years, including collection, storage, and isolation methods. The normal and disease proteomic analyses of urinary exosomes are also presented. Thus, this review may provide a valuable reference for future research. PMID:24962155

  6. [Urinary antimicrobial prophylaxis].

    Nathanson, S; Deschênes, G

    2002-05-01

    Antibiotics are usually used to prevent childhood recurrent urinary tract infections: cystitis or pyelonephritis. The mechanism of action of these antibiotics, although imperfectly known, seems to be double: the antibiotic acts by its bactericidal effect, but also probably for minimal concentrations by reducing adhesion capability of bacteria to the urothelium. The most commonly used molecules are cotrimoxazole, trimethoprime, pivmecillinam, cefaclor and nalidixic acid. However all have not been studied rigorously as for their prophylactic capacity, and in particular very little is known for patients presenting with vesico-ureteral reflux. PMID:12053547

  7. 多层螺旋CT平扫联合尿路重建在急性肾绞痛诊断中的临床应用%Clinical application of multi-slice helical CT plain scan combined with urinary reconstruction in diagnosis of acute renal colic

    陈刚; 吴小候; 尹志康; 何云锋

    2011-01-01

    目的 探讨多层螺旋CT平扫联合尿路重建在急性肾绞痛诊断中的的临床应用价值.方法 将126例急诊肾绞痛患者随机分两组:CT组(67例)和静脉尿路造影(IVU)组(59例),CT组行多层(16层或64层)螺旋CT平扫联合尿路重建,IVU组行相关准备后行腹部X线平片(KUB)联合IVU检查.在明确诊断为输尿管梗阻或输尿管结石后,急诊行输尿管镜碎石术或置管治疗,比较两组患者的术前结石确诊率、肾绞痛缓解时间、住院时间及住院总费用等.结果 所有患者术后肾绞痛均缓解,CT组术前结石确诊率明显高于IVU组(P<0.05),CT组肾绞痛缓解时间和住院时间短于IVU组(P<0.05),CT组住院总费与IVU组比较差异无统计学意义(P>0.05).结论 多层螺旋CT平扫联合尿路重建对于急诊肾绞痛患者的诊治是高效和相对经济的.%Objective To investigate clinical application of multi-slice helical CT plain scan combined with urinary reconstruction in diagnosis of acute renal colic. Methods 126 patients with acute renal colic were randomized divided into two groups. 67 cases were diagnosed by multi-slice helical CT combined with urinary reconstruction and 59 cases were diagnosed by abdominal plain film radiography combined with IVU. All patients were treated by ureteroscope lithotripsy. The stone diagnosis rate was compared as well as the renal colic time , the hospitalization time and the hospitalization cost. Results The stone diagnosis rate in CT group was more than that in IVU group(P<0. 05). However,the renal colic time hospitalization time in CT group was less than that in IVU group as well as hospitalization time(P<0. 05). There was no significantly difference on the hospitalization cost between two groups(P>0. 05). Conclusion Multi-slice helical CT plain scan combined with urinary reconstruction is efficient and economic in diagnosis of acute renal colic.

  8. Clinical comparison of Fosfomycin ammonia butyl alcohol three powder combined with norfloxacin in treatment of acute urinary tract infection%磷霉素氨丁三醇散与诺氟沙星治疗急性泌尿系感染

    秦大勇; 刘生

    2015-01-01

    目的 比较磷霉素氨丁三醇散与诺氟沙星治疗急性泌尿系感染的效果.方法 将80例急性泌尿系统感染患者随机分为两组,每组40例.对照组采用诺氟沙星治疗,观察组采用磷霉素氨丁三醇散治疗,观察两组患者的临床疗效,记录两种药物对致病菌的清除率、敏感率耐药率.结果 观察组治疗有效率为92.5%,高于对照组的75.0%,差异有统计学意义(P<0.05).观察组细菌清除率、敏感率分别为90.63%、96.88%,均高于对照组的58.09%、80.62%,细菌耐药率为3.12%,低于对照组55.58%,差异有统计学意义(P<0.05).结论 磷霉素氨丁三醇散治疗急性泌尿系统感染,细菌耐药性较低,可提高细菌清除率.%Objective To compare the effects of fosfomycin ammonia butyl alcohol three powder and norfloxacin on acute urinary tract infection.Methods Eighty patients with acute urinary system infection were selected as the research objects,and were randomly divided into two groups.The patients in the control group were given norfloxacin treatment,and the patients in the observation group were given fosfomycin ammonia butyl alcohol three powder treatment.The clinical effects of the two groups were observed,and the remove rates,sensitive rates and drug resistance rates of the two kinds of drugs were recorded.Results The effective rate of observation group (92.5 %) was higher than that of control group (75 %),the difference was significant (P < 0.05).The bacterial clearance rate,sensitive rates of the observation group(90.63%,96.88%)were lower than those of the control group(58.09%,80.62%),the bacterial drug resistance rate(3.12%) was lower than that of the control group(55.58%),the differences were significant (P < 0.05).Conclusions The bacterial resistance is low that fosfomycin ammonia butyl alcohol three powder in the treatment of acute urinary tract infection.It can increase the clearance rate of bacteria.

  9. Urinary AQP2 excretion is increased during nephrotic syndrome and is associated with reduced urine production

    Andersen, René Frydensbjerg; Kamperis, Konstantinos; Frøkjær, Jørgen; Rittig, Søren

    OBJECTIVES: Edema is a hallmark of nephrotic syndrome (NS) and has largely been attributed to sodium retention. Yet low plasma sodium is frequently observed in children with acute NS suggesting that a disturbance in renal water handling may coexist together with sodium retention. The aim of the...

  10. Perturbations in the Urinary Exosome in Transplant Rejection

    Sigdel, Tara K.; NG, Yolanda; Lee, Sangho; Nicora, Carrie D.; Qian, Weijun; Smith, Richard D.; Camp, David G.; Sarwal, Minnie M.

    2015-01-05

    Background: Urine exosomes, vesicles exocytosed into urine by all renal epithelial cell types, occur under normal physiologic and disease states. Exosome contents may mirror disease-specific proteome perturbations in kidney injury. Analysis methodologies for the exosomal fraction of the urinary proteome were developed and for comparing the urinary exosomal fraction versus unfractionated proteome for biomarker discovery. Methods: Urine exosomes were isolated by centrifugal filtration from mid-stream, second morning void, urine samples collected from kidney transplant recipients with and without biopsy matched acute rejection. The proteomes of unfractionated whole urine (Uw) and urine exosomes (Uexo) underwent mass spectrometry-based quantitative proteomics analysis. The proteome data were analyzed for significant differential protein abundances in acute rejection (AR). Results: Identifications of 1018 and 349 proteins, Uw and Uexo fractions, respectively, demonstrated a 279 protein overlap between the two urinary compartments with 25%(70) of overlapping proteins unique to Uexoand represented membrane bound proteins (p=9.31e-7). Of 349 urine exosomal proteins identified in transplant patients 220 were not previously identified in the normal urine exosomal fraction. Uexo proteins (11), functioning in the inflammatory / stress response, were more abundant in patients with biopsy-confirmed acute rejection, 3 of which were exclusive to Uexo. Uexo AR-specific biomarkers (8) were also detected in Uw, but since they were observed at significantly lower abundances in Uw, they were not significant for AR in Uw. Conclusions: A rapid urinary exosome isolation method and quantitative measurement of enriched Uexo proteins was applied. Urine proteins specific to the exosomal fraction were detected either in unfractionated urine (at low abundances) or by Uexo fraction analysis. Perturbed proteins in the exosomal compartment of urine collected from kidney transplant patients were

  11. Renal scar formation after urinary tract infection in children

    Young Seo Park

    2012-01-01

    Urinary tract infection (UTI) is a common bacterial illness in children. Acute pyelonephritis in children may lead to renal scarring with the risk of later hypertension, preeclampsia during pregnancy, proteinuria, and renal insufficiency. Until now, vesicoureteral reflux (VUR) has been considered the most important risk factor for post-UTI renal scar formation in children. VUR predisposes children with UTI to pyelonephritis, and both are associated with renal scarring. However, reflux nephrop...

  12. Acidosis and Urinary Calcium Excretion

    Alexander, R Todd; Cordat, Emmanuelle; Chambrey, Régine;

    2016-01-01

    Metabolic acidosis is associated with increased urinary calcium excretion and related sequelae, including nephrocalcinosis and nephrolithiasis. The increased urinary calcium excretion induced by metabolic acidosis predominantly results from increased mobilization of calcium out of bone and...... renal tubule and then discuss why not all gene defects that cause renal tubular acidosis are associated with hypercalciuria and nephrocalcinosis....

  13. Urinary Tract Infections in Children

    Mustafa Taskesen

    2009-04-01

    Full Text Available Urinary tract infections (UTI are frequent conditions in children. Untreated urinary tract infections can lead to serious kidney problems that could threaten the life of the child. Therefore, early detection and treatment of urinary tract infection is important. In older children, urinary tract infections may cause obvious symptoms such as stomach ache and disuria. In infants and young children, UTIs may be harder to detect because of less specific symptoms. Recurrences are common in children with urinary abnormalities such as neurogenic bladder, vesicourethral reflux or those with very poor toilet and hygiene habits. This article reviews the diagnostic approach and presents the current data related to the roles of radiologic imaging, surgical correction and antibiotic prophylaxis of UTIs in children. [Archives Medical Review Journal 2009; 18(2.000: 57-69

  14. Value of Ultrasound in Detecting Urinary Tract Anomalies After First Febrile Urinary Tract Infection in Children.

    Ghobrial, Emad E; Abdelaziz, Doaa M; Sheba, Maha F; Abdel-Azeem, Yasser S

    2016-05-01

    Background Urinary tract infection (UTI) is an infection that affects part of the urinary tract. Ultrasound is a noninvasive test that can demonstrate the size and shape of kidneys, presence of dilatation of the ureters, and the existence of anatomic abnormalities. The aim of the study is to estimate the value of ultrasound in detecting urinary tract anomalies after first attack of UTI. Methods This study was conducted at the Nephrology Clinic, New Children's Hospital, Faculty of Medicine, Cairo University, from August 2012 to March 2013, and included 30 children who presented with first attack of acute febrile UTI. All patients were subjected to urine analysis, urine culture and sensitivity, serum creatinine, complete blood count, and imaging in the form of renal ultrasound, voiding cysto-urethrography, and renal scan. Results All the patients had fever with a mean of 38.96°C ± 0.44°C and the mean duration of illness was 6.23 ± 5.64 days. Nineteen patients (63.3%) had an ultrasound abnormality. The commonest abnormalities were kidney stones (15.8%). Only 2 patients who had abnormal ultrasound had also vesicoureteric reflux on cystourethrography. Sensitivity of ultrasound was 66.7%, specificity was 37.5%, positive predictive value was 21.1%, negative predictive value was 81.8%, and total accuracy was 43.33%. Conclusion We concluded that ultrasound alone was not of much value in diagnosing and putting a plan of first attack of febrile UTI. It is recommended that combined investigations are the best way to confirm diagnosis of urinary tract anomalies. PMID:26084536

  15. [Retention of adhesive bridges].

    Raes, F; De Boever, J

    1994-04-01

    Since the development of adhesive bridges in the early seventies, the retention and therefore the durability of these bridges has been tremendously improved. Conditioning of the non-precious metal by silanisation, careful acid etching of the enamel and the use of the appropriate composite resin are of prime importance. Furthermore, the meticulous preparation with enough interproximal embrace, occlusal rests, interocclusal clearance and cingulum stops is equally important. Including more teeth in the design does not necessarily lead to an improved retention. Besides the material and technical aspects, the whole clinical procedure needs much attention. The retention does not depend on one single factor, but on the precision of all the necessary clinical steps and on a well-defined selection of the material. In this way a five-year survival rate of close to 80% can be obtained. PMID:11830965

  16. ILEOCYSTOPLASTY IN INVASIVE URINARY BLADDER CARCINOMA

    V. N. Pavlov

    2009-01-01

    Full Text Available Objective: to assess the results of surgical treatment of patients with the intestinal urinary bladder, to characterize its early and late postoperative complications, and to develop their correction tactics.  Subjects and methods. The results of treatment in 198 patients who had undergone ileocystoplasty were analyzed.  Results. The developed diagnostic approach and the determined examination periods could reduce the number of late postoperative complications of ileocystoplasty: acute and chronic pyelonephritis from 19.4 to 7.6%, urolithiasis from 17.2 to 1.9%, bladder dysfunction from 25.8 to 7.6%, and metabolic acidosis from 4.3 to 1.9%, and prevent the development of ureterovesical anastomosis stricture.  Conclusion. Radical cystectomy with the ileoplasty using an isolated segment of the ileum in patients with invasive urinary bladder carcinoma has been the operation of choice no longer; it has become an essential surgical adjunct. This method permits overall 5-year survival to be achieved in 69.7% of patients.  

  17. Urinary proteomics to support diagnosis of stroke.

    Jesse Dawson

    Full Text Available Accurate diagnosis in suspected ischaemic stroke can be difficult. We explored the urinary proteome in patients with stroke (n = 69, compared to controls (n = 33, and developed a biomarker model for the diagnosis of stroke. We performed capillary electrophoresis online coupled to micro-time-of-flight mass spectrometry. Potentially disease-specific peptides were identified and a classifier based on these was generated using support vector machine-based software. Candidate biomarkers were sequenced by liquid chromatography-tandem mass spectrometry. We developed two biomarker-based classifiers, employing 14 biomarkers (nominal p-value <0.004 or 35 biomarkers (nominal p-value <0.01. When tested on a blinded test set of 47 independent samples, the classification factor was significantly different between groups; for the 35 biomarker model, median value of the classifier was 0.49 (-0.30 to 1.25 in cases compared to -1.04 (IQR -1.86 to -0.09 in controls, p<0.001. The 35 biomarker classifier gave sensitivity of 56%, specificity was 93% and the AUC on ROC analysis was 0.86. This study supports the potential for urinary proteomic biomarker models to assist with the diagnosis of acute stroke in those with mild symptoms. We now plan to refine further and explore the clinical utility of such a test in large prospective clinical trials.

  18. Acute toxicity in prostate cancer patients treated with and without image-guided radiotherapy

    Image-guided radiotherapy (IGRT) increases the accuracy of treatment delivery through daily target localisation. We report on toxicity symptoms experienced during radiotherapy treatment, with and without IGRT in prostate cancer patients treated radically. Between 2006 and 2009, acute toxicity data for ten symptoms were collected prospectively onto standardized assessment forms. Toxicity was scored during radiotherapy, according to the Common Terminology Criteria Adverse Events V3.0, for 275 prostate cancer patients before and after the implementation of a fiducial marker IGRT program and dose escalation from 74Gy in 37 fractions, to 78Gy in 39 fractions. Margins and planning constraints were maintained the same during the study period. The symptoms scored were urinary frequency, cystitis, bladder spasm, urinary incontinence, urinary retention, diarrhoea, haemorrhoids, proctitis, anal skin discomfort and fatigue. Analysis was conducted for the maximum grade of toxicity and the median number of days from the onset of that toxicity to the end of treatment. In the IGRT group, 14228 toxicity scores were analysed from 249 patients. In the non-IGRT group, 1893 toxicity scores were analysed from 26 patients. Urinary frequency ≥G3 affected 23% and 7% in the non-IGRT and IGRT group respectively (p = 0.0188). Diarrhoea ≥G2 affected 15% and 3% of patients in the non-IGRT and IGRT groups (p = 0.0174). Fatigue ≥G2 affected 23% and 8% of patients in the non-IGRT and IGRT groups (p = 0.0271). The median number of days with a toxicity was higher for ≥G2 (p = 0.0179) and ≥G3 frequency (p = 0.0027), ≥G2 diarrhoea (p = 0.0033) and ≥G2 fatigue (p = 0.0088) in the non-IGRT group compared to the IGRT group. Other toxicities were not of significant statistical difference. In this study, prostate cancer patients treated radically with IGRT had less severe urinary frequency, diarrhoea and fatigue during treatment compared to patients treated with non-IGRT. Onset of these

  19. Acute toxicity in prostate cancer patients treated with and without image-guided radiotherapy

    Williams Scott

    2011-10-01

    Full Text Available Abstract Background Image-guided radiotherapy (IGRT increases the accuracy of treatment delivery through daily target localisation. We report on toxicity symptoms experienced during radiotherapy treatment, with and without IGRT in prostate cancer patients treated radically. Methods Between 2006 and 2009, acute toxicity data for ten symptoms were collected prospectively onto standardized assessment forms. Toxicity was scored during radiotherapy, according to the Common Terminology Criteria Adverse Events V3.0, for 275 prostate cancer patients before and after the implementation of a fiducial marker IGRT program and dose escalation from 74Gy in 37 fractions, to 78Gy in 39 fractions. Margins and planning constraints were maintained the same during the study period. The symptoms scored were urinary frequency, cystitis, bladder spasm, urinary incontinence, urinary retention, diarrhoea, haemorrhoids, proctitis, anal skin discomfort and fatigue. Analysis was conducted for the maximum grade of toxicity and the median number of days from the onset of that toxicity to the end of treatment. Results In the IGRT group, 14228 toxicity scores were analysed from 249 patients. In the non-IGRT group, 1893 toxicity scores were analysed from 26 patients. Urinary frequency ≥G3 affected 23% and 7% in the non-IGRT and IGRT group respectively (p = 0.0188. Diarrhoea ≥G2 affected 15% and 3% of patients in the non-IGRT and IGRT groups (p = 0.0174. Fatigue ≥G2 affected 23% and 8% of patients in the non-IGRT and IGRT groups (p = 0.0271. The median number of days with a toxicity was higher for ≥G2 (p = 0.0179 and ≥G3 frequency (p = 0.0027, ≥G2 diarrhoea (p = 0.0033 and ≥G2 fatigue (p = 0.0088 in the non-IGRT group compared to the IGRT group. Other toxicities were not of significant statistical difference. Conclusions In this study, prostate cancer patients treated radically with IGRT had less severe urinary frequency, diarrhoea and fatigue during treatment

  20. Urinary System anomalies at birth

    Sharada B. Menasinkai

    2015-06-01

    Full Text Available Background: Congenital anomalies of urinary system are common and are found in 3-4% of population, and lethal urinary anomalies account for 10% of termination of pregnancy. Methods: A study was done to know the incidence of congenital anomalies at birth for the period of 4 months from May 99 - Sept 99 at Cheluvamba hospital attached to Mysore medical college. Congenital anomalies in the still births, live births and aborted fetuses >20 weeks were studied along with the case history and ultrasound reports. Aborted fetuses and still born babies were collected for autopsy after the consent of parents. These babies were fixed in 10% formalin and autopsy was done after fixing, and anomalies were noted. Results: Total births during study period were 3000. There were 61 babies with congenital anomalies and 6 babies had anomalies of urinary system. Among the urinary system anomalies 1 baby had bilateral renal agenesis, 1 baby had unilateral renal agenesis with anophthalmia (Fraser syndrome, 2 babies had Multicystic dysplastic kidney disease (MCDK and 1 live baby had hydronephrosis due to obstruction at pelvi ureteric junction, and 1 live female baby had polycystic kidneys. Conclusion: Incidence of urinary system anomalies in the present study was 2 per 1000 births. U/S detection of urinary anomalies varies with period of gestation, amniotic fluid volume and visualisation of urinary bladder. Autopsy helps to detect renal agenesis. [Int J Res Med Sci 2015; 3(3.000: 743-748

  1. Surface retention capacity calculation

    David, Vaclav; Dostal, Tomas

    2010-05-01

    Flood wave transformation in the floodplain is the phenomenon which is researched within interdisciplinary project NIVA - Water Retention in Floodplains and Possibilities of Retention Capacity Increase. The project focuses on broad range of floodplain ecosystem services and mitigation of flooding is one of them. Despite main influence on flood wave transformation is due to flow retardation, retention in surface depressions within floodplain has been analyzed to get better overview of whole transformation process. Detail digital relief model (DRM) has been used for given purposes to be able to analyze terrain depressions volumes. The model was developed with use of stereophotogrammetric evaluation of airborne images with high resolution of 10 cm. It was essential for purposes of presented analysis not to apply pit removal routines which are often used for generation of DRM for hydrological modelling purposes. First, the methodology of analysis was prepared and tested on artificial surface. This surface was created using random raster generation, filtration and resampling with final resolution of 1000 x 1000 units and height of maximum 10 units above datum. The methodology itself is based on analysis of areas inundated by water at different elevation levels. Volume is than calculated for each depression using extraction of terrain elevations under corresponding water level. The method was then applied on the area of Lužnice River floodplain section to assess retention capacity of real floodplain. The floodplain had to be cut into sections perpendicular to main river orientation for analyses as the method was tested for square shaped area without any significant inclination. Results obtained by mentioned analysis are presented in this paper. Acknowledgement Presented research was accomplished within national project NIVA - Water Retention in Floodplains and Possibilities of Retention Capacity Increase, nr. QH82078. The project is funded by Ministry of Agriculture of

  2. KIDNEY AND URINARY TRACT

    2003-01-01

    14.1 Renal failure2003118 Comparison of two score models in predicting prognosis and renal outcome in acute renal failure.ZHANG Wenxian(张文贤), et al. Dept Nephrol, Nan-fang Hosp 1st Milit Med Univ, Guangzhou 510516.

  3. Kidney and Urinary Tract

    2006-01-01

    11.1 Renal failure 2006090 Clinical and image study of pancreatic he-mocirculatory change in patients with acute pacreati- tis WANG Pei - wen(汪佩文) , et al. Dept Gastroen-terol, Shanghai 1 st People’ s Hosp, Shanghai Jiaotong Univ, Shanghai 200080. Chin J Dig 2005;25(8) :469 -472.

  4. Catheter-Associated Urinary Tract Infections

    ... Top of page What is a urinary tract infection? A urinary tract infection (UTI) is an infection that involves ... page What is a catheter-associated urinary tract infection (CAUTI)? A catheter-associated urinary tract infection (CAUTI) occurs when germs (usually bacteria) ...

  5. Perturbations in the Urinary Exosome in Transplant Rejection

    Tara eSigdel

    2015-01-01

    Full Text Available Urine exosomes are small vesicles exocytosed into the urine by all renal epithelial cell types under normal physiologic and disease states. Urine exosomal proteins may mirror disease specific proteome perturbations in kidney injury. Analysis methodologies for the exosomal fraction of the urinary proteome were developed for comparing the urinary exosomal fraction versus unfractionated proteome for biomarker discovery. Urine exosomes were isolated by centrifugal filtration of urine samples collected from kidney transplant patients with and without acute rejection, which were biopsy matched. The proteomes of unfractionated whole urine (Uw and urine exosomes (Ue underwent mass spectroscopy-based quantitative proteonomics analysis. The proteome data were analyzed for significant differential protein abundances in acute rejection (AR. A total of 1018 proteins were identified in Uw and 349 proteins in Ue. 279 overlapped between the two urinary compartments and 70 proteins were unique to the Ue compartment. Of 349 exosomal proteins identified from transplant patients,220 had not been previously identified in the normal Ue fraction. 11 Ue proteins, functionally involved in an inflammatory and stress response, were more abundant in urine samples from patients with acute rejection, 3 of which are exclusive to the Ue fraction. Ue AR-specific biomarkers(8 were also detected in Uw, but since they were observed at significantly lower abundances in Uw, they were not significant for AR in Uw. A rapid urinary exosome isolation method and quantitative measurement of enriched Ue proteins was applied. Perturbed proteins in the exosomal compartment of urine collected from kidney transplant patients were specific to inflammatory responses, and were not observed in the Ue fraction from normal healthy subjects. Ue specific protein alterations in renal disease provide potential mechanistic insights and offer a unique panel of sensitive biomarkers for monitoring AR.

  6. The clearance concept with special reference to determination of glomerular filtration rate in patients with fluid retention

    Henriksen, Ulrik L; Henriksen, Jens H

    2014-01-01

    be assessed to obtain a correct measurement of the glomerular filtration rate (GFR). In theory, total plasma clearance with late samples (24-h, 48-h) may be applied in patients with fluid retention, but validation hereof has not been performed. Until such studies are completed, it is recommended that......In subjects without fluid retention, the total plasma clearance of a renal filtration indicator (inulin, (99m) Tc-DTPA, (51) Cr-EDTA) is close to the urinary plasma clearance. Conversely, in patients with fluid retention (oedema, pleural effusions, ascites), there is a substantial discrepancy...... patients with fluid retention have their GFR measured by a urinary plasma clearance technique with controlled quantitativeurinary sampling within a few hours after indicator injection....

  7. Tritium retention in TFTR

    This report discusses the materials physics related to D-T operation in TFTR. Research activities are described pertaining to basic studies of hydrogenic retention in graphite, hydrogen recycling phenomena, first-wall and limiter conditioning, surface analysis of TFTR first-wall components, and estimates of the tritium inventory

  8. Urinary incontinence - vaginal sling procedures

    ... your doctor will have you try bladder retraining, Kegel exercises, medicines, or other options. If you tried ... Urinary incontinence - tension-free vaginal tape Patient Instructions Kegel exercises - self-care Self catheterization - female Suprapubic catheter ...

  9. Urinary Tract Infections (For Kids)

    Full Text Available ... your urinary tract, take these steps: Keep clean. Wash your private parts every day when you take ... choices. Those trips to the bathroom can help wash bacteria out of your body and cranberry juice ...

  10. Feline Lower Urinary Tract Disease

    ... FIC. To help reduce the chances of recurrence: • Feed small meals on a frequent basis. • Consult with your veterinarian about the best diet for your cat. Many commercial diets are acceptable, but some urinary ...

  11. Urinary Tract Infections (For Kids)

    Full Text Available ... Your pee smells bad. These changes occur because bacteria have caused an infection somewhere in your urinary ... shorter than boys' urethras. The shorter urethra means bacteria can get up into the bladder more easily ...

  12. Urinary Tract Infections (For Kids)

    Full Text Available ... Urinary Tract Troubles Girls are more likely than boys to get a UTI. That's because their urethras are much shorter than boys' urethras. The shorter urethra means bacteria can get ...

  13. Pivmecillinam versus sulfamethizole for short-term treatment of uncomplicated acute cystitis in general practice: a randomized controlled trial

    Bjerrum, Lars; Gahrn-Hansen, Bente; Grinsted, Per

    2009-01-01

    To investigate whether short-term treatment with pivmecillinam was more effective than sulfamethizole in patients with acute uncomplicated urinary tract infection (UTI).......To investigate whether short-term treatment with pivmecillinam was more effective than sulfamethizole in patients with acute uncomplicated urinary tract infection (UTI)....

  14. Diseases of the urinary system

    Age-dependent anatomo-physiological regularities of development urogenital system of in children are considered. A description of performing examination methods is given: summarized roentgenography, excretary urography, cystography, kidney angiography. Great attention is given to the choice of contrast media, dose calculation, excretion and pharmokinetic mechanism of contrast media. Particular items of roentgenodiagnosis of urinary tract diseases are given: anomalies and acquired diseases of urinary system

  15. Controversies in urinary iodine determinations

    Soldin, Offie Porat

    2002-01-01

    Iodine deficiency (ID) is associated with increased prevalence of goiter, increased risk for neurodevelopmental disorders, and is the world’s leading cause of intellectual deficits. Iodine nutritional status of a population is assessed by measurements of urinary iodine concentrations which are also used to define, indicate, survey and monitor iodine deficiency and consequently its treatment. Several methods are available for urinary iodine determination. Discussed here are some of the limitat...

  16. Urinary System anomalies at birth

    Sharada B. Menasinkai; Mahantappa A. Chiniwar; Saraswathi, G

    2015-01-01

    Background: Congenital anomalies of urinary system are common and are found in 3-4% of population, and lethal urinary anomalies account for 10% of termination of pregnancy. Methods: A study was done to know the incidence of congenital anomalies at birth for the period of 4 months from May 99 - Sept 99 at Cheluvamba hospital attached to Mysore medical college. Congenital anomalies in the still births, live births and aborted fetuses >20 weeks were studied along with the case history and ul...

  17. Urinary conduits in gynecologic oncology

    Over an 11-year period (1971 to 1981), 212 urinary conduit surgeries were performed by the Department of Gynecology at the University of Texas, M. D. Anderson Hospital and Tumor Institute at Houston. The urinary diversions were performed as part of the pelvic exenteration operation in 154 patients, for radiation injury in 48 patients, and for palliation of disease recurrence in ten patients. Ninety-three percent had prior pelvic radiotherapy. Various segments of the gastrointestinal tract were used, including the ileum (102), sigmoid colon (99), transverse colon (four), jejunum (four), and others (three). Fifty percent of abnormal preoperative intravenous pyelograms reverted to normal after urinary diversion. Revision of the stoma was required in 6%. Other complications included infection (18%), renal loss (17%), and urinary leaks and fistulae (3%). The overall perioperative mortality was 7%, decreasing from 11% in the first five years to 3% during the last six years. Ureteral stents were routinely used. When selecting a segment of bowel for a urinary conduit, both tissue quality and mobility are important. Mortality and morbidity of urinary conduit surgery continues to decrease with experience

  18. General Reviews of Vocabulary Retention

    ZHANG Yuan

    2013-01-01

    This paper will try to review two important theories (repletion and retrieval) which are crucial for vocabulary retention. These two methods are well connected and each of them cannot lead to successful vocabulary retention without sensible utilization of the other.

  19. Host-pathogen interactions in urinary tract infection.

    Nielubowicz, Greta R; Mobley, Harry L T

    2010-08-01

    The urinary tract is a common site of bacterial infections; nearly half of all women experience at least one urinary tract infection (UTI) during their lifetime. These infections are classified based on the condition of the host. Uncomplicated infections affect otherwise healthy individuals and are most commonly caused by uropathogenic Escherichia coli, whereas complicated infections affect patients with underlying difficulties, such as a urinary tract abnormality or catheterization, and are commonly caused by species such as Proteus mirabilis. Virulence and fitness factors produced by both pathogens include fimbriae, toxins, flagella, iron acquisition systems, and proteins that function in immune evasion. Additional factors that contribute to infection include the formation of intracellular bacterial communities by E. coli and the production of urease by P. mirabilis, which can result in urinary stone formation. Innate immune responses are induced or mediated by pattern recognition receptors, antimicrobial peptides, and neutrophils. The adaptive immune response to UTI is less well understood. Host factors TLR4 and CXCR1 are implicated in disease outcome and susceptibility, respectively. Low levels of TLR4 are associated with asymptomatic bacteriuria while low levels of CXCR1 are associated with increased incidence of acute pyelonephritis. Current research is focused on the identification of additional virulence factors and therapeutic or prophylactic targets that might be used in the generation of vaccines against both uropathogens. PMID:20647992

  20. Anatomo-pathological and epidemiological analysis of urinary tract lesions in dogs

    Carolina da Fonseca Sapin

    2016-01-01

    Full Text Available ABSTRACT: In dogs, diseases of the urinary tract are common and can be caused by disorders of varied etiology. The objective of this study was to classify qualitatively and quantitatively urinary tract lesions of 363 dogs, which were classified according to its anatomical distribution and etiology. The data was obtained from the revision of 36 years of protocols from the Regional Laboratory of Diagnosis (LRD/UFPel and it represents 4.0% of diagnoses from a total of 8980 for that period and species. Renal injury accounted for 93.1% of cases, with 309 being primary kidney lesions; from which the main lesions were the tubulointerstitial nephritis (142 cases often associated with Leptospirosis (47. Injuries of lower urinary tract accounted for 6.9% of the cases where acute cystitis stands out (19. In this study, renal failure, acute or chronic, represented an important cause of death in dogs.

  1. Retention of ingested (60)Co by a freshwater fish

    The experiment was carried out on a group of 10 carp receiving the soft tissue of previously contaminated lymnaea as food. Ingestion by carp of 45 daily rations, distributed over a 63-day period, resulted in a low retention of the radionuclide. The contamination kinetics showed that the steady state should be reached after only 225 days. The 60Co transfer factor was approximately 10−2 and the retention factor about 3.3 x 10−3. During the depuration phase, radiocobalt elimination by the carp developed in accordance with an exponential model based on the existence of two biological half-lives of 1.5 and 35 days which indicate a high Co turnover. During both phases of the experiment, urinary and branchial excretion appeared to be higher than faecal excretion

  2. Palliative urinary conduit diversion in cases of intolerable urinary discomfort

    Fifteen patients with incurable gynecological cancers, all primary radiation treated and all having severe urinary discomfort due to urinary tract injuries were retrospectively examined after urinary conduit diversion. All have been followed-up until termination or until all survivors had lived for 6 months after the operation. Twelve of the 15 were discharged from the hospital, 10 of whom survived the first 6 months. Of those discharged 82% of the cumulated sum of postoperative observations days was spent out of the hospital. At the end of the observation period nine patients had been supplied with a colostomy as well, thus having double stomas. All six patients still alive declared in retrospect that given the choice again, they would still be willing to undergo the operation

  3. In Vivo Dynamics of Type 1 Fimbria Regulation in Uropathogenic Escherichia coli during Experimental Urinary Tract Infection

    Gunther, Nereus W.; Lockatell, Virginia; Johnson, David E.; Mobley, Harry L. T.

    2001-01-01

    Escherichia coli is the primary cause of uncomplicated infections of the urinary tract including cystitis. More serious infections, characterized as acute pyelonephritis, can also develop. Type 1 fimbriae of E. coli contribute to virulence in the urinary tract; however, only recently has the expression of the type 1 fimbriae been investigated in vivo using molecular techniques. Transcription of type 1 fimbrial genes is controlled by a promoter that resides on a 314-bp invertible element capab...

  4. Clinical Characteristics and Management of Late Urinary Symptom Flare Following Stereotactic Body Radiation Therapy for Prostate Cancer

    Woo, Jennifer A; Leonard N Chen; Bhagat, Aditi; Oermann, Eric K; Kim, Joy S; Moures, Rudy; Yung, Thomas; Lei, Siyuan; Collins, Brian T.; Kumar, Deepak; Suy, Simeng; Dritschilo, Anatoly; Lynch, John H.; Sean P Collins

    2014-01-01

    Purpose: Stereotactic body radiation therapy (SBRT) is increasingly utilized as primary treatment for clinically localized prostate cancer. While acute post-SBRT urinary symptoms are well recognized, the late genitourinary toxicity of SBRT has not been fully described. Here, we characterize the clinical features of late urinary symptom flare and recommend conservative symptom management approaches that may alleviate the associated bother. Methods: Between February 2008 and August 2011, 216...

  5. Two Cases of Omental Torsion Mimicking Acute Appendicitis

    Feeroz Alam Khan; Naeem Liaqat; Sajid Hameed Dar; Asif Iqbal Sandhu; Sajid Nayyer

    2014-01-01

    Acute appendicitis is often simulated by other entities like mesenteric adenitis, worm infestation, Meckel’s diverticulitis, urinary tract infection and rarely omental torsion. We report two cases, a 6 year old boy and an 11 year old girl, who presented with symptoms and signs of acute appendicitis but upon exploration turned out to be omental torsion.

  6. Two Cases of Omental Torsion Mimicking Acute Appendicitis

    Feeroz Alam Khan

    2014-02-01

    Full Text Available Acute appendicitis is often simulated by other entities like mesenteric adenitis, worm infestation, Meckel’s diverticulitis, urinary tract infection and rarely omental torsion. We report two cases, a 6 year old boy and an 11 year old girl, who presented with symptoms and signs of acute appendicitis but upon exploration turned out to be omental torsion.

  7. Two Cases of Omental Torsion Mimicking Acute Appendicitis

    Liaqat, Naeem; Dar, Sajid Hameed; Sandhu, Asif Iqbal; Nayyer, Sajid

    2014-01-01

    Acute appendicitis is often simulated by other entities like mesenteric adenitis, worm infestation, Meckel’s diverticulitis, urinary tract infection and rarely omental torsion. We report two cases, a 6 year old boy and an 11 year old girl, who presented with symptoms and signs of acute appendicitis but upon exploration turned out to be omental torsion. PMID:24834389

  8. The menopause and urinary incontinence

    Foldspang, Anders; Mommsen, Søren

    1994-01-01

    The objective was to study the possible role of the menopause in adult female urinary incontinence (UI) etiology, using a cross-sectional population study comprising a random sample of adult females and self-reported data based on postal questionnaires. The study group comprised 915 women who...... prevalence in 1987 of episodes of stress and urge urinary incontinence; prevalence of menopause and exposure to childbirth, gynecologic surgery, cystitis and obesity as indicated by body mass index more than 29; prevalence relative risks, as indicated by odds ratio of UI conditional on menopause and other...... prevalence risk indicators. The 1987 period prevalences of stress and urge urinary incontinence were 15.9% and 8.7%, respectively. Forty-one percent had ceased to menstruate. Irrespective of the UI risk indicators mentioned, UI prevalence was significantly raised from 1 year before until 1 year after...

  9. Drug-Induced Urinary Calculi

    Matlaga, Brian R; Shah, Ojas D; Assimos, Dean G

    2003-01-01

    Urinary calculi may be induced by a number of medications used to treat a variety of conditions. These medications may lead to metabolic abnormalities that facilitate the formation of stones. Drugs that induce metabolic calculi include loop diuretics; carbonic anhydrase inhibitors; and laxatives, when abused. Correcting the metabolic abnormality may eliminate or dramatically attenuate stone activity. Urinary calculi can also be induced by medications when the drugs crystallize and become the primary component of the stones. In this case, urinary supersaturation of the agent may promote formation of the calculi. Drugs that induce calculi via this process include magnesium trisilicate; ciprofloxacin; sulfa medications; triamterene; indinavir; and ephedrine, alone or in combination with guaifenesin. When this situation occurs, discontinuation of the medication is usually necessary. PMID:16985842

  10. Urinary tract infection in the neurogenic bladder.

    Vigil, Humberto R; Hickling, Duane R

    2016-02-01

    There is a high incidence of urinary tract infection (UTI) in patients with neurogenic lower urinary tract function. This results in significant morbidity and health care utilization. Multiple well-established risk factors unique to a neurogenic bladder (NB) exist while others require ongoing investigation. It is important for care providers to have a good understanding of the different structural, physiological, immunological and catheter-related risk factors so that they may be modified when possible. Diagnosis remains complicated. Appropriate specimen collection is of paramount importance and a UTI cannot be diagnosed based on urinalysis or clinical presentation alone. A culture result with a bacterial concentration of ≥10(3) CFU/mL in combination with symptoms represents an acceptable definition for UTI diagnosis in NB patients. Cystoscopy, ultrasound and urodynamics should be utilized for the evaluation of recurrent infections in NB patients. An acute, symptomatic UTI should be treated with antibiotics for 5-14 days depending on the severity of the presentation. Antibiotic selection should be based on local and patient-based resistance patterns and the spectrum should be as narrow as possible if there are no concerns regarding urosepsis. Asymptomatic bacteriuria (AB) should not be treated because of rising resistance patterns and lack of clinical efficacy. The most important preventative measures include closed catheter drainage in patients with an indwelling catheter and the use of clean intermittent catheterization (CIC) over other methods of bladder management if possible. The use of hydrophilic or impregnated catheters is not recommended. Intravesical Botox, bacterial interference and sacral neuromodulation show significant promise for the prevention of UTIs in higher risk NB patients and future, multi-center, randomized controlled trials are required. PMID:26904414

  11. Urinary incontinence - what to ask your doctor

    ... to help with my urinary incontinence? What are Kegel exercises? What can I do when I want ... tape Urinary incontinence - vaginal sling procedures Patient Instructions Kegel exercises - self-care Self catheterization - female Self catheterization - ...

  12. Cranberry Juice for Urinary Tract Infection?

    ... nih.gov/medlineplus/news/fullstory_157466.html Cranberry Juice for Urinary Tract Infection? Specialist says grocery-store ... 2016 (HealthDay News) -- Contrary to popular belief, cranberry juice does not cure a urinary tract infection, a ...

  13. Urinary tract infection in childhood: lower or upper level? DMSA scintigraphic validation of a new clinical risk index

    Urinary tract infection in children can be limited most of time at the lower level of the urinary tractus but an extension to the upper level of the tractus should not be neglected due to the asymptomatic nature of the disease. In our study, we suggest a new graph to predict the probability of acute pyelonephritis only if the bacteriological urinary analyse were obtained in good conditions and without any treatment. In the other cases, a DMSA scintigram should be proposed at the earlier phase of the diagnosis not to underestimate the risk of asymptomatic pyelonephritis. (authors)

  14. Radiology of continent urinary diversions

    Continent urinary diversions are gaining wide acceptance as alternatives to the ideal conduit following cystectomy. Clean intermittent catheterization of the pouch at regular intervals obviates the inconvenience of an external stomal appliance. A variety of surgical techniques have been described for continent pouches. These use the small bowel alone or a combination of the cecum and the terminal ileum. The optimum pouch protects upper tracts by preventing reflux, provides urinary continence, and has sufficient capacity to require infrequent catheterization. Simplified construction techniques for the common pouches are graphically presented, and methods are suggested for identification and study of continent diversions

  15. Urinary incontinence in children Invited Editor

    Canpolat, Nur; ,; Çalışkan, Salim

    2007-01-01

    Urinary incontinence which is defined as the involuntary loss of urine is a very common clinical problem in childhood Its etiology includes delayed bladder control effects of environmental and social factors on toilet training urinary tract infection anatomic abnormalities of lower urinary tract and neurogenic disorders The more common cause of childhood urinary incontinence is non neurogenic abnormalities classified as anatomic abnormalities or bladder dysfunction Voiding dysfunction is asso...

  16. Clinical Observation on Electroacupuncture Against Urinary Incontinence

    赵文洁; 胡昌东; 王洁茹; 洪珏

    2009-01-01

    @@ Urinary incontinence is a common problem, usually classified as stress incontinence or urge incontinence[1]. With the development of medical science, people have got more and more profound knowledge towards urinary incontinence. We treated urinary incontinence with electroacupuncture since 2006, and now reported it as follows.

  17. Valor diagnóstico y pronóstico de la determinación de tripsinógeno-2 urinario en pacientes con pancreatitis aguda Usefulness of determining urinary trypsinogen-2 in diagnosis and prognosis of patients with acute pancreatitis

    J.A. Díaz Peromingo

    2009-12-01

    Full Text Available Fundamento. Estudiar el papel del tripsinógeno-2 urinario en el diagnóstico y pronóstico inicial de pacientes con pancreatitis aguda (PA así como su relación con la estancia media hospitalaria y la mortalidad. Método. Se incluyeron 42 pacientes diagnosticados de PA a los que se realizó hematimetría, bioquímica sanguínea, amilasuria y tripsinógeno-2 urinario. Se estableció un punto de corte de 50 µg/L y una segunda dilución a 2.000 µg/L. Otras variables incluidas fueron etiología, estancia media hospitalaria, traslado a UCI y fallecimiento. Resultados. De los 42 pacientes, 29 (69% eran hombres y 13 (31% mujeres; edad media 61 años. La etiología más frecuente era la biliar, seguida del alcohol. Estancia media: 8,38 días. Traslado a UCI en 4 (9,5% pacientes. Dos de los pacientes trasladados a UCI y otro que no requirió traslado fallecieron (7,14%. La amilasa sérica fue elevada en 33 (78,57% pacientes y la lipasa en 36 (85,71%. El tripsinógeno urinario fue positivo en 34 pacientes (80,95%. Se evidenció asociación entre tripsinógeno-2 urinario y edad (p=0,016; r=0,893, glucemia (p=0,005, r=0,901, amilasa plasmática (p=0,029; r=0,852, lipasa (p=0,022; r=0,809 e hipoxemia (p=0,001; r=0,962. En cuanto a la estancia media, se observó asociación estadística con edad (p=0,046; r=0,784 y acidosis metabólica (p=0,016; r=0,839. La mortalidad se asoció a hipocalcemia (p=0,008; r=0,899 y acidosis metabólica (p=0,032; r=0,814. Conclusión. La determinación del tripsinógeno-2 urinario en pacientes con PA es un test útil y rápido. Los pacientes mayores de 65 años, con hipoxemia, acidosis metabólica e hipocalcemia tienen tendencia a presentar una estancia media hospitalaria prolongada y mayor mortalidad.Background. To study the role of urinary trypsinogen-2 in diagnosing and early prognosis of patients with acute pancreatitis (AP and the relationship to length of hospital stay and mortality. Methods. Forty-two patients were

  18. Pivmecillinam plus pivampicillin in complicated urinary tract infection. Double-blind comparison of the combination pivmecillinam/pivampicillin and pivmecillinam alone in patients with urinary tract infection.

    Frimodt-Møller, C; Vejlsgaard, R

    1981-01-01

    Twenty-six surgical-urological patients with severe underlying diseases of the urinary tract and an acute urinary tract infection received a 10-day treatment with either pivmecillinam, 400 mg three times daily (twelve patients), or the fixed dose combination of pivmecillinam/pivampicillin (pivmecillinam 200 mg plus pivampicillin 250 mg) three times daily (fourteen patients). Eleven of the fourteen patients given combined therapy were cured bacteriologically, compared to only four out of twelve patients taking pivmecillinam alone. Clinical success was achieved in eleven out of fourteen patients who received combination therapy and in seven out of twelve subjects given pivmecillinam. Mild gastro-intestinal discomfort was recorded in a few patients in both treatment groups. The results suggest that the combination of pivmecillinam and pivampicillin is a promising alternative in patients with complicated urinary tract infections. PMID:6266897

  19. Urinary lithiasis and urinary tract malformations in children: A retrospective study of 34 cases

    Jamila Chahed

    2011-01-01

    Full Text Available Background: Although the association of urinary lithiasis and urinary tract malformation is not rare, their management poses challenges. The aim of this study was to evaluate the relationship between urolithiasis and malformations of the urinary system. There were 34 patients (19 males and 15 females with a mean age of 4.8 years (range, 2 months to 14 years. All patients had urinary lithiasis with a urinary tract malformation. Abdominal pain was the most frequent clinical symptom (38%. Urinary infection was found in 7 patients (21% and macroscopic haematuria was present in 10 patients (29%. The most frequent urinary tract malformations were megaureter (8 cases, uretero-pelvic junction obstruction (7 cases and vesico-ureteric reflux (8 cases, but its malformative origin could not be confirmed. Treatment consisted of lithiasis extraction in 32 cases associated with specific treatment of the uropathy in 27 cases. Postoperative outcome was uneventful in all cases. In fact, urinary lithiasis and urinary tract malformation association is not rare. Indeed, 9-34% of urinary lithiasis are noted to be associated with urinary tract malformation. Positive diagnosis relies specifically on kidney ultrasound, intravenous urography, and urethrocystography. Treatment depends on the type of urinary tract malformation, localisation and size of the urinary lithiasis. Conclusion: In conclusion, urinary lithiasis and urinary tract malformation association is a frequent eventuality. Surgical intervention is the usual mode of treatment.

  20. Treatment of stress urinary incontinence

    Fischer-Rasmussen, W

    1990-01-01

    This review presents reported cure and improvement rates of stress urinary incontinence in women obtained by different treatment modalities. Apart from the urodynamic findings, histological and histochemical changes of the pelvic floor may be clinically relevant to treatment in the future. Long...

  1. Imaging of the Urinary Tract

    ... takes pictures of the body’s internal organs and soft tissues without using x rays. MRI machines use radio waves and magnets to ... Urinary tract imaging techniques include conventional radiology, or x rays; ... tomography (CT) scans; and radionuclide scans. Preparations for an ...

  2. Biofilm infections of urinary tract

    Holá, V.; Růžička, F.; Horáková, L.; Renata, R.; Horká, Marie

    Istanbul, 2008. s. 232. [International Congress of Bacteriology and Applied Microbiology /12./. 05.08.2008-09.08.2008, Istanbul] R&D Projects: GA AV ČR IAAX00310701 Keywords : catheter related urinary tract infections * affection of culture conditions * capillary isoelectric focusing Subject RIV: CB - Analytical Chemistry, Separation

  3. Frank hematuria as the presentation feature of acute leukemia

    Suriya Owais

    2010-01-01

    Full Text Available Muco-cutaneous bleeding is a common presenting feature of acute leukemias. Mucosal bleeding usually manifests as gum bleeding and/or epistaxis but may occur in any mucosal surface of the body. Hematuria as an isolated or main presenting feature of acute leukemia is rare. We describe two cases of acute leukemia, a 19 year old male with acute lymphoblastic leukemia and a 52 year old male with acute myeloid leukemia, both presenting with gross hematuria. There was no demonstrable leukemic infiltration of the urinary tract on imaging studies. Hematuria in these patients was likely to be due to occult leukemic infiltration of the urinary system, aggravated by thrombocytopenia, as it subsided after starting chemotherapy. Our cases highlight that hematuria should be remembered as a rare presenting feature of acute leukemia.

  4. Urinary tract infections in infants and children: Diagnosis and management.

    Robinson, Joan L; Finlay, Jane C; Lang, Mia Eileen; Bortolussi, Robert

    2014-06-01

    Recent studies have resulted in major changes in the management of urinary tract infections (UTIs) in children. The present statement focuses on the diagnosis and management of infants and children >2 months of age with an acute UTI and no known underlying urinary tract pathology or risk factors for a neurogenic bladder. UTI should be ruled out in preverbal children with unexplained fever and in older children with symptoms suggestive of UTI (dysuria, urinary frequency, hematuria, abdominal pain, back pain or new daytime incontinence). A midstream urine sample should be collected for urinalysis and culture in toilet-trained children; others should have urine collected by catheter or by suprapubic aspirate. UTI is unlikely if the urinalysis is completely normal. A bagged urine sample may be used for urinalysis but should not be used for urine culture. Antibiotic treatment for seven to 10 days is recommended for febrile UTI. Oral antibiotics may be offered as initial treatment when the child is not seriously ill and is likely to receive and tolerate every dose. Children <2 years of age should be investigated after their first febrile UTI with a renal/bladder ultrasound to identify any significant renal abnormalities. A voiding cystourethrogram is not required for children with a first UTI unless the renal/bladder ultrasound reveals findings suggestive of vesicoureteral reflux, selected renal anomalies or obstructive uropathy. PMID:25332662

  5. Staphylococcus saprophyticus Bacteremia originating from Urinary Tract Infections: A Case Report and Literature Review

    Lee, Anna; Hong, Jeongmin; Jo, Won-yong; Cho, Oh-Hyun; Kim, Sunjoo

    2016-01-01

    Staphylococcus saprophyticus is a common pathogen of acute urinary tract infection (UTI) in young females. However, S. saprophyticus bacteremia originating from UTI is very rare and has not been reported in Korea. We report a case of S. saprophyticus bacteremia from UTI in a 60-year-old female with a urinary stone treated successfully with intravenous ciprofloxacin, and review the cases of S. saprophyticus bacteremia reported in the literature. Thus, the microorganism may cause invasive infection and should be considered when S. saprophyticus is isolated from blood cultures in patients with UTI.

  6. Staphylococcus saprophyticus Bacteremia originating from Urinary Tract Infections: A Case Report and Literature Review.

    Hur, Jaehyung; Lee, Anna; Hong, Jeongmin; Jo, Won-Yong; Cho, Oh-Hyun; Kim, Sunjoo; Bae, In-Gyu

    2016-06-01

    Staphylococcus saprophyticus is a common pathogen of acute urinary tract infection (UTI) in young females. However, S. saprophyticus bacteremia originating from UTI is very rare and has not been reported in Korea. We report a case of S. saprophyticus bacteremia from UTI in a 60-year-old female with a urinary stone treated successfully with intravenous ciprofloxacin, and review the cases of S. saprophyticus bacteremia reported in the literature. Thus, the microorganism may cause invasive infection and should be considered when S. saprophyticus is isolated from blood cultures in patients with UTI. PMID:27433385

  7. Procalcitonin: A Key Marker in Children with Urinary Tract Infection

    Sandrine Leroy

    2011-01-01

    Full Text Available Urinary tract infections (UTIs are the most common source of bacterial infections among young febrile children. Accurate diagnosis of acute pyelonephritis (APN and vesicoureteral reflux (VUR is important because of their association with renal scarring, leading in the cases to long-term complications. However, the gold standard examinations for both are either DMSA scan (for APN and scar or cystography (for VUR and present limitations (feasibility, pain, cost, etc.. Procalcitonin, a reliable marker of bacterial infections, was demonstrated to be a good predictor of both renal parenchymal involvement in the acute phase and late renal scars. Furthermore, it was also found to be associated with high-grade VUR and was the key tool of a clinical decision rule to predict high-grade VUR in children with a first UTI. Therefore, procalcitonin may certainly be found playing a role in the complex and still debated picture of which examination should be performed after UTI in children.

  8. Acute Bronchitis

    ... of bronchitis: acute and chronic. Most cases of acute bronchitis get better within several days. But your cough ... that cause colds and the flu often cause acute bronchitis. These viruses spread through the air when people ...

  9. Military Retention. A Comparative Outlook

    Vasile Sminchise

    2016-06-01

    Full Text Available One of the main goals for human resources management structures and for armed forces leaders is to maintain all necessary personnel, both qualitatively and quantitatively for operational needs or for full required capabilities. The retention of military personnel is essential to keep morale and unit readiness and to reduce the costs for recruiting, training, replacement of manpower. Retention rates depend not only on money or other social measures. The goal for retention is to keep in use the most valuable resource that belongs to an organization: the human beings and their knowledge. The aim pf this paper is to provide a comparative analysis of retention measures in various countries based on Research and Technology Organisation report released in 2007 and, thus, provide more examples of retention measures as far as the Romanian military system is concerned.

  10. Defective urinary crystallization inhibition and urinary stone formation

    Mauricio Carvalho

    2006-06-01

    Full Text Available INTRODUCTION: Nephrocalcin (NC is a glycoprotein produced in the kidney and inhibits calcium oxalate crystal formation. It has been separated into 4 isoforms (A, B, C, and D and found that (A + B are more abundant than (C + D in urine of healthy subjects, but the reverse is seen in human urine of kidney stone patients. To further examine the role of this protein in inhibition of urinary crystallization, nephrocalcin isoforms were purified from 2 genetically pure dog species. MATERIALS AND METHODS: We studied healthy Beagles, known to be non-stone forming dogs, and Mini-Schnauzers, known to be calcium oxalate stone formers. NC was isolated and purified from each group. Urinary biochemistry and calcium oxalate crystal growth inhibition were measured. RESULTS: Specific crystal growth inhibition activity was significantly higher in non-stone forming dogs (9.79 ± 2.25 in Beagles vs. 2.75 ± 1.34 of Mini-Schnauzers, p < 0.005. Dissociation constants toward calcium oxalate monohydrate were 10-fold different, with Beagles' isoforms being 10 times stronger inhibitors compare to those of Mini-Schnauzers'. Isoforms C + D of NC were the main isoforms isolated in stone-forming dogs. CONCLUSION: NC of these two species of dogs differently affects calcium oxalate crystallization and might have a role in determining ulterior urinary stone formation.

  11. Urinary Tract Infection: How It Happens?

    Silvio Altarac

    2015-01-01

    Full Text Available Urinary tract infections (UTIs, including cystitis and pyelonephritis, affect a large proportion of the world population and account for substantial morbidity and medical costs. Classification of the UTIs is based on the anatomical level of infection, the grade of severity of infection, the underlying risk factors, and the microbiological findings. Uropathogenic Escherichia coli is the causative agent in 70-95% of community-acquired uroinfections and about 50% of all cases of nosocomial uroinfections. Virulence factors associated with uropathogenic strains of E. coli contain toxins such as haemolysin and cytotoxic necrotising factor, capsules, lipopolysaccharide, the siderophore aerobactin, and adhesive organelles. The ability to attach to urothelial cells is the most important determinant of pathogenicity. An adherence is followed by inflammation involving the urothelial cells’ cytokine response. Whereas interleukin (IL-6 can cause the fever and systemic response of the UTIs, IL-8 can function as a neutrophil chemoattractant. Cytokines released by T cells and monocytes modify initiative urothelial cells’ cytokine response to bacteria. Nevertheless, antibiotic treatments can effectively sterilise the urine, but bacteria can survive and persist in the bladder tissue, serving as a reservoir for the recurrent UTIs. The severity of UTI reflects the quality and magnitude of the host response. While strong local and systemic innate immune activation occurs in patients with acute pyelonephritis, the response to asymptomatic bacteriuria is low. It should be reasonable to ‘individualise’ diagnosis and therapy by interconnecting information on uropathogenic bacterial virulence and the host response.

  12. [Uncomplicated urinary tract infection and treatment].

    Wagenlehner, F M E; Vahlensieck, W; Watermann, D; Weidner, W; Naber, K G

    2011-01-01

    Urinary tract infections (UTI) are frequent infections in the outpatient and hospital setting. With respect to treatment options, UTI can generally be stratified into uncomplicated and complicated / nosocomial infections. Uncomplicated UTI are represented by the acute uncomplicated cystitis and the uncomplicated pyelonephritis. They are mainly caused by E. coli. There are, however, also increasing resistance rates found in uncomplicated UTI, e. g., against aminopenicillins, cotrimoxazole and increasingly also fluoroquinolones. This development has called for a new evaluation of the treatment recommendations in uncomplicated UTI. As an empirical therapy for uncomplicated cystitis fosfomycin trometamol, nitrofurantoin or pivmecillinam are recommended as first-line agents. As the oral first line therapy for uncomplicated pyelonephritis fluroquinolones in high dosages are recommended. The frequent asymptomatic bacteriuria does not need to be treated, with only a few exceptions. Due to the increasing antibiotic resistance and the emergence of multiresistant uropathogens, empirical antibiotic treatment becomes more difficult. Therefore the results of susceptibility testing should be awaited whenever possible. PMID:21267803

  13. 穴位按压配合音频治疗手术后尿潴留%Audio frequency and acupuncture point pressing to treat retention of urine

    2001-01-01

    @@Background: Retention of urine is a command complication for the postoperative patients who recepte the general or vertebral canal anesthesia.Because the micturition reflex center is temporarily disturbed by the anesthetic , the vegetative nerve system that control the bladder is functional disorder.The urinary bladder sphincter relatively contracts,and the detrusor urinae of bladder relatively relax. Objective: To discuss the effect of audio frequency and acupuncture point pressing to treat retention of urine. Unit: General Hospital of Shenyang Military Region.

  14. Visualization of Proteus mirabilis Morphotypes in the Urinary Tract: the Elongated Swarmer Cell Is Rarely Observed in Ascending Urinary Tract Infection

    Jansen, Angela M.; Lockatell, C. Virginia; Johnson, David E.; Mobley, Harry L. T.

    2003-01-01

    Proteus mirabilis, a common cause of nosocomial and catheter-associated urinary tract infection, colonizes the bladder and ascends the ureters to the proximal tubules of the kidneys, leading to the development of acute pyelonephritis. P. mirabilis is capable of swarming, a form of multicellular behavior in which bacteria differentiate from the short rod typical of members of the family Enterobacteriaceae, termed the swimmer cell, into hyperflagellated elongated bacteria capable of rapid and c...

  15. Perturbations in the Urinary Exosome in Transplant Rejection

    Sigdel, Tara K.; Ng, Yolanda W.; Lee, Sangho; Nicora, Carrie D.; Qian, Wei-Jun; Smith, Richard D.; Camp, David G.; Sarwal, Minnie M.

    2015-01-01

    Background: Urine exosomes are small vesicles exocytosed into the urine by all renal epithelial cell types under normal physiologic and disease states. Urine exosomal proteins may mirror disease specific proteome perturbations in kidney injury. Analysis methodologies for the exosomal fraction of the urinary proteome were developed for comparing the urinary exosomal fraction versus unfractionated proteome for biomarker discovery. Methods: Urine exosomes were isolated by centrifugal filtration of urine samples collected from kidney transplant patients with and without acute rejection (AR), which were biopsy matched. The proteomes of unfractionated whole urine (Uw) and urine exosomes (Ue) underwent mass spectroscopy-based quantitative proteomics analysis. The proteome data were analyzed for significant differential protein abundances in AR. Results: A total of 1018 proteins were identified in Uw and 349 proteins in Ue. Two hundred seventy-nine overlapped between the two urinary compartments and 70 proteins were unique to the Ue compartment. Of 349 exosomal proteins identified from transplant patients, 220 had not been previously identified in the normal Ue fraction. Eleven Ue proteins, functionally involved in an inflammatory and stress response, were more abundant in urine samples from patients with AR, three of which are exclusive to the Ue fraction. Ue AR-specific biomarkers (1) were also detected in Uw, but since they were observed at significantly lower abundances in Uw, they were not significant for AR in Uw. Conclusion: A rapid urinary exosome isolation method and quantitative measurement of enriched Ue proteins was applied. Perturbed proteins in the exosomal compartment of urine collected from kidney transplant patients were specific to inflammatory responses, and were not observed in the Ue fraction from normal healthy subjects. Ue-specific protein alterations in renal disease provide potential mechanistic insights and offer a unique panel of sensitive

  16. The DMSA scan in paediatric urinary tract infection

    The objective of the present paper was to review the use of the dimercaptosuccinic acid (DMSA) scan in urinary tract infection at British Columbia's Children's Hospital to determine the frequency of cortical defects and the association between vesico-ureteric reflux and the presence of cortical defects in children with urinary tract infection. A total of 129 consecutive children with a urinary tract infection referred for a DMSA scan in a 2-year period (January 1992-January 1994) were retrospectively studied. The results were analysed in terms of kidneys, and the incidence of cortical defects was determined. Eighty-eight patients (68%) had a radiographic micturating cysto-urethrogram within 6 months of the DMSA scan, and in this group the relationship of defects with vesico-ureteric reflux was determined. Overall, 81/258 (31%) of kidneys had a cortical defect on a DMSA scan. Of those who had a micturating cysto-urethrogram, 53/176 (30%) kidneys had vesico-ureteric reflux, and of those that had reflux, 21/53 (40%) had a cortical defect on a DMSA scan. In the group of children without reflux, 38/123 (31%) had a cortical defect. Renal cortical scan defects are common findings in paediatric urinary infection, and frequently occur in the absence of vesico-ureteric reflux. These defects represent either established scars or acute pyelonephritis that can proceed to scarring. The micturating cysto-urethro-gram alone is insufficient as a screening modality to identify those kidneys at risk of renal scarring. Copyright (1998) Blackwell Science Pty Ltd

  17. Diagnosis and treatment of acute low back pain.

    Casazza, Brian A

    2012-02-15

    Acute low back pain is one of the most common reasons for adults to see a family physician. Although most patients recover quickly with minimal treatment, proper evaluation is imperative to identify rare cases of serious underlying pathology. Certain red flags should prompt aggressive treatment or referral to a spine specialist, whereas others are less concerning. Serious red flags include significant trauma related to age (i.e., injury related to a fall from a height or motor vehicle crash in a young patient, or from a minor fall or heavy lifting in a patient with osteoporosis or possible osteoporosis), major or progressive motor or sensory deficit, new-onset bowel or bladder incontinence or urinary retention, loss of anal sphincter tone, saddle anesthesia, history of cancer metastatic to bone, and suspected spinal infection. Without clinical signs of serious pathology, diagnostic imaging and laboratory testing often are not required. Although there are numerous treatments for nonspecific acute low back pain, most have little evidence of benefit. Patient education and medications such as nonsteroidal anti-inflammatory drugs, acetaminophen, and muscle relaxants are beneficial. Bed rest should be avoided if possible. Exercises directed by a physical therapist, such as the McKenzie method and spine stabilization exercises, may decrease recurrent pain and need for health care services. Spinal manipulation and chiropractic techniques are no more effective than established medical treatments, and adding them to established treatments does not improve outcomes. No substantial benefit has been shown with oral steroids, acupuncture, massage, traction, lumbar supports, or regular exercise programs. PMID:22335313

  18. Association between diaphragm use and urinary tract infection.

    Fihn, S D; Latham, R H; Roberts, P; Running, K; Stamm, W E

    1985-07-12

    We conducted independent case-control and retrospective cohort investigations to assess the relationship between diaphragm use and urinary tract infection (UTI). In the former, we compared diaphragm use and vaginal flora among 114 women with acute UTI and 85 women with acute urinary tract symptoms and no UTI. In the latter study, we ascertained the incidence of UTI in 192 diaphragm users and 182 women taking oral contraceptives during a mean follow-up of 9.4 months. Both studies demonstrated a significantly increased risk of UTI in diaphragm users: relative odds were 2.0 in the case-control study and the relative risk was 2.5 in the retrospective cohort study. Vaginal colonization with Escherichia coli was significantly greater in diaphragm users. The incidence of UTI in the cohort study was 26.6 per 1,000 patient-months for diaphragm users and 8.9 per 1,000 patient-months for women taking oral contraceptives. The increased risk of UTI in diaphragm users could not be attributed to differences in age, parity, sexual activity, or previous UTI. PMID:3999367

  19. Approach to urinary tract infections

    Najar, M S; Saldanha, C. L.; Banday, K. A.

    2009-01-01

    Urinary tract infection (UTI) is the most common infection experienced by humans after respiratory and gastro-intestinal infections, and also the most common cause of both community-acquired and nosocomial infections for patients admitted to hospitals. For better management and prognosis, it is mandatory to know the possible site of infection, whether the infection is uncomplicated or complicated, re-infection or relapse, or treatment failure and its pathogenesis and risk factors. Asymptomati...

  20. Urinary Bladder Cancer in Yemen

    Abdullah Saleh Al-Samawi; Saleh Mansoor Aulaqi

    2013-01-01

    Objectives: The aims of this study are to highlight the clinicopathological features of urinary bladder cancer in Yemen, and to describe the histological grading of urothelial neoplasms according to the World Health Organization and International Society of Urologic pathology (WHO/ISUP 1998) classification.Methods: This is a descriptive record-based study of 316 cases of bladder cancer diagnosed by two pathologists at the Department of pathology, Sana'a University from 1st January 2005 to 30t...

  1. Promotion in urinary bladder carcinogenesis.

    Cohen, S M

    1983-01-01

    Aromatic amines, including 2-naphthylamine, 4-aminobiphenyl and benzidine, are known urinary bladder carcinogens in man and other species, but in rodents, aromatic amines and amides have usually induced liver tumors, occasionally also with tumors of the bladder and other tissues. Variations in organ specificity are related to differences in metabolism; for the production of bladder tumors, the rates of acetylation and deacetylation appear to be critical. Bladder specific carcinogens in rodent...

  2. Drugs for treating urinary schistosomiasis

    Kramer, Christine V; Zhang, Fan; Sinclair, David; Olliaro, Piero L

    2014-01-01

    Background Urinary schistosomiasis is caused by an intravascular infection with parasitic Schistosoma haematobium worms. The adult worms typically migrate to the venous plexus of the human bladder and excrete eggs which the infected person passes in their urine. Chronic infection can cause substantial morbidity and long-term complications as the eggs become trapped in human tissues causing inflammation and fibrosis. We summarised evidence of drugs active against the infection. This is new edi...

  3. Temporal resolution of urinary morbidity following prostate brachytherapy

    Purpose: To report the short-term urinary morbidity for prostate brachytherapy patients without a preimplant history of a transurethral resection of the prostate gland and who received prophylactic and prolonged α-blockers. α-blockers may decrease radiation-induced urethritis and increase urinary flow. Multiple clinical and treatment parameters were evaluated to identify factors associated with increased acute urinary morbidity. Materials and Methods: One hundred seventy consecutive patients without a prior history of a transurethral resection of the prostate gland underwent transperineal ultrasound guided prostate brachytherapy for clinical T1c-T3a carcinoma of the prostate gland. For all patients, an α-blocker was initiated prior to implantation and continued at least until the international prostate symptom score (IPSS) returned to baseline levels. Clinical parameters evaluated for short-term urinary morbidity included patient age, clinical T stage, preimplant IPSS (obtained within 3 weeks of implantation), and prostate ultrasound volume. Treatment parameters included the utilization of neoadjuvant hormonal manipulation, the utilization of moderate dose external beam radiation therapy before implantation, the choice of isotope, the urethral dose, the total implant activity in millicuries, and a variety of dosimetric quality indicators (D90 and V100/V150/V200). Catheter dependency and the duration of α-blocker dependency was also evaluated. On average, 11.2 IPSS surveys were obtained for each patient. Results: One hundred fifty of the 170 patients (88.2%) had the urinary catheter permanently removed on day 0. Only one patient required an urinary catheter for > 5 days. Two patients (1.2%) required a subsequent transurethral resection of the prostate gland because of prolonged obstructive/irritative symptoms. To date, no patient has developed an urinary stricture or urinary incontinence. The IPS score on average peaked at 2 weeks following implantation. This

  4. Data Retention and Anonymity Services

    Berthold, Stefan; Böhme, Rainer; Köpsell, Stefan

    The recently introduced legislation on data retention to aid prosecuting cyber-related crime in Europe also affects the achievable security of systems for anonymous communication on the Internet. We argue that data retention requires a review of existing security evaluations against a new class of realistic adversary models. In particular, we present theoretical results and first empirical evidence for intersection attacks by law enforcement authorities. The reference architecture for our study is the anonymity service AN.ON, from which we also collect empirical data. Our adversary model reflects an interpretation of the current implementation of the EC Directive on Data Retention in Germany.

  5. [URINARY DISCOMFORTS IN PATIENTS AFTER RADICAL PROSTATECTOMY].

    Al'-Shukri, S Kh; Ananiĭ, I A; Amdiĭ, R E; Kuz'min, I V

    2015-01-01

    The authors showed the result of complication treatment of lower urinary tracts in 128 patients with localized prostate cancer. The patients underwent radical prostatectomy. Urinary discomforts included enuresis, urinary incontinence in postoperative period. Abnormalities of urine outflow due to urethral stricture were revealed in 6 (4,6%) patients by the 6 month after operation. These complications required surgical treatment. Urinary incontinence was noted in 20 (15,6%) patients in this period. It was stressful urinary incontinence in 16 (12,6%) and urgent - in 4 (3%). Patents with stressful urinary difficulty were advised to use the conservative treatment (pelvic floor muscle training and electrostimulation), but in case of inefficiency - surgical treatment. PMID:26390591

  6. Myeloid sarcoma of the urinary bladder with cutaneous tumour seeding after percutaneous suprapubic catheterization.

    Geok Chin, Tan; Masir, Noraidah; Noor Hussin, Hamidah; Mohd Sidik, Shiran; Boon Cheok, Lee; Yean, Thean

    2011-06-01

    Myeloid sarcoma (MS) is a rare extramedullary myeloid tumour. It has been reported in various sites, including lymph node, bone, skin, soft tissue, various organs and the CNS. It may precede or occur concurrently with acute myeloid leukemia. Urinary bladder involvement is extremely uncommon. We report a 70-year-old female who had MS of the urinary bladder, presented with frank and persistent hematuria associated with lower abdominal pain. She subsequently had tumour seeding in the abdominal skin via percutaneous suprapubic catheter. Tumours from both the urinary bladder and skin showed immature cells that were immunoreactive toward LCA (focal), MPO (strong), CD99 (weak) and CD117 (weak). Summary of cases in the literature is presented. The potential of its misdiagnosis and the useful markers for the diagnosis of MS are discussed. PMID:21874752

  7. Helical CT of the urinary organs

    Schreyer, H.H.; Uggowitzer, M.M.; Ruppert-Kohlmayr, A. [Graz Univ. (Austria). Dept. of Radiology

    2002-03-01

    Despite of the diagnostic potential of conventional CT (CCT), limitations being inherent in this technology reduce its diagnostic confidence and limit clinical CT applications as 3D imaging. Helical CT (HCT) has far overcome the limitations of CCT and has become the standard CT technology. After a short overview on the technique of HCT and its advantages over CCT, the impact of HCT on the detection of disorders of the urinary organs is discussed. Due to the high quality of 3D reconstructions, vessels are visualized free of artefacts resulting in a dramatic improvement and acceptance of CT angiography, which has become a clinically important examination in the evaluation of obstructive renal artery disease. Fast HCT provides a precise assessment of the three phases of the nephrogram and it is a prerequisite for an improved depiction of abnormal vascular perfusion and impaired tubule transit of contrast material. Helical CT enables an improved characterization of cystic mass lesions reducing the diagnosis of indeterminate masses and thus facilitating a better therapeutic management. The diagnosis of renal cell carcinomas (RCC) has improved due to an increased sensitivity in detecting small RCCs, and an increased specificity in the diagnosis of neoplastic lesions. Improved staging of RCCs is the result of accurate assessment of venous tumour extension. When planning nephron-sparing surgery 3D display of the renal tumour helps to determine the resectability of the mass depicting its relation to major renal vessels and the renal collecting system. In the evaluation of renal trauma HCT provides shorter scanning time and thus fewer artefacts in the examination of traumatized patients who cannot cooperate adequately. Three-dimensional postprocessing modalities allow the assessment of the renal vascular pedicel by CT angiography and improve the demonstration of complex lacerations of the renal parenchyma. In the evaluation of the upper urinary tract unenhanced HCT has

  8. Helical CT of the urinary organs

    Despite of the diagnostic potential of conventional CT (CCT), limitations being inherent in this technology reduce its diagnostic confidence and limit clinical CT applications as 3D imaging. Helical CT (HCT) has far overcome the limitations of CCT and has become the standard CT technology. After a short overview on the technique of HCT and its advantages over CCT, the impact of HCT on the detection of disorders of the urinary organs is discussed. Due to the high quality of 3D reconstructions, vessels are visualized free of artefacts resulting in a dramatic improvement and acceptance of CT angiography, which has become a clinically important examination in the evaluation of obstructive renal artery disease. Fast HCT provides a precise assessment of the three phases of the nephrogram and it is a prerequisite for an improved depiction of abnormal vascular perfusion and impaired tubule transit of contrast material. Helical CT enables an improved characterization of cystic mass lesions reducing the diagnosis of indeterminate masses and thus facilitating a better therapeutic management. The diagnosis of renal cell carcinomas (RCC) has improved due to an increased sensitivity in detecting small RCCs, and an increased specificity in the diagnosis of neoplastic lesions. Improved staging of RCCs is the result of accurate assessment of venous tumour extension. When planning nephron-sparing surgery 3D display of the renal tumour helps to determine the resectability of the mass depicting its relation to major renal vessels and the renal collecting system. In the evaluation of renal trauma HCT provides shorter scanning time and thus fewer artefacts in the examination of traumatized patients who cannot cooperate adequately. Three-dimensional postprocessing modalities allow the assessment of the renal vascular pedicel by CT angiography and improve the demonstration of complex lacerations of the renal parenchyma. In the evaluation of the upper urinary tract unenhanced HCT has

  9. Female urinary incontinence: effective treatment strategies.

    Castro, R A; Arruda, R M; Bortolini, M A T

    2015-04-01

    Urinary incontinence is a dysfunction that tremendously affects women's quality of life, involving social, emotional and economic aspects. Although various treatments for urinary incontinence have been described, it is important to know which of them are truly effective. This review seeks to determine the current available therapies for women with stress urinary incontinence and overactive bladder syndrome, based on the best scientific evidence. PMID:25307986

  10. Urinary tract infections and Candida albicans

    BEHZADI, Payam; BEHZADI, Elham; Ranjbar, Reza

    2015-01-01

    Introduction Urinary tract candidiasis is known as the most frequent nosocomial fungal infection worldwide. Candida albicans is the most common cause of nosocomial fungal urinary tract infections; however, a rapid change in the distribution of Candida species is undergoing. Simultaneously, the increase of urinary tract candidiasis has led to the appearance of antifungal resistant Candida species. In this review, we have an in depth look into Candida albicans uropathogenesis and distribution o...

  11. Focal bacterial nephritis without pyuria in a boy presenting with high urinary β2-MG and NAG levels

    Sekine, Hitomi; Kawasaki, Yukihiko; Ohara, Shinichiro; Suyama, Kazuhide; Hosoya, Mitsuaki

    2014-01-01

    Acute focal bacterial nephritis (AFBN) is a localized bacterial infection of the kidney presenting as an inflammatory mass without frank abscess formation. We report a case of acute focal bacterial nephritis without pyuria in a five-month-old boy presenting with high urinary β2-microglobulin (β2-MG) and N-Acetyl-β-(D)-Glucosaminidase (NAG) levels. The infant initially presented with high-grade fever, and plain computed tomography (CT) showed a nearly isodense mass, and contrast-enhanced abdom...

  12. [Ascites and acute kidney injury].

    Piano, Salvatore; Tonon, Marta; Angeli, Paolo

    2016-07-01

    Ascites is the most common complication of cirrhosis. Ascites develops as a consequence of an abnormal splanchnic vasodilation with reduction of effecting circulating volume and activation of endogenous vasoconstrictors system causing salt and water retention. Patients with ascites have a high risk to develop further complications of cirrhosis such as hyponatremia, spontaneous bacterial peritonitis and acute kidney injury resulting in a poor survival. In recent years, new studies helped a better understanding of the pathophysiology of ascites and acute kidney injury in cirrhosis. Furthermore, new diagnostic criteria have been proposed for acute kidney injury and hepatorenal syndrome and a new algorithm for their management has been recommended with the aim of an early diagnosis and treatment. Herein we will review the current knowledge on the pathophysiology, diagnosis and treatment of ascites and acute kidney injury in patients with cirrhosis and we will identify the unmet needs that should be clarified in the next years. PMID:27571467

  13. Long term retention and excretion of 201Tl in a patient after myocardial perfusion imaging

    201Tl is widely used in nuclear medicine to carry out myocardial perfusion imaging (MPI). However, very limited data is available on long-term distribution in the body, excretion and corresponding dose. In this study we performed a 2 month follow-up of a patient who underwent MPI, by urine analysis and in vivo measurements. The biological half-life of thallium was consequently estimated to be 11.6-27 d, which is in partial agreement with previous studies. We also estimated excretion and retention of 200Tl, 201Tl and 202Tl isotopes using the biokinetic parameters from ICRP publication 53 and compared the forecast result with actual measurements. The latter demonstrated a higher urinary excretion and a higher body retention than what was expected. Our results therefore suggest that the long-term retention and consequently the effective dose coefficient for 201Tl considered in ICRP publications 53 and 80 may be slightly underestimated. (authors)

  14. Long term retention and excretion of 201Tl in a patient after myocardial perfusion imaging.

    Blanchardon, E; Challeton-de Vathaire, C; Boisson, P; Célier, D; Martin, J-C; Cassot, S; Herbelet, G; Franck, D; Jourdain, J R; Biau, A

    2005-01-01

    201Tl is widely used in nuclear medicine to carry out myocardial perfusion imaging (MPI). However, very limited data is available on long-term distribution in the body, excretion and corresponding dose. In this study we performed a 2 month follow-up of a patient who underwent MPI, by urine analysis and in vivo measurements. The biological half-life of thallium was consequently estimated to be 11.6-27 d, which is in partial agreement with previous studies. We also estimated excretion and retention of 200Tl, 201Tl and 202Tl isotopes using the biokinetic parameters from ICRP publication 53 and compared the forecast result with actual measurements. The latter demonstrated a higher urinary excretion and a higher body retention than what was expected. Our results therefore suggest that the long-term retention and consequently the effective dose coefficient for 201Tl considered in ICRP publications 53 and 80 may be slightly underestimated. PMID:15671052

  15. Non-contrast thin-section helical CT of urinary tract calculi in children

    Background: Non-contrast thin-section helical CT has gained acceptance for the diagnosis of urinary tract calculi in adults, but experience with the technique in children is limited. Purpose: To evaluate the utility of non-contrast thin section helical CT for the diagnosis of urinary tract calculi in children. Materials and methods: Radiology databases at three pediatric institutions were searched to identify all pediatric patients evaluated by ''renal stone'' protocol CT scans (no oral or intravenous contrast, scans covering the entire urinary tract obtained in helical mode with narrow collimation (< 5 mm)). CT scans were reviewed for the primary finding of urinary tract calculi, for secondary signs of acute urinary tract obstruction and for evidence of alternative diagnoses. Medical records were reviewed to determine clinical presentation and to confirm the eventual diagnosis. Results: One hundred thirty-seven scans of 113 children (mean age: 11.2 years) were studied. Thirty-eight of 94 examinations (40%) performed on 82 children for acute pain and/or hematuria showed ureteral calculi. Alternative diagnoses were suggested by CT on 16 scans (17%). Twenty-eight scans were performed on 10 asymptomatic children with known calculus disease confirming renal stone burden on 21 scans (75%) and persistent ureteral calculi on 6 scans (21%). Upper tract calculi were demonstrated on 10 of 15 scans (67%) performed to evaluate for calculi in patients with known non-calculus genitourinary tract abnormalities. Conclusions: Non-contrast thin section helical CT is a useful method to diagnose urinary tract calculi in children. Radiation dose in this retrospective study may exceed the lowest possible radiation dose for diagnostic accuracy. Further research is needed to optimize CT imaging parameters, while maintaining diagnostic accuracy and minimizing radiation dose. (orig.)

  16. Non-contrast thin-section helical CT of urinary tract calculi in children

    Strouse, Peter J. [Section of Pediatric Radiology, University of Michigan Medical Center, Ann Arbor, MI (United States); Bates, Gregory D. [Department of Radiology, Columbus Children' s Hospital, Columbus, OH (United States); Bloom, David A. [Department of Pediatric Imaging, Children' s Hospital of Michigan, Detroit, MI (United States); Goodsitt, Mitchell M. [Department of Radiology, University of Michigan Medical Center, Ann Arbor, MI (United States)

    2002-05-01

    Background: Non-contrast thin-section helical CT has gained acceptance for the diagnosis of urinary tract calculi in adults, but experience with the technique in children is limited. Purpose: To evaluate the utility of non-contrast thin section helical CT for the diagnosis of urinary tract calculi in children. Materials and methods: Radiology databases at three pediatric institutions were searched to identify all pediatric patients evaluated by ''renal stone'' protocol CT scans (no oral or intravenous contrast, scans covering the entire urinary tract obtained in helical mode with narrow collimation (< 5 mm)). CT scans were reviewed for the primary finding of urinary tract calculi, for secondary signs of acute urinary tract obstruction and for evidence of alternative diagnoses. Medical records were reviewed to determine clinical presentation and to confirm the eventual diagnosis. Results: One hundred thirty-seven scans of 113 children (mean age: 11.2 years) were studied. Thirty-eight of 94 examinations (40%) performed on 82 children for acute pain and/or hematuria showed ureteral calculi. Alternative diagnoses were suggested by CT on 16 scans (17%). Twenty-eight scans were performed on 10 asymptomatic children with known calculus disease confirming renal stone burden on 21 scans (75%) and persistent ureteral calculi on 6 scans (21%). Upper tract calculi were demonstrated on 10 of 15 scans (67%) performed to evaluate for calculi in patients with known non-calculus genitourinary tract abnormalities. Conclusions: Non-contrast thin section helical CT is a useful method to diagnose urinary tract calculi in children. Radiation dose in this retrospective study may exceed the lowest possible radiation dose for diagnostic accuracy. Further research is needed to optimize CT imaging parameters, while maintaining diagnostic accuracy and minimizing radiation dose. (orig.)

  17. Fetal MRI of the urinary system

    Hoermann, Marcus [Department of Radiodiagnostics, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria)]. E-mail: marcus.hoermann@meduniwien.ac.at; Brugger, Peter C. [Center of Anatomy and Cell Biology, Medical University of Vienna (Austria); Balassy, Csilla [Department of Radiodiagnostics, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria); Witzani, Linde [Department of Radiodiagnostics, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria); Prayer, Daniela [Department of Radiodiagnostics, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria)

    2006-02-15

    The assessment of the urinary system is typically performed by ultrasound. Nevertheless, an ultrasound may be inconclusive in fetuses with renal diseases that result in anhydramnios or oligohydramnios. In such cases, and in other cases in which ultrasound is limited, further investigation with MR should be considered. In the following article, we will provide an overview of the most commonly encountered disorders of the urinary system and their appearance on fetal MR imaging. Fetal MR imaging can accurately diagnose a wide variety of urinary tract disorders and must be seen as a valuable complementary tool to ultrasound in the assessment of the urinary system, particularly in cases of inconclusive ultrasound findings.

  18. Fetal MRI of the urinary system

    The assessment of the urinary system is typically performed by ultrasound. Nevertheless, an ultrasound may be inconclusive in fetuses with renal diseases that result in anhydramnios or oligohydramnios. In such cases, and in other cases in which ultrasound is limited, further investigation with MR should be considered. In the following article, we will provide an overview of the most commonly encountered disorders of the urinary system and their appearance on fetal MR imaging. Fetal MR imaging can accurately diagnose a wide variety of urinary tract disorders and must be seen as a valuable complementary tool to ultrasound in the assessment of the urinary system, particularly in cases of inconclusive ultrasound findings

  19. Pulmonary retention of coal dusts

    Morrow, P.E.; Gibb, F.R.; Beiter, H.; Amato, F.; Yuile, C.; Kilpper, R.W.

    1980-01-01

    The principal objectives of this study were: to determine, quantitatively, coal dust retention times in the dog lung; to test the appropriateness of a pulmonary retention model which incorporates first order rate coefficients obtained from in vitro and in vivo experiments on neutron-activated coal; to acquire a temporal description of the pulmonary disposition of the retained coal dust, and to compare the behavior of two different Pennsylvania coals in the foregoing regards. The principal findings include: retention half-times for both coals of approximately 2 years following single, hour-long exposures; a vivid association of the retained coal dust with the pulmonic lymphatics; and a general validation of the retention model.

  20. Acute exercise improves motor memory

    Skriver, Kasper Christen; Roig, Marc; Lundbye-Jensen, Jesper;

    2014-01-01

    We have recently shown that a single bout of acute cardiovascular exercise improves motor skill learning through an optimization of long-term motor memory. Here we expand this previous finding, to explore potential exercise-related biomarkers and their association with measures of motor memory and...... hours and 7 days after practice. Plasma levels of brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), insulin-like growth factor (IGF-1), epinephrine, norepinephrine, dopamine and lactate were analyzed at baseline, immediately after exercise or rest and during motor...... practice whereas lactate correlated with better retention 1 hour as well as 24 hours and 7 days after practice. Thus, improvements in motor skill acquisition and retention induced by acute cardiovascular exercise are associated with increased concentrations of biomarkers involved in memory and learning...

  1. Value of joint detecion of multiple biomarkers on early diagnosis of acute kidney injury in critical patients

    许光银

    2014-01-01

    Objective To assess the value of joint detection of serum cysteine proteinase inhibitors C(sCys-C),urinary kidney injury molecule 1(uKIM-1),urinary neutrophil gelatinase-associated lipocalin(uNGAL)and urinary interleukin 18(uIL-18)for early diagnosis of acute kidney injury(AKI)in critically ill patients.Methods A total of256 adult patients who stayed in Intensive Care Unit for

  2. Turnover: strategies for staff retention.

    SnowAntle, S

    1990-01-01

    This discussion has focused on a number of areas where organizations may find opportunities for more effectively managing employee retention. Given the multitude of causes and consequences, there is no one quick fix. Effective management of employee retention requires assessment of the entire human resources process, that is, recruitment, selection, job design, compensation, supervision, work conditions, etc. Regular and systematic diagnosis of turnover and implementation of multiple strategies and evaluation are needed (Mobley, 1982). PMID:10106673

  3. Acute pyelonephritis in ER

    Giovanni Volpicelli

    2007-10-01

    Full Text Available Symptoms and signs of acute pyelonephritis sometimes are subtle and emergency physicians attending overcrowded and busy institutions could easily miss the right diagnosis. The presence of a renal damage is decisive in the therapeutic choice. Aims of our study are: 1 to assess prevalence of renal damage in patients presenting to our ED with symptoms and signs of primary urinary tract infection (UTI; 2 to evaluate the reliability of such symptoms and signs in predicting a renal damage; 3 to assess accuracy of the contrast enhanced ultrasound (CEUS in the ED diagnosis of renal damage due to acute uncomplicated pyelonephritis. We studied 54 patients with suspected UTI. Each patient underwent clinical examination, routine blood and urine sampling and conventional renal ultrasound (US. 23 patients had confirmation of acute primary UTI, and performed renal magnetic resonance (MR to rule out renal parenchymal involvement. In 16 patients (69,6% one or more parenchymal lesions were visualized at MR, and diagnosis of acute uncomplicated pyelonephritis was confirmed (group A. The other 7 patients had a diagnosis of UTI without renal involvement (group B. Some of 23 patients presented with few atypical symptoms. Lumbar pain was the most frequent symptom (n = 21, without a statistically significant difference between group A and B (P 0,958; p = 0,328. No other symptom or sign has demonstrated statistically valid in predicting the renal involvement. Renal US was positive in only 3 patients of group A (18,7%. During this first part of our study, CEUS was performed in a limited number of patients (n = 8, and in 7 examinations data were concordant with MR. In conclusion, analysis of our preliminary data confirms that a distinction between patients with different extension of the UTI is not possible through the simple clinical examination and routine tests. CEUS is very promising and its routine employment in the ED could simplify the diagnostic practice in

  4. Radionuclide retention in geologic media

    GEOTRAP is the OECD/NEA Project on Radionuclide Migration in Geologic, Heterogeneous Media carried out in the context of site evaluation and safety assessment of deep repository systems for long-lived radioactive waste. Retention of radionuclides within the geosphere for prolonged periods is an important safety function of deep geologic disposal concepts for radioactive waste. The extent to which retention processes can be relied upon in repository performance assessment depends upon the existence of well-established theoretical bases for the processes. It also depends on support for the operation of specific retention processes, and models for their quantitative evaluation, from a wide range of laboratory and field experiments and observations from nature. The fifth GEOTRAP workshop, 'Geological Evidence and Theoretical Bases for Radionuclide-retention Processes in Heterogeneous Media' held in May 2001, looked at radionuclide-retention processes and their consideration and representation in performance assessments. Current approaches to characterising and modelling retention processes, and suggestions for future improvements, were presented and discussed. In addition to the material presented during the workshop, this publication includes a technical synthesis reflecting the discussions that took place as well as the conclusions and recommendations made, notably during the working group sessions. (author)

  5. FAQs about Catheter-Associated Urinary Tract Infection

    ... Tract Infection” What is “catheter-associated urinary tract infection”? A urinary tract infection (also called “UTI”) is an infection in the urinary system, which includes the bladder (which stores the ...

  6. Urinary metabolite levels and symptoms in Filipino workers using organic solvents.

    Cucueco, M T; Espinosa, N C; Villanueva, M B; Castro, F T; Sison, S Y; Ortega, V S; Hisanaga, N

    1993-01-01

    To compare symptoms with urinary metabolite levels, 900 workers from 7 organic solvent-using industries were studied. Urinary metabolites were determined using a high performance liquid chromatograph. Urinary hippuric acid concentrations exceeding the reference value (2.5 g/g creatinine) were found in 78 (8.7%) workers. However, only 3 (0.3%) and 1 (0.1%) of the participants exceeded the reference value for mandelic (0.8 g/g creatinine) and total methylhippuric acid (1.5 g/g creatinine), respectively. The sum of the values of the ratio of measured urinary metabolite concentration to the corresponding ACGIH's biological exposure indices (BEI) [(HA/BEI of HA + MHA/BEI of MHA + MA/BEI of MA)] exceeded 1.0 in 166 (18.4%) workers. Majority of them were from the footwear manufacturing industry (63/129 or 49.2%). Questionnaire interviews were also administered to determine the prevalence of symptoms while at work (acute symptoms) or within the past 6 months (chronic symptoms). Urinary metabolite levels of individual and mixed solvents were compared with the symptoms of all workers. Analysis using Spearman's rank correlation showed in workers whose urinary hippuric acid exceeded 3.75 g/g creatine (1.5 x BEI), significant correlation between their hippuric acid levels and subjective complaints. Workers whose sum of the values of the ratio of measured urinary metabolite concentration to corresponding BEI exceeded 1.5 were selected and comparing this level with their symptoms, significant correlation was also noted in some complaints. PMID:8406919

  7. Prevalence of enuresis and urinary symptoms at age 7 years in the 2004 birth cohort from Pelotas, Brazil

    Denise M. Mota

    2015-02-01

    Full Text Available OBJECTIVE: To determine the prevalence of enuresis, urinary, and bowel symptoms and associated factors in children aged 7 years in a birth cohort. METHODS: A pre-coded questionnaire was applied to 3,602 children who belonged to a birth cohort initiated in 2004 in Pelotas, Brazil. During home visits at 12, 24, and 48 months and at age 7 years, mothers answered a questionnaire with demographic questions and characteristics of bladder and bowel habits of children using a urinary symptom score. Poisson regression was used for the hierarchical multivariable analysis, with robust variance. RESULTS: The prevalence of enuresis was 10.6%;11.7% in males and 9.3% in females; enuresis was monosymptomatic in 9.8% of the children (10.8% of males and 8.3% of females; 37.4% had symptoms up to once a week; 32.9%, two to four times a week; and 26.2%, every day, with no difference between genders. The most common urinary symptoms were urinary urgency (22.7% and urinary retention maneuvers (38.2%. In the multivariate analysis, it was observed that the number of urinary symptoms and the number of children at home showed a direct association with the presence of enuresis, whereas maternal education was inversely associated. CONCLUSIONS: Enuresis is a prevalent condition and should be investigated in clinical practice, especially in children of lower socioeconomic status. A detailed history of urinary habits detects associated urinary symptoms, which is important for adequate classification of enuresis and subsequent management.

  8. Common errors in diagnosis and management of urinary tract infections: Microbiological aspects

    Bojić-Miličević Gordana

    2005-01-01

    Full Text Available Introduction Urinary tract infections (UTI are among the most common infectious diseases affecting all age groups, from infants to the elderly. The majority of these infections occur in otherwise healthy individuals who present with symptoms of acute uncomplicated bacterial cystitis or pyelonephritis. Certain patient populations with complicated conditions are at increased risk for acquiring infection or failing therapy. Forty to 50% of adult women have a history of at least one urinary tract infection. Diagnosis and classification of UTI Although there are general guidelines concerning diagnosis and classification of urinary tract infections, there are wide variations in clinical practice. There are both errors which are frequently committed and mysteries that are still unsolved. Active management is important because under some circumstances urinary tract infections may cause permanent renal scarring. Imaging procedures are a cornerstone for critical evaluation of urinary tract infections, but avoidance of investigative routines will allow a marked saving in terms of costs and in terms of unnecessary radiation and psychological stress to the patient.

  9. [Urinary diversion in patients treated with pelvic irradiation: transverse colon conduit revisited].

    Matsui, Yoshiyuki; Kanematsu, Akihiro; Negoro, Hiromitsu; Kobayashi, Takashi; Terada, Naoki; Sugino, Yoshio; Yamasaki, Toshinari; Inoue, Takahiro; Kamba, Tomomi; Yoshimura, Koji; Ogawa, Osamu

    2014-08-01

    In patients receiving pelvic irradiation for gynecological or genitourinary malignancies, urinary diversion is sometimes required for complete resection of malignancies or treatment of urological complications by irradiation. We report our attempts to promote healing and prevent complications by urinary diversion using a transverse colon conduit in cases in which urinary reconstruction was performed with irradiated lower abdominal organs such as small intestine or distal ureters. Between 2008 and 2012, 9 patients with pelvic irradiation received transverse colon conduit urinary diversion. Six patients received diversion for genitourinary complications, while 3 patients received complete resection of pelvic malignancies. Colostomy formation and lithotripsy of vesical stones were simultaneously performed in 4 cases. Wallace method was adopted for ureterointestinal anastomosis. There was no operative mortality. Although acute pyelonephritis, ileus, wound dehiscence and pelvic abscess formation were seen as postoperative complications, all but two improved without any additional procedure. Cases of pelvic abscess or wound dehiscence were treated by abscess drainage. In observation periods, no patients required urinary stent placement and none suffered from defecation problems. We think that transverse colon conduit can be a viable option for patients with pelvic irradiation history, affording them reasonable quality of life postoperatively. PMID:25179985

  10. Treatment duration of febrile urinary tract infection (FUTIRST trial): a randomized placebo-controlled multicenter trial comparing short (7 days) antibiotic treatment with conventional treatment (14 days)

    Kuijper Ed J; Ablij Hans C; Delfos Nathalie M; Wattel-Louis G Hanke; Koster Ted; Leyten Eliane MS; Elzevier Henk W; Assendelft Willem JJ; van't Wout Jan W; van Nieuwkoop Cees; Pander Jan; Blom Jeanet W; Spelt Ida C; van Dissel Jaap T

    2009-01-01

    Abstract Background Current guidelines on the management of urinary tract infection recommend treating febrile urinary tract infection or acute pyelonephritis with antimicrobials for at least 14 days. Few randomized trials showed the effectiveness of treatment durations of 5 to 7 days but this has only been studied in young previously healthy women. Methods/Design A randomized placebo-controlled double-blind multicenter non-inferiority trial in which 400 patients with community acquired febri...

  11. The efficacy and safety of urethral injection therapy for urinary incontinence in women: a systematic review

    Priscila Katsumi Matsuoka

    2016-02-01

    Full Text Available To evaluate the efficacy and safety of different bulking agents for treating urinary incontinence in women, a systematic review including only randomized controlled trials was performed. The subjects were women with urinary incontinence. The primary outcomes were clinical and urodynamic parameters. The results were presented as a weighted mean difference for non-continuous variables and as relative risk for continuous variables, both with 95% confidence intervals. Initially, 942 studies were identified. However, only fourteen eligible trials fulfilled the prerequisites. Altogether, the review included 1814 patients in trials of eight different types of bulking agents, and all studies were described and analyzed. The measured outcomes were evaluated using a large variety of instruments. The most common complications of the bulking agents were urinary retention and urinary tract infection. Additionally, there were certain major complications, such as one case of death after use of autologous fat. However, the lack of adequate studies, the heterogeneous populations studied, the wide variety of materials used and the lack of long-term follow-up limit guidance of practice. To determine which substance is the most suitable, there is a need for more randomized clinical trials that compare existing bulking agents based on standardized clinical outcomes.

  12. Acute Pancreatitis and Pregnancy

    ... Acute Pancreatitis > Acute Pancreatitis and Pregnancy test Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is ... of acute pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for ...

  13. Acute colonic obstruction due to benign prostatic hypertrophy.

    Mac Giobuin, S

    2012-02-01

    A seventy two year old man presented to the Emergency Department with clinical features of colonic obstruction. Subsequent radiological investigations confirmed this impression and revealed the aetiology to be compression of the sigmoid colon against the sacrum by a massively distended urinary bladder. Chronic urinary retention due to benign prostatic hypertrophy is an extremely unusual cause of large bowel obstruction. Little in this patient\\'s clinical findings suggested this aetiology. We reviewed the literature in this area and highlight the benefits of CT scanning over contrast studies.

  14. Undertreatment of urinary incontinence in general practice.

    Penning-van Beest, F.J.A.; Sturkenboom, M.C.; Bemelmans, B.L.H.; Herings, R.M.C.

    2005-01-01

    BACKGROUND: In the urinary incontinence guidelines that are issued by the Dutch College of General Practitioners, treatment guidelines are related to the type of incontinence. It is unknown whether treatment of urinary incontinence in general practice complies with these guidelines. OBJECTIVE: To de

  15. Urinary Incontinence: Management and Treatment Options

    Griebling, Tomas L.

    2009-01-01

    Urinary incontinence, defined as the involuntary leakage of urine, is a common health problem in both women and men. Children may also suffer from this condition. Management and treatment of urinary incontinence depends primarily on the specific type of incontinence and the underlying problem causing the leakage for a given patient. Because…

  16. Isolated Primary Schwannoma of Urinary Bladder

    Bhat, Suresh; Paul, Fredrick

    2016-01-01

    Primary schwannoma of urinary bladder is a very rare tumour. It usually occurs in association with Von Recklinghausen’s disease. It arises from Schwann’s cells in the nerve sheath. We report here a very rare case of primary schwannoma of urinary bladder managed by complete transurethral resection. PMID:27437301

  17. Hypercalciuria in children with urinary tract symptoms

    Fallahzadeh M

    2010-01-01

    Full Text Available We performed this prospective study to determine the urinary calcium to creatinine ratio (Ca/Cr in children with different urinary symptoms. We studied 523 children in our neph-rology clinic with an age range of 3 to 14 years (mean= 8 and male to female ratio of 0.61. All the children had at least one of the urinary tract symptoms (dysuria, frequency, urgency, abdo-minal and/or flank pain, diurnal incontinence or enuresis, microscopic hematuria, urinary tract infection or urolithiasis. Fasting urine was collected for measuring calcium and creatinine and the results were compared to the values for the normal Iranian children. Ca/Cr ratio of more than 0.2 (mg/mg was considered as hypercalciuria. Of all the patients, 166 (31.3% were hypercalciuric. Urine Ca/Cr ratio was significantly higher in all the subgroups with one or more of the urinary symptoms (P< 0.001. We conclude that urine Ca/Cr ratio is significantly increased in children with all types of urinary symptoms. We recommend measuring urinary calcium in all children with urinary tract symptoms, especially if unexplained.

  18. Kidneys and Urinary Tract (For Parents)

    ... disorders. In kids, the more common problems include: Congenital problems of the urinary tract. As a fetus develops in the womb, any part of the urinary tract can grow to an abnormal size or in an abnormal shape or position. One common congenital abnormality (an abnormality that exists at birth) is ...

  19. Follow the Stream: Imaging of Urinary Diversions.

    Moomjian, Lauren N; Carucci, Laura R; Guruli, Georgi; Klausner, Adam P

    2016-01-01

    Urinary diversion is a surgical technique to redirect the stream of urine, most often after cystectomy. Cystectomy may be performed both for benign and for malignant conditions. Bladder cancer is the most common indication for cystectomy, and most patients who undergo radical cystectomy and urinary diversion have muscle-invasive or high-risk non-muscle-invasive bladder cancer. There are two major surgical approaches for urinary diversions performed after radical cystectomy: continent and incontinent diversions. For incontinent urinary diversions, a cutaneous ostomy is used for continuous urine drainage (eg, ileal conduit). With a continent diversion procedure, the patient may void through the native urethra or self-catheterize through a surgically created stoma. The goals of imaging after urinary diversion are to assess postoperative anatomy, detect postoperative complications, evaluate for residual or recurrent tumor and metastatic disease, and monitor for upper tract distention and/or deterioration. Multiple imaging modalities and techniques may be used to evaluate urinary diversions, including computed tomographic and magnetic resonance urography, intravenous pyelography, ultrasonography, pouchography, loopography, and nephrostomy studies. Knowledge of the expected postoperative appearance after urinary diversions and potential postoperative complications is crucial because many complications may be clinically silent. Radiologists must be able to recognize the expected postoperative appearance as well as complications to facilitate appropriate diagnosis and treatment of patients after cystectomy and urinary diversion. (©)RSNA, 2016. PMID:27058730

  20. URINARY MUTAGENICITY AND COLORECTAL ADENOMA RISK

    AbstractWe investigated urinary mutagenicity and colorectal adenoma risk in a clinic-based, case-control study of currently nonsmoking cases (n = 143) and controls (n = 156). Urinary organics were extracted by C18/methanol from 12-h overnight urine samples, and mutagenici...

  1. Sexually acquired Salmonella Typhi urinary tract infection.

    Wielding, Sally; Scott, Gordon

    2016-05-01

    We report a case of isolated urinarySalmonella entericaserotype Typhi in an HIV-positive man who has sex with men. He was clinically well and blood and stool cultures were negative, indicating that this may have been a sexually acquired urinary tract infection. PMID:25953964

  2. Urinary tract infection in girls - aftercare

    Symptoms of urinary tract infection (UTI) should begin to improve within 1 to 2 days in most girls. The advice below may not ... Elder JS. Urinary tract infections. In: Kliegman RM, Stanton BF, ... NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, ...

  3. ENTEROCOCCAL URINARY TARACT INFECTION: AN EMERGING THREAT

    Mohua; Shiv Sekhar; Kheya;; Sanjeev; Chinmoy; Banya; Mitali; Mandira

    2015-01-01

    INTRODUCTION: Enterococcus faecalis is a frequent cause of hospital acquired urinary tract infection and is being increasingly recognized as a cause of community acquired urinary tract infection. The organism is resistant to commonly used antibiotics, thereby limiting treatment options. OBJECTIVES: To study the epidemiology and resistogram of enterococcal ...

  4. 尿L-FABP和NGAL在梗阻性肾病所致急性肾损伤诊断及其肾脏预后预测中的价值%Value of urinary L-FABP and NGAL in the diagnosis of acute kidney injury caused by obstructive nephropathy and the prediction of renal outcome

    谢园园; 倪兆慧; 薛蔚; 蒋晨; 徐维佳; 牟姗

    2013-01-01

    目的 探讨尿肝型脂肪酸结合蛋白(uL-FABP)、尿中性粒细胞明胶酶相关脂质运载蛋白(uNGAL)诊断梗阻性肾病所致急性肾损伤(AKI)和预测肾脏预后的价值.方法 前瞻性收集30例梗阻性肾病患者解除梗阻前后不同时相的尿液标本,应用ELISA法检测uL-FABP、uNGAL水平.对不同时相、是否发生AKI等情况进行分析比较.对这2个指标与其他临床指标进行相关分析.随访1年,评估uL-FABP、uNGAL对梗阻性肾病肾脏的预后价值.结果 与非AKI患者相比,AKI患者的uL-FABP和uNGAL水平显著升高[700.00(154.62~1216.14) μg/g·Cr比26.90(16.77~41.38) μg/g·Cr;1266.69(671.57~3396.07) μg/g· Cr比179.12(90.98~215.16) μg/g· Cr,均P<0.01].uL-FABP、uNGAL与Scr呈正相关(r=0.552,0.553,均P< 0.01);两者预测AKI的受试者工作特征(ROC)曲线下面积(AUC)分别为0.925和0.900.随访1年时肾功能未恢复患者各时间点uL-FABP水平均显著高于肾功能恢复组(均P<0.01).术前uL-FABP水平在肾脏预后判断中的AUC为0.948,敏感度为85.7%,特异度为90.9%;术后72 h uL-FABP在肾脏预后判断中的AUC为0.935,敏感度为85.7%,特异度为90.9%.Kaplan-Meier生存曲线分析显示,术前uL-FABP> 366.57 μg/g· Cr或术后72 h uL-FABP>223.60 μg/g· Cr,与不良预后呈明显相关性.结论 uL-FABP、uNGAL对诊断梗阻性肾病所致AKI有较高的准确性.术前及术后72 h uL-FABP有助于判断梗阻性肾病的肾脏预后.%Objective To evaluate the values of urinary liver-fatty acid binding protein (uL-FABP) and urinary neutrophil gelatinase-associated lipocalin (uNGAL) in diagnosis of acute kidney injury (AKI) caused by obstructive nephropathy and in the prediction of renal prognosis.Methods Clinical data of 30 patients with obstructive nephropathy were collected prospectively.uL-FABP and uNGAL were measured by ELISA at various time points.Risk factors of the renal outcome were evaluated.The patients were

  5. Lymphoma of the Urinary Bladder

    Anthony Kodzo-Grey Venyo

    2014-01-01

    Full Text Available Background. Lymphoma of the urinary bladder (LUB is rare. Aims. To review the literature on LUB. Methods. Various internet databases were used. Results. LUB can be either primary or secondary. The tumour has female predominance; most cases occur in middle-age women. Secondary LUB occurs in 10% to 25% of leukemias/lymphomas and in advanced-stage systemic lymphoma. Less than 100 cases have been reported. MALT typically affects adults older than 60 years; 75% are female. Diffuse large B-cell lymphoma is also common and may arise from transformation of MALT. LUB presents with haematuria, dysuria, urinary frequency, nocturia, and abdominal or back pain. Macroscopic examination of LUBs show large discrete tumours centred in the dome or lateral walls of the bladder. Positive staining of LUB varies by the subtype of lymphoma; B-cell lymphomas are CD20 positive. MALT lymphoma is positively stained for CD20, CD19, and FMC7 and negatively stained for CD5, CD10, and CD11c. LUB stains negatively with Pan-keratin, vimentin, CK20, and CK7. MALT lymphoma exhibits t(11; 18(q21: 21. Radiotherapy is an effective treatment for the MALT type of LUB with no recurrence. Conclusions. LUB is diagnosed by its characteristic morphology and immunohistochemical characteristics. Radiotherapy is a useful treatment.

  6. Chronic Psychological Stress Enhances Nociceptive Processing in the Urinary Bladder in High-Anxiety Rats

    Robbins, M.T.; DeBerry, J.; Ness, T. J

    2007-01-01

    This study sought to determine whether acute and/or chronic psychological stress produce changes in urinary bladder nociception. Female Sprague-Dawley (SD; low/moderate anxiety) or Wistar-Kyoto (WK; high-anxiety) rats were exposed to either an acute (1 day) or a chronic (10 days) water avoidance stress paradigm or a sham stress paradigm. Paw withdrawal thresholds to mechanical and thermal stimuli and fecal pellet output, were quantified at baseline and after the final stress or sham stress ex...

  7. STUDY OF URINARY CALCIUM AND URINARY CREATININE LEVELS AND URINARY CALCIUM/CREATININE RATIO IN GESTATIONAL HYPERTENSIVE PATIENTS

    Swapna

    2015-06-01

    Full Text Available BACKGROUND: Gestational hypertension (BP>140/90mmHg or pregnancy induced hypertension usually precedes pre - eclampsia (BP>140/90mmHg associated with proteniuria. Many tests to predict pre - eclampsia are coming up on the horizon. Hypocalciuria is one such test to predict pre - eclampsia which may be present before other clinical signs and symptoms. AIM: To determine urinary calcium, urinary creatinine and urinary calcium/creatinine ratio in pregnancy induced hypertension and in normal pregnant women. MATERIAL AND METHODS: The study included 100 subjects with gestational age between 24 - 38 weeks and divided into two groups’ viz. control group and study group . The control group included 50 subjects who were normal pregnant women and study group included 50 subjects who were gestational hypertensive patients. Urinary calcium was estimated by Ortho - Cresolphthalein Complexone (CPC method, urinary creatinine was estimated by Jaffe’s method in all the subjects. RESULTS: The estimated mean levels (Mean±SD of urinary calcium, creatinine in control group were 263.0±80.3, 0.95±0.16 respectively and in patients with gestational hypertension they were 86.2±19.5, 1.21±0. 37 respectively. The statistical analysis by unpaired t - test shows that the levels of urinary calcium were significantly decreased (p<0.001 and the urinary creatinine were significantly increased (p <0.001 in gestational hypertensive patients when compar ed to healthy controls. The mean urinary calcium/creatinine ratio in control group were 0.28±0.08 and in gestational hypertensive patients were 0.07±0.03.The statistical analysis by unpaired t - test shows that the levels of urinary calcium/creatinine ratio were significantly decreased (p<0.001 in gestational hypertensive patients when compared to healthy controls. CONCLUSION: This study suggests that a regular evaluation of urinary calcium/creatinine ratio after 20wks of gestation may be an effective screen ing method for

  8. Bronchitis - acute

    ... sharing features on this page, please enable JavaScript. Acute bronchitis is swelling and inflammation in the main passages ... present only for a short time. Causes When acute bronchitis occurs, it almost always comes after having a ...

  9. Bronchitis - acute

    Acute bronchitis is swelling and inflammation in the main passages that carry air to the lungs. The swelling narrows ... makes it harder to breathe. Another symptom of bronchitis is a cough. Acute means the symptoms have ...

  10. Acute Bronchitis

    Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It ... chest tightness. There are two main types of bronchitis: acute and chronic. Most cases of acute bronchitis ...

  11. Clinical analysis of 135 cases with stress urinary incontinence%压力性尿失禁诊疗135例临床分析

    李环; 吴瑞芳; 李瑞珍; 张礼婕; 王苏梅; 张巍颖

    2011-01-01

    Objective The purpose of this study is to evaluate and compare the two different treatments by researching 135 cases with stress urinary incontinence .Methods From June 2006 to June 2010,135 patients with stress urinary incontinence were treated in Department of Gynecology and Obstetrics of Peking University Shenzhen Hospital.91 cases of them were treated with low frequency electric stimulation and biofeedback therapy (Group A),and the other 44 cases were treated by improved transobturaor tension -free vaginal tape(TVT-O) and TVT-O (Group B).Then,we compared these two groups by whole recovery rate ,recovery rate of patients with urge incontinence , charge of treatment and complication , respectively.Results Group B's recovery rate for stress urinary incontinence was 100%.Ⅰ degree stress urinary inconti-nence in Group A's recovery rate was higher;Ⅱ degree patients'recovery rate for stress urinary incontinence was lower;Ⅲ degree patients'recovery rate was 0%.Only 1 case showed abnormal urine stream;2 cases showed urinary retention,but the symptoms disappeared after the treatment .No significant complication in Group A.There were huge differences of the expense between the two groups .The effect in Group A for pa-tients with urge incontinence was good,but there was no effect shown in Group B.Conclusions The two treatments are safe and effective for stress urinary incontinence ,but there are existed prominent differences of the therapeutic efficacy between the two groups .

  12. Ultrasound in Acute Kidney Disease.

    Meola, Mario; Nalesso, Federico; Petrucci, Ilaria; Samoni, Sara; Ronco, Claudio

    2016-01-01

    Kidneys' imaging provides useful information in acute kidney injury (AKI) diagnosis and management. Today, several imaging techniques give information on kidneys anatomy, urinary obstruction, differential diagnosis between AKI and chronic kidney disease (CKD), renal blood flow and glomerular filtration rate. Ultrasound is a safe, non-invasive and repeatable imaging technique so it is widely used in the first level work-up of AKI. The utility of contrast-enhanced computed tomography and magnetic resonance imaging in AKI or in AKI during CKD is limited because of renal toxicity associated with contrast agents used. PMID:27169556

  13. Acute pancreatitis

    Bo-Guang Fan; Åke Andrén-Sandberg

    2010-01-01

    Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline) addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingest...

  14. Acute pancreatitis

    Bo-Guang Fan; Åke Andrén-Sandberg

    2010-01-01

    Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline) addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion....

  15. [Clinical studies on pivmecillinam in urinary tract infections (author's transl)].

    Amano, M; Kiuchi, H; Suzuki, M; Morinaga, O; Tanaka, H

    1979-09-01

    Pivmecillinam (PMPC), semisynthetic penicillin for oral use, was studied clinically and following results were obtained. 1) Twenty-eight patients with acute simple cystitis treated with the drug 200 mg/day for 4 days, clinical results were excellent in 23 cases and moderate in 5 cases. Six patients with chronic simple cystitis treated with the drug 400 mg/day for 7 days, clinical results were excellent in 4 cases, moderate in 1 case and poor in 1 case. Eight patients with complicated urinary tract infections treated with the drug 400 mg/day for 7 days, clinical results were excellent in 2 cases, moderate in 2 cases and poor in 4 cases. Overall effectiveness amounted to 88.1%. 2) Pivmecillinam was clinically effective in patients infected by Gram-negative bacteria except Pseudomonas aeruginosa. 3) No side effects were observed in all cases. The effectiveness of PMPC for acute simple cystitis was compared with that of talampicillin (TAPC), ampicillin (ABPC), amoxicillin (AMPC) and pivampicillin (PVPC) reported previously and PMPC was assessed as the most useful agent in these. Then, pivmecillinam should be chosen firstly as a chemotherapeutic agent for acute simple cystitis. PMID:228097

  16. PREVALENCE OF URINARY TRACT INFECTION IN PREGNANT W OMEN

    Nawaz

    2012-10-01

    Full Text Available ABSTRACT: Urinary tract infection is one of the most frequen tly seen medical complications in pregnancy. UTI in pregnancy is an important concern, as it possesses risk of complications such as acute and chronic pyelonephritis, toxaemia, anaemi a, hypertension, intrauterine growth retardation and increased perinatal mortality. The detection of bacteriuria allows an approach to be made for the prevention of chronic urinary dis ease in the community and to avoid complications in pregnancy at an early stage. OBJECTIVES: (1 To study the prevalence of bacterial pathogens causing urinary tract infection among pregnant women; (2 To evaluate the sensitivity of the screening test with culture. MATERIALS AND METHODS : A total of 500 samples were investigated from pregnant women aged be tween 18 to 35 years, with varying gravida and from all three trimesters were included in a period of one year i.e., from January to December 2011. The samples were collected asepticall y from women attending the antenatal clinic at the Khaja Banda Nawaz Hospital, Gulbarga. Urine was collected in the sterile urine container. Both macroscopic and microscopic examinat ion was done. Screening tests like Griess Nitrite test and TTC tests were done. Cultu re was done by standard loop technique. RESULTS : The prevalence rate of UTI in pregnancy was 10.40% i.e., with significant bacteriuria (1,00,000 or more bacterial count/ ml of urine by Kass concept. The incidence of bacteriuria increased along with age and rising parity. Inciden ce was similar during all three trimesters. Gram’s staining, TTC and Griess nitrite gave 88.46% , 73.07% and 57.69% respectively correlate with culture positive bacteriurics. CONCLUSIONS : UTI, the most commonly seen complications in pregnancy was 10.4%. Early treatment of bacteriu ria not only averts the occurrence of other complications, but also diminishes the risk of premat ure and perinatal mortality

  17. [Nitrofurantoin--clinical relevance in uncomplicated urinary tract infections].

    Stock, Ingo

    2014-07-01

    The nitrofuran derivative nitrofurantoin has been used for more than 60 years for the antibacterial therapy of uncomplicated urinary tract infections (UTI). Despite its long application, this antibiotic retained good activity against Escherichia coli and some other pathogens of uncomplicated urinary tract infections such as Staphylococcus saprophyticus and Enterococcus species. Nitrofurantoin therapy has been shown to be accompanied by numerous adverse drug effects. Among these, there are also serious side effects such as pulmonary reactions and polyneuropathy, which mainly occur in long-term use. Recent studies, however, have shown a good efficacy and tolerability of short-term nitrofurantoin therapy comparable to previous established standard therapeutic regimens applying cotrimoxazole or quinolones. Because of these data and the alarming resistance rates of uropathogenic Escherichia coli to cotrimoxazole and quinolones that have been increased markedly in several countries, the clinical significance ofnitrofurantoin has been raised again. In many current treatment guidelines, e. g., the international clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women published by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases, nitrofurantoin has been recommended as one first-line antibiotic of empiric antibacterial treatment of uncomplicated cystitis in otherwise healthy women. In Germany, however, nitrofurantoin should only be applied if more effective and less risky antibiotics cannot be used. Nitrofurantoin is contraindicated in the last three months of pregnancy and in patients suffering from renal impairment of each degree. Despite compatibility concerns, nitrofurantoin has also been recommended for the re-infection prophylaxis of recurrent uncomplicated urinary tract infections in Germany and several other countries. PMID:25065160

  18. The significance of ultrasonography in urinary tract infection in children

    Urinary tract infection(UTI) is one of the major bacterial disease of children that causes morbidity and inconvenience to many patients were related to recurrent vesicoureteral reflux. Radiological examinations of the 72 patients of urinary tract infection(UTI) who were visited to Seoul Paik Hospital from Jan 1st 1986 to Jul 30th 1989, were analysed in this study. US was used as an initial study in all patients who showed acute stage of UTI and followed by IVP, VCUG, 99mTc-DMSA scan for veslcoureteral reflex or renal scarring. If US showed obstructing lesion, no further study was performed. The resulted were as follows: 1. US is valuable as a screening procedure during the first UTI in congenital abnormalities and in particular obstructive lesions that require surgery. 2. A normal US in a child older than 5 or 6 years is meaningful as an investigation in the group of the first documented UTI uncomplicated. 3. Vesicoureteral reflex, a major factor leading to parenchymal damage in young children can not be detected reliably by US. If the US is suggestive of vesicoureteral reflex, this should be confirmed by VCUG and 99mTc-DMSA scan for renal scarring. If the US is normal or equivocal in recurrent infection and unexplained persistent clinical findings, this should be followed by VCUG and 99mTc-DMSA scan

  19. The significance of ultrasonography in urinary tract infection in children

    Hwang, Dae Hyun; Lee, Kwang Sul; Jeon, Woo Ki; Kim, Ho Kyun; Lee, Ghi Jai; Kim, Jeong Sook; Jeon, Jong Dong; Han, Chang Yul; Song, Moon Kab [Inje University School of Medicine, Busan (Korea, Republic of)

    1990-12-15

    Urinary tract infection(UTI) is one of the major bacterial disease of children that causes morbidity and inconvenience to many patients were related to recurrent vesicoureteral reflux. Radiological examinations of the 72 patients of urinary tract infection(UTI) who were visited to Seoul Paik Hospital from Jan 1st 1986 to Jul 30th 1989, were analysed in this study. US was used as an initial study in all patients who showed acute stage of UTI and followed by IVP, VCUG, {sup 99m}Tc-DMSA scan for veslcoureteral reflex or renal scarring. If US showed obstructing lesion, no further study was performed. The resulted were as follows: 1. US is valuable as a screening procedure during the first UTI in congenital abnormalities and in particular obstructive lesions that require surgery. 2. A normal US in a child older than 5 or 6 years is meaningful as an investigation in the group of the first documented UTI uncomplicated. 3. Vesicoureteral reflex, a major factor leading to parenchymal damage in young children can not be detected reliably by US. If the US is suggestive of vesicoureteral reflex, this should be confirmed by VCUG and {sup 99m}Tc-DMSA scan for renal scarring. If the US is normal or equivocal in recurrent infection and unexplained persistent clinical findings, this should be followed by VCUG and {sup 9}9mTc-DMSA scan.

  20. CT appearance of acute inflammatory disease of the renal interstitium

    Today, infection remains the most common disease of the urinary tract and constitutes almost 75% of patient problems requiring urologic evaluation. There have been several major factors responsible for our better understanding of the nature and pathophysiology of urinary tract infection. One has been quantitated urine bacteriology and another, the discovery that a significant part of the apparently healthy adult female population has asymptomatic bacteriuria. Abnormal conditions such as neurogenic bladder, bladder malignancy, prolonged catheter drainage and reflux, altered host resistance, diabetes mellitus, and urinary tract obstruction, as well as pregnancy, may either predispose to or be implicated in the pathogenesis of urinary tract infection. There is a wide range of conditions that result in acute renal inflammation and those under discussion affect primarily the interstitium. This term refers to the connective tissue elements separating the tubules in the cortex and medulla. Hence, the interstitial nephritides are to be distinguished from the glomerulonephritides and fall into two general etiologic categories: infectious and noninfectious

  1. Urinary Biomarkers of Brain Diseases

    Manxia An

    2015-12-01

    Full Text Available Biomarkers are the measurable changes associated with a physiological or pathophysiological process. Unlike blood, urine is not subject to homeostatic mechanisms. Therefore, greater fluctuations could occur in urine than in blood, better reflecting the changes in human body. The roadmap of urine biomarker era was proposed. Although urine analysis has been attempted for clinical diagnosis, and urine has been monitored during the progression of many diseases, particularly urinary system diseases, whether urine can reflect brain disease status remains uncertain. As some biomarkers of brain diseases can be detected in the body fluids such as cerebrospinal fluid and blood, there is a possibility that urine also contain biomarkers of brain diseases. This review summarizes the clues of brain diseases reflected in the urine proteome and metabolome.

  2. Urinary Bladder Cancer in Yemen

    Abdullah Saleh Al-Samawi

    2013-09-01

    Full Text Available Objectives: The aims of this study are to highlight the clinicopathological features of urinary bladder cancer in Yemen, and to describe the histological grading of urothelial neoplasms according to the World Health Organization and International Society of Urologic pathology (WHO/ISUP 1998 classification.Methods: This is a descriptive record-based study of 316 cases of bladder cancer diagnosed by two pathologists at the Department of pathology, Sana'a University from 1st January 2005 to 30th April 2009. The diagnoses were made on hematoxylin and eosin stained sections and categorized according to WHO/ISUP 1998 classification.Results: Out of 316 urinary bladder cancers, 248 (78% were urothelial neoplasms, 53 (17% were squamous cell carcinoma, 7 (2% were adenocarcinoma, and 3 (1% were rhabdomyosarcoma. The remaining cases were metastatic carcinomas (n=3, small cell carcinoma (n=1, and non-Hodgkin's lymphoma (n=1. The urothelial neoplasms observed were carcinoma in situ 4 (2%, papilloma 7 (3%, papillary urothelial neoplasm of low malignant potential 26 (11%, papillary urothelial carcinoma of low grade 107 (43%, papillary urothelial carcinoma of high grade 18 (7%, and non-papillary urothelial carcinoma of high grade 85 (34%, with 60 years mean age for males and 58 years for females; along with a male to female ratio of 4:1. The peak incidence was observed in the 61-70 years age group.Conclusion: This study documents a high frequency of urothelial neoplasms, mostly papillary urothelial carcinoma of low grade and non-papillary urothelial carcinoma of high grade with male preponderance and peak incidence in 6th decade of age.

  3. Acute pancreatitis

    Bo-Guang Fan

    2010-05-01

    Full Text Available Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions: Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  4. Acute pancreatitis

    Bo-Guang Fan

    2010-01-01

    Full Text Available Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions : Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  5. Persistent renal cortical scintigram defects in children 2 years after urinary tract infection

    Background: Renal cortical scintigraphic studies challenge the role of vesicoureteric reflux in renal scar development, emphasizing instead the part played by acute pyelonephritis. Objective: To determine the prevalence of renal cortical defects in a child cohort 2 years after the child's first diagnosed urinary tract infection and to analyze the relationship of these defects with acute illness variables, primary vesicoureteric reflux and recurrent infections. Materials and methods: In a prospective cohort study, 193 children younger than 5 years with their first proven urinary tract infection underwent renal sonography, voiding cystourethrogram, and renal cortical scintigraphy within 15 days of diagnosis. Two years later, 150 of the 193 children, or 77.7%, had a further renal cortical scintigram, including 75, or 86.2%, of the 87 children who had acute scintigraphic defects. The relationship of cortical defects to age, gender, pre-treatment symptom duration, hospitalization, presence and grade of vesicoureteric reflux, and recurrent urinary tract infections was evaluated. Results: Overall, 20 of the 150 (13.3%; 95% confidence interval (CI) 8.3, 19.8) children had persistent defects 2 years after infection. This included 20 of 75 (26.7%; 95% CI 17.1, 38.1) with initially abnormal scintigrams. No new defects were detected. Although acute defects were more common in the young, those with persistent defects were older (median ages 16.4 vs. 6.8 months, P=0.004) than those with transient abnormalities. After adjustment for age, persistent defects were no longer associated with gender and were not predicted by acute illness variables, primary vesicoureteric reflux or recurrent infections. (orig.)

  6. Absorption and retention of selenium from shrimps in man

    Bugel, S. H.; Sandstrom, B.; Larsen, Erik Huusfeldt

    2001-01-01

    This study was undertaken to evaluate the bioavailability of selenium in shrimps, a possible good source of selenium, by measurements of the absorption and retention of selenium and the effects on plasma selenium concentration and glutathione peroxidase activity. Twelve healthy young subjects (9F...... commencement of the study, after 2, 4, and 6 weeks. The selenium intake increased from 39.4 +/- 15.3 mug/d to 127 +/- 5.5 mug/d with the addition of shrimps. The apparent absorption of selenium from shrimps was 83 +/- 4%, Faecal and urinary selenium excretion was 32.5 +/- 17.0 mug/d and 21.2 +/- 9.0 mug/d, re...... spectively and the total retention of selenium was 3.1 +/- 1.1 mg. Plasma selenium concentrations were 95.2 +/- 9.7 mug/L and 101.5 +/- 9.7 mug/L before and after six weeks of shrimp intake, respectively (p...

  7. Clinical course of a cohort of children with non-neurogenic daytime urinary incontinence symptoms followed at a tertiary center

    Adrienne Lebl

    2016-04-01

    Full Text Available Abstract Objective: To characterize a cohort of children with non-neurogenic daytime urinary incontinence followed-up in a tertiary center. Methods: Retrospective analysis of 50 medical records of children who had attained bladder control or minimum age of 5 years, using a structured protocol that included lower urinary tract dysfunction symptoms, comorbidities, associated manifestations, physical examination, voiding diary, complementary tests, therapeutic options, and clinical outcome, in accordance with the 2006 and 2014 International Children's Continence Society standardizations. Results: Female patients represented 86.0% of this sample. Mean age was 7.9 years and mean follow-up was 4.7 years. Urgency (56.0%, urgency incontinence (56.0%, urinary retention (8.0%, nocturnal enuresis (70.0%, urinary tract infections (62.0%, constipation (62.0%, and fecal incontinence (16.0% were the most prevalent symptoms and comorbidities. Ultrasound examinations showed alterations in 53.0% of the cases; the urodynamic study showed alterations in 94.7%. At the last follow-up, 32.0% of patients persisted with urinary incontinence. When assessing the diagnostic methods, 85% concordance was observed between the predictive diagnosis of overactive bladder attained through medical history plus non-invasive exams and the diagnosis of detrusor overactivity achieved through the invasive urodynamic study. Conclusions: This subgroup of patients with clinical characteristics of an overactive bladder, with no history of urinary tract infection, and normal urinary tract ultrasound and uroflowmetry, could start treatment without invasive studies even at a tertiary center. Approximately one-third of the patients treated at the tertiary level remained refractory to treatment.

  8. Mechanisms of gas bubble retention

    Retention and episodic release of flammable gases are critical safety concerns regarding double-shell tanks (DSTs) containing waste slurries. Previous investigations have concluded that gas bubbles are retained by the slurry that has settled at the bottom of the DST. However, the mechanisms responsible for the retention of these bubbles are not well understood. In addition, the presence of retained gas bubbles is expected to affect the physical properties of the sludge, but essentially no literature data are available to assess the effect of these bubbles. The rheological behavior of the waste, particularly of the settled sludge, is critical to characterizing the tendency of the waste to retain gas bubbles. The objectives of this study are to elucidate the mechanisms contributing to gas bubble retention and release from sludge such as is in Tank 241-SY-101, understand how the bubbles affect the physical properties of the sludge, develop correlations of these physical properties to include in computer models, and collect experimental data on the physical properties of simulated sludges with bubbles. This report presents a theory and experimental observations of bubble retention in simulated sludge and gives correlations and new data on the effect of gas bubbles on sludge yield strength

  9. Exploring General Education Development Retention

    Grover, Sharon D.

    2013-01-01

    According to the instructors and administrators at a local adult education (AE) program in Houston, Texas, retaining and graduating general education development (GED) students has been a constant challenge. Locating GED attendance barriers could enable AE programs to develop techniques that increase student retention and graduation rates. The…

  10. [Gastroduodenal intussusception causing gastric retention.

    Alamili, M.; Berg, J.O.; Lindstrom, C.; Jensen, C.V.; Wettergren, A.

    2008-01-01

    A case of gastroduodenal intussusception caused by a duodenal lipoma is presented. The condition was characterized by severe upper gastrointestinal retention, epigastric pain and weight loss. The mass was diagnosed by CT scan. The diagnosis was confirmed by operation. The patient was treated...

  11. Maslow's Hierarchy and Student Retention.

    Brookman, David M.

    1989-01-01

    Abraham Maslow's hierarchy of needs offers perspective on student motivation and a rationale for college retention programing. Student affairs and faculty interventions addressing student safety needs and engaging students' sense of purpose reinforce persistence. A mentor program is a possible cooperative effort between student personnel and…

  12. Lake retention of manufactured nanoparticles

    Koelmans, A.A.; Quik, J.T.K.; Velzeboer, I.

    2015-01-01

    For twenty-five world lakes and three engineered nanoparticles (ENP), lake retention was calculated using a uniformly mixed lake mass balance model. This follows similar approaches traditionally used in water quality management. Lakes were selected such that lake residence times, depths and areal hy

  13. Breastfeeding reduces postpartum weight retention

    Baker, Jennifer Lyn; Gamborg, Michael; Heitmann, Berit L;

    2008-01-01

    BACKGROUND: Weight gained during pregnancy and not lost postpartum may contribute to obesity in women of childbearing age. OBJECTIVE: We aimed to determine whether breastfeeding reduces postpartum weight retention (PPWR) in a population among which full breastfeeding is common and breastfeeding d...

  14. Acute Salpingitis in a Nonsexually Active Adolescent.

    Fein, Daniel M; Sellinger, Catherine; Fagan, Michele J

    2015-12-01

    Acute salpingitis is an uncommon cause of an acute surgical abdomen, especially in an adolescent who is not sexually active. The following is a case of a 12-year-old girl who denied sexual activity, had a remote history of an appendectomy, and a recent diagnosis of a large, right-sided ovarian cyst, who presented with acute abdominal pain, urinary symptoms, and fever. The patient was ill-appearing and progressed to uncompensated septic shock in the emergency department despite aggressive fluid resuscitation and empiric antibiotics. She ultimately underwent an exploratory laparotomy and was diagnosed with acute bilateral salpingitis. This case highlights the diagnostic dilemmas facing those caring for an adolescent girl with abdominal pain and presents an extremely rare etiology for abdominal pain in a nonsexually active adolescent. PMID:26626893

  15. A new molecular approach to the diagnosis of acute rejection

    Chandraker, Anil; Strom, Terry B.

    2013-01-01

    Renal biopsy is the gold standard for detection of rejection in kidney transplant recipients but is not considered until evidence of renal dysfunction is apparent. Now, Suthanthiran and colleagues suggest that mRNA levels in urinary cells from these patients might be diagnostic and prognostic of acute cellular rejection.

  16. Pivmecillinam--therapy of choice for lower urinary tract infection.

    Graninger, W

    2003-10-01

    Pivmecillinam is the pro-drug of mecillinam, a beta-lactam antibiotic with a novel site of action and with specific and high activity against Gram-negative organisms such as Escherichia coli and other Enterobacteriaceae. Since its introduction, it has been widely used for the treatment of acute lower urinary tract infections (UTI), primarily in the Nordic countries. In contrast to the increasing resistance of urinary pathogens to other beta-lactams particularly ampicillin/amoxycillin and to other UTI antibiotics such as trimethoprim and trimethoprim/sulphamethoxazole (TMP/SMX), the level of resistance has remained on a low level. Less than 2% of E. coli community isolates are resistant to mecillinam. This paper reviews the clinical data on pivmecillinam with a special focus on the safety aspects. A large number of studies from the 70s to 80s have proven the clinical efficacy and safety of pivmecillinam for empirical treatment of acute cystitis. More recent studies confirm short-term treatment with pivmecillinam results in clinical and bacteriological cure rates similar to those obtained with other UTI agents. Both clinical studies in pregnant women with UTI and large epidemiological studies have confirmed the safety of pivmecillinam used in pregnancy. In the Nordic countries pivmecillinam has been the most widely used agent for treatment of UTI in pregnancy for many years. Ecological aspects of antibiotic treatment are important both with regard to adverse effects and development of resistance due to disturbance of the normal micro flora. Studies have shown that pivmecillinam has a very minor impact on the normal oropharyngeal, intestinal and skin microflora. The clinical implications of this are a low frequency of diarrhoea and Candida vaginitis as confirmed in the clinical studies. The high and increasing level of resistance among E. coli to currently recommended first-line agents for acute cystitis requires a re-evaluation of treatment guidelines. With the low

  17. 78 FR 40149 - Scientific Information Request on Chronic Urinary Retention (CUR) Treatment

    2013-07-03

    ... and electronic database searches of the literature by requesting information from the public (e.g... can be made public. Materials that are considered confidential; marketing materials; study types not... documents. Email submissions: src.org ">SIPS@epc- src.org . Print submissions: Mailing Address: Portland...

  18. Regional anesthesia for management of acute pain in the intensive care unit.

    De Pinto, Mario; Dagal, Armagan; O'Donnell, Brendan; Stogicza, Agnes; Chiu, Sheila; Edwards, William Thomas

    2015-01-01

    Pain is a major problem for Intensive Care Unit (ICU) patients. Despite numerous improvements it is estimated that as many as 70% of the patients experience moderate-to-severe postoperative pain during their stay in the ICU. Effective pain management means not only decreasing pain intensity, but also reducing the opioids' side effects. Minimizing nausea, vomiting, urinary retention, and sedation may indeed facilitate patient recovery and it is likely to shorten the ICU and hospital stay. Adequate postoperative and post-trauma pain management is also crucial for the achievement of effective rehabilitation. Furthermore, recent studies suggest that effective acute pain management may be helpful in reducing the development of chronic pain. When used appropriately, and in combination with other treatment modalities, regional analgesia techniques (neuraxial and peripheral nerve blocks) have the potential to reduce or eliminate the physiological stress response to surgery and trauma, decreasing the possibility of surgical complications and improving the outcomes. Also they may reduce the total amount of opioid analgesics necessary to achieve adequate pain control and the development of potentially dangerous side effects. PMID:26557482

  19. Adult female urinary incontinence and childhood bedwetting

    Foldspang, Anders; Mommsen, S.

    1994-01-01

    A cross-sectional random population sample of women 30 to 59 years old was sent a questionnaire on urinary incontinence and, among other things, childhood bedwetting. Among 2,613 responders 17.0% reported prevalent urinary incontinence (14.7% stress provoked, 8.3% associated with urge, 6.8% stress...... and urge overlap, 2.2% occurring especially during sleep and 3.9% occurring especially when anxious), and 6.5% reported childhood bedwetting after age 5 years and 3.3% after age 10 years. Childhood bedwetting was associated with prevalent urge urinary incontinence (p incontinence occurring...... during sleep (p urinary incontinence occurring in situations of anxiety (p

  20. Neutron activation analysis of urinary calculi

    Urinary calculi resulting from disorders in the urinary system are mostly composed of uric acid, urates, calcium oxalate, alkaline earth phosphates (Ca and Mg), triple phosphate (magnesium ammonium phosphate), calcium carbonate, cystine, xanthine, and traces of proteins. The determination of these macro-constituents has been carried out by different analytical procedures. No attempts however, have been reported regarding the determination of trace elements in urinary stones, apart from that of Herring et al., who investigated the consumption of strontium by urolithiasis patients. The present work is a non-destructive neutron activation analysis of urinary calculi, to search the variation in concentration of certain trace elements with the chemical composition of the calculus

  1. [Conservative treatment in male urinary incontinence].

    Kirschner-Hermanns, R; Anding, R

    2014-03-01

    Prevalence, pathophysiology, diagnostic and therapeutic approaches of urinary incontinence are well studied in women; however, studies on male urinary incontinence focus on incontinence following surgery of the bladder or prostate, predominantly incontinence after radical prostatectomy. Aging men suffer from incontinence, most frequently urge incontinence (overactive bladder, OAB), nearly as often as women do.The domain of conservative therapy of urinary stress incontinence in men is pelvic floor training. It remains unclear whether biofeedback procedures, electrostimulation therapy, or magnetic stimulation therapy can enhance pelvic floor training. There are data suggesting that an off-label therapy with Duloxetin®, a selective serotonin-noradrenaline reuptake inhibitor (SSNRI), improves urinary incontinence following radical prostatectomy. Antimuscarinic agents in combination with bladder training have been proven as safe and effective treatment in men with OAB. Data, however, suggest that men with OAB are far less frequently treated than women. PMID:24585116

  2. Pivmecillinam in the treatment of urinary tract infections.

    Nicolle, L E

    2000-09-01

    The efficacy of pivmecillinam for empirical treatment of acute uncomplicated urinary tract infection (UTI) was initially reported in clinical trials published in the 1970s and 1980s. Bacteriological cure rates observed in these trials were consistently >85%, and studies of different dosing regimens suggested that a 3 day course was appropriate. Comparative studies reported that pivmecillinam was equivalent to other antimicrobial agents in terms of clinical and bacteriological outcomes. These studies also documented that pivmecillinam was effective for treatment of Staphylococcus saprophyticus infections, was acceptable for use in pregnancy and was well tolerated. Subsequent widespread use of pivmecillinam in Scandinavian countries has led to a body of clinical experience which confirms the efficacy and safety of this antimicrobial agent in the treatment of acute cystitis. Recently, two large, prospective, randomized, double-blind, multi-centre clinical trials have been completed to assist in defining the role of this antimicrobial agent in the treatment of acute cystitis. A comparison of 3 day courses of pivmecillinam or norfloxacin, both at 400 mg bd, showed higher bacteriological cure rates with norfloxacin but generally similar clinical outcomes. A second, dose-ranging study found that pivmecillinam, given bd for 7 days, led to superior bacteriological and clinical outcomes at short-term follow-up than the 3 day regimen. Pooling bacteriological outcomes from the two studies showed similar outcomes with 7 days of pivmecillinam 200 mg bd or 3 days of norfloxacin 400 mg bd. The shorter, 3 day, course achieved similar short-term clinical outcomes to 7 days of pivmecillinam and 3 days of norfloxacin in women aged pivmecillinam is effective and well tolerated for the treatment of acute cystitis in women. PMID:11051622

  3. Bariatric Surgery and Urinary Stone Disease

    Cevahir Ozer

    2014-01-01

    Obesity is a major public health problem and has been suggested to play a role in the etiology of urinary tract stone disease. Furthermore, the increasingly widespread use of surgery in the treatment of obesity also is related with urinary stone disease. In daily practice, patients to whom obesity surgery has been planned or who have undergone obesity surgery are seen more frequently. This review aims to highlight the urological evaluation and management of this patient group.

  4. Bariatric Surgery and Urinary Stone Disease

    Cevahir Ozer

    2014-12-01

    Full Text Available Obesity is a major public health problem and has been suggested to play a role in the etiology of urinary tract stone disease. Furthermore, the increasingly widespread use of surgery in the treatment of obesity also is related with urinary stone disease. In daily practice, patients to whom obesity surgery has been planned or who have undergone obesity surgery are seen more frequently. This review aims to highlight the urological evaluation and management of this patient group.

  5. Neuropeptides in Lower Urinary Tract (LUT) Function

    Arms, Lauren; Vizzard, Margaret A.

    2011-01-01

    Numerous neuropeptide/receptor systems including vasoactive intestinal polypeptide, pituitary adenylate cyclase-activating polypeptide, calcitonin gene-related peptide, substance P, neurokinin A, bradykinin, and endothelin-1 are expressed in the lower urinary tract (LUT) in both neural and non-neural (e.g., urothelium) components. LUT neuropeptide immunoreactivity is present in afferent and autonomic efferent neurons innervating the bladder and urethra and in the urothelium of the urinary bla...

  6. Herbs In Treatment Of Urinary Tract Infections

    Manish Wasamwar; Vijay S.Wadha; Gopal S. Gond

    2012-01-01

    It is known that urinary tract is very common source of infection and UTIs are second most common reason people visit their doctors each year. Escherichia coli is responsible for large majority of UTIs. UTIs is most commonly diagnosed bacterial infection in woman. Population at risk of complication include older woman, pregnant woman. Continuous antibiotics prophylaxis are used to treat and prevent recurrent urinary tract infections, frequent antibiotic use can result in vagin...

  7. Epidemiology of community urinary tract infections

    Savoye-Rossignol, Louise

    2015-01-01

    Urinary tract infections (IUs) are a frequent reason for consultation and prescription of antibiotics in general practice. The choice of the antibiotic is based on the patient’s characteristics, the antibiotic susceptibility of bacteria and cost analyzes. This therapeutic approach has become increasingly complex due to the increase in antibiotic resistance. In this context, my thesis is based on two main studies:From the data of IMS health France, a spectral analysis of urinary antibiotic sal...

  8. Analysis of related factors of urinary tract infections and prevention measures%尿路感染的相关因素分析与预防措施研究

    张弦; 林尔将; 陈力; 李志家; 洪诗哲; 刘晟

    2015-01-01

    目的:研究尿路感染与留置导尿的相关因素及预防措施,以提高尿路感染的治愈率。方法回顾性分析2012年1月-2013年1月医院收治的92例尿路感染患者临床资料,记录患者病原菌感染类型及不同年龄、留置尿管时间、尿潴留对尿路感染的影响,采用SPSS17.0进行统计分析。结果92例尿路感染患者感染病原菌以大肠埃希菌为主,共31株占33.69%;不同年龄患者中以45~70岁发生尿路感染最高,感染率为57.61%;留置尿管滞留9~14 d的患者尿路感染率最高,感染率为59.78%;尿潴留评分为6~10分者尿路感染率最高,感染率为66.30%,经比较差异均有统计学意义( P<0.05)。结论留置尿管滞留的时间、患者的年龄及尿潴留均为尿路感染相关因素,采取有效的预防措施后,能有效减少尿路感染率。%OBJECTIVE To study the correlation factors of urinary tract infections and urinary catheters and preven‐tion measures ,so as to improve the cure rate for urinary tract infections .METHODS A retrospective analysis was conducted on the clinical data of 92 patients with urinary tract infections admitted and treated from Jan .2012 to Jan .2013 .The types of bacterial infections and the effects of age ,catheter retention time ,and urinary retention on urinary tract infections were recorded .The software SPSS 17 .0 was used for statistical analysis .RESULTS In the 92 patients with urinary tract infections ,Escherichia coli (31 strains ,33 .69% ) were the main pathogens cau‐sing infections .Patients aged 45~70 years had the highest incidence of urinary tract infections (the infection rate 57 .61% ) .Patients with catheter retention time of 9~14 d had the highest incidence of urinary tract infections (59 .78% ) .Patients with the urinary retention score of 6~10 points had the highest incidence of urinary tract in‐fections (66 .30% ) . Differences between patients

  9. Reframing Retention Strategy: A Focus on Profile

    Kalsbeek, David H.; Zucker, Brian

    2013-01-01

    Over 35 years of retention theory and literature have acknowledged the importance of institutional and student profiles in accounting for cross-sectional differences in retention and completion rates between types of colleges and universities. The first "P" within a 4 Ps framework of student retention--"profile"--recognizes that an institution's…

  10. Complicated Urinary Tract Infection in Adults

    LE Nicolle

    2005-01-01

    Full Text Available BACKGROUND: Complicated urinary tract infection occurs in individuals with functional or structural abnormalities of the genitourinary tract.OBJECTIVE: To review current knowledge relevant to complicated urinary tract infection, and to provide evidence-based recommendations for management.METHODS: The literature was reviewed through a PubMed search, and additional articles were identified by journal reference review. A draft guideline was prepared and critically reviewed by members of the Association of Medical Microbiology and Infectious Disease Canada Guidelines Committee, with modifications incorporated following the review.RESULTS: Many urological abnormalities may be associated with complicated urinary infection. There is a wide spectrum of potential infecting organisms, and isolated bacteria tend to be more resistant to antimicrobial therapy. Morbidity and infection outcomes in subjects with complicated urinary infection are principally determined by the underlying abnormality rather than the infection. Principles of management include uniform collection of a urine specimen for culture before antimicrobial therapy, characterization of the underlying genitourinary abnormality, and nontreatment of asymptomatic bacteriuria except before an invasive genitourinary procedure. The antimicrobial regimen is determined by clinical presentation, patient tolerance, renal function and known or anticipated infecting organisms. If the underlying abnormality contributing to the urinary infection cannot be corrected, then early post-treatment recurrence of infection is anticipated.CONCLUSIONS: The management of complicated urinary infection is individualized depending on patient variables and the infecting organism. Further clinical investigations are necessary to assist in determining optimal antimicrobial regimens.

  11. Surface charge-conversion polymeric nanoparticles for photodynamic treatment of urinary tract bacterial infections

    Liu, Shijie; Qiao, Shenglin; Li, Lili; Qi, Guobin; Lin, Yaoxin; Qiao, Zengying; Wang, Hao; Shao, Chen

    2015-12-01

    Urinary tract infections are typical bacterial infections which result in a number of economic burdens. With increasing antibiotic resistance, it is urgent that new approaches are explored that can eliminate pathogenic bacteria without inducing drug resistance. Antimicrobial photodynamic therapy (PDT) is a new promising tactic. It is a gentle in situ photochemical reaction in which a photosensitizer (PS) generates reactive oxygen species (ROS) under laser irradiation. In this work, we have demonstrated Chlorin e6 (Ce6) encapsulated charge-conversion polymeric nanoparticles (NPs) for efficiently targeting and killing pathogenic bacteria in a weakly acidic urinary tract infection environment. Owing to the surface charge conversion of NPs in an acidic environment, the NPs exhibited enhanced recognition for Gram-positive (ex. S. aureus) and Gram-negative (ex. E. coli) bacteria due to the charge interaction. Also, those NPs showed significant antibacterial efficacy in vitro with low cytotoxicity. The MIC value of NPs to E. coli is 17.91 μg ml-1, compared with the free Ce6 value of 29.85 μg ml-1. Finally, a mouse acute cystitis model was used to assess the photodynamic therapy effects in urinary tract infections. A significant decline (P strategy opens a new door for the treatment of urinary tract infections with minimal side effects.

  12. Urethral Stone Disease Leading to Retention After Hair-bearing Neophalloplasty

    Robert Viviano

    2014-03-01

    Full Text Available A 35-year-old male patient with a past history of traumatic penile amputation and subsequent penile reconstruction with a radial artery free flap phalloplasty presented to the urology clinic for urinary retention and complaint of a firm penile mass. The patient had been lost to follow-up for 2 years before this presentation. Patient had a suprapubic tube in place from initial surgery, with imaging showing 2 large uroliths encrusted around the end. Urethral stricture was suspected in the patient. On cystoscopy, an additional obstructing urolith was found in penile urethra, appearing to have formed in situ.

  13. Urinary neutral endopeptidase 24.11 activity: modulation by chronic salt loading.

    Aviv, R; Gurbanov, K; Hoffman, A; Blumberg, S; Winaver, J

    1995-03-01

    Neutral endopeptidase (NEP) 24.11 is a zinc-metallopeptidase involved in the metabolism of several biologically active peptides including enkephalin, atrial natriuretic peptide, bradykinin, and endothelin. The enzyme is found in abundant amounts in the brush border of renal proximal epithelial cells. A soluble form of NEP was previously identified in human urine with characteristics similar to the renal enzyme. The present study further characterized the excreted form of NEP activity in urine of normal rats using a sensitive two-stage enzymatic assay. The response of urinary NEP to known inhibitors such as phosphoramidon and thiorphan, and its dependence on pH and salt concentration was studied. In addition, we evaluated the effects of acute and chronic changes in salt balance, induced by i.v. saline infusion and drinking of saline solution, on urinary NEP and on the activity of the enzyme in isolated proximal tubules. Our findings demonstrated that abundant NEP activity was detected in the urine of normal rats. Furthermore, chronic salt loading, but not acute salt infusion, was associated with increased activity of NEP in urine and in isolated proximal tubules, suggesting that the enzyme may be regulated by salt balance. Finally, the data suggest that urinary NEP may be used as an index of enzyme activity in the kidney. PMID:7752584

  14. Severe Sepsis due to Clostridium perfringens Bacteremia of Urinary Origin: A Case Report and Systematic Review.

    Millard, Michael A; McManus, Kathleen A; Wispelwey, Brian

    2016-01-01

    Clostridium perfringens bacteremia is an uncommon yet serious clinical syndrome that typically arises from a gastrointestinal source. However, clinicians should consider nongastrointestinal sources as well. We present a rare case of C. perfringens bacteremia of urinary origin that required surgical intervention for definitive treatment. A 61-year-old male presented with acute nausea and vomiting, altered mental status, and chronic diarrhea. His physical exam revealed right costovertebral tenderness and his laboratory work-up revealed acute renal failure. Percutaneous blood cultures grew C. perfringens. Cross-sectional imaging revealed a right-sided ureteral stone with hydronephrosis, which required nephrostomy placement. On placement of the nephrostomy tube, purulent drainage was identified and Gram stain of the drainage revealed Gram-variable rods. A urinary source of C. perfringens was clinically supported. Although it is not a common presentation, nongastrointestinal sources such as a urinary source should be considered in C. perfringens bacteremia because failure to recognize a nongastrointestinal source can delay appropriate treatment, which may include surgical intervention. PMID:26998370

  15. Severe Sepsis due to Clostridium perfringens Bacteremia of Urinary Origin: A Case Report and Systematic Review

    Michael A. Millard

    2016-01-01

    Full Text Available Clostridium perfringens bacteremia is an uncommon yet serious clinical syndrome that typically arises from a gastrointestinal source. However, clinicians should consider nongastrointestinal sources as well. We present a rare case of C. perfringens bacteremia of urinary origin that required surgical intervention for definitive treatment. A 61-year-old male presented with acute nausea and vomiting, altered mental status, and chronic diarrhea. His physical exam revealed right costovertebral tenderness and his laboratory work-up revealed acute renal failure. Percutaneous blood cultures grew C. perfringens. Cross-sectional imaging revealed a right-sided ureteral stone with hydronephrosis, which required nephrostomy placement. On placement of the nephrostomy tube, purulent drainage was identified and Gram stain of the drainage revealed Gram-variable rods. A urinary source of C. perfringens was clinically supported. Although it is not a common presentation, nongastrointestinal sources such as a urinary source should be considered in C. perfringens bacteremia because failure to recognize a nongastrointestinal source can delay appropriate treatment, which may include surgical intervention.

  16. Urinary tract stones in pregnancy.

    Swanson, S K; Heilman, R L; Eversman, W G

    1995-02-01

    The presence of stones during an otherwise uneventful pregnancy is a dramatic and potentially serious issue for the mother, the fetus, and the treating physicians alike. The incidence and predisposing factors are generally the same as in nonpregnant, sexually active, childbearing women. Unique metabolic effects in pregnancy such as hyperuricuria and hypercalciuria, changes in inhibitors of lithiasis formation, stasis, relative dehydration, and the presence of infection all have an impact on stone formation. The anatomic changes and physiologic hydronephrosis of pregnancy make the diagnosis and treatment more challenging. Presenting signs and symptoms include colic, flank pain, hematuria, urinary tract infection, irritative voiding, fever, premature onset or cessation of labor, and pre-eclampsia. The initial evaluation and treatment are again similar to those used for the nonpregnant population. The most appropriate first-line test is renal ultrasonography, which may, by itself, allow the diagnosis to be made and provide enough information for treatment. Radiographic studies, including an appropriately performed excretory urogram, give specific information as to size and location of the stones, location of the kidneys, and differential renal function and can be used safely, but the ionizing radiation risks should be considered. All forms of treatment with the exception of extracorporeal shock wave lithotripsy and some medical procedures are appropriate in the pregnant patient. Close coordination by the urologist, the obstetrician, the pediatrician, the anesthesiologist, and the radiologist is required for the appropriate care of these patients. PMID:7855714

  17. Retention of Root Canal Posts

    Sahafi, A; Benetti, Ana Raquel; Flury, S;

    2015-01-01

    The aim of this study was to investigate the effect of the cement film thickness of a zinc phosphate or a resin cement on retention of untreated and pretreated root canal posts. Prefabricated zirconia posts (CosmoPost: 1.4 mm) and two types of luting cements (a zinc phosphate cement [DeTrey Zinc......] and a self-etch adhesive resin cement [Panavia F2.0]) were used. After removal of the crowns of 360 extracted premolars, canines, or incisors, the root canals were prepared with a parallel-sided drill system to three different final diameters. Half the posts did not receive any pretreatment. The other...... half received tribochemical silicate coating according to the manufacturer's instructions. Posts were then luted in the prepared root canals (n=30 per group). Following water storage at 37°C for seven days, retention of the posts was determined by the pull-out method. Irrespective of the luting cement...

  18. Asset Securitization and Optimal Retention

    John Kiff; Michael Kisser

    2010-01-01

    This paper builds on recent research by Fender and Mitchell (2009) who show that if financial institutions securitize loans, retaining an interest in the equity tranche does not always induce the securitizer to diligently screen borrowers ex ante. We first determine the conditions under which this scenario becomes binding and further illustrate the implications for capital requirements. We then propose an extension to the existing model and also solve for optimal retention size. This also all...

  19. Initial pathological events in renal dysplasia with urinary tract obstruction in utero.

    Shibata, S; Shigeta, M; Shu, Y; Watanabe, T; Nagata, M

    2001-10-01

    Multicystic dysplastic kidneys (MCDK) and obstructive renal dysplasia (ORD) are two different phenotypes of dysplasia commonly associated with urinary tract obstruction. However, the mechanisms whereby obstruction in the developing kidney leads to each dysplasia are unknown. In the present study, 16 fetal MCDKs and 3 fetal ORDs (18-35 weeks of gestation) were analyzed with light microscopy, point-counting morphometry, immunohistochemistry with a podocyte marker, and scanning electron microscopy. Additionally, reconstructions of dysplastic nephrons were done via serial section analysis. Early stages of MCDK and ORD similarly revealed numerous cyst formations, predominantly in the subcapsular nephrogenic zone. Occasionally, glomerular tuft remnants with mature podocyte phenotypes were observed in cysts, suggesting the acquisition of filtration. Three dimensionally, basic nephron structures were installed in the cystic nephrons, namely the macula densa with a primary loop structure. Cysts developed in the once-induced nephrons due to fluid retention in both MCDK and ORD. In utero urinary tract obstruction may cause urine retention in functioning nephrons and lead to glomerular cysts in the nephrogenic zone. These findings were common to MCDK and ORD, albeit at different sites of obstruction. Expansion of glomerular cysts with tubular dilatation (cysts) disturbs the subsequent nephrogenesis and may contribute to the misdevelopment of fetal kidneys. PMID:11710644

  20. Plunger with simple retention valve

    This patent describes a positive displacement retention valve apparatus in which the actual flow equals the theoretical maximum flow through the retention valve. The apparatus includes, in combination, a confined fluid flow conduit, a piston adapted for reciprocal movement within the fluid flow conduit between upstream and downstream limit positions, piston reciprocating means, and pressure responsive check valve means located upstream with respect to the piston in the fluid flow conduit. The pressure responsive check valve means operable to permit fluid flow therethrough in a downstream direction toward the piston, and to preclude fluid flow therethrough in an opposite direction. The piston is composed of parts which are relatively movable with respect to one another. The piston includes a simple retention valve consisting of a plug means, a cylinder having a minimum and a maximum internal cross section flow area therein and being reciprocal within the confined fluid flow conduit, and a seat on the cylinder for the plug means. The piston reciprocating means are operatively connected to the plug means

  1. Urinary Peptide Levels in Patients with Chronic Renal Failure

    Mungli Prakash

    2010-10-01

    Full Text Available Introduction: Peptide levels in urine are found to be decreased in renal failure. In the current study urinary peptide levels were determined in chronic renal failure (CRF patients. Method: 86 CRF patients and 80 healthy controls were selected for the study. Urinary proteins and peptide levels were determined by spectrophotometer based Lowry and Bradford methods. Urinary creatinine levels were determined by clinical chemistry analyzer. Results: There was significant decrease in urinary peptide levels in CRF patients and Urinary % peptides were significantly decreased in CRF patients as compared to healthy controls. Urinary % peptides correlated negatively with proteinuria. Conclusion: we have found decrease in urinary peptides and % urinary peptides in CRF patients and possibly measurement of % urinary peptides may possibly serve as better indicator in early detection of impairment in renal function.

  2. Use of antibiotics for urinary tract infection in women undergoing surgery for urinary incontinence

    Guldberg, Rikke; Kesmodel, Ulrik Schiøler; Brostrøm, Søren;

    2014-01-01

    OBJECTIVE: To describe the use of antibiotics for urinary tract infection (UTI) before and after surgery for urinary incontinence (UI); and for those with use of antibiotics before surgery, to estimate the risk of treatment for a postoperative UTI, relative to those without use of antibiotics...

  3. Disintegration of urinary calculi by laser beam: drilling experiment in extracted urinary stones.

    Tanahashi, Y; Orikasa, S; Chiba, R; Tahira, K; Fukatsu, T; Miyakawa, T

    1979-06-01

    Disintegration of urinary calculi was attempted by the use of laser beam. As a first step, drilling of extracted urinary stones was attempted using a continuous wave CO2 laser and a pulse ruby laser. Stones were drilled easily by either laser beam. The power around 10 W of continuous CO2 laser beam was sufficient to drill through the stone. PMID:462477

  4. Some biomarkers of acute kidney injury are increased in pre-renal acute injury

    Nejat, Maryam; Pickering, John W; Devarajan, Prasad; Edelstein, Charles L.; Walker, Robert J.; Endre, Zoltán H; Bonventre, Joseph Vincent

    2012-01-01

    Pre-renal acute kidney injury (AKI) is assumed to represent a physiological response to underperfusion. Its diagnosis is retrospective after a transient rise in plasma creatinine, usually associated with evidence of altered tubular transport, particularly that of sodium. In order to test whether pre-renal AKI is reversible because injury is less severe than that of sustained AKI, we measured urinary biomarkers of injury (cystatin C, neutrophil gelatinase-associated lipocalin (NGAL), \\(\\gamma\\...

  5. A comparison of urinary neutrophil gelatinase-associated lipocalin in patients undergoing on- versus off-pump coronary artery bypass graft surgery

    Wagener, Gebhard; Gubitosa, Gina; Wang, Shuang;

    2009-01-01

    NGAL in patients who underwent off-pump CABG surgery was 94.7 +/- 30.9 ng/mL compared with 122.7 +/- 57.0 ng/mL in patients with on-pump CABG surgery (p = 0.6). Peak serum creatinine and the incidence of acute kidney injury also were not different between the groups. CONCLUSIONS: Urinary NGAL was not...... RESULTS: Urinary NGAL, a novel, highly sensitive biomarker for renal injury, was measured before and immediately after surgery and then 3, 18, and 24 hours later. There were no differences in urinary NGAL at any time point between patients subjected to off-pump or on-pump CABG surgery; the peak urinary...

  6. Epidemiology of urinary infections in renal transplant recipients.

    Valera, B; Gentil, M A; Cabello, V; Fijo, J; Cordero, E; Cisneros, J M

    2006-10-01

    Urinary tract infection (UTI) remains a significant cause of infectious complications in renal transplant recipients. We evaluated prospectively all the UTIs in 161 kidney recipients transplanted between July 2003 and July 2005. All patients received prophylaxis with sulfadoxine-pyrimethamine. We excluded asymptomatic bacteriuria. Forty-one patients (25%) suffered at least one UTI episode. Ninety-two episodes of infection were confirmed with an incidence rate of 97 UTI episodes per 100 patient-years. The most common clinical features were uncomplicated acute bacterial cystitis, 71 episodes (77%), and acute pyelonephritis, 21 episodes (23%). Microbiological isolation was confirmed in 58 episodes (63%). Bacterial infections were the most frequent etiologies: gram-negative bacilli in 52 (90%), gram-positive cocci in 4 (7%), fungal in 2 (3%), and one viral BK virus (2%) infection. The causative microorganisms were E. coli as the principal isolated agent in 41 cases (71%), including 10 (24%) that were extended-spectrum betalactamases (ESBLEC). All episodes showed a favorable course. The survival rate of the graft at the end of the study period was 90.7%, and the survival rate of the transplant recipients was 97.5%. The incidence of UTI in transplant patients who received antibiotic prophylaxis was high. E. coli (ESBLEC) was the main agent isolated. Uncomplicated UTI, the most frequent post transplantation infection, showed a good prognosis. PMID:17097953

  7. Determination of dose coefficients and urinary excretion function for inhalation of carbon-14-labelled benzene

    Based on existing pharmacokinetic models for benzene, the distribution and retention of activity after inhalation of 14C-labelled benzene in humans were studied. Six different benzene concentrations from 0.1 to 10,000 ppm (corresponding to activity concentrations between 9.6 x 106 and 9.6 x 1011 Bq m-3) and five exposure times from 0.1 to 1000 min were considered. The cumulated activities in the different organs and tissues and the urinary excretion rates were observed to depend non-linearly on the activity intake. The fraction of activity removed via urine varies between 52 and 10% of the intake. Nevertheless, for times that are long compared to the exposure duration the urinary excretion rate is determined by the activity clearance from adipose tissue and thus decreases at a constant rate. This decrease is common for all exposure conditions examined and thus allowed determining a mean urinary excretion rate and corresponding dose coefficients for committed equivalent doses as well as for the effective dose. The uncertainty of the dose coefficients is estimated to be about 50% for the exposure range covered. A 14-day interval for the incorporation monitoring by urine activity counting seems to be reasonable. (author)

  8. Urinary Dopamine as a Potential Index of the Transport Activity of Multidrug and Toxin Extrusion in the Kidney

    Kajiwara, Moto; Ban, Tsuyoshi; Matsubara, Kazuo; Nakanishi, Yoichi; Masuda, Satohiro

    2016-01-01

    Dopamine is a cationic natriuretic catecholamine synthesized in proximal tubular cells (PTCs) of the kidney before secretion into the lumen, a key site of its action. However, the molecular mechanisms underlying dopamine secretion into the lumen remain unclear. Multidrug and toxin extrusion (MATE) is a H+/organic cation antiporter that is highly expressed in the brush border membrane of PTCs and mediates the efflux of organic cations, including metformin and cisplatin, from the epithelial cells into the urine. Therefore, we hypothesized that MATE mediates dopamine secretion, a cationic catecholamine, into the tubule lumen, thereby regulating natriuresis. Here, we show that [3H]dopamine uptake in human (h) MATE1-, hMATE-2K- and mouse (m) MATE-expressing cells exhibited saturable kinetics. Fluid retention and decreased urinary excretion of dopamine and Na+ were observed in Mate1-knockout mice compared to that in wild-type mice. Imatinib, a MATE inhibitor, inhibited [3H]dopamine uptake by hMATE1-, hMATE2-K- and mMATE1-expressing cells in a concentration-dependent manner. At clinically-relevant concentrations, imatinib inhibited [3H]dopamine uptake by hMATE1- and hMATE2-K-expressing cells. The urinary excretion of dopamine and Na+ decreased and fluid retention occurred in imatinib-treated mice. In conclusion, MATE transporters secrete renally-synthesized dopamine, and therefore, urinary dopamine has the potential to be an index of the MATE transporter activity. PMID:27483254

  9. Urinary tract injuries in children

    As shown by literature data, abdominal trauma in children is responsible for 14% of deaths, whereas in adults for 10%. Although abdominal traumas in children can be severe and lead to massive blood loss, most children die because of accompanying traumas of the thorax and head. It validates the surgical rule concerning abdominal traumas 'investigate aggressively, manage conservatively'. Posttraumatic injury of the urinary system is not frequent in children and its specificity (compared with adults), depends on greater susceptibility to external aggressive factors. Blunt trauma is the cause of renal parenchyma injury and acceleration/deceleration injury affects the excretory system and vessels. Extension mechanism is the cause of ureter avulsion and/or thrombus formation in stretched renal vessels- it is characteristic in children with non-accidental traumas. Bladder and urethra injuries are rare in children. During car accidents, a rupture of full bladder (seat belt injury) or bladder perforation by fractured bones of the pelvis is possible. We analyzed all hospitalizations of abdominal trauma in our surgical ward in the year 2004 (70 cases). Renal injuries were found in 6 children (8.6%). Thanks to five-year clinical experience of our hospital, on the average only 1-2 cases per annum needed operation. The management of renal injuries involves first of all conservative treatment. This publication has educational character and may serve as a valuable reminder of the useful knowledge in daily cooperation between the emergency room, radiology department and surgical ward. Based on available literature from recent few years, we quote suggested renal injuries classifications and procedures.This publication contains only images from our department of radiology archives. Clinical symptoms are often not appropriate for blunt abdominal traumas diagnosis. Owing to clinical status, which is difficult to interpret, fast and complete radiological diagnosis is necessary for

  10. Imaging of urinary bladder tumors

    Full text: Primary bladder neoplasms account for 2%-6% of all tumors, with urinary bladder cancer ranked as the fourth most common cancer in males. Transitional cell carcinoma (TCC) is the most common subtype of urothelial tumour accounting for approximately 90% of all urothelial cancers. It is typically observed in men aged 50-70 years with history of smoking or occupational exposure to carcinogens. Most urothelial neoplasms are low-grade papillary tumors, with high incidence of recurrence, requires rigorous follow-up but have a relatively good prognosis. Other bladder neoplasm include squamous cell carcinoma accounts for 2%-15% mainly according to geographic location; adenocarcinoma - less than 2% /both occurring in the context of chronic bladder infection and irritation/; mesenchymal tumors in 5%, with the most common examples being rhabdomyosarcoma in children and leiomyosarcoma in adults. More rare mesenchymal tumors include paraganglioma, lymphoma, leiomyoma and solitary fibrous tumor which have no specific typical imaging findings to be differentiated. Multidetector computed tomography urography is an efficient tool for diagnosis and follow-up in patients with transitional cell carcinoma and it can be considered the primary radiologic method for detection, staging and assessment of the entire urothelium regarding the multicentric nature of TCC. MRI is rapidly expanding modality of choice especially in locally staging the tumor and in controversies. Accurate TNM staging is primordial in choosing treatment and prognosis for patients with bladder carcinoma. Correct interpretation and classification of the tumour is helpful for the urologists to determine further management in these cases. The learning objectives of the presentation are: to illustrate the spectrum of CT and MRI findings and to assess their clinical value in patients with transitional cell carcinoma and some other bladder neoplasm; to discuss the TNM staging based on the imaging findings; to be

  11. Shotgun Proteomics Identifies Proteins Specific for Acute Renal Transplant Rejection

    Sigdel, Tara K.; Kaushal, Amit; Gritsenko, Marina A.; Norbeck, Angela D.; Qian, Weijun; Xiao, Wenzhong; Camp, David G.; Smith, Richard D.; Sarwal, Minnie M.

    2010-01-04

    Acute rejection (AR) remains the primary risk factor for renal transplant outcome; development of non-invasive diagnostic biomarkers for AR is an unmet need. We used shotgun proteomics using LC-MS/MS and ELISA to analyze a set of 92 urine samples, from patients with AR, stable grafts (STA), proteinuria (NS), and healthy controls (HC). A total of 1446 urinary proteins were identified along with a number of NS specific, renal transplantation specific and AR specific proteins. Relative abundance of identified urinary proteins was measured by protein-level spectral counts adopting a weighted fold-change statistic, assigning increased weight for more frequently observed proteins. We have identified alterations in a number of specific urinary proteins in AR, primarily relating to MHC antigens, the complement cascade and extra-cellular matrix proteins. A subset of proteins (UMOD, SERPINF1 and CD44), have been further cross-validated by ELISA in an independent set of urine samples, for significant differences in the abundance of these urinary proteins in AR. This label-free, semi-quantitative approach for sampling the urinary proteome in normal and disease states provides a robust and sensitive method for detection of urinary proteins for serial, non-invasive clinical monitoring for graft rejection after

  12. Urinary infection before and after prostatectomy

    Pourmand Gholamreza

    2010-01-01

    Full Text Available To determine the prevalence of pre and post prostatectomy related urinary tract in-fection and its correlation with peri-operative events, we studied 120 patients who underwent pros-tatectomy due to benign prostatic hypertrophy from September 2005 to September 2006. Urine cultures were performed before the operations, after a week, and three months later. Data including prostate volume, prostatic specific antigen (PSA, post voiding residue (PVR and histopathological reports as well as the duration of urinary leak, bladder irrigation, hospitalization, and catheterization were studied. The mean age of the studied patients was 70.5 ± 8 years. Significant preoperative bac-teriuria was revealed in 18 (15% patients of whom 14(77% patients developed negative cultures following the operation. Postoperative bacteriuria was detected in 9(7.5% patients who negative urine cultures preoperatively. Pre and post operative micro-organisms were different in the majority of the cases. The mean PSA was higher in patients with a positive history of infection. Following prostatectomy, patients with positive urine cultures had significantly longer urinary leakage, cathe-terization, and hospital stays compared with those who remained culture negative. We conclude that the incidence of positive urine culture pri-prostatectomy for BPH can be improved by appropriate antibiotic therapy, and the risk factors for postoperative urinary infection include preoperative infec-tion, prolonged urinary leakage, catheterization, and hospital stay. The elevated PSA may be a risk factor.

  13. Electrolyte-free milk protein solution influences sodium and fluid retention in rats.

    Ishihara, Kengo; Kato, Yoshiho; Usami, Ayako; Yamada, Mari; Yamamura, Asuka; Fushiki, Tohru; Seyama, Yousuke

    2013-01-01

    Milk is an effective post-exercise rehydration drink that maintains the net positive fluid balance. However, it is unclear which components are responsible for this effect. We assessed the effect of milk protein solution (MPS) obtained by dialysis on body fluid retention. Milk, MPS, milk electrolyte solution (MES), sports drink and water were administered to male Wistar rats at a dose of 6 ml/rat after treadmill exercise. Total body fluid retention was assessed by urine volume 4 h after administration of hydrating liquids. The rate of gastric emptying was evaluated by a tracer method using (13)C-labelled acetate. Plasma osmolality, Na and K levels, and urinary Na and K were measured by HPLC and osmometry, respectively. The gastric emptying rate was not delayed by MPS. During 4 h of rehydration, cumulative urine volumes differed significantly between treatment groups (P water-, milk- and MPS-fed rats, respectively. Thus, MPS elicited 50 % of the total body fluid retention of milk. Plasma aldosterone levels were significantly higher in MPS- and milk-fed rats compared with water-fed rats. Plasma osmolality was maintained at higher levels in MPS-fed rats than in water- and MES-fed rats (P water balance without affecting gastric emptying after exercise. This effect was attributed to retention of Na and water, and maintenance of plasma osmolality. PMID:25191594

  14. Circulating angiogenic factors and urinary prolactin as predictors of adverse outcomes in women with preeclampsia.

    Leaños-Miranda, Alfredo; Campos-Galicia, Inova; Ramírez-Valenzuela, Karla Leticia; Chinolla-Arellano, Zarela Lizbeth; Isordia-Salas, Irma

    2013-05-01

    Preeclampsia is characterized by an imbalance in angiogenic factors. Urinary prolactin (PRL) levels and its antiangiogenic PRL fragments have been associated with disease severity. In this study, we assessed whether these biomarkers are associated with an increased risk of adverse maternal and perinatal outcomes in preeclamptic women. We studied 501 women with preeclampsia attended at a tertiary care hospital. Serum concentrations of soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and soluble endoglin (sEng), as well as urinary PRL levels, were measured by enzymed-linked immunosorbent assay. Antiangiogenic PRL fragments were determined by immunoblotting. The risk for any adverse maternal outcome and for having a small-for-gestational-age infant was higher among women with sFlt-1/PlGF ratios, sEng, and urinary PRL level values in the highest quartile (odds ratios ≥ 2.7), compared with the lowest quartile. Both urinary PRL levels and the presence of antiangiogenic PRL fragments were more closely associated with the risk of specific adverse maternal outcomes (placental abruption, hepatic hematoma or rupture, acute renal failure, pulmonary edema, maternal death, and need for endotracheal intubation, positive inotropic drug support, and hemodialysis; odds ratios ≥ 5.7 and ≥ 4.7, respectively) than either sFlt-1/PlGF ratio or sEng alone. We concluded that in preeclamptic women at the time of initial evaluation, sFlt-1/PlGF ratio and sEng are associated with increased risk of combined adverse maternal outcomes. However, urinary PRL concentrations and its antiangiogenic fragments appear to be better predictors of an adverse maternal outcome and may be useful for risk stratification in preeclampsia. PMID:23460287

  15. Herbs In Treatment Of Urinary Tract Infections

    Manish Wasamwar

    2012-10-01

    Full Text Available It is known that urinary tract is very common source of infection and UTIs are second most common reason people visit their doctors each year. Escherichia coli is responsible for large majority of UTIs. UTIs is most commonly diagnosed bacterial infection in woman. Population at risk of complication include older woman, pregnant woman. Continuous antibiotics prophylaxis are used to treat and prevent recurrent urinary tract infections, frequent antibiotic use can result in vaginal and intestinal dysbiosis as well as antibiotic resistance. Thus, it is desirable to seek alternative methods of prevention and treatment of simple UTIs. Few herbal antimicrobial agents Vaccinium macrocarpon (Cranberry, Vaccinium myrtillus (Bilberry; Blueberry, Berberine, Arctostaphylos uva ursi (Bearberry are proved to be very effective in preventing and treating urinary tract infections.

  16. CT findings of melamine caused urinary calculi

    Objective: To analyze the CT findings of melamine induced urinary calculi. Methods: Nineteen children with a history of ingestion of melamine contaminated infant formula milk were studied, including 12 males and 7 females, age ranged from 50 days to 5 years. Results: CT demonstrated renal pelvic and ureteral stones in 13 cases, with urinary obstruction in 9 of them. The size of the stones ranged from 0.3 cm x 0.3 cm to stag-horn calculus. Tine density of the stones measured from a low of 40-70 HU up to a high of 410 HU with an average density of 160 HU. Conclusion: CT scan is an excellent modality in demonstrating urinary tract calculi caused by melamine. It is the method of choice when ultrasound examinations are equivocal. (authors)

  17. Urinary infections in children: main radiological alterations

    The authors present 120 cases of urinary tract infection in children. Radiological evaluation of every child with urinary tract infection included both excretory urography and voiding cyst urethrography. Fifty eight percent of the children were found to have urinary anomalies. Reflux was present in 26.6% of the cases and congenital anomalies in 25%. Among the latter, duplication of collecting system and pyeloureteral and ureterovesical stenosis were the more frequent findings. Hypo tony of the collecting systems, loss of cortical renal tissue and irregularities of the renal contour were the main radiological signs. The delay in performing the radiological evaluation (46% of the children presenting radiological abnormalities were examined only one year after the beginning of the symptoms) contributed to a greater incidence of irreversible lesions, showing therefore that it should be done immediately. A scheme for radiological investigation is also proposed. (author)

  18. Differences in urinary trichloroethylene metabolites of animals.

    Ogata,Masana

    1979-12-01

    Full Text Available Differences in urinary excretion of trichloroethylene were studied in rabbits, rats and mice. Trichloretylene (1 m mole/kg was injected intra-peritoneally, then urinary trichloroacetic acid and trichloroethanol glucuronide were measured. The results were: 1. The ratio of total excretion of trichloroethylene metabolites to the administered trichloroethylene decreased in the order of mice, rats and rabbits. 2. The ratio of total trichloroethanol to trichloroacetic acid in urine decreased in the order of rabbits (69.2, mice (12.8 and rats (2.3. The high ratio in rabbits was due to the extremely small amount of trichloroacetic acid in the urine. 3. Differences in these two urinary metabolites in the three kinds of animals and in human subjects were discussed.

  19. MRI study on urinary abnormalities of fetus

    Objective: To illustrate the important complemental function of MRI in dignosing the urinary abnormalities of the fetus by analyzing MR features. Methods: MRI findings in 34 fetal urinary abnormalities were retrospectively analyzed. Results: Upper urinary tract dilatation was found in 12 cases: one case presented obstructed right renal dysplasia and was on the follow-up, postnatal MR imaging proved the duplex anomaly in one case, one case showed left PUJO on postnatal US imaging and prepared to surgery, 7 cases were normal on postnatal US imaging, 2 cases were lost to follow up. Bilateral urinary anomalies were found in 7 cases: Muhicystic renal dysplasia (n=3), Combined horseshoe kidney in 2 fetuses and bilateral renal aplasia in one case. Bilateral renal dysplasia was diagnosed in 2 cases, one was still bom and proved by autopsy and the other was lost to follow up. The case of bilateral renal agenesis displayed the appearance of sirenomelia on general specimen. The case of right renal agenesis associated contralateral kidney dyspalsia (n=1) was lost to follow up. MR imaging showed low signal intensity of lung and oligohydramnios in the bilateral anomalies. Unilateral urinary anomalies was found in 15 cases, including 9 cases of unilateral renal dysplasia. Two fetuses were aborted and 3 fetuses were proved with postnatal US or MR. One was lost to follow up; 3 cases were on the follow-up. There were 4 cases of unilateral renal agenesis, two fetuses were aborted and 2 fetuses were proved with postnatal US or MR imaging. The case of ectopic kidney was proved with postnatal US imaging. One case of urachal cyst was aborted without autopsy. In the unilateral anomalies, the volume of amniotic fluid was normal, and the fetal lung presented homogenious high signal intensity. Conclusion: As a complemental method, MRI is of great value in displaying and dignosing the urinary abnormalities of fetus. (authors)

  20. Intake of Caffeinated, Carbonated, or Citrus Beverage Types and Development of Lower Urinary Tract Symptoms in Men and Women

    Maserejian, Nancy N.; Wager, Carrie G.; Giovannucci, Edward L.; Curto, Teresa M.; McVary, Kevin T.; McKinlay, John B.

    2013-01-01

    Evidence to substantiate recommendations for restriction of caffeinated or acidic beverages as self-management for lower urinary tract symptoms (LUTS) is limited. We examined longitudinal and acute associations between beverage intake and LUTS in the Boston Area Community Health (BACH) cohort (n = 4,145) between 2002 and 2010. Multivariable models tested associations between baseline intakes and progression of LUTS at 5-year follow-up, between follow-up intakes and International Prostate Symp...