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Sample records for acute urinary retention

  1. Comparison of men with acute versus chronic urinary retention ...

    African Journals Online (AJOL)

    Comparison of men with acute versus chronic urinary retention: aetiology, clinical features and complications. SPJ Van Vuuren, CF Heyns, AD Zarrabi. Abstract. Background: The objectives were to investigate the aetiology and clinical features of urinary retention and to analyse differences between acute urinary retention ...

  2. Herpes Zoster‑Induced Acute Urinary Retention: Two Cases and ...

    African Journals Online (AJOL)

    2018-04-04

    Apr 4, 2018 ... We report two uncommon cases of acute urinary retention in Chinese patients caused by reactivation of sacral herpes zoster and ... creations are licensed under the identical terms. For reprints contact: reprints@medknow.com .... anonymity cannot be guaranteed. Financial support and sponsorship. Nil.

  3. Acute urinary retention after Black Widow envenomation: a case report.

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    Carere, Matthew; Sterret, Russel; Timmerman, Nicholas; Taylor, Ian

    2017-10-16

    Latrodectism following Black Widow envenomation is rare in Canada. We present the case of a previously healthy 50 year old male who presented with an acute abdomen, hypertension, and urinary retention. After a thorough work up it was determined to be as a result of a Black Widow spider bite. Due to climate change we may see more cases of Latrodectism in the future and it should be considered as a differential diagnosis in anyone presenting with an acute abdomen after an insect bite.

  4. Acute urinary retention in a young man secondary to colonic irrigation: a case report

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    Raheem Omer A

    2009-06-01

    Full Text Available Abstract Introduction Autonomic innervation of the bladder is complex and regulated by a hierarchy of mechanisms of the central nervous system. Any dysfunction in these regulatory mechanisms can lead to acute urinary retention. Case presentation A 36-year-old Caucasian man presented with acute urinary retention following extensive bowel irrigation. His urinary bladder was decompressed and his normal voiding mechanism was restored thereafter. Conclusion We postulate that prolonged anorectal and sigmoid dilatation can stimulate the recto-vesicourethral reflex and lead to acute urinary retention via autonomic dysfunction.

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

    LENUS (Irish Health Repository)

    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. Urinary retention in women.

    Science.gov (United States)

    Juma, Saad

    2014-07-01

    This review is a summary of the most pertinent published studies in the literature in the last 18 months that address cause, diagnosis, and management of urinary retention in women. Symptoms, uroflow, and pressure-flow studies have a low predictive value for and do not correlate with elevated postvoid residual urine (PVR). Anterior and posterior colporrhaphy do not cause de-novo bladder outlet obstruction in the majority of patients with elevated PVR, and the cause of elevated PVR may be other factors such as pain or anxiety causing abnormal relaxation of the pelvic floor and contributing to voiding difficulty. The risk of urinary retention in a future pregnancy after mid-urethral sling (MUS) is small. The risk of urinary tract infection and urinary retention after chemodenervation of the bladder with onabotulinumtoxin-A (100 IU) in patients with non-neurogenic urge incontinence is 33 and 5%, respectively. There is a lack of consensus among experts on the timing of sling takedown in the management of acute urinary retention following MUS procedures. There has been a significant progress in the understanding of the causation of urinary retention. Important areas that need further research (basic and clinical) are post-MUS and pelvic organ prolapse repair urinary retention and obstruction, and urinary retention owing to detrusor underactivity.

  7. Acute urinary retention as a late complication of subcutaneous liquid silicone injection: a case report

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    Leandro Luongo de Matos

    2009-12-01

    Full Text Available Acute urinary retention is characterized by a sudden interruption of urinary output; urine is retained in the bladder due to either functional or obstructive anatomic factors, and cannot be voided. The main causes of acute urinary obstruction are benign prostatic hyperplasia, constipation, prostate adenocarcinoma, urethral stenosis, clot retention, neurological disorders, following surgery, calculi, drugs, or urinary tract infections. A transvestite patient, aged 55 years, described having had liquid silicone subcutaneously injected in various parts of the body, the last one four years ago. He complained of absent urinary output during the last 14 hours. The physical examination revealed skin deformation due to migration of implants; a hard nodule (characterized as a foreign body was present in the preputium and a diagnosis of acute urinary retention was made; an unsuccessful attempt to exteriorize the glans for urinary catheterization, was followed by therapeutic cystostomy. Acute urinary retention has not been mentioned in the medical literature as a complication of liquid silicone subcutaneous injection.

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

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    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.

  9. Female urethral diverticulum presenting with acute urinary retention: Reporting the largest diverticulum with review of literature

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    Manas Ranjan Pradhan

    2012-01-01

    Full Text Available Female urethral diverticulum is a rare entity with diverse spectrum of clinical manifestations. It is a very rare cause of bladder outlet obstruction and should be considered as a differential diagnosis in females presenting with acute urinary retention associated with a vaginal mass. Strong clinical suspicion combined with thorough physical examination and focused radiological investigations are vital for its diagnosis. Herein we report a case of giant urethral diverticulum presenting with acute urinary retention in a young female. It was managed by excision and urethral closure, and is the largest urethral diverticulum reported till date in the literature.

  10. Undiagnosed nephrogenic diabetes insipidus as a cause of acute urinary retention in a young soldier.

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    Kim, Hyung Jin; Shin, Y S; Choi, H; Kim, M K; Jeong, Y B; Park, J K

    2016-10-01

    We present a case of undiagnosed nephrogenic diabetes insipidus as a cause of acute urinary retention in a 21-year-old male soldier. Soldiers live in close quarters, and have a regimented lifestyle that may not allow for frequent voiding; therefore, undiagnosed nephrogenic diabetes insipidus may result in acute urinary retention. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Renal cell carcinoma in an ectopic pelvic kidney in a patient presenting with acute urinary retention

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    Isabella Dash

    2010-12-01

    Full Text Available The incidence of renal cell carcinoma in a pelvic kidney is rare, and has only been described in a very small number of cases. We describe a case where an incidental ectopic kidney with invasive renal cell carcinoma was diagnosed during a separate emergency admission for acute urinary retention.

  12. Prostatitis and acute urinary retention as first manifestations of Wegnener's granulomatosis.

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    Pereira Beceiro, Javier; Rodríguez Alonso, Andrés; Bonelli Martín, Carlos; Pérez Valcárcel, Javier; Mosquera Seoane, Teresa; Cuerpo Pérez, Miguel Ángel

    2014-01-01

    We present a case of prostatitis with acute urinary retention as a rare initial manifestation of Wegener' Granulomatosis. The case was a 48-year-old male with symptoms of prostatitis over ten days. The patient presented urinary retention, with partial response to antibiotic treatment. High levels of cytoplasmic antineutrophil cytoplasmic antibody and a prostatic biopsy were compatible with Wegener' Granulomatosis. After starting treatment with glucocorticoids and cyclophosphamide, a significant improvement to the point of disappearance of symptoms was observed. At 3 months pulmonary and upper airway symptoms began, requiring higher doses of cyclophosphamide to control symptoms. Wegener's Granulomatosis is a multisystem entity whose presentation as prostatitis with urinary retention is rare. Copyright © 2012 Elsevier España, S.L.U. All rights reserved.

  13. Urinary Retention

    Science.gov (United States)

    ... of the bladder. At the same time, the brain signals the sphincters to relax. As the sphincters relax, urine exits the bladder through the urethra. Male and female urinary tracts Kidney Ureter Bladder Prostate Urethra 2   ...

  14. Urinary Retention

    Science.gov (United States)

    ... fall asleep for the test. CT scans can show urinary tract stones UTIs tumors traumatic injuries abnormal, fluid-containing sacs called cysts Urodynamic tests . Urodynamic tests include a variety of procedures that look at how well the ...

  15. Herpes Zoster‑Induced Acute Urinary Retention: Two Cases and ...

    African Journals Online (AJOL)

    2018-04-04

    Apr 4, 2018 ... She was diagnosed as a case of herpes zoster reactivation and treatment commenced with oral methylcobalamin, acyclovir (dosage unknown), and catheterization for 3 days. Despite this, her pain persisted and there was progressive worsening of urinary stream after removal of urinary catheter.

  16. Presentation and prognosis of female acute urinary retention: Analysis of an unusual clinical condition in outpatients.

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    Özveren, Bora; Keskin, Selçuk

    2016-01-01

    Acute urinary retention (AUR) in females is a poorly defined condition with undetermined epidemiology. This study aimed to evaluate female AUR in an outpatient population. One hundred and thirty-eight adult female outpatients who presented to the emergency room with symptoms of urinary retention were retrospectively analyzed. The women who were ultimately diagnosed with true, complete AUR were systematically reviewed for clinical characteristics and management. In this outpatient cohort with urinary retention complaints, only 23% of the patients were diagnosed with objective AUR. Detailed medical and urological history in addition to urogenital, neurological, and pelvic examinations was essential; urine analysis and pelvic ultrasonography were necessary as baseline investigations. Further radiological and urodynamic tests were required in a minority. Specific etiology was established in 77% of the patients, whereas there was more than one probable cause in 16% of the patients, and no specific cause was found in 6.5% of the patients. Bladder decompression and correction of the underlying cause helped 92.6% of the reviewed patients to eventually achieve spontaneous micturition. The proportion of true, complete AUR among female outpatients presenting to the emergency department was 23% following urological evaluation. Acute condition was resolved by urgent catheterization in all, and the majority of women had eventually resumed spontaneous voiding.

  17. Does sildenafil enhance the effect of tamsulosin in relieving acute urinary retention?

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    Seyed Hossein Hosseini Sharifi

    2014-06-01

    Full Text Available Objective To compare the safety and efficacy of combined therapy using sildenafil and tamsulosin for management of acute urinary retention (AUR with tamsulosin alone in patients with benign prostate hyperplasia (BPH. Materials and Methods 101 patients were enrolled in a randomized placebo-controlled study from June 2009 to April 2012. Patients presenting with an initial episode of spontaneous AUR underwent urethral catheterization and then prospectively randomized to receive tamsulosin 0.4mg plus sildenafil 50mg in group A and tamsulosin 0.4mg plus placebo in group B for three days. Urethral catheter was removed three days after medical treatment and patient’s ability to void assessed at the day after catheter removal and seven days later. Patients who voided successfully were followed at least for three months. Results Mean age of patients was 59.64 ± 3.84 years in group A and 60.56 ± 4.12 years in group B (p value = 0.92. Mean prostate volume and mean residual urine were comparable between both groups (p value = 0.74 and 0.42, respectively. Fifteen patients in group A (success rate: 70% and nineteen patients in group B (success rate: 62.7% had failed trial without catheter (TWOC at 7th day following AUR (p value = 0.3. No significant difference was noted between both groups regarding the rate of repeated AUR at one month and three month follow-up period (p = 0.07 and p = 0.45, respectively. Conclusion It seems that combination therapy by using 5-phosphodiesterase inhibitor and tamsulosin has no significant advantages to improve urinary retention versus tamsulosin alone.

  18. Does sildenafil enhance the effect of tamsulosin in relieving acute urinary retention?

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    Sharifi, Seyed Hossein Hosseini; Mokarrar, Mohsen Heidari; Khaledi, Flora; Yamini-Sharif, Reyhaneh; Lashay, Alireza; Soltani, Mohammad Hossein

    2014-01-01

    To compare the safety and efficacy of combined therapy using sildenafil and tamsulosin for management of acute urinary retention (AUR) with tamsulosin alone in patients with benign prostate hyperplasia (BPH). 101 patients were enrolled in a randomized placebo-controlled study from June 2009 to April 2012. Patients presenting with an initial episode of spontaneous AUR underwent urethral catheterization and then prospectively randomized to receive tamsulosin 0.4 mg plus sildenafil 50mg in group A and tamsulosin 0.4 mg plus placebo in group B for three days. Urethral catheter was removed three days after medical treatment and patient's ability to void assessed at the day after catheter removal and seven days later. Patients who voided successfully were followed at least for three months. Mean age of patients was 59.64 ± 3.84 years in group A and 60.56 ± 4.12 years in group B (p value = 0.92). Mean prostate volume and mean residual urine were comparable between both groups (p value = 0.74 and 0.42, respectively). Fifteen patients in group A (success rate: 70%) and nineteen patients in group B (success rate: 62.7%) had failed trial without catheter (TWOC) at 7th day following AUR (p value = 0.3). No significant difference was noted between both groups regarding the rate of repeated AUR at one month and three month follow-up period (p = 0.07 and p = 0.45, respectively). It seems that combination therapy by using 5-phosphodiesterase inhibitor and tamsulosin has no significant advantages to improve urinary retention versus tamsulosin alone.

  19. [Acute urinary retention secondary to giant prolapsed ureterocele in a young adult woman. Case report].

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    Villagómez-Camargo, Roberto; Chopin-Gazga, Marco; Saucedo-Bravo, Jonathan; García-Cano, Eugenio; Montiel-Jarquín, Álvaro

    2016-01-01

    Ureterocele is a cystic dilation of the distal ureteral segment. The incidence in women ranges from 1/5,000 to 1/12,000. In adults, they are poorly diagnosed and are asymptomatic. Prolapse through the urethra is uncommon, and involves acute urine retention and a reducible vulvar tumour. Woman of 24 years old, two previous caesarean and two abortions. She had incomplete bladder emptying, intermittent voiding, bladder straining and tenesmus, three months before admission. After the voiding effort she presented with acute urine retention with sudden onset of tumour in the vulva. The tumour was manually reduced under regional anaesthesia. A cystoscopy was performed, finding an ischaemic de-roofing of the anterior wall of the ureterocele, causing vesicoureteral reflux grade IV. Surgical correction was performed with Cohen re-implantation and insertion of a double-J catheter. The catheter was removed 30 days later, with a successful post-operative course. Its aetiology is unclear, and most are diagnosed by ultrasound in the prenatal period. The clinical presentation is variable, from urinary tract infection to prolapse. Despite its size, it may cause complications such as ischaemic de-roofing, which if diagnosed soon may be resolved successfully, as with this patient. The results and treatment may be favourable when no renal impact or concomitant anatomical changes are present, as is the case of this patient. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  20. Emergency management of acute urinary retention: results from an all-Ireland urologist practice survey.

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    Cullen, I M; Dowling, C M; Thornhill, J A; Grainger, R

    2013-06-01

    Anecdotal evidence suggests that current service restrictions and operative cancellations are resulting in increased numbers of catheterized men in the community awaiting definitive management of their bladder outlet obstruction. We wished to analyse current admission policies and management strategies of acute urinary retention (AUR) secondary to benign prostatic enlargement (BPE) in Ireland. A total of 58 consultant urologists practicing in Ireland were sent a questionnaire about their management of AUR secondary to BPE. Data was collected relating to initial emergency management, timing of trial without catheter (TWOC), their use of alpha-blockers and follow-up policy. Urethral catheterization is the initial management of choice by all 42 respondents. The patient is routinely admitted after catheterization by 20/42 consultants (48 %) and 22/42 (52 %) discharge the patient home with a urinary catheter (UC). TWOC is performed on day 2 in 11/20 (55 %) and on day 3 in 9/20 (45 %). In terms of individuals who admit patients presenting with AUR one failed TWOC is an indication for transurethral resection of the prostate in 10/20 (50 %), with 6/20 (30 %) performing a second TWOC on the same admission and 4/20 (20 %) discharging the patient for interval TURP. A total of 83 % of respondents, all of whom work in public institutions, expressed concerns relating to elective admission difficulties for definitive management of catheterized patients following AUR. There is variation in the admission policy for AUR in Ireland. Elective admission and operative restrictions for catheterized patients following episodes of AUR are causing concern to the urologists in Ireland.

  1. [Histological changes of the prostate and acute urinary retention in patients with benign prostatic hyperplasia].

    Science.gov (United States)

    Bao, Qing-Bing; He, Guo-Hua; Liu, Guang-Yao; Zhang, Chang-Geng; Yang, Cheng

    2013-09-01

    To investigate the roles of prostatic infarction, prostatic inflammation and the type of prostatic hyperplasia in acute urinary retention (AUR) in patients with benign prostatic hyperplasia (BPH). We retrospectively analyzed 102 cases of BPH, 49 complicated by AUR and the other 53 without AUR. We compared the incidences of prostatic infarction and prostatic inflammation, the types of prostatic hyperplasia, the patients' age, the level of prostate specific antigen (PSA), the prostate volume, and international prostate symptom score (IPSS) between the AUR and non-AUR groups. The PSA level was significantly increased in the AUR group as compared with the non-AUR group (P prostate volume and IPSS (P > 0.05). The type of prostatic hyperplasia showed no correlation with AUR. The incidence rate of AUR was 5.620 and 2.326 times higher in the BPH patients with prostatic infarction and prostatic inflammation respectively than in those without (P Prostatic infarction and prostatic inflammation are important risk factors of AUR in BPH patients.

  2. APPLICATION OF TRANSURETHRAL MICROWAVE THERMOTHERAPY FOR PATIENTS WITH ACUTE URINARY RETENTION AND SEVERE COMBINED COMORBIDITY FROM BENIGN PROSTATIC HYPERPLASIA

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    A. Mysak

    2014-12-01

    Conclusions. Taking into consideration the minimally invasive nature, favourable tolerability and absence of adverse effects, TUMT can be considered a method of choice in patients with BPH-triggered AUR and contraindications to major surgical treatments and general anaesthesia. Remote outcomes of TUMT may be evaluated as satisfactory, with good effects in 71.62% patients. However in prostatic volumes exceeding 85 cm3 and pronounced intravesical pattern of BPH growth the efficcacy of TUMT is arguable. KEY WORDS: benign prostatic hyperplasia, acute urinary retention, transurethral microwave hermotherapy.

  3. The Reten-World survey of the management of acute urinary retention: preliminary results.

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    Emberton, Mark; Fitzpatrick, John M

    2008-03-01

    Acute urinary retention (AUR) is a urological emergency characterized by a sudden and painful inability to pass urine. It represents a significant worldwide public health issue, as mortality within the year following an AUR episode appears much higher than in the general population, especially in younger patients. Management of AUR involves immediate bladder catheterization usually followed, until recently, by prostatic surgery. The greater morbidity and mortality associated with emergency surgery (within a few days after AUR), and the potential morbidity associated with prolonged catheterization (bacteriuria, fever, urosepsis) has led to an increasing use of a trial without catheter (TWOC). TWOC involves catheter removal after 1-3 days, allowing 23-40% of patients to void successfully, so that surgery can be performed at a later stage, if needed. Use of an alpha(1)-blocker before a TWOC may also be of help, as it has been demonstrated that it increases the chances of successful voiding after catheter removal. In the UK, this TWOC policy has resulted in a progressive decrease in the number of surgical procedures following a first episode of AUR, with the detriment of a slight increase in the AUR recurrence rate. Currently, there is no consensus on the optimal management of AUR in terms of type of catheterization, duration of catheterization and management following catheterization. The Reten-World survey is aimed at assessing current practice in the management of AUR in France, Asia, Latin America, North Africa and the Middle East. Interim results based on 3785 men with AUR associated with benign prostatic hyperplasia show that a urethral catheter is inserted in most cases (87%). Following this initial step, a TWOC after a median of 3 days' catheterization has become standard practice worldwide, with only a minority of men (6%) undergoing immediate surgery. Treatment with an alpha(1)-blocker before a TWOC improves the chances of success, regardless of the duration

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

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    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.

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

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    Le-Ye He

    2016-01-01

    Full Text Available 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 < 0.01. However, there was no significant difference in international prostate symptom score, painful 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.

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

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    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.

  7. [Causes, characteristics and mid-term course of acute urinary retention in women referred to a urodynamics unit].

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    García-Fadrique, G; Morales, G; Arlandis, S; Bonillo, M A; Jiménez-Cruz, J F

    2011-01-01

    Acute urinary retention (AUR) is uncommon in women and can be related to different conditions. Only some patients are referred to the urodynamics units for a more extensive study. We intend to describe the charcteristics and causes of AUR in women referred to our unit and to analyze their middle term evolution. We performed a descriptive retrospective study (January 1982-December 2006), including the women referred to our Uro-Neurology and Urodynamics Unit after suffering an AUR. Medical charts were reviewed with special emphasis on medical history, physical examination, and also complete urodynamics study during the AUR event and after its resolution. A total of 202 women were included, median age of 57 years (12-87 years). Prior to the AUR, 59 women (28.7%) reported voiding symptoms. The urodynamics findings were: 65 (32.2%) detrusor hypocontractility; 64 (31.7%) normal study; 37 (18.3%) detrusor acontractility; 21 (10.4%) bladder outlet obstruction; 15 (7.4%) poor pelvic floor relaxation. The causes of the AUR were: 53 neurological (26.2%); 46 unknown (22.8%); 19 gynecological (9.4%); 22 diabetes mellitus (10.9%); 16 urological (7.9%). Renal insufficiency was observed in 14 patients (6.9%). After the AUR 106 women (52.4%) needed some kind of prolonged treatment. In our experience, AUR in the female is mainly related to underlying neurologic/urogynecologic disease, even though the etiology could not be known in a significant percentage of patients. Half of the patients recovered completely and did not require any treatment. Copyright © 2011 AEU. Published by Elsevier Espana. All rights reserved.

  8. Comparison of tamsulosin and silodosin in the management of acute urinary retention secondary to benign prostatic hyperplasia in patients planned for trial without catheter. A prospective randomized study.

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    Patil, Siddangouda B; Ranka, Kshitiz; Kundargi, Vinay S; Guru, Nilesh

    2017-01-01

    We present a prospective randomized study to compare the efficacy of tamsulosin and silodosin in patients suffering from acute urinary retention caused by benign prostatic hyperplasia, planned for trial without catheter. Patients with acute urinary retention secondary to benign prostatic hyperplasia (total 160) were catheterized and randomized into two groups: Group A: tamsulosin 0.4 mg (80 patients) and Group B: silodosin 8 mg (80 patients). After three days, the catheter was removed, and patients were put on trial without catheter. Patients with a successful trial without catheter were followed up after two weeks and one month, taking into account the international prostate symptom score (IPSS), post void residual volume (PVR), and peak flow rate (PFR). Statistical analysis of the data was performed. Both group A (tamsulosin) and group B (silodosin) had similar results of trial without catheter (group A: 67.50%, group: B 60%). In follow up, three patients in group A and four patients in group B had retention of urine, requiring recatheterization. These patients were withdrawn from the study. No significant differences were present between group A and group B patients in regard with IPSS, PVR and PFR measured at the time of successful trial without catheter and during follow up at two weeks and one month. Efficacy for trial without catheter of tamsulosin was slightly higher than silodosin, but comparable. No statistical difference between tamsulosin & silodosin treated groups were found in regard with IPSS, PVR and PFR.

  9. Diethylstilbestrol 1 mg in the Treatment of Acute Urinary Retention due to Prostatic Obstruction in the Elderly: A Preliminary Study

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    Leonardo Oliveira Reis

    2014-01-01

    Full Text Available Patients who failed a catheter-free trial after acute urinary retention and one week of full dose alpha-blocker and 5-alpha-reductase inhibitor were offered Diethylstilbestrol 1 mg plus Aspirin 100 mg over 4 weeks. Prostate volume, age, serum creatinine, and initial retention drained urine volume were recorded. After excluding cardiovascular morbidity (n=7, upper urinary tract dilation (n=3, compromised renal function (n=2, urinary tract infection (n=2, neurological diagnosis (n=2, or preferred immediate channel transurethral resection of prostate (n=5, 48 of 69 consecutive patients ≥70 years were included. Mean age was 76.6 years (70–84, mean prostate volume 90 cm3 (42–128, and mean follow-up 204 days; 58% (28/48 were passing urine and 42% (20/48 were catheter dependent after 4 weeks Diethylstilbestrol trial. Mean age and drained urine volume of catheter dependent patients were 82.4 years and 850 mL compared with 74.6 years and 530 mL in catheter-free men, respectively. Age and drained urine volume were independent predictors of catheter-free trial (both P<0.01. Seventy-five percent (6/8 of patients 80 years and older were catheter dependent. Transient nipple/breast tenderness and gynecomastia were the only adverse effects reported by 21% (10/48 and 4% (2/48, respectively. No patient presented severe complications.

  10. Acute Retention of Urine Following Intraocular Surgery | Nwosu ...

    African Journals Online (AJOL)

    Hyperosmolar agents and carbonic anhydrase inhibitors are used to lower the intraocular pressure and thus minimize the chances of vitreous loss during intraocular surgery. However, these agents could precipitate urinary retention. This is a report on two elderly men who had perioperative acute urinary retention following ...

  11. [Urinary retention caused by female urethral diverticulum].

    Science.gov (United States)

    Shindo, Tetsuya; Nishida, Sachiyo; Maehana, Takeshi; Miyamoto, Shintarou; Muranaka, Takashi; Hisasue, Shin-ichi; Yanase, Masahiro; Takatsuka, Keiji

    2007-11-01

    We report a 49-year-old female who had circumferential urethral diverticulum. She was admitted to our department for urinary retention. A cystic lesion surrounding the urethra had been detected by magnetic resonance imaging. We diagnosed the lesion as a urethral diverticulum after injecting dye to the cystic mass from vagina and confirming its discharge from the urethra at the pubic side by urethroscopy. Transvaginal resection of the diverticulum was peformed. In general, 4% of female urethral diverticula cause urinary retention. On the other hand, 1% of female bladder outlet obstruction is caused by urethral diverticula. It is neccessary for us to keep in mind urethral diverticulum when we evaluate female patients with urinary retention.

  12. Neurogenic bladder and chronic urinary retention associated with MDMA abuse.

    Science.gov (United States)

    Beuerle, John R; Barrueto, Fermin

    2008-06-01

    The use of 3,4-methylenedioxymethamphetamine (MDMA, known as "ecstasy"), a synthetic amphetamine and "club drug," has been associated with acute, transient urinary retention. We report a case of neurogenic bladder and chronic urinary retention associated with MDMA abuse. A 21-year-old male presented to the emergency department (ED) because he had abdominal pain and difficulty urinating. He had experienced difficulty in initiating urination over the past 1.5 months, with periods of 24 to 36 hours between voids and large volumes of urine. The patient had a chronic pattern of MDMA use, taking 4 tablets/day for 3 months. Two weeks before coming to the ED, he had been admitted to an inpatient drug rehabilitation center. During the time since that admission, the patient had visited EDs repeatedly for insertion and removal of Foley catheters to relieve the urinary retention until he could be admitted to a urologic service. Cystometrogram was abnormal, finding no sensation of bladder fullness after instillation of 350 mL of saline and inability to generate a voluntary voiding pressure. Cystoscopy revealed no outlet obstruction. The findings were consistent with neurogenic bladder. The patient was given prescriptions for bethanecol and phenazopyridine, and told to continue a 10-day course of sulfamethoxazole/trimethoprim for urinary tract infection. He was discharged with a Foley catheter in place. Symptoms of urinary retention persisted at 1-year follow-up, despite self-catheterization and complete cessation of MDMA use. Chronic MDMA use may lead to neurogenic bladder and chronic urinary retention.

  13. Biodegradable braided poly(lactic-co-glycolic acid) urethral stent combined with dutasteride in the treatment of acute urinary retention due to benign prostatic enlargement: a pilot study.

    Science.gov (United States)

    Kotsar, Andres; Isotalo, Taina; Juuti, Hanne; Mikkonen, Joonas; Leppiniemi, Jenni; Hänninen, Venla; Kellomäki, Minna; Talja, Martti; Tammela, Teuvo L J

    2009-03-01

    To evaluate, in a pilot study, the efficacy and safety of combining a braided poly(lactic-co-glycolic acid) (PLGA, a copolymer of l-lactide and glycolide) urethral stent and dutasteride in the treatment of acute urinary retention (AUR) due to benign prostatic enlargement (BPE). Ten men with AUR due to BPE were treated as outpatients. A biodegradable braided PLGA urethral stent was inserted into the prostatic urethra, using a specially designed insertion device under visual control. Dutasteride treatment was started and the patients were followed up for 3 months after insertion of the stents. In all patients the stents were placed successfully with the new insertion device. All men were able to void after inserting the stent. At 1 month five patients voided freely with a low residual urine volume (biodegradable braided prostatic stents. The new braided-pattern stent overcomes the earlier problems of migration and sudden breakage into large particles associated with biodegradable spiral stents. However, the mechanical properties of the new stent need to be improved and tested in a longer follow-up. We consider that this new biodegradable braided-pattern urethral stent could provide a new option in the future treatment of AUR.

  14. Acute urine retention induced by ceftriaxone

    Directory of Open Access Journals (Sweden)

    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.

  15. Urinary Retention in Women: Causes and Management | van der ...

    African Journals Online (AJOL)

    Objectives: Urinary retention in women is uncommon and there are numerous etiological factors. Most reported studies are from Europe and North America, with few studies from developing countries. The aim of this study was to review the etiology of urinary retention in women referred to our institution, a public sector ...

  16. Impacted calculus within a urethral stent: A rare cause of urinary retention

    Directory of Open Access Journals (Sweden)

    Shanmugasundaram Rajaian

    2011-01-01

    Full Text Available An elderly male presented to the emergency department with acute urinary retention. He had poor flow of urine associated with serosanguinous discharge per urethra for 3 days duration. Earlier he underwent permanent metallic urethral stenting for post TURP bulbar urethral stricture. Plain X-ray of Pelvis showed an impacted calculus within the urethral stent in bulbar urethra. Urethrolitholapaxy was done with semirigid ureteroscope. Urethral stent was patent and well covered. Subsequently he had an uneventful recovery. We describe a unique case of acute urinary retention due to calculus impaction within a urethral stent.

  17. Urinary trypsinogen-2 dipstick in acute pancreatitis

    DEFF Research Database (Denmark)

    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....

  18. Post-operative urinary retention in a general surgical population

    DEFF Research Database (Denmark)

    Dreijer, Bjørn; Møller, Morten H; Bartholdy, Jens

    2011-01-01

    Post-operative urine retention is a frequent and serious complication. The aims of this study were to evaluate the prevalence of post-operative urinary retention in a general surgical population and to identify the perioperative risk factors for developing this condition.......Post-operative urine retention is a frequent and serious complication. The aims of this study were to evaluate the prevalence of post-operative urinary retention in a general surgical population and to identify the perioperative risk factors for developing this condition....

  19. Community-Acquired Methicillin-Resistant Staphylococcus aureus Prostatic Abscess Presenting as Acute Urinary Retention: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ali Naboush

    2013-01-01

    Full Text Available Background. Community-associated MRSA (CA-MRSA strains have emerged as a substantial cause of infection in individuals without exposure to the healthcare system. Prostatic abscess is an uncommon disease. To date, there are only 6 published reports of a prostatic abscess secondary to CA-MRSA. Case Description. A 52-year-old diabetic Caucasian presented to the emergency department with severe lower abdominal pain of few hours duration, urinary frequency, and dribbling over the last 3 weeks. Physical examination was remarkable for an enlarged nontender prostate. A urine analysis showed pyuria while urine cultures grew CA-MRSA. Computed tomography of the abdomen and pelvis showed multiple prostate abscesses and a thickened urinary bladder wall. A TURP was performed by the urology team and pathology showed severe acute and chronic prostatitis with abscess formation and necrotic tissue. Our treatment regimen included IV vancomycin followed by oral trimethoprim/sulfamethoxazole and rifampin. Eradication of CA-MRSA was confirmed by follow-up cultures 2 months following discharge. Conclusion. This case illustrates the successful identification, diagnosis, and prompt treatment of a prostatic abscess secondary to CA-MRSA in a diabetic patient without recent hospitalization. Early treatment with antibiotics and transurethral resection of the prostate abscess led to a shortened hospital stay and decreased morbidity.

  20. Inguinal Herniation of the Urinary Bladder Presenting as Recurrent Urinary Retention

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    Amit Frenkel

    2015-01-01

    Full Text Available Herniation of the urinary bladder into the inguinal canal is an uncommon finding, observed in 0.5–4% of inguinal hernias (Curry (2000. It is usually associated with other conditions that increase intra-abdominal pressure such as bladder neck obstruction due to prostatic hypertrophy. Consequently, in men, it is usually associated with some degree of urinary retention. We present a 42-year-old man in whom herniation of the urinary bladder was the cause of urinary retention, and not vice versa. The patient was on tumor necrosis factor alpha antagonist (TNFA (Etanercept for severe Ankylosing spondylitis. Initially, the urinary retention was thought to be a side effect of the medication, but after the drug was discontinued, urinary retention persisted. CT and MRI demonstrated huge herniation of the urinary bladder into the inguinal canal. Immediately after the hernia was repaired, bladder function was restored. TNF treatment was restarted, and no further urinary symptoms were observed in the next two years of follow-up. In this case, the primary illness and its treatment were distracting barriers to early diagnosis and treatment. In younger patients with a large hernia who develop unexpected urinary retention, herniation of the urinary bladder should be highly considered in the differential diagnosis.

  1. Postpartum urinary retention : Risk factors, clinical impact and management

    NARCIS (Netherlands)

    Mulder, F.E.M.

    2017-01-01

    Pregnancy as well as delivery are both associated with pelvic floor disorders such as pelvic organ prolapse, overactive bladder syndrome and urinary incontinence. However, little is known about the relationship between voiding dysfunction and postpartum urinary retention (PUR). It is feasible that

  2. Can Urinary Catheterization Before Birth Reduce Postpartum Urinary Retention?

    Directory of Open Access Journals (Sweden)

    Mehmet B. Şentürk

    2016-04-01

    Results: The time to first micturition was determined to be shorter in the group where urinary catheterization was applied before birth, the PUR rate was lower and the amount of residual urine was less (p0.05. Conclusion: Urinary catheterization before birth reduces the rate of PUR.

  3. Prolonged postpartum urinary retention: A case report and review of ...

    African Journals Online (AJOL)

    Postpartum urinary retention (PUR), which is defined as difficulty in emptying the bladder completely after delivery, may be clinically pronounced or silent. The incidence differs according to the definition. Although many risk factors for this disturbance are identified in the literature, every patient at risk does not necessarily ...

  4. Prolonged postpartum urinary retention: A case report and review of ...

    African Journals Online (AJOL)

    Postpartum urinary retention (PUR), which is defined as difficulty in emptying the bladder completely after delivery, may be clinically pronounced or silent. The incidence differs according to the definition. Although many risk factors for this ... second time, and the patient was catheterised again. Urodynamic tests and pelvic ...

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

    Directory of Open Access Journals (Sweden)

    Ercan KAZAN

    2015-06-01

    Full Text Available 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 papilloma virus (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 review of the literature. [J Contemp Med 2015; 5(2.000: 131-134

  6. [Urinary incontinence in patients with acute ictus].

    Science.gov (United States)

    Suñer Soler, R; Vega Iñigo, R; García Garrido, L; García Gutiérrez, T; Mascort Toral, Z; Segura Martín, T; Dávalos Errando, A

    2000-02-01

    This project won the "Ausonia" Incontinence First Prize among those projects submitted during 1999. This article analyzes the prevalence of urinary incontinence among patients diagnosed as suffering acute ictus after 3 months, 6 months and 12 months. The authors also investigate those factors associated with acute ictus incontinence, how incontinence influences a patient's evolution, and how incontinence affects the environment where recuperation occurs, at home or in an institution, while the patient is recovering. The results confirm that acute urinary incontinence is a forecasting factor, independent of the poor middle and long range functional prognosis, and that the potential prognosis is superior than the seriousness of the neurological deficit at the moment a patient enters a hospital.

  7. [Urinary retention secoundary to cervical myoma large items].

    Science.gov (United States)

    Hernández-Ojeda, Humberto; Torres-Hernández, María Rosa; Rivera-Secchi, Alfredo; Altamirano-Hueto, Doris Giovanna; Cruz-Cano, Pamela Aremy

    2015-12-01

    To describe the clinical-diagnostic importance of cystic appearance of a cervical myoma large elements result produced secondary We described a case of a 40-year-old with abdominal discomfort producing difficulty walking, dyspareunia, urinary retention seven months of evolution. The USG diagnosis was a cystic mass consistent with a right ovarian cyst. The surgical abdominal total hysterectomy is performed. Histopathological study of approximately 1 3x6 cm uterus with myoma fund of approximately 4 cm and myoma level cervical posterior surface of 15x12 cm.

  8. Impact of tamsulosin on urinary retention following early catheter removal after robot-assisted laparoscopic radical prostatectomy: a prospective randomized controlled trial.

    Science.gov (United States)

    Jeong, In Gab; You, Dalsan; Yoon, Jong Hyun; Hong, Sungwoo; Lim, Ju Hyun; Hong, Jun Hyuk; Choo, Myung-Soo; Ahn, Hanjong; Kim, Choung-Soo

    2014-02-01

    To examine the impact of tamsulosin on the rate of acute urinary retention following early catheter removal after robot-assisted laparoscopic radical prostatectomy. A total of 236 patients who underwent robot-assisted laparoscopic radical prostatectomy for prostate cancer carried out by a single surgeon were enrolled in this randomized study. Patients were randomly divided into two groups: treatment with tamsulosin (0.4 mg) from 1 day before to 14 days after surgery (tamsulosin group), or no tamsulosin treatment (control group). The urethral catheter was removed on the fifth postoperative day. The primary end-point was the acute urinary retention rate. Changes in each domain of the International Continence Society male short-form questionnaire and uroflowmetry parameters were secondary end-points. The primary end-point was assessed in 218 patients (92.4%; n = 109 in each group). It was not assessed in 18 patients because of cystographic leak from the vesicourethral anastomosis. The acute urinary retention rate was lower in the tamsulosin group (7.3%) than in the control group (17.4%, P = 0.018). Multivariate logistic regression analysis identified tamsulosin treatment and the operative experience of the surgeon as independent risk factors for acute urinary retention. Tamsulosin-treated patients had a 0.30-fold lower risk of developing acute urinary retention compared with control patients (95% confidence interval 0.12-0.76; P = 0.011). None of the International Continence Society male questionnaire domain scores showed significant changes between the groups. Perioperative treatment with tamsulosin in patients undergoing robot-assisted laparoscopic radical prostatectomy reduces the rate of acute urinary retention after early catheter removal, without aggravating urinary incontinence. © 2013 The Japanese Urological Association.

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

    Directory of Open Access Journals (Sweden)

    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

  10. Postoperative urinary retention after general and spinal anesthesia in orthopedic surgical patients

    Directory of Open Access Journals (Sweden)

    Alaa Abdel aziz Niazi

    2015-01-01

    Conclusion: Urinary retention is more common after spinal than general anesthesia in orthopedic patients. Adding narcotics to the local anesthetics intrathecally causes more incidence of postoperative urinary retention, which may delay patients discharge and transabdominal ultrasonography is a reliable, noninvasive, inexpensive and simple method to measure bladder volume postoperatively.

  11. POSTOPERATIVE URINARY RETENTION AND EARLY REPOSITION OF TENSION-FREE VAGINAL TAPE

    Directory of Open Access Journals (Sweden)

    Marijan Lužnik

    2003-12-01

    Full Text Available Background. The purpose of this article is to show a possible method of treatment of postoperative urinary retention after an initial tension-free vaginal tape.Methods. From December 1999 to May 2003 we performed one hundred TVT procedures at our department, among them five women had postoperative urinary retention evaluated with catheterization. Revision and reposition of tension-free vaginal tape were performed if retention of urine was over 100 ml.Results. Urinary retention after an initial tension-free vaginal tape was successfully treated by early reposition of tension-free vaginal tape. This resulted in immediate residualfree voiding and continence, which remained unchanged at 6 week and 3 month follow-up.Conclusions. Postoperative urinary retention may be treated by reposition instead of dissection or elongation of the tension-free vaginal tape.

  12. Neurogenic bladder dysfunction presenting as urinary retention in neuronopathic Gaucher disease.

    Science.gov (United States)

    McNamara, Erin R; Sullivan, Jennifer; Nagaraj, Shashi K; Wiener, John S; Kishnani, Priya S

    2015-01-01

    Neuronopathic Gaucher disease can present as a continuum of clinical findings, including somatic symptoms of anemia, thrombocytopenia, hepatosplenomegaly, and bone disease as well as neurologic sequelae. There is a spectrum of neurologic symptoms ranging from oculomotor apraxia to severe convulsions. The heterozygosity of phenotypes makes it difficult to predict the disease course. We describe an 8-year-old male with neuronopathic type III Gaucher disease who developed bladder dysfunction and was unable to completely void. He also presented with hypertension and acute renal insufficiency, most likely secondary to urinary retention. A complete evaluation was done for causes of urinary retention and bladder dysfunction. A renal bladder ultrasound demonstrated marked hydroureteronephrosis. There was no clinical evidence of infection and cystoscopy revealed no anatomic obstruction. In addition, MRI showed no spinal abnormalities. His bladder dysfunction was managed operatively by creating a catheterizable stoma, using his appendix, to empty his bladder, and surgical findings were consistent with neurogenic bladder. He continues to be managed for his Gaucher disease and neurogenic bladder by genetics, nephrology and urology. This is the first clinical report of neurogenic bladder dysfunction in neuronopathic Gaucher disease.

  13. Perioperative use of tamsulosin significantly decreases rates of urinary retention in men undergoing pelvic surgery.

    Science.gov (United States)

    Poylin, Vitaliy; Curran, Thomas; Cataldo, Thomas; Nagle, Deborah

    2015-09-01

    Urinary retention is a common complication of pelvic surgery, leading to urinary tract infection and prolonged hospital stays. Tamsulosin is an alpha blocker that works by relaxing bladder neck muscles. It is used to treat benign prostatic hypertrophy and retention. We aim to investigate the potential benefits of preemptive tamsulosin use on rates of urinary retention in men undergoing pelvic surgery. This is a retrospective review of an institutional colorectal database. All men undergoing pelvic surgery between 2004 and 2013 were included. Patients given 0.4 mg of tamsulosin 3 days prior and after surgery at discretion of surgeon starting in 2007 were compared with patients receiving expectant postoperative management. One hundred eighty-five patients were included in the study (study group: N = 30; control group: N = 155). Study group patients were older (56.8 vs. 50.1 years). Overall urinary retention rate was 22% with significantly lower rates in the study group compared with control (6.7 vs. 25%; p = 0.029). Study group had higher rates of minimally invasive surgery (61 vs. 29.7%); however, this did not impact urinary retention rate (20.6 vs. 22.7% for minimally invasive surgery vs. open surgery; p = 0.85). Independent predictors of urinary retention included lack of preemptive tamsulosin (odds ratio (OR), 7.67; 95% confidence interval (CI), 1.4-41.7) and cancer location in the distal third of the rectum (OR, 18.8; 95% CI, 2.1-172.8). Preemptive perioperative use of tamsulosin may significantly decrease the incidence of urinary retention in men undergoing pelvic surgery. This may play a role in avoidance of urinary retention, particularly in patients with distal rectal cancer.

  14. Hydronephrosis Predicts Successful Catheter Removal after Painful Urinary Retention - Preliminary Results of a Prospective Single Center Study.

    Science.gov (United States)

    Heidegger, Isabel; Fritz, Josef; Steiner, Hannes; Bektic, Jasmin; Pichler, Renate

    2016-01-01

    The study aims to identify candidates who can be managed conservatively after the first episode of spontaneous painful acute urinary retention (AUR). A total of 20 patients with primary spontaneous painful AUR were prospectively included in the study. Twenty-four hours after AUR, the catheter was removed. When residual urinary volume was <100 ml, patients were referred without catheter, when residual urinary volume was ≥100 ml, the catheter was replaced and removed again at day 4, 7 or 10 after AUR, respectively. Receiver operating characteristic curves, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated to assess predictors for successful catheter removal. Thirteen out of 20 (65%) patients had a successful catheter removal until day 10 after AUR. Among them 12 of 13 (93.2%) had a successful catheter removal until day 4 of AUR. Hydronephrosis urinary volume and Qmax at the time of AUR were significant numeric predictors for failure of successful catheter removal. In addition, we calculated a prediction model combing age + prostate volume + urinary volume + Qmax that highly predicts successful catheter removal (sensitivity 100%, specificity 69%, PPV 64%, NPV 100%). We found for the first time a significant association between hydronephrosis and successful catheter removal. Successful catheter removal until day 4 after AUR can safely be managed without immediate transurethral resection of the prostate. © 2015 S. Karger AG, Basel.

  15. Urinary tract infection after acute stroke: Impact of indwelling urinary catheterization and assessment of catheter-use practices in French stroke centers.

    Science.gov (United States)

    Net, P; Karnycheff, F; Vasse, M; Bourdain, F; Bonan, B; Lapergue, B

    2018-03-01

    Urinary catheterization and acute urinary retention increase the risk of urinary tract infection (UTI). Our study aimed to investigate the incidence of UTI following acute stroke at our stroke center (SC) and to assess urinary catheter-care practices among French SCs. Stroke patients hospitalized within 24h of stroke onset were prospectively enrolled between May and September 2013. Neurological deficit level was assessed on admission using the US National Institutes of Health Stroke Scale (NIHSS). Patients were followed-up until discharge. Indwelling urinary catheterization (IUC) was the only technique authorized during the study. An electronic survey was also conducted among French SCs to assess their practices regarding urinary catheterization in acute stroke patients. A total of 212 patients were included, with 45 (21.2%) receiving indwelling urinary catheters. The overall estimated incidence of UTI was 14.2%, and 18% among patients receiving IUC. On univariate analysis, IUC was significantly associated with older age, longer hospital stays and higher NIHSS scores. Of the 30 SCs that responded to our survey, 19 (63.3%) declared using IUC when urinary catheterization was needed. The main argument given to justify its use was that it was departmental policy to adopt this technique. Also, 27 participants (90%) stated that conducting a study to assess the impact of urinary catheterization techniques on UTI rates in acute stroke patients would be relevant. Our results are in accord with previously reported data and confirm the high burden of UTI among acute stroke subjects. However, no association was found between IUC and UTI on univariate analysis due to a lack of statistical power. Also, our survey showed high heterogeneity in catheter-use practices among French SCs, but offered no data to help determine the best urinary catheterization technique. Urinary catheterization is common after acute stroke and a well-known risk factor of UTI. However, as high

  16. Sacral Region Massage as an Alternative to the Urinary Catheter Used to Prevent Urinary Retention after Cesarean Delivery

    Directory of Open Access Journals (Sweden)

    Ümran Dal

    2013-03-01

    Full Text Available Objective: The aim of the study was to determine the effect of massage to the sacral region after cesarean delivery instead of employing a urinary catheter for the prevention of urinary retention. Study Design: Cross sectional study. Material and Methods: This interventional study population consisted of 60 women who were divided into two intervention groups and one control group. For the first intervention group, the sacral region was massaged every hour 10-15 minutes after cesarean delivery and every 30 minutes after a voiding sensation for the second intervention group. No interventions were made in the control group, although routine hospital services were provided. Socio-demographic data were collected using a questionnaire developed by the researchers. Other data were collected via observation. Results: Fifteen percent (15% of the women in the first intervention group needed to void 2 hours after cesarean delivery, 35% after 3 hours, and the mean time to void after delivery was 3.4±0.8 hours. Forty percent (40% of the women in the second intervention group needed to void after 5 hours, and the mean time to void after delivery was 5.5±0.8 hours. Sixty percent (60% of the women in the control group needed to void 6 hours later, and the mean time to void after delivery was 6.2±0.7 hours. Urinary retention was not observed in the first intervention group. Our statistical analysis showed a significant difference between the three groups in terms of mean times to void after cesarean delivery (p<0.05. Conclusion: In order to facilitate voiding and to prevent urinary retention, which is seen as a post-cesarean complication, massaging the sacral region could be recommended instead of urinary catheter insertion. Additional studies with larger groups are also recommended.

  17. Sacral nerve stimulation for urinary urge incontinence, urgency-frequency, urinary retention, and fecal incontinence: an evidence-based analysis.

    Science.gov (United States)

    2005-01-01

    The aim of this review was to assess the effectiveness, safety, and cost of sacral nerve stimulation (SNS) to treat urinary urge incontinence, urgency-frequency, urinary retention, and fecal incontinence. CONDITION AND TARGET POPULATION Urinary urge incontinence, urgency-frequency, urinary retention, and fecal incontinence are prevalent, yet rarely discussed, conditions. They are rarely discussed because patients may be uncomfortable disclosing their symptoms to a health professional or may be unaware that there are treatment options for these conditions. Briefly, urge incontinence is an involuntary loss of urine upon a sudden urge. Urgency-frequency is an uncontrollable urge to void, which results in frequent, small-volume voids. People with urgency-frequency may or may not also experience chronic pelvic pain. Urinary retention refers to the inability to void despite having the urge to void. It can be caused by a hypocontractile detrusor (weak or no bladder muscle contraction) or obstruction due to urethral overactivity. Fecal incontinence is a loss of voluntary bowel control. The prevalence of urge incontinence, urgency-frequency, and urinary retention in the general population is 3.3% to 8.2%, and the prevalence of fecal incontinence is 1.4% to 1.9%. About three-quarters of these people will be successfully treated by behaviour and/or drug therapy. For those who do not respond to these therapies, the options for treatment are management with diapers or pads, or surgery. The surgical procedures are generally quite invasive, permanent, and are associated with complications. Pads and/or diapers are used throughout the course of treatment as different therapies are tried. Patients who respond successfully to treatment may still require pads or diapers, but to a lesser extent. SACRAL NERVE STIMULATION Sacral nerve stimulation is a procedure where a small device attached to an electrode is implanted in the abdomen or buttock to stimulate the sacral nerves in an

  18. Delivery-related risk factors for covert postpartum urinary retention after vaginal delivery

    NARCIS (Netherlands)

    Mulder, Femke E. M.; Oude Rengerink, Katrien; van der Post, Joris A. M.; Hakvoort, Robert A.; Roovers, Jan-Paul W. R.

    2016-01-01

    Postpartum urinary retention (PUR) is a common consequence of bladder dysfunction after vaginal delivery. Patients with covert PUR are able to void spontaneously but have a postvoid residual bladder volume (PVRV) of ≥150 mL. Incomplete bladder emptying may predispose to bladder dysfunction at a

  19. Delivery-related risk factors for covert postpartum urinary retention after vaginal delivery

    NARCIS (Netherlands)

    Mulder, Femke E M; Rengerink, Katrien Oude; van der Post, Joris A M; Hakvoort, Robert A; Roovers, Jan-Paul W R; Oude Rengerink, K|info:eu-repo/dai/nl/375367292

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: Postpartum urinary retention (PUR) is a common consequence of bladder dysfunction after vaginal delivery. Patients with covert PUR are able to void spontaneously but have a postvoid residual bladder volume (PVRV) of ≥150 mL. Incomplete bladder emptying may predispose to

  20. Effectiveness of tamsulosin in prevention of post-operative urinary retention: a randomized double-blind placebo-controlled study.

    Science.gov (United States)

    Madani, Ali Hamidi; Aval, Hamidreza Baghani; Mokhtari, Gholamreza; Nasseh, Hamidreza; Esmaeili, Samaneh; Shakiba, Maryam; Shakiba, Reza Shahrokhi; Seyed Damavand, Seyed Mohamad

    2014-01-01

    Urinary retention is one of the most common complications contributing to surgical procedures. Recent studies have shown the benefits of alpha-adrenergic blockers in preventing post-operative urinary retention (POUR). The aim of this prospective study was to compare the prophylactic effect of tamsulosin with placebo on postoperative urinary retention. In this randomized placebo controlled, clinical trial, 232 male patients aged 18 to 50 years old admitted to Razi University Hospital for varicocelectomy, inguinal herniorrhaphy, and scrotal surgery were randomly assigned to receive either three doses of 0.4mg tamsulosin (n = 118) or placebo (n = 114), 14 and 2 hours before, and 10 hours after surgery. Patients were closely monitored for the development of urinary retention 24 hours after surgical intervention. The primary endpoint was to investigate the effect of tamsulosin in prevention of post-operative urinary retention during the first 24 hours after surgical intervention. Collected data were analyzed using SPSS software version 18 and the P tamsulosin arm and 114 in placebo arm. POUR in patients who received tamsulosin was significantly lower than placebo, as 5.9% of the patients treated with tamsulosin and 21.1% placebo group, reported urinary retention following surgery (P = 0.001). No serious adverse effects were seen in both groups. This study suggests that short perioperative treatment with tamsulosin can reduce the incidence of urinary retention and the need for catheterization after varicocelectomy, inguinal herniorrhaphy, and scrotal surgery.

  1. Urinary Tract Infection in Children with Acute Glomerulonephritis in ...

    African Journals Online (AJOL)

    This is a prospective study of 47 cases of acute glomerunephritis seen in paediatric ward of Aminu Kano Teaching Hospital, Kano over a 5year period; they were evaluated for prevalence of urinary tract infection, urine specimen were obtained by midstream urine following careful cleaning of the orifices with chlorhexidine.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    Webb, J.A.W.

    1997-01-01

    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

  4. Fowler's syndrome--a cause of unexplained urinary retention in young women?

    Science.gov (United States)

    Osman, Nadir I; Chapple, Christopher R

    2014-02-01

    Urinary retention in women is an uncommon and poorly understood condition. In 1986, Fowler and colleagues described a syndrome in young women with unexplained urinary retention associated with polycystic ovary syndrome. The underlying abnormality was a poorly relaxing external urethral sphincter that when studied using concentric needle electromyography showed a distinct abnormal pattern suggesting direct spread of impulses between muscle fibres. These findings were subsequently reproduced by other researchers and in larger patient cohorts, but remain the subject of much debate. A poorly relaxing sphincter is thought to cause increased urethral afferent activity, which inhibits bladder afferent signalling leading to poor bladder sensation and detrusor underactivity. Most studies of Fowler's syndrome are limited due to small cohorts with no control group and a lack of videourodynamic data. Whether Fowler's syndrome represents a distinct cause of urinary retention or results from a maladaptive behaviour and is similar to dysfunctional voiding is unclear. Application of sacral neuromodulation in patients diagnosed with Fowler's syndrome can restore normal voiding, in the absence of any effective pharmacotherapy or surgical treatment.

  5. Can androgen-deprivation therapy obviate the need of channel transurethral resection of the prostate in advanced prostate cancer with urinary retention? A prospective study

    Directory of Open Access Journals (Sweden)

    Rajeev Sood

    2017-12-01

    Full Text Available Objective: To evaluate the efficacy of androgen-deprivation therapy (ADT in relieving urinary retention in patients with advanced prostate cancer presenting with urinary retention or a high post-void residual urine volume (PVR. Patients and methods: Patients with advanced prostate cancer with an indwelling catheter for acute/chronic urinary retention, or with a high PVR (>200 mL who had not received any previous treatment were included in the study. Patients with localised prostate cancer eligible for receiving any therapy aimed at cure were excluded. All enrolled patients were managed by ADT (LHRH antagonist/agonist or orchidectomy combined with α-adrenoceptor antagonist/combined therapy for at least 1 month to a maximum of 3 months; they were given their first trial of voiding without catheter after 1 month, and monthly thereafter. Results: A total of 101 patients received ADT of which 97 were able to void successfully at the end of 3 months. In all, 27 patients could void in the first month, followed by 50 in the second month, and an additional 20 in the third month. There was a significant decrease in prostate volume, PVR, and International Prostate Symptom Score, and maximum urinary flow rates improved with normalisation of renal functions and resolution of upper tract changes noted on ultrasonography. Conclusion: ADT can relieve retention and decrease PVR over a period of time obviating the need for channel transurethral resection of the prostate. Keywords: ADT, ADT in retention, Prostate cancer

  6. Prediction of acute coronary syndromes by urinary proteome analysis.

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    Nay M Htun

    Full Text Available Identification of individuals who are at risk of suffering from acute coronary syndromes (ACS may allow to introduce preventative measures. We aimed to identify ACS-related urinary peptides, that combined as a pattern can be used as prognostic biomarker. Proteomic data of 252 individuals enrolled in four prospective studies from Australia, Europe and North America were analyzed. 126 of these had suffered from ACS within a period of up to 5 years post urine sampling (cases. Proteomic analysis of 84 cases and 84 matched controls resulted in the discovery of 75 ACS-related urinary peptides. Combining these to a peptide pattern, we established a prognostic biomarker named Acute Coronary Syndrome Predictor 75 (ACSP75. ACSP75 demonstrated reasonable prognostic discrimination (c-statistic = 0.664, which was similar to Framingham risk scoring (c-statistics = 0.644 in a validation cohort of 42 cases and 42 controls. However, generating by a composite algorithm named Acute Coronary Syndrome Composite Predictor (ACSCP, combining the biomarker pattern ACSP75 with the previously established urinary proteomic biomarker CAD238 characterizing coronary artery disease as the underlying aetiology, and age as a risk factor, further improved discrimination (c-statistic = 0.751 resulting in an added prognostic value over Framingham risk scoring expressed by an integrated discrimination improvement of 0.273 ± 0.048 (P < 0.0001 and net reclassification improvement of 0.405 ± 0.113 (P = 0.0007. In conclusion, we demonstrate that urinary peptide biomarkers have the potential to predict future ACS events in asymptomatic patients. Further large scale studies are warranted to determine the role of urinary biomarkers in clinical practice.

  7. The Diagnosis, Evaluation and Treatment of Acute and Recurrent Pediatric Urinary Tract Infections

    Science.gov (United States)

    Becknell, Brian; Schober, Megan; Korbel, Lindsey; Spencer, John David

    2015-01-01

    Urinary tract infection is one of the most common bacterial infections encountered by pediatricians. Currently, the diagnosis and management of acute urinary tract infection and recurrent urinary tract infection in children remains controversial. Recently published guidelines and large clinical trials have attempted to clarify UTI diagnostic and management strategies. In this manuscript, we review the diagnosis and management of acute and recurrent urinary tract infection in the pediatric population. PMID:25421102

  8. Effectiveness of tamsulosin in prevention of post-operative urinary retention: a randomized double-blind placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Ali Hamidi Madani

    2014-01-01

    Full Text Available Purpose: Urinary retention is one of the most common complications contributing to surgical procedures. Recent studies have shown the benefits of alpha-adrenergic blockers in preventing post-operative urinary retention (POUR. The aim of this prospective study was to compare the prophylactic effect of tamsulosin with placebo on postoperative urinary retention. Materials and Methods: In this randomized placebo controlled, clinical trial, 232 male patients aged 18 to 50 years old admitted to Razi University Hospital for varicocelectomy, inguinal herniorrhaphy, and scrotal surgery were randomly assigned to receive either three doses of 0.4mg tamsulosin (n = 118 or placebo (n = 114, 14 and 2 hours before, and 10 hours after surgery. Patients were closely monitored for the development of urinary retention 24 hours after surgical intervention. The primary endpoint was to investigate the effect of tamsulosin in prevention of post-operative urinary retention during the first 24 hours after surgical intervention. Collected data were analyzed using SPSS software version 18 and the P < 0.05 was considered statistically significant. Results: One hundred and eighteen patients were included in tamsulosin arm and 114 in placebo arm. POUR in patients who received tamsulosin was significantly lower than placebo, as 5.9% of the patients treated with tamsulosin and 21.1% placebo group, reported urinary retention following surgery (P = 0.001. No serious adverse effects were seen in both groups. Conclusions: This study suggests that short perioperative treatment with tamsulosin can reduce the incidence of urinary retention and the need for catheterization after varicocelectomy, inguinal herniorrhaphy, and scrotal surgery.

  9. Urinary Analysis of Fluid Retention in the General Population: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Robert G Hahn

    Full Text Available Renal conservation (retention of fluid might affect the outcome of hospital care and can be indicated by increased urinary concentrations of metabolic waste products. We obtained a reference material for further studies by exploring the prevalence of fluid retention in a healthy population.Spot urine sampling was performed in 300 healthy hospital workers. A previously validated algorithm summarized the urine-specific gravity, osmolality, creatinine, and color to a fluid retention index (FRI, where 4.0 is the cut-off for fluid retention consistent with dehydration. In 50 of the volunteers, we also studied the relationships between FRI, plasma osmolality, and water-retaining hormones.The cut-off for fluid retention (FRI ≥ 4.0 was reached by 38% of the population. No correlation was found between the FRI and the time of the day of urine sample collection, and the FRI was only marginally correlated with the time period spent without fluid intake. Volunteers with fluid retention were younger, generally men, and more often had albuminuria (88% vs. 34%, P < 0.001. Plasma osmolality and plasma sodium were somewhat higher in those with a high FRI (mean 294.8 vs. 293.4 mosmol/kg and 140.3 vs. 139.9 mmol/l. Plasma vasopressin was consistently below the limit of detection, and the plasma cortisol, aldosterone, and renin concentrations were similar in subjects with a high or low FRI. The very highest FRI values (≥ 5.0, N = 61 were always accompanied by albuminuria.Fluid retention consistent with moderate dehydration is common in healthy staff working in a Swedish hospital.

  10. Obesity and the Incidence of Bladder Injury and Urinary Retention Following Tension-Free Vaginal Tape Procedure: Retrospective Cohort Study

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    Vladimir Revicky

    2011-01-01

    Full Text Available Background/Aims. Aim of the study was to establish an effect of obesity on the incidence of bladder injury or urinary retention following tension-free vaginal tape (TVT procedure. Methods. This was a retrospective cohort study based at the Norfolk and Norwich University Hospital in the UK. Study population included 342 cases of TVT procedures. Incidence of bladder injury was 4.7% (16/342. Rate of urinary retention was 9% (31/342. Body mass index (BMI, age, type of analgesia, concomitant prolapse repair, and previous surgery were factors studied. Univariate analysis was performed to establish a relationship between BMI and complications, followed by a multivariable regression analysis to adjust for age, concomitant surgery, type of analgesia, and previous surgery. Results. Neither univariate analysis nor multivariate regression analysis revealed any statistically significant influence of obesity on the incidence of bladder injury or urinary retention. Unadjusted odds ratios and adjusted odds ratios for bladder injury and urinary retention by BMI groups were OR 1.7296 CI 0.4818–6.2097; OR 1.3745 CI 0.5718–3.3043 and adj. OR 2.885 CI 0.603–13.8; adj. OR 1.299 CI 0.502–3.365. Conclusion. Obesity does not appear to influence the rate of bladder injury or urinary retention following TVT procedure.

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

    International Nuclear Information System (INIS)

    Khan, M.T.J.; Saeed, S.; Ali, A.; Qureshi, M.A.; Alam, S.N.

    2015-01-01

    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)

  12. Prevalence of postoperative bladder distension and urinary retention detected by ultrasound measurement.

    Science.gov (United States)

    Lamonerie, L; Marret, E; Deleuze, A; Lembert, N; Dupont, M; Bonnet, F

    2004-04-01

    Postoperative bladder distension and urinary retention are commonly underestimated. Ultrasound enables accurate measurement of bladder volume and thus makes it possible to determine the prevalence of postoperative bladder distension. Using ultrasound, we measured the volume of the bladder contents at the time of discharge from the recovery room in 177 adult patients who had undergone thoracic, vascular, abdominal, orthopaedic or ENT surgery. Forty-four per cent of the patients had a bladder volume >500 ml and 54% of the 44%, who had no symptoms of bladder distension, were unable to void spontaneously within 30 min. The risk factors for urinary retention were age >60 yr (odds ratio (OR) 2.11, 95% confidence interval (CI) 1.01-4.38), spinal anaesthesia (OR 3.97, 95% CI 1.32-11.89) and duration of surgery >120 min (OR 3.03, 95% CI 1.39-6.61). Before discharge from the recovery room it seems worthwhile to systematically check the bladder volume with a portable ultrasound device in patients with risk factors.

  13. Postoperative Urinary Retention is an Independent Predictor of Short-Term and Long-Term Future Bladder Outlet Procedure in Men.

    Science.gov (United States)

    Blackwell, Robert H; Vedachalam, Srikanth; Shah, Arpeet S; Kothari, Anai N; Kuo, Paul C; Gupta, Gopal N; Turk, Thomas M T

    2017-11-01

    Postoperative urinary retention is a common complication across surgical specialties. To our knowledge no literature to date has examined postoperative urinary retention as a predictor of long-term receipt of surgery for bladder outlet obstruction. We retrospectively reviewed the records of inpatients who underwent nonurological surgery in California between 2008 and 2010. Postoperative urinary retention during the index admission was identified, as was receipt of a bladder outlet procedure (transurethral prostate resection, prostate photoselective vaporization or suprapubic prostatectomy) at a subsequent encounter. Patients were matched using propensity scoring of demographics, comorbidities and surgery type. Adjusted Kaplan-Meier analysis was performed to determine the cumulative incidence of subsequent bladder outlet procedures by patient group, including group 1-age 60 years or greater and postoperative urinary retention, group 2-age 60 years or greater and no postoperative urinary retention, group 3-age less than 60 years and postoperative urinary retention, and group 4-age less than 60 years and no postoperative urinary retention. Of 769,141 eligible male patients postoperative urinary retention developed in 8,051 (1.1%). Following hospital discharge 1,855 patients (0.24%) underwent a bladder outlet procedure. Those treated with a bladder outlet procedure were significantly more likely to have experienced postoperative urinary retention during the index admission (6.3% vs 1.0%, p outlet procedure rate at 3 years was 7.1%, 2.2%, 0.8% and 0.0% in groups 1, 2, 3 and 4, respectively. In men 60 years old or older postoperative urinary retention identified those with an increased incidence of bladder outlet procedures within 3 years. Men younger than 60 years had a low rate of subsequent bladder outlet procedures regardless of a postoperative urinary retention diagnosis. Copyright © 2017 American Urological Association Education and Research, Inc. Published by

  14. Clinical, Laboratorial, and Urodynamic Findings of Prostatic Artery Embolization for the Treatment of Urinary Retention Related to Benign Prostatic Hyperplasia. A Prospective Single-Center Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Antunes, Alberto A. [University of Sao Paulo Medical School, Division of Urology (Brazil); Carnevale, Francisco C., E-mail: fcarnevale@uol.com.br; Motta Leal Filho, Joaquim M. da [University of Sao Paulo Medical School, Interventional Radiology Unit (Brazil); Yoshinaga, Eduardo M. [University of Sao Paulo Medical School, Division of Urology (Brazil); Cerri, Luciana M. O. [University of Sao Paulo Medical School, Ultrasound Unit (Brazil); Baroni, Ronaldo H. [University of Sao Paulo Medical School, Magnetic Resonance Unit (Brazil); Marcelino, Antonio S. Z. [University of Sao Paulo Medical School, Ultrasound Unit (Brazil); Cerri, Giovanni G. [University of Sao Paulo Medical School, Radiology Department (Brazil); Srougi, Miguel [University of Sao Paulo Medical School, Division of Urology (Brazil)

    2013-08-01

    PurposeThis study was designed to describe the clinical, laboratorial, and urodynamic findings of prostatic artery embolization (PAE) in patients with urinary retention due to benign prostatic hyperplasia (BPH).MethodsA prospective study of 11 patients with urinary retention due to BPH was conducted. Patients underwent physical examination, prostate specific antigen (PSA) measurement, transrectal ultrasound, and magnetic resonance imaging. International prostate symptom score (IPSS), quality of life (QoL), and urodynamic testing were used to assess the outcome before and after 1 year.ResultsClinical success was 91 % (10/11 patients) with a mean follow-up of 22.3 months (range, 12-41 months). At the first year follow-up, the mean IPSS score was 2.8 points (p = 0.04), mean QoL was 0.4 points (p = 0.001), mean PSA decreased from 10.1 to 4.3 ng/mL (p = 0.003), maximum urinary flow (Qmax) improved from 4.2 to 10.8 mL/sec (p = 0.009), and detrusor pressure (Pdet) decreased from 85.7 to 51.5 cm H{sub 2}O (p = 0.007). Before PAE, Bladder Outlet Obstruction Index (BOOI) showed values >40 in 100 % of patients. After PAE, 30 % of patients were >40 (obstructed), 40 % were between 20 and 40 (undetermined), and 30 % were <20 (unobstructed). Patients with a BOOI <20 had higher PSA values at 1-day after PAE.ConclusionsClinical and urodynamic parameters improved significantly after PAE in patients with acute urinary retention due to BPH. Total PSA at day 1 after PAE was higher in patients with unobstructed values in pressure flow studies.

  15. Factors affecting de novo urinary retention after Holmium laser enucleation of the prostate.

    Directory of Open Access Journals (Sweden)

    Sung Han Kim

    Full Text Available OBJECTIVE: Patients can experience urinary retention (UR after Holmium laser enucleation of the prostate (HoLEP that requires bladder distension during the procedure. The aim of this retrospective study is to identify factors affecting the UR after HoLEP. MATERIALS AND METHODS: 336 patients, which underwent HoLEP for a symptomatic benign prostatic hyperplasia between July 2008 and March 2012, were included in this study. Urethral catheters were routinely removed one or two days after surgery. UR was defined as the need for an indwelling catheter placement following a failure to void after catheter removal. Demographic and clinical parameters were compared between the UR (n = 37 and the non-urinary retention (non-UR; n = 299 groups. RESULTS: The mean age of patients was 68.3 (±6.5 years and the mean operative time was 75.3 (±37.4 min. Thirty seven patients (11.0% experienced a postoperative UR. UR patients voided catheter free an average of 1.9 (±1.7 days after UR. With regard to the causes of UR, 24 (7.1% and 13 (3.9% patients experienced a blood clot-related UR and a non-clot related UR respectively. Using multivariate analysis (p0.05. CONCLUSIONS: De novo UR after HoLEP was found to be self-limited and it was not related to learning curve, patient age, diabetes, or operative time. Efficient morcellation and careful control of bleeding, which reduces clot formation, decrease the risk of UR after HoLEP.

  16. Incidence of delayed hair re-growth, pruritus, and urinary retention after epidural anaesthesia in dogs.

    Science.gov (United States)

    Kalchofner Guerrero, K S; Guerrero, T G; Schweizer-Kölliker, M; Ringer, S K; Hässig, M; Bettschart-Wolfensberger, R

    2014-04-16

    Delayed hair re-growth, pruritus and urinary retention are known complications after epidural anaesthesia in dogs. The aim of this study was to prospectively evaluate the effect of epidurally administered drugs on the occurrence of these complications in dogs. Ninety dogs were included in this study. Eighty client-owned dogs undergoing surgery were randomly assigned to one of three epidural treatment groups: either morphine and bupivacaine (MB), bupivacaine (B), or saline solution 0.9% (S) was administered epidurally to these patients. Ten dogs were only clipped in the lumbosacral area (C). Follow-up started 4 weeks after clipping and was performed every 4-5 weeks in cases of delayed hair re-growth or pruritus. Hair re-growth in the lumbosacral area was observed and compared to hair re-growth in the surgical field and the fentanyl patch area. Cytological analysis and a trichogram were performed if hair re-growth was delayed after 6 months. Time interval to first urination postoperatively was recorded (n = 80). Hair re-growth was delayed in 11 dogs (12.2%; B: n = 7, S: n = 2, MB: n = 1, C: n = 1) with no differences between groups. Pruritus was evident in two dogs (2.2%; MB: n = 1, S: n = 1). After 6 months, hair had started to re-grow in all but one dog (B). After 10 months the coat of this dog had re-grown. Time to first urination did not differ between groups. No direct correlation between the particular drugs injected epidurally and delayed hair re-growth, pruritus and urinary retention could be shown. Dog owners should be informed that hair re-growth after epidural anaesthesia could be markedly delayed.

  17. Intraurethral Catheter: Alternative Management for Urinary Retention in Patients With Benign Prostatic Hypertrophy

    Directory of Open Access Journals (Sweden)

    Sulabha Punekar

    1995-01-01

    Full Text Available A polyurethane intraurethral catheter (IUC was used in 27 patients with benign prostatic hypertrophy who were unfit for surgery, or were awaiting surgery. All of them had previously had a periurethral catheter inserted. The IUC was inserted with a cystoscope under fluoroscopic control. Spontaneous voiding through the IUC resumed in 25 patients (93% in the immediate postprocedure period. At the end of 6 months follow-up, the peak flow rates and the residual volumes estimated in 22 patients were satisfactory. Immediate complications included incontinence due to distal displacement in 2 patients and hematuria in one patient; long-term complications included mild encrustation of the IUC in 2 patients and calculus formation on the IUC in 1 patient. None of the patients had clinically significant urinary tract infection. The presence of the IUC did not compromise the subsequent transurethral resection of the prostate gland. We recommend the use of an IUC for up to 6 months in patients with urinary retention who are awaiting surgery or are unfit for surgery as an alternative to an indwelling urethral catheter.

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

    Directory of Open Access Journals (Sweden)

    Josef Finsterer

    2015-01-01

    Full Text Available 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 investigations, however, revealed pleocytosis, elevated protein, and antibodies against Borrelia burgdorferi. Intravenous ceftriaxone for three weeks resulted in immediate improvement of bladder dysfunction, with continuous decline of residual urine volume and continuous increase of spontaneous urine volume even after removal of the catheter and initiation of self-catheterization. Sacral radiculitis due to infection with Borrelia burgdorferi is a potential cause of detrusor areflexia and urethral, perineal, inguinal, and scrotal pain and may be misinterpreted as cystitis or urethritis. Ceftriaxone may result in progressive recovery of bladder dysfunction and pain. Neuroborreliosis may manifest exclusively as neurourological problem.

  19. Preventive effect of tamsulosin on postoperative urinary retention in neurosurgical patients.

    Science.gov (United States)

    Basheer, Azam; Alsaidi, Mohammed; Schultz, Lonni; Chedid, Mokbel; Abdulhak, Muwaffak; Seyfried, Donald

    2017-01-01

    Postoperative urinary retention (POUR) is common in neurosurgical patients. The use of alpha-blockade therapy, such as tamsulosin, has benefited many patients with a history of obstructive uropathy by decreasing lower urinary tract symptoms such as distension, infections, and stricture formation, as well as the incidence of POUR. For this study, we targeted patients who had undergone spinal surgery to examine the prophylactic effects of tamsulosin. Increased understanding of this therapy will assist in minimizing the morbidity of spinal surgery. We enrolled 95 male patients undergoing spine surgery in a double-blind, randomized, placebo-controlled trial. Patients were randomly assigned to receive either preoperative tamsulosin (N = 49) or a placebo (N = 46) and then followed-up prospectively for the development of POUR after removal of an indwelling urinary catheter (IUC). They were also followed-up for the incidence of IUC reinsertions. The rate of developing POUR was similar in both the groups. Of the 49 patients given tamsulosin, 16 (36%) developed POUR compared to 13 (28%) from the control group ( P = 0.455). In the control group, 5 (11%) patients had IUC re-inserted postoperatively, whereas 7 (14%) patients in the tamsulosin group had IUC re-inserted postoperatively ( P = 0.616). In patients suffering from axial-type symptoms (i.e., mechanical back pain), 63% who received tamsulosin and 18% from the control group ( P = 0.048) developed POUR. Overall, there was no statistically significant difference in the rates of developing POUR among patients in either group. POUR is caused by a variety of factors, and further studies are needed to shed light on its etiology.

  20. Urinary Retention, Incontinence, and Dysregulation of Muscarinic Receptors in Male Mice Lacking Mras.

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    Annette Ehrhardt

    Full Text Available Here we show that male, but not female mice lacking expression of the GTPase M-Ras developed urinary retention with distention of the bladder that exacerbated with age but occurred in the absence of obvious anatomical outlet obstruction. There were changes in detrusor morphology in Mras-/- males: Smooth muscle tissue, which exhibited a compact organization in WT mice, appeared disorganized and became increasingly 'layered' with age in Mras-/- males, but was not fibrotic. Bladder tissue near the apex of bladders of Mras-/- males exhibited hypercontractility in response to the cholinergic agonist carbachol in in vitro, while responses in Mras-/- females were normal. In addition, spontaneous phasic contractions of detrusors from Mras-/- males were increased, and Mras-/- males exhibited urinary incontinence. We found that expression of the muscarinic M2 and M3 receptors that mediate the cholinergic contractile stimuli of the detrusor muscle was dysregulated in both Mras-/- males and females, although only males exhibited a urinary phenotype. Elevated expression of M2R in young males lacking M-Ras and failure to upregulate M3R with age resulted in significantly lower ratios of M3R/M2R expression that correlated with the bladder abnormalities. Our data suggests that M-Ras and M3R are functionally linked and that M-Ras is an important regulator of male bladder control in mice. Our observations also support the notion that bladder control is sexually dimorphic and is regulated through mechanisms that are largely independent of acetylcholine signaling in female mice.

  1. Acute and chronic urine retention among adults at the urology ...

    African Journals Online (AJOL)

    E.M.T. Yenli

    AUR) and chronic urine retention. (CUR) are different and varied in both gender and age. Urine retention has been well studied among males worldwide, while data on urine retention among women are sparse. This study aimed at determining the.

  2. Management of acute uncomplicated urinary tract infection in adults.

    Science.gov (United States)

    Hooton, T M; Stam, W E

    1991-03-01

    Acute uncomplicated UTI is one of the most common problems for which young women seek medical attention, and it accounts for considerable morbidity and health care costs. Acute cystitis is a superficial infection of the bladder mucosa, whereas pyelonephritis involves tissue invasion of the upper urinary tract. Localization tests suggest that as many as one third of episodes of acute cystitis are associated with silent upper tract involvement. Acute cystitis or pyelonephritis in the adult patient should be considered uncomplicated if the patient is not pregnant or elderly, if there has been no recent instrumentation or antimicrobial treatment, and if there are no known functional or anatomic abnormalities of the genitourinary tract. Most of these infections are caused by E. coli, which are susceptible to many oral antimicrobials. Because of the superficial nature of cystitis, single-dose and 3-day regimens have gained wide acceptance as the preferred methods of treatment. Review of the published data suggests that a 3-day regimen is more effective than a single-dose regimen for all antimicrobials tested. Regimens with trimethoprim-sulfamethoxazole appear to be more effective than those with beta-lactams, regardless of the duration. Acute pyelonephritis does not necessarily imply a complicated infection. Upper tract infection with highly virulent uropathogens in an otherwise healthy woman may be considered an uncomplicated infection. The optimal treatment duration for acute uncomplicated pyelonephritis has not been established, and 14-day regimens are often used. We prefer to use antimicrobials that attain high renal tissue levels, such as trimethoprim-sulfamethoxazole or quinolones, for pyelonephritis. Women with frequently recurring infections can be successfully managed by continuous prophylaxis, either daily or thrice-weekly, by postcoital prophylaxis, or, in compliant patients, by early self-administration of single-dose or 3-day therapy as soon as typical

  3. Plutonium fecal and urinary excretion functions: Derivation from a systematic whole-body retention function

    International Nuclear Information System (INIS)

    Sun, C.; Lee, D.

    1999-01-01

    Liver-bile secretion directly influences the content of plutonium in feces. To assess the reliability of plutonium metabolic models and to improve the accuracy of interpreting plutonium fecal data, the authors developed a compartmental model that simulates the metabolism of plutonium in humans. With this model, they can describe the transport of plutonium contaminants in the systemic organs and tissues of the body, including fecal and urine excretions, without using elaborate kinetic information. The parameter values of the models, which describe the translocation rates and recycling of plutonium in the body, can be derived from a multi-term exponential systemic function for whole-body retention. The analytical derivations and algorithms for solving translocation parameter values are established for the model and illustrated by applying them to the biokinetics and bioassay of plutonium. This study describes how to (1) design a physiological model for incorporating liver biliary secretion and for obtaining a fecal-excretion function, (2) develop an analytical solution for identifying the translocation-parameter values incorporating the recycling of plutonium in the body, and (3) derive a set of urinary and fecal excretion-functions from a published systemic whole-body retention function, generally acknowledged to be accurate, as a real and practical example

  4. Urinary incontinence and indwelling urinary catheters in acutely admitted elderly patients: relationship with mortality, institutionalization, and functional decline

    NARCIS (Netherlands)

    Bootsma, A. M. Jikke; Buurman, Bianca M.; Geerlings, Suzanne E.; de Rooij, Sophia E.

    2013-01-01

    To study differences in functional status at admission in acutely hospitalized elderly patients with urinary incontinence, a catheter, or without a catheter or incontinence (controls) and to determine whether incontinence or a catheter are independent risk factors for death, institutionalization, or

  5. Prevalence of histological prostatitis in men with benign prostatic hyperplasia or adenocarcinoma of the prostate presenting without urinary retention.

    Science.gov (United States)

    Edlin, Rachel S; Heyns, Chris F; Van Vuuren, Stephan P J; Zarrabi, Amir D

    2012-11-12

    To determine the prevalence of prostatitis on histopathological evaluation of prostatic tissue in men without urinary retention. The clinical data and histopathology reports of men seen from January 1999 through March 2009 at our institution were analysed using Student's t-test, the Mann-Whitney test and Fisher's exact test where appropriate. Values were expressed as means, medians and ranges (p<0.05 accepted as statistically significant). Data collected included patient age, duration of lower urinary tract symptoms and hospitalisation, findings on digital rectal examination, prostate volume, haemoglobin concentration, serum creatinine and prostate-specific antigen (PSA) levels, and histological findings. Prostatic tissue of 385 men without urinary retention at presentation was obtained via biopsy (48.3% of cases), transurethral prostatectomy (62.9%), retropubic prostatectomy (6.8%) or radical prostatectomy (28.3%). On histological examination, benign prostatic hyperplasia (BPH) was found to be present in 213 patients (55.3%) and adenocarcinoma of the prostate (ACP) in 172 (44.7%). Histological prostatitis was present in 130 patients (61.0%) with BPH and 51 (29.7%) with ACP (p<0.001). A previous study of 405 men presenting with urinary retention at our institution showed histological prostatitis in 98/204 (48.0%) with BPH and in 51/201 (25.4%) with ACP. The group of men with BPH alone had a significantly lower mean serum PSA at presentation (4.5 ng/ml, range 0.3 - 20.8 ng/ml) compared with the group with BPH and prostatitis (11.2 ng/ml, range 0.2 - 145 ng/ml, p=0.011). The mean PSA level at presentation did not differ significantly between the group with ACP only (40.9 ng/ml, range 0 - 255 ng/ml) and the group with ACP plus prostatitis (1 672 ng/ml, range 0.3 - 38 169 ng/ml, p=0.076). Among men presenting without urinary retention, histological prostatitis was significantly more prevalent in those with BPH than in those with ACP (61% v. 30%), similar to the

  6. Urinary biomarkers for the prediction of reversibility in acute-on-chronic renal failure.

    Science.gov (United States)

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

    2013-01-01

    There is no reliable clinical test to predict the reversibility of acute-on-chronic renal failure. We study whether urinary biomarkers could be used as a noninvasive prognostic marker in patients with acute-on-chronic renal failure. We studied 39 adult patients with pre-existing chronic renal impairment presenting to us with acute-on-chronic renal failure. Urinary neutrophil gelatinase-associated lipocalin (NGAL) level was measured. The mRNA of kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18), alpha-1-microglobulin (α1M), sodium/hydrogen exchanger-3 (NHE3), beta-2 microglobulin (β2M), and N-acetyl-β-D-glucosaminidase (NAG) in urinary sediment were quantified. Urinary NGAL level significantly correlated with the serum creatinine at presentation (r=0.762, pacute tubular necrosis than other causes of acute kidney injury (prenal function (r=0.387, p=0.026), as well as the estimated GFR 6 months later (r=0.386, p=0.027). In patients with acute-on-chronic renal failure, urinary NGAL level correlates with the severity of renal failure, while urinary α1M expression correlates with the degree of renal function recovery. Quantification of urinary α1M mRNA may be developed as an non-invasive tool for risk stratification of this group of patients.

  7. POLYMORPHISM OF THE SYNDROME OF HYPERACTIVE URINARY BLADDER IN PATIENTS WITH ACUTE AND CHRONIC VASCULAR DISEASES OF THE BRAIN

    Directory of Open Access Journals (Sweden)

    P. G. Shvarts

    2016-01-01

    Full Text Available Abstract. The paper discusses the main etiological, phenomenological and pathogenetic mechanisms of forming the syndrome of overactive bladder (OAB in patients with acute and chronic cerebrovascular diseases. Describes the role of melatonin, arginine vasopressin (AVP and corticotropin-releasing factor hormone (CRFH in maintaining the rhythms of urination, urine formation and retention of urine in norm and abnormalities in these systems in acute and chronic vascular pathology of the brain. Described phenomenology OAB syndrome in vascular diseases of the brain. Shows a differentiated approach to pharmacological correction in patients with different clinical variants of urinary disorders and urine formation in the framework of the OAB syndrome with the use of neurotransmitter therapy and hormonesensitive.

  8. Significance of histological prostatitis in patients with urinary retention and underlying benign prostatic hyperplasia or adenocarcinoma of the prostate.

    Science.gov (United States)

    van Vuuren, Stephan P J; Heyns, Chris F; Zarrabi, Amir D

    2012-04-01

    To compare the clinical features of patients having urinary retention and benign prostatic hyperplasia (BPH) with those having adenocarcinoma of the prostate (ACP) and to evaluate the significance of histological prostatitis. The clinical data and histopathology reports of patients with retention admitted to Tygerberg Hospital between September 1998 and June 2007 were evaluated. Statistical analysis was performed with Student's t-test, Mann-Whitney test and Fisher's exact test where appropriate and P < 0.05 was considered to indicate statistical significance. Prostatic histology was available in 405 patients, 204 with BPH and 201 with ACP. Comparing those with BPH and those with ACP showed statistically significant differences in mean age (69.5 vs 71.9 years), serum prostate-specific antigen (PSA) level (18.6 vs 899.5 ng/mL) and histological prostatitis (48 vs 25%) but not duration of catheterization, prostate volume or urinary tract infection (UTI). Comparing those with BPH only and those with BPH plus prostatitis showed significant differences in mean age (71.9 vs 67.1 year) and PSA level (14.6 vs 22.8 ng/mL) but not prostate volume, UTI or duration of catheterization. Comparing those with ACP only and those with ACP plus prostatitis showed significant differences in stage T4 cancer (68.1 vs 35.4%) and PSA level (1123.4 vs 232.4 ng/mL) but not age, prostate volume, UTI or duration of catheterization. Histological prostatitis was almost twice as common in patients with urinary retention associated with underlying BPH than in patients with ACP, but there was no significant difference in the duration of catheterization, prostatic volume or presence of UTI, suggesting that histological prostatitis more often contributes to the development of retention in patients with underlying BPH than in those with ACP. In patients with BPH, histological prostatitis was associated with urinary retention at a significantly younger age and with higher serum PSA levels. In patients

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Urinary heat shock protein 72 as a biomarker of acute kidney injury in dogs.

    Science.gov (United States)

    Bruchim, Yaron; Avital, Yochai; Horowitz, Michal; Mazaki-Tovi, Michal; Aroch, Itamar; Segev, Gilad

    2017-07-01

    Early recognition of acute kidney injury (AKI) is important, as therapy is potentially more efficacious if instituted early in the course of disease. Urinary heat shock protein-72 to urinary creatinine ratio (uHSP72/uCr) was assessed as a diagnostic and prognostic marker in AKI in dogs. Fifty-three dogs were enrolled in five groups: healthy controls (n=11), urinary tract infection (n=10), chronic kidney disease (CKD; n=11), AKI (n=13), and acute decompensating CKD (n=8). Urinary heat shock protein-72 to urinary creatinine ratio was highest in the AKI group (P0.05 compared to each of the other two groups). The area under the curve (AUC) for the receiver operator characteristic (ROC) analysis of uHSP72/uCr to predict AKI, compared to the control group, was 0.97. A cutoff value of 0.20ng/mg corresponded to sensitivity and specificity of 100% and 82%, respectively. Urinary heat shock protein-72 to urinary creatinine ratio was significantly lower in dogs categorized as survivors vs. non-survivors of AKI; ROC AUC, 0.91 (95% confidence intervals, 0.74-1.0). Urinary heat shock protein-72 to urinary creatinine ratio is a potentially useful diagnostic and prognostic biomarker of AKI in dogs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Urinary Calprotectin Differentiates Between Prerenal and Intrinsic Acute Renal Allograft Failure.

    Science.gov (United States)

    Seibert, Felix S; Rosenberger, Christian; Mathia, Susanne; Arndt, Robert; Arns, Wolfgang; Andrea, Huppertz; Pagonas, Nikolaos; Bauer, Frederic; Zidek, Walter; Westhoff, Timm H

    2017-02-01

    Urinary calprotectin has recently been identified as a promising biomarker for the differentiation between prerenal and intrinsic acute kidney injury (AKI) in the nontransplant population. The present study investigates whether calprotectin is able to differentiate between these 2 entities in transplant recipients as well. Urinary calprotectin was assessed by enzyme-linked immunosorbent assay in 328 subjects including 125 cases of intrinsic acute allograft failure, 27 prerenal graft failures, 118 patients with stable graft function, and 58 healthy controls. Acute graft failure was defined as AKI stages 1 to 3 (Acute Kidney Injury Network criteria), exclusion criteria were obstructive uropathy, urothelial carcinoma, and metastatic cancer. The clinical differentiation of prerenal and intrinsic graft failure was performed either by biopsy or by a clinical algorithm including response to fluid repletion, history, physical examination, and urine dipstick examination. Reasons for intrinsic graft failure comprised rejection, acute tubular necrosis, urinary tract infection/pyelonephritis, viral nephritis, and interstitial nephritis. Calprotectin concentrations of patients with stable graft function (50.4 ng/mL) were comparable to healthy controls (54.8 ng/mL, P = 0.70) and prerenal graft failure (53.8 ng/mL, P = 0.62). Median urinary calprotectin was 36 times higher in intrinsic AKI (1955 ng/mL) than in prerenal AKI (P renal allograft biopsy specimens confirmed the serological results. Urinary calprotectin is a promising biomarker for the differentiation of prerenal and intrinsic acute renal allograft failure.

  12. Management of temporary urinary retention after arthroscopic knee surgery in low-dose spinal anesthesia: development of a simple algorithm.

    Science.gov (United States)

    Luger, Thomas J; Garoscio, Ivo; Rehder, Peter; Oberladstätter, Jürgen; Voelckel, Wolfgang

    2008-06-01

    In practice, trauma and orthopedic surgery during spinal anesthesia are often performed with routine urethral catheterization of the bladder to prevent an overdistention of the bladder. However, use of a catheter has inherent risks. Ultrasound examination of the bladder (Bladderscan) can precisely determine the bladder volume. Thus, the aim of this study was to identify parameters indicative of urinary retention after low-dose spinal anesthesia and to develop a simple algorithm for patient care. This prospective pilot study approved by the Ethics Committee enrolled 45 patients after obtaining their written informed consent. Patients who underwent arthroscopic knee surgery received low-dose spinal anesthesia with 1.4 ml 0.5% bupivacaine at level L3/L4. Bladder volume was measured by urinary bladder scanning at baseline, at the end of surgery and up to 4 h later. The incidence of spontaneous urination versus catheterization was assessed and the relative risk for catheterization was calculated. Mann-Whitney test, chi(2) test with Fischer Exact test and the relative odds ratio were performed as appropriate. *P 300 ml postoperatively had a 6.5-fold greater likelihood for urinary retention. In the management of patients with short-lasting spinal anesthesia for arthroscopic knee surgery we recommend monitoring bladder volume by Bladderscan instead of routine catheterization. Anesthesiologists or nurses under protocol should assess bladder volume preoperatively and at the end of surgery. If bladder volume is >300 ml, catheterization should be performed in the OR. Patients with a bladder volume of 500 ml.

  13. Predictive factors for acute and late urinary toxicity after permanent interstitial brachytherapy in Japanese patients

    International Nuclear Information System (INIS)

    Tanimoto, Ryuta; Bekku, Kensuke; Katayama, Norihisa

    2013-01-01

    The objectives of this study were to describe the frequency of and to determine predictive factors associated with Radiation Therapy Oncology Group urinary toxicity in prostate brachytherapy patients. From January 2004 to April 2011, 466 consecutive Japanese patients underwent permanent iodine-125-seed brachytherapy (median follow up 48 months). International Prostate Symptom Score and Radiation Therapy Oncology Group toxicity data were prospectively collected. Prostate volume, International Prostate Symptom Score before and after brachytherapy, and postimplant analysis were examined for an association with urinary toxicity, defined as Radiation Therapy Oncology Group urinary toxicity of Grade 1 or higher. Logistic regression analysis was used to examine the factors associated with urinary toxicity. The rate of Radiation Therapy Oncology Group urinary toxicity grade 1 or higher at 1, 6, 12, 24, 36 and 48 months was 67%, 40%, 21%, 31%, 27% and 28%, respectively. Grade 2 or higher urinary toxicity was less than 1% at each time-point. International Prostate Symptom Score was highest at 3 months and returned to normal 12 months after brachytherapy. On multivariate analysis, patients with a larger prostate size, greater baseline International Prostate Symptom Score, higher prostate V100, higher prostate V150, higher prostate D90 and a greater number of seeds had more acute urinary toxicities at 1 month and 12 months after brachytherapy. On multivariate analysis, significant predictors for urinary toxicity at 1 month and 12 months were a greater baseline International Prostate Symptom Score and prostate V100. Most urinary symptoms are tolerated and resolved within 12 months after prostate brachytherapy. Acute and late urinary toxicity after brachytherapy is strongly related to the baseline International Prostate Symptom Score and prostate V100. (author)

  14. How Hugh Hampton Young's treatment of President Woodrow Wilson's urinary retention and urosepsis affected the resolution of World War I.

    Science.gov (United States)

    Fogg, Ryan; Kutikov, Alexander; Uzzo, Robert G; Canter, Daniel

    2011-09-01

    President Woodrow Wilson was never able to gain ratification of the Treaty of Versailles, the peace accord to end World War I. Before he could convince the American people of the importance of ratification, Wilson suffered a stroke followed by life threatening urinary sepsis due to urinary retention, and was treated by the father of modern urology, Hugh Hampton Young. The effects of these health problems are examined in the context of their implications on international affairs. Biographical sources and primary documentation of Wilson's physicians were reviewed to determine the effect of Wilson's stroke on his voiding habits. Hugh Hampton Young's evaluation and decision making is examined in depth. In the fall of 1919 President Wilson was recovering from a stroke. Shortly after the stroke his preexisting voiding dysfunction progressed to urinary retention from which urinary sepsis developed. Hugh Hampton Young advised on Wilson's case and counseled patience over surgery. The President began voiding spontaneously and recovered from sepsis. The illness left him severely weakened and unable to mount an aggressive campaign to persuade the U.S. Senate of the importance of ratifying the Treaty of Versailles. His personal physician, Admiral Cary T. Grayson, stated that the President was mentally never the same after the sepsis. Wilson's voiding dysfunction contributed to his inability to win approval for the Treaty of Versailles and the League of Nations. As a result, the United States returned to a policy of isolationism and Europe plunged into 2 decades of upheaval, leading to World War II. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  15. Acute and chronic urine retention among adults at the urology ...

    African Journals Online (AJOL)

    Two women each had bladder carcinoma and neurogenic bladder respectively. One each of utero-vaginal prolapse, bladder stones, urethral tumour and urethral trauma respectively were also found. Urinary tract infection occurred in 20 (9.7%) and renal insufficiency in 32 (16.5.0%) of respondents. The mean volume of ...

  16. A New Perspective on Nursing Retention: Job Embeddedness in Acute Care Nurses.

    Science.gov (United States)

    Hopson, Michelle; Petri, Laura; Kufera, Joseph

    Job embeddedness considers job satisfaction while incorporating the concepts of environment and community. This exploratory, mixed methods study used the Job Embeddedness Instrument to examine factors that influence retention of acute care nurses. Qualitative methods informed the survey results. Increasing age, ties to community, and peer relationships were found to be most indicative of job embeddedness. Nursing professional development practitioners can impact retention by focusing on factors that encourage nurses to stay in their positions.

  17. Serum amylase and lipase and urinary trypsinogen and amylase for diagnosis of acute pancreatitis.

    Science.gov (United States)

    Rompianesi, Gianluca; Hann, Angus; Komolafe, Oluyemi; Pereira, Stephen P; Davidson, Brian R; Gurusamy, Kurinchi Selvan

    2017-04-21

    The treatment of people with acute abdominal pain differs if they have acute pancreatitis. It is important to know the diagnostic accuracy of serum amylase, serum lipase, urinary trypsinogen-2, and urinary amylase for the diagnosis of acute pancreatitis, so that an informed decision can be made as to whether the person with abdominal pain has acute pancreatitis. There is currently no Cochrane review of the diagnostic test accuracy of serum amylase, serum lipase, urinary trypsinogen-2, and urinary amylase for the diagnosis of acute pancreatitis. To compare the diagnostic accuracy of serum amylase, serum lipase, urinary trypsinogen-2, and urinary amylase, either alone or in combination, in the diagnosis of acute pancreatitis in people with acute onset of a persistent, severe epigastric pain or diffuse abdominal pain. We searched MEDLINE, Embase, Science Citation Index Expanded, National Institute for Health Research (NIHR HTA and DARE), and other databases until March 2017. We searched the references of the included studies to identify additional studies. We did not restrict studies based on language or publication status, or whether data were collected prospectively or retrospectively. We also performed a 'related search' and 'citing reference' search in MEDLINE and Embase. We included all studies that evaluated the diagnostic test accuracy of serum amylase, serum lipase, urinary trypsinogen-2, and urinary amylase for the diagnosis of acute pancreatitis. We excluded case-control studies because these studies are prone to bias. We accepted any of the following reference standards: biopsy, consensus conference definition, radiological features of acute pancreatitis, diagnosis of acute pancreatitis during laparotomy or autopsy, and organ failure. At least two review authors independently searched and screened the references located by the search to identify relevant studies. Two review authors independently extracted data from the included studies. The thresholds used

  18. Toward A Simple Diagnostic Index for Acute Uncomplicated Urinary Tract Infections

    NARCIS (Netherlands)

    Knottnerus, Bart J.; Geerlings, Suzanne E.; Moll van Charante, Eric P.; ter Riet, Gerben

    2013-01-01

    PURPOSE Whereas a diagnosis of acute uncomplicated urinary tract infection (UTI) in clinical practice comprises a battery of several diagnostic tests, these tests are often studied separately (in isolation from other test results). We wanted to determine the value of history and urine tests for

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

    DEFF Research Database (Denmark)

    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 ...

  20. Urinary incontinence and indwelling urinary catheters in acutely admitted elderly patients: relationship with mortality, institutionalization, and functional decline.

    Science.gov (United States)

    Bootsma, A M Jikke; Buurman, Bianca M; Geerlings, Suzanne E; de Rooij, Sophia E

    2013-02-01

    To study differences in functional status at admission in acutely hospitalized elderly patients with urinary incontinence, a catheter, or without a catheter or incontinence (controls) and to determine whether incontinence or a catheter are independent risk factors for death, institutionalization, or functional decline. Prospective cohort study conducted between 2006 and 2008 with a 12-month follow-up. Eleven medical wards of 2 university teaching hospitals and 1 teaching hospital in The Netherlands. Participants included 639 patients who were 65 years and older, acutely hospitalized for more than 48 hours. Baseline characteristics, functional status, presence of urinary incontinence or catheter, length of hospital stay, mortality, institutionalization, and functional decline during admission and 3 and 12 months after admission were collected. Regression analyses were done to study a possible relationship between incontinence, catheter use, and adverse outcomes at 3 and 12 months. Of all patients, 20.7% presented with incontinence, 23.3% presented with a catheter, and 56.0% were controls. Patients with a catheter scored worst on all baseline characteristics. A catheter was an independent risk factor for mortality at 3 months (odds ratio [OR] = 1.73, 95% confidence interval [CI] 1.10-2.70), for institutionalization at 12 months (OR = 4.03, 95% CI 1.67-9.75), and for functional decline at 3 (OR = 2.17, 95% CI 1.32-3.54) and 12 months (OR = 3.37, 95% CI 1.81-6.25). Incontinence was an independent risk factor for functional decline at 3 months (OR = 1.84, 95% CI 1.11-3.04). There is an association between presence of a catheter, urinary incontinence, and development of adverse outcomes in hospitalized older patients. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

  1. Urinary excretion of furosemide in rats with HgCl sub 2 -induced acute renal damage

    Energy Technology Data Exchange (ETDEWEB)

    Fujimura, Akio; Sudoh, Toshiaki; Ohashi, Kyoichi; Ebihara, Akio (Jichi Medical School, Tochigi (Japan))

    1992-01-01

    To examine the influence of mercuric chloride (HgCl{sub 2})-induced acute renal damage on urinary excretion of furosemide, HgCl{sub 2} or its vehicle along was given intraperitoneally to Wistar rats. The following two experiments were done. Study 1: three percent body weight (b.w.) of 1% NaCl solution or furosemide in 3% b.w. of 1% NaCl solution was given orally before and after HgCl{sub 2} treatment, and an 8-hour urine was collected. Study 2: furosemide was given orally, and blood samples were obtained at 1, 2, 3, 4, 6 and 8 hours after administration. Urinary excretion of N-acetyl-{beta}-D-glucosaminidase increased, and urine volume and urinary excretions of furosemide and sodium decreased in the HgCl{sub 2}-treated rats. There were significant correlations between the urinary furosemide and its diuretic effects. Regression lines after HgCl{sub 2} were significantly different from those before treatment. The values of absorption as well as elimination rate constant were smaller, while the time to maximum concentration and the elimination half-life were longer in the HgCl{sub 2}-treated rats compared to vehicle-treated animals. These results suggest that the urinary excretion of furosemide and the responsiveness of renal tubular cells to this agent are impaired in rats with HgCl{sub 2}-induced acute renal damage.

  2. Capgras-like syndrome in a patient with an acute urinary tract infection.

    Science.gov (United States)

    Salviati, Massimo; Bersani, Francesco Saverio; Macrì, Francesco; Fojanesi, Marta; Minichino, Amedeo; Gallo, Mariana; De Michele, Francesco; Chiaie, Roberto Delle; Biondi, Massimo

    2013-01-01

    Delusional misidentification syndromes are a group of delusional phenomena in which patients misidentify familiar persons, objects, or themselves, believing that they have been replaced or transformed. In 25%-40% of cases, misidentification syndromes have been reported in association with organic illness. We report an acute episode of Capgras-like delusion lasting 8 days, focused on the idea that people were robots with human bodies, in association with an acute urinary infection. To our knowledge, this is the first case report associating urinary tract infection with Capgras-like syndrome. Awareness of the prevalence of delusional misidentification syndromes associated with acute medical illness should promote diligence on the part of clinicians in recognizing this disorder.

  3. Urinary neutrophil gelatinase-associated lipocalin levels predict cisplatin-induced acute kidney injury better than albuminuria or urinary cystatin C levels

    Directory of Open Access Journals (Sweden)

    Hugo You-Hsien Lin

    2013-06-01

    Full Text Available Cisplatin-induced acute kidney injury (AKI is a major concern among clinicians in prescribing cisplatin-based chemotherapy. This study evaluated and compared the ability of urinary biomarkers, including urinary neutrophil gelatinase-associated lipocalin (NGAL, cystatin C, and the urinary albumin to creatinine ratio (ACR to predict cisplatin-induced AKI. Thirty-three cancer patients receiving cisplatin-based chemotherapy were prospectively studied, including 10 (30% who developed AKI (the study group. Changes of urinary biomarkers were compared at 4 hours, 8 hours, and 12 hours, and 1 day, 2 days, 3 days, and 4 days after cisplatin intravenous infusions (75 mg/m2 versus the baseline. There was a significant increase in urinary NGAL levels from 12 hours to 4 days (p<0.05 compared to baseline after cisplatin infusion in the AKI group. The magnitude of these changes over time differed significantly by group (p<0.001. The area under the receiver operating curve describing the relationship between urinary NGAL levels and AKI within 12 hours was 0.865 (95% confidence interval=0.691–1.000. Urinary NGAL levels independently predicted AKI 12 hours after cisplatin (p=0.045 after adjustments for age, gender, body mass index, baseline serum creatinine, and urinary total protein. Urinary NGAL levels may be an early biomarker of AKI in patients receiving cisplatin-based treatment.

  4. Simultaneous retention index analysis of urinary amino acids and carboxylic acids for graphic recognition of abnormal state.

    Science.gov (United States)

    Paik, Man-Jeong; Lee, Hong-Jin; Kim, Kyoung-Rae

    2005-07-05

    Simultaneous profiling analysis of urinary amino acids (AAs) and carboxylic acids (CAs) was combined with retention index (I) analysis for graphic recognition of abnormal metabolic state. The temperature-programmed I values of the AA and CA standards measured as ethoxycarbonyl (EOC)/methoxime (MO)/tert-butyldimethylsilyl (TBDMS) derivatives were used as the reference I values. Urine samples were subjected to the sequential EOC, MO and TBDMS reactions for the analysis by gas chromatography (GC) and GC-mass spectrometry. The complex GC profiles were then transformed into their respective I patterns in bar graphic forms by plotting the normalized peak area ratios (%) of the identified AAs and CAs against their reference I values as the identification numbers. When the present method was applied to infant urine specimens from normal controls and patients with inherited metabolic diseases such as phenylketonuria, maple syrup urine disease, methylmalonic aciduria or isovaleric aciduria, each I pattern of bar graph more distinctly displayed quantitative abundances of urinary AAs and CAs in qualitative I scale, thus allowing graphic discrimination between normal and abnormal states.

  5. Dose-response of acute urinary toxicity of long-course preoperative chemoradiotherapy for rectal cancer

    DEFF Research Database (Denmark)

    Appelt, Ane L.; Bentzen, Søren M.; Jakobsen, Anders

    2015-01-01

    BACKGROUND: Long-course preoperative chemoradiotherapy (chemo-RT) improves outcomes for rectal cancer patients, but acute side effects during treatment may cause considerable patient discomfort and may compromise treatment compliance. We developed a dose-response model for acute urinary toxicity...... based on a large, single-institution series. MATERIAL AND METHODS: In total 345 patients were treated with (chemo-)RT for primary rectal cancer from January 2007 to May 2012. Urinary toxicity during RT was scored prospectively using the CTCAE v 3.0 cystitis score (grade 0-5). Clinical variables...... and radiation dose to the bladder were related to graded toxicity using multivariate ordinal logistic regression. Three models were optimized, each containing all available clinical variables and one of three dose metrics: Mean dose (Dmean), equivalent uniform dose (EUD), or relative volume given x Gy or above...

  6. Capgras-like syndrome in a patient with an acute urinary tract infection

    Directory of Open Access Journals (Sweden)

    Salviati M

    2013-01-01

    Full Text Available Massimo Salviati, Francesco Saverio Bersani, Francesco Macrì, Marta Fojanesi, Amedeo Minichino, Mariana Gallo, Francesco De Michele, Roberto Delle Chiaie, Massimo BiondiDepartment of Neurology and Psychiatry, Sapienza University of Rome, Rome, ItalyAbstract: Delusional misidentification syndromes are a group of delusional phenomena in which patients misidentify familiar persons, objects, or themselves, believing that they have been replaced or transformed. In 25%–40% of cases, misidentification syndromes have been reported in association with organic illness. We report an acute episode of Capgras-like delusion lasting 8 days, focused on the idea that people were robots with human bodies, in association with an acute urinary infection. To our knowledge, this is the first case report associating urinary tract infection with Capgras-like syndrome. Awareness of the prevalence of delusional misidentification syndromes associated with acute medical illness should promote diligence on the part of clinicians in recognizing this disorder.Keywords: delusional misidentification, Capgras syndrome, urinary tract infection, psychosis

  7. Assessment of Urinary-5-Hydroxyindolacetic Acid as A Diagnostic Parameter in Early Detection of Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Zuhair B Kamal

    2017-04-01

    Full Text Available Background: Acute appendicitis is the most common abdominal surgical emergency especially in children and young adults. The diagnosis of appendicitis is difficult because half the cases are incorrectly identified. Serotonin was defined as a good diagnostic marker for many inflammations including appendicitis and it is metabolite into 5-hydroxyindolacetic acid (5-HIAA to be excreted in urine. 5-HIAA is suggested to be of diagnostic importance in the detection of this disease. The aim of this study was to evaluate the diagnostic importance of urinary-5-HIAA as an added parameter to Alvarado score. Methods: Seventy patients (35 females and 35 males with acute appendicitis (35 were mild and 35 severe-perforated and gangrenous were included in this study and 70 healthy individuals were taken as a control group. Urinary-5-HIAA was estimated in all patients and control group using ELISA method. Results: Sensitivity for the mild group is 94.2%, specificity 100% and diagnostic accuracy is 97.4%, while the sensitivity for the severe group is 37%. It was found that there is a highly significant difference between mild and control groups (P<0.05. The diagnostic accuracy for the mild group is 97.4% and for the severe is 68.5%. Conclusion: We conclude that urinary-5-HIAA is a high sensitive test for early detection of acute appendicitis.

  8. Pathogenesis of acute radiation effects in the urinary bladder. Experimental results

    International Nuclear Information System (INIS)

    Doerr, W.; Eckhardt, M.; Ehme, A.; Koi, S.

    1998-01-01

    Purpose: The present review summarizes experimental studies of the pathogenesis of acute radiation-induced changes in urinary bladder function. Material and methods: Transurethral cystometry was used for longitudinal assessment of bladder function in mice. With this technique, radiation-induced changes in storage capacity can be quantified. In histological studies, changes in urothelial cell density and in urothelial protein expression during the acute radiation response were determined. Acetylsalicylic acid (ASA) was used for the treatment of acute functional changes. Results: The histological studies did not reveal any systematic fluctuations in urothelial cell density during the time of the acute radiation response. However, characteristic changes in the expression of proteins associated with urothelial cell function, differentiation and cell contact were observed, which correlated with the functional impairment. By local or systemical application of ASA, a significant restoration of bladder function compared to placebo treatment could be achieved. Conclusion: Acute functional radiation effects in the urinary bladder are not based on urothelial denudation. However, changes in protein expression indicate an impairment of the urothelial barrier function. The results of ASA treatment demonstrate that prostaglandins are involved in the response. Alterations in urothelial or endothelial prostaglandin metabolism may be primarily radiation-induced or secondary because of the impaired urothelial barrier. (orig.) [de

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

    DEFF Research Database (Denmark)

    Skriver, Kasper Christen

    . 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....... Additionally, POST outperformed PRE after seven days, thus indicating that exercise affects the process during which the memory is consolidated more than learning itself. In order to investigate if the behavioral effects of exercise could be demonstrated in school children, we conducted Study II, partially......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...

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

    DEFF Research Database (Denmark)

    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 mean 4.5 m...

  11. Prostatic Lymphoma Masquerading as Urinary Retention and Hematuria With Review of Literature

    Science.gov (United States)

    Tamang, Tsering Gyalpo Lama; Singh, Prabhsimranjot; Garellek, Jonathan; Malhotra, Sonali; Chandra, Abhinav Binod; Solomon, William

    2017-01-01

    Lymphomas of prostate are very rare tumors. They are not commonly considered in the clinical and histological differential diagnosis of prostatic enlargement. We report a case of a 49-year-old man who presented to emergency department with several weeks of difficulty in urination, for which he was being treated for benign prostate hyperplasia with no improvement. Computerized tomography scan showed lobulated mass originating from the superior aspect of the prostate with right inguinal lymph node involvement and no distant organ metastatic disease. Prostatic biopsy revealed diffuse large B-cell lymphoma. The patient achieved complete remission after six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy regimen. Lymphomas of the prostate should be considered in differential diagnosis of the patient presenting with obstructive lower urinary tract symptoms especially in patients with normal prostatic-specific antigen level and previous history of lymphoma in other sites. PMID:29147449

  12. Restoration from acute urinary dysfunction using Utah electrode arrays implanted into the feline pudendal nerve.

    Science.gov (United States)

    Wark, Heather Anna Cary; Black, Shana R; Mathews, Kiran Serah; Cartwright, Patrick C; Gustafson, Kenneth J; Normann, Richard Alan

    2015-06-01

    To investigate intrafascicular pudendal nerve stimulation in felines as a means to restore urinary function in acute models of urinary incontinence, overactive bladder, and underactive bladder. Felines were anesthetized, and high-electrode-count (48 electrodes; 25 electrodes/mm(2) ) electrode arrays were implanted intrafascicularly into the pudendal nerve trunk. Electrodes were mapped for their ability to selectively or nonselectively excite the external anal sphincter, external urethral sphincter, and the detrusor bladder muscle. Statistical analysis was carried out to quantify reflexive voiding efficiencies, mean impedances of the microelectrodes used in this study, and to determine what differences, if any, in bladder contraction amplitudes were evoked by different electrode configurations. Multielectrode arrays implanted into the pudendal nerve trunk were able to selectively and nonselectively excite genitourinary muscles. After inducing urinary incontinence with bilateral pudendal nerve transections (proximal to the implants), electrical stimulation delivered through certain microelectrodes was able to significantly reduce leaking (p = 0.008). Electrical stimulation delivered through detrusor selective electrodes was able to inhibit reflexive bladder contractions and excite bladder contractions, depending on the stimulation frequency. Specific electrode configurations were able to drive significantly (p electrically driven bladder contractions were achieved in 46% and 38% of the preparations, respectively, an observation that has not been noted in previously published feline pudendal stimulation studies. Multielectrode arrays implanted intrafascicularly into the pudendal nerve trunk may provide a promising new clinical neuromodulation therapy for the restoration of urinary function. © 2014 International Neuromodulation Society.

  13. Decline in acute urinary toxicities with increased institutional experience: 15-year experience of permanent seed prostate brachytherapy in a single Australasian institution.

    Science.gov (United States)

    Ong, Wee Loon; Matheson, Bronwyn; Millar, Jeremy

    To evaluate the incidence of acute urinary toxicity after permanent seed prostate brachytherapy (BT) over a 15-year period. The study consisted of 782 prostate cancer patients treated with BT. All patients completed self-administered International Prostate Symptoms Score (IPSS) at baseline and during regular follow-up. We evaluated the risk of acute urinary retention (AUR) up to 3 months post-BT and lower urinary tract symptom (LUTS) resolution (defined as return to within two points of baseline IPSS score) at regular intervals, up to 24 months post-BT. Univariate and multivariate logistic regressions were used to evaluate the effect of various patient, tumor, and treatment factors on the risk of AUR and the likelihood of LUTS resolution. Ninety-six patients (12%) developed AUR at a median of 1 day post-BT. Increased peak urinary flow is independently associated with lower risk of AUR (odds ratio [OR] = 0.94; 95% confidence interval [CI] = 0.91-0.97). Decline in incidence of AUR was observed over time with increased institutional experience (p = 0.03). Of the 646 patients with a minimum of 24-month follow-up, 29%, 49%, and 72% had LUTS resolution at 6, 12, and 24 months, respectively. Patients who had pre-BT transurethral resection of prostate (OR = 2.4; 95% CI = 1.5-4.0), cytoreductive neo-adjuvant androgen deprivation (OR = 2.0; 95% CI = 1.0-4.0), and higher baseline IPSS (OR = 1.1; 95% CI = 1.07-1.19) are more likely to report LUTS resolution at 24 months. We reported decline in AUR over time with increased institutional experience in one of the largest Australasian BT series. Approximately three-quarters of patients achieved LUTS resolution at 24-month follow-up. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

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

    NARCIS (Netherlands)

    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

  15. Seasonal variation in the acute presentation of urinary calculi over 8 years in Auckland, New Zealand.

    Science.gov (United States)

    Lo, Sum Sum; Johnston, Richard; Al Sameraaii, Ahmed; Metcalf, Patricia A; Rice, Michael L; Masters, Jonathan G

    2010-07-01

    Symptom prevalence (retrospective cohort) Level of Evidence 2b. To determine the incidence of acute presentation of urinary calculi (UC) in Auckland, New Zealand, during the period 1999-2007, and whether there was any significant seasonal variation. The details of all UC within the population presenting acutely to public hospitals in Auckland between 1999 and 2007 were collected using clinical coding searches International Classification of Disease 10th revision (Australian Modification) N132 and N20. Climatic variables for the Auckland region were obtained from the National Institute of Water and Atmospheric Research, New Zealand. The mean atmospheric temperature, hours of sunshine and humidity data were calculated monthly for this period. During the study there were 7668 acute presentations of UC in the Auckland region. A Poisson regression model showed that the number of presentations was significantly related to temperature (P Auckland, New Zealand, varies significantly with temperature and hours of sunshine. Humidity was not a significant factor.

  16. A rare cause of progressive paraparesis and urinary retention: Spinal dural arteriovenous fistula- Case report

    Directory of Open Access Journals (Sweden)

    Sırma Geyik

    2016-12-01

    Full Text Available Spinal arteriovenous fistulas (AVF, are rarely seen clinical pathology, have serious morbidity in cases without treatment although spinal AVF are the most common types of spinal arteriovenous malformation. Fifty years old male patient suffered from urine retention and paraparesis after lifted a heavy object. Spinal magnetic resonance images (MRI showed diffuse hyper intense lesion from midthoracic spinal cord segment to conus medullaris in T2A sequance. Spinal angiography revealed a long segmental dorsal AVF on the right side of T 7-8 level in spinal cord. Because of the low flow and a small AVF neurosurgical Department decided to perform an operation for spinal AVF. We should keep in mind spinal AVF, in which prognosis is well after prompt and appropriate theraphy, as a differential diagnosis in patients presented with progressive spinal symptoms.

  17. Incidence of urinary retention during treatment with single tablet combinations of solifenacin+tamsulosin OCAS™ for up to 1 year in adult men with both storage and voiding LUTS: A subanalysis of the NEPTUNE/NEPTUNE II randomized controlled studies.

    Directory of Open Access Journals (Sweden)

    Marcus J Drake

    Full Text Available The emergence of urinary retention (UR, specifically acute urinary retention (AUR, has been a concern when treating men with lower urinary tract symptoms (LUTS with antimuscarinic drugs.In NEPTUNE (12-week, double-blind, men (≥45 years with LUTS were randomized to receive tamsulosin oral-controlled absorption system (TOCAS 0.4 mg, fixed-dose combination (FDC of solifenacin (Soli 6 mg + TOCAS 0.4 mg, FDC Soli 9 mg + TOCAS 0.4 mg, or placebo. In NEPTUNE II (40-week, open-label extension of NEPTUNE, continuing patients received 4-week FDC Soli 6 mg + TOCAS, then FDC Soli 6 mg or 9 mg + TOCAS for the remainder of the study, switchable every 3 months.Across both studies, 1208 men received ≥1 dose of FDC Soli 6 mg or 9 mg + TOCAS for up to 52 weeks; 1199 men completed NEPTUNE and 1066 received ≥1 dose in NEPTUNE II. In total, 13 men (1.1%; 95% CI, 0.6%-1.8% reported a UR event while receiving FDC, eight of which were AUR (0.7%; 95% CI, 0.3%-1.3%, incidence 7/1000 man-years. Six men reported UR events while taking Soli 6 mg + TOCAS (three AUR, and seven men reported a UR event while taking Soli 9 mg + TOCAS (five AUR. One man developed AUR while taking TOCAS alone and four reported UR (three AUR during placebo run-in. Most AUR/UR events occurred within 4 months of treatment initiation.FDC Soli and TOCAS was associated with a low rate of UR and AUR in men with LUTS.

  18. Prophylactic effects of alpha-blockers, Tamsulosin and Alfuzosin, on postoperative urinary retention in male patients undergoing urologic surgery under spinal anaesthesia.

    Science.gov (United States)

    Akkoc, Ali; Aydin, Cemil; Topaktas, Ramazan; Kartalmis, Mahir; Altin, Selcuk; Isen, Kenan; Metin, Ahmet

    2016-01-01

    Postoperative urinary retention (POUR) is one of the most common complications after surgical procedures under spinal anaesthesia. Recent studies have shown the beneficial effects of alpha-adrenergic blockers in preventing POUR. The aim of this prospective study was to investigate and compare the prophylactic effects of tamsulosin and alfuzosin on POUR after urologic surgical procedures under spinal anaesthesia. A total of 180 males who underwent elective urologic surgery were included in this study. The patients were randomly allocated into three Groups. The Group I received placebo. Patients in Group II were given 0.4mg of tamsulosin orally 14 and 2 hours before surgery. Patients in Group III were given 10mg of alfuzosin ER orally 10 and 2 hours before surgery. All patients were closely followed for 24 hours postoperatively and their episodes of urinary retentions were recorded. There were 60 patients in each Group. Their mean age was 35.95±15.16 years. Fifteen patients in Group I (25%), 3 patients in Group II (5%) and 4 patients in Group III (6.7%) required catheterization because of urinary retention. In tamsulosin group and alfuzosin group, there were a significantly lower proportion of patients with POUR compared with the placebo Group (p=0.002 and p=0.006). The beneficial effects of tamsulosin and alfuzosin on POUR were similar between both Groups (p=0.697). This study suggests that the use of prophylactic tamsulosin or alfuzosin can reduce the incidence of urinary retention and the need for catheterization after urologic surgical procedures under spinal anaesthesia.

  19. Prophylactic effects of alpha-blockers, Tamsulosin and Alfuzosin, on postoperative urinary retention in male patients undergoing urologic surgery under spinal anaesthesia

    Directory of Open Access Journals (Sweden)

    Ali Akkoc

    2016-06-01

    Full Text Available ABSTRACT Purpose Postoperative urinary retention (POUR is one of the most common complications after surgical procedures under spinal anaesthesia. Recent studies have shown the beneficial effects of alpha-adrenergic blockers in preventing POUR. The aim of this prospective study was to investigate and compare the prophylactic effects of tamsulosin and alfuzosin on POUR after urologic surgical procedures under spinal anaesthesia. Materials and Methods A total of 180 males who underwent elective urologic surgery were included in this study. The patients were randomly allocated into three Groups. The Group I received placebo. Patients in Group II were given 0.4mg of tamsulosin orally 14 and 2 hours before surgery. Patients in Group III were given 10mg of alfuzosin ER orally 10 and 2 hours before surgery. All patients were closely followed for 24 hours postoperatively and their episodes of urinary retentions were recorded. Results There were 60 patients in each Group. Their mean age was 35.95±15.16 years. Fifteen patients in Group I (25%, 3 patients in Group II (5% and 4 patients in Group III (6.7% required catheterization because of urinary retention. In tamsulosin group and alfuzosin group, there were a significantly lower proportion of patients with POUR compared with the placebo Group (p=0.002 and p=0.006. The beneficial effects of tamsulosin and alfuzosin on POUR were similar between both Groups (p=0.697. Conclusion This study suggests that the use of prophylactic tamsulosin or alfuzosin can reduce the incidence of urinary retention and the need for catheterization after urologic surgical procedures under spinal anaesthesia.

  20. Prolonged second stage of labour, maternal infectious disease, urinary retention and other complications in the early postpartum period.

    Science.gov (United States)

    Stephansson, O; Sandström, A; Petersson, G; Wikström, A-K; Cnattingius, S

    2016-03-01

    To study the association between duration of second stage of labour and risks of maternal complications (infection, urinary retention, haematoma or ruptured sutures) in the early postpartum period. Population-based cohort study. We included 72 593 mothers with singleton vaginal deliveries at ≥37 weeks of gestation in cephalic presentation, using the obstetric database from the Stockholm-Gotland region in Sweden, 2008-12. Logistic regression analysis. Odds ratios (ORs) with 95% confidence intervals (95% CI) were calculated and adjustments were made for maternal age, body mass index, height, smoking, cohabitation, gestational age, labour induction, epidural analgesia and oxytocin augmentation. Rates of any complication varied by parity from 7.3% in parous women with previous caesarean section, 4.8% in primiparas and 1.7% in parous women with no previous caesarean section. Compared with a second stage caesarean were 2.27 (1.78-2.90), 2.97 (2.09-4.22), 3.65 (2.25-5.94) and 3.16 (1.44-6.94), respectively. The adjusted ORs for women with previous caesarean were for 1 to caesarean deliveries. © 2015 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

  1. Urinary metabolic fingerprint of acute intermittent porphyria analyzed by (1)H NMR spectroscopy.

    Science.gov (United States)

    Carichon, Mickael; Pallet, Nicolas; Schmitt, Caroline; Lefebvre, Thibaud; Gouya, Laurent; Talbi, Neila; Deybach, Jean Charles; Beaune, Philippe; Vasos, Paul; Puy, Hervé; Bertho, Gildas

    2014-02-18

    (1)H NMR is a nonbiased technique for the quantification of small molecules that could result in the identification and characterization of potential biomarkers with prognostic value and contribute to better understand pathophysiology of diseases. In this study, we used (1)H NMR spectroscopy to analyze the urinary metabolome of patients with acute intermittent porphyria (AIP), an inherited metabolic disorder of heme biosynthesis in which an accumulation of the heme precursors 5-aminolaevulinic acid (ALA) and porphobilinogen (PBG) promotes sudden neurovisceral attacks, which can be life-threatening. Our objectives were (1) to demonstrate the usefulness of (1)H NMR to identify and quantify ALA and PBG in urines from AIP patients and (2) to identify metabolites that would predict the response to AIP crisis treatment and reflect differential metabolic reprogramming. Our results indicate that (1)H NMR can help to diagnose AIP attacks based on the identification of ALA and PBG. We also show that glycin concentration increases in urines from patients with frequent recurrences at the end of the treatment, after an initial decrease, whereas PBG concentration remains low. Although the reasons for this altered are elusive, these findings indicate that a glycin metabolic reprogramming occurs in AIPr patients and is associated with recurrence. Our results validate the proof of concept of the usefulness of (1)H NMR spectroscopy in clinical chemistry for the diagnosis of acute attack of AIP and identify urinary glycin as a potential marker of recurrence of AIP acute attacks.

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

    DEFF Research Database (Denmark)

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

    1998-01-01

    was independent of blood pressure, body weight, smoking, diabetes mellitus, renal disease, and thrombolytic treatment. There was a positive correlation between urinary albumin excretion and thickness of the left ventricle wall (R = 0.28; p = 0.001) which was independent of blood pressure. Follow-up examination......Microalbuminuria, a subclinical rise in the urinary albumin excretion, is a risk indicator of atherosclerotic cardiovascular disease. The aim of this study was to measure the urinary albumin excretion in patients with acute myocardial infarction, and to correlate this with known atherosclerotic...

  3. Association of pyuria and clinical characteristics with the presence of urinary tract infection among patients with acute nephrolithiasis.

    Science.gov (United States)

    Abrahamian, Fredrick M; Krishnadasan, Anusha; Mower, William R; Moran, Gregory J; Talan, David A

    2013-11-01

    Pyuria is a useful indicator of urinary tract infection among patients with compatible symptoms; however, its utility has not been adequately investigated among patients with acute nephrolithiasis. Therefore, we examine performance characteristics of pyuria and other clinical and laboratory correlates for urinary tract infection among patients with acute nephrolithiasis. A single-center prospective observational study examining the performance characteristics of pyuria and other clinical correlates for urinary tract infection was conducted among patients older than 17 years and presenting with acute nephrolithiasis confirmed by computed tomography and for whom urine culture was obtained. Of 360 patients with acute nephrolithiasis, 28 (7.8%) had urinary tract infection, defined as growth of a single uropathogen at greater than or equal to 10(3) colony-forming units/mL. For the presence of urinary tract infection, pyuria level greater than 5 WBCs/high-power field (hpf) had a sensitivity of 86% and specificity of 79%; greater than 20 WBCs/hpf had a sensitivity of 68% and specificity of 93%. In 307 patients who lacked history of fever or measured temperature greater than 37.9°C (100.2°F), pyuria level greater than 5 WBCs/hpf had a sensitivity of 79% and specificity of 81% for urinary tract infection; greater than 20 WBCs/hpf had a sensitivity of 57% and specificity of 94%. Patients with urinary tract infection more often were female; had a history of dysuria, frequent urination, chills, urinary tract infection, or subjective fever; or had measured temperature of greater than 37.9°C (100.2°F). About 8% of patients presenting with acute nephrolithiasis have urinary tract infection, in many without clinical findings of infection, and pyuria has only a moderate accuracy in identifying urinary tract infection in this setting. Clinical features of urinary tract infection, a greater degree of pyuria, and female sex increases the likelihood of infection. Copyright

  4. Urinary biomarkers may provide prognostic information for subclinical acute kidney injury after cardiac surgery.

    Science.gov (United States)

    Albert, Christian; Albert, Annemarie; Kube, Johanna; Bellomo, Rinaldo; Wettersten, Nicholas; Kuppe, Hermann; Westphal, Sabine; Haase, Michael; Haase-Fielitz, Anja

    2017-12-22

    This study aimed to determine the biomarker-specific outcome patterns and short-and long-term prognosis of cardiac surgery-asoociated acute kidney injury (AKI) identified by standard criteria and/or urinary kidney biomarkers. Patients enrolled (N = 200), originated a German multicenter study (NCT00672334). Standard risk injury, failure, loss, and end-stage renal disease classification (RIFLE) criteria (including serum creatinine and urine output) and urinary kidney biomarker test result (neutrophil gelatinase-associated lipocalin, midkine, interleukin 6, and proteinuria) were used for diagnosis of postoperative AKI. Primary end point was acute renal replacement therapy or in-hospital mortality. Long-term end points among others included 5-year mortality. Patients with single-biomarker-positive subclinical AKI (RIFLE negative) were identified. We controlled for systemic inflammation using C-reactive protein test. Urinary biomarkers (neutrophil gelatinase-associated lipocalin, midkine, and interleukin 6) were identified as independent predictors of the primary end point. Neutrophil gelatinase-associated lipocalin, midkine, or interleukin 6 positivity or de novo/worsening proteinuria identified 21.1%, 16.9%, 30.5%, and 48.0% more cases, respectively, with likely subclinical AKI (biomarker positive/RIFLE negative) additionally to cases with RIFLE positivity alone. Patients with likely subclinical AKI (neutrophil gelatinase-associated lipocalin or interleukin 6 positive) had increased risk of primary end point (adjusted hazard ratio, 7.18; 95% confidence interval, 1.52-33.93 [P = .013] and hazard ratio, 6.27; 95% confidence interval, 1.12-35.21 [P = .037]), respectively. Compared with biomarker-negative/RIFLE-positive patients, neutrophil gelatinase-associated lipocalin positive/RIFLE-positive or midkine-positive/RIFLE-positive patients had increased risk of primary end point (odds ratio, 9.6; 95% confidence interval, 1.4-67.3 [P = .033] and odds ratio, 14

  5. Plasma and Urinary Phenolic Profiles after Acute and Repetitive Intake of Wild Blueberry.

    Science.gov (United States)

    Feliciano, Rodrigo P; Istas, Geoffrey; Heiss, Christian; Rodriguez-Mateos, Ana

    2016-08-25

    Recent studies have shown that blueberries may have cardiovascular and cognitive health benefits. In this work, we investigated the profile of plasma and urine (poly)phenol metabolites after acute and daily consumption of wild blueberries for 30 days in 18 healthy men. The inter-individual variability in plasma and urinary polyphenol levels was also investigated. Blood samples were collected at baseline and 2 h post-consumption on day 1 and day 30. Twenty-four-hour urine was also collected on both days. A total of 61 phenolic metabolites were quantified in plasma at baseline, of which 43 increased after acute or chronic consumption of blueberries over one month. Benzoic and catechol derivatives represented more than 80% of the changes in phenolic profile after 2 h consumption on day 1, whereas hippuric and benzoic derivatives were the major compounds that increased at 0 and 2 h on day 30, respectively. The total (poly)phenol urinary excretion remained unchanged after 30 days of wild blueberry intake. The inter-individual variability ranged between 40%-48% in plasma and 47%-54% in urine. Taken together, our results illustrate that blueberry (poly)phenols are absorbed and extensively metabolized by phase II enzymes and by the gut microbiota, leading to a whole array of metabolites that may be responsible for the beneficial effects observed after blueberry consumption.

  6. Plasma and Urinary Phenolic Profiles after Acute and Repetitive Intake of Wild Blueberry

    Directory of Open Access Journals (Sweden)

    Rodrigo P. Feliciano

    2016-08-01

    Full Text Available Recent studies have shown that blueberries may have cardiovascular and cognitive health benefits. In this work, we investigated the profile of plasma and urine (polyphenol metabolites after acute and daily consumption of wild blueberries for 30 days in 18 healthy men. The inter-individual variability in plasma and urinary polyphenol levels was also investigated. Blood samples were collected at baseline and 2 h post-consumption on day 1 and day 30. Twenty-four-hour urine was also collected on both days. A total of 61 phenolic metabolites were quantified in plasma at baseline, of which 43 increased after acute or chronic consumption of blueberries over one month. Benzoic and catechol derivatives represented more than 80% of the changes in phenolic profile after 2 h consumption on day 1, whereas hippuric and benzoic derivatives were the major compounds that increased at 0 and 2 h on day 30, respectively. The total (polyphenol urinary excretion remained unchanged after 30 days of wild blueberry intake. The inter-individual variability ranged between 40%–48% in plasma and 47%–54% in urine. Taken together, our results illustrate that blueberry (polyphenols are absorbed and extensively metabolized by phase II enzymes and by the gut microbiota, leading to a whole array of metabolites that may be responsible for the beneficial effects observed after blueberry consumption.

  7. Urinary excretion of porphyrins, porphobilinogen and δ-aminolaevulinic acid following an attack of acute intermittent porphyria.

    Science.gov (United States)

    Marsden, Joanne T; Rees, David C

    2014-01-01

    The porphyrias are a group of rare, mainly inherited, diseases caused by a deficiency of one of the enzymes of the haem biosynthesis pathway. The biochemical hallmark of an acute attack is an increase in urine porphobilinogen (PBG), together with an increase in urinary excretion of δ-aminolaevulinic acid (ALA) and total urine porphyrins (TUP). In patients with acute intermittent porphyria (AIP) the concentrations of the porphyrin precursors are thought to remain elevated for many years following an acute attack, although this has not been well documented. We measured urine ALA, PBG and TUP excretion in 20 patients with AIP following an attack of acute porphyria over a time period of 3 months to 23 years after their last documented acute attack. We showed that urinary concentrations of all metabolites remain elevated for many years. The urinary half life of TUP was 5.3 years, ALA 7.7 years and PBG 10.6 years. Even after 20 years, PBG concentrations remained elevated above the normal range. Our study highlights the difficulties of using urinary analysis for diagnosing recurrent attacks, and also raises important questions about the pathophysiology of the condition.

  8. A double-blind, randomized, placebo-controlled pilot study to investigate the effects of finasteride combined with a biodegradable self-reinforced poly L-lactic acid spiral stent in patients with urinary retention caused by bladder outlet obstruction from benign prostatic hyperplasia.

    Science.gov (United States)

    Isotalo, T; Talja, M; Hellström, P; Perttilä, I; Välimaa, T; Törmälä, P; Tammela, T L

    2001-07-01

    To assess whether patients in acute urinary retention from benign prostatic enlargement can be treated with a combined therapy comprising finasteride and a bioabsorbable self-reinforced poly L-lactic acid (SR-PLLA) urethral stent. Fifty-five patients in acute urinary retention were treated as outpatients; they had a suprapubic catheter inserted and the SR-PLLA stent placed cystoscopically. After 2 weeks the patients were randomized to receive either finasteride 5 mg daily or placebo. They were assessed at baseline and at 6, 12 and 18 months for maximum urinary flow rate, prostate volume and serum prostate-specific antigen (PSA). Nineteen patients completed the study while 36 discontinued. There was a statistically significant increase in the mean maximum flow rate, and a statistically significant decrease in the prostatic volume and serum PSA in the finasteride group. The same number of patients discontinued in both groups; the major reason for discontinuation was insufficient therapeutic response. The major problems were discontinuation of treatment because the response to therapy was insufficient, and uncontrolled breakdown of the spiral stent. To solve these problems, new configurations of bioabsorbable stents are needed.

  9. Single dose antibiotic therapy is not as effective as conventional regimens for management of acute urinary tract infections in children.

    Science.gov (United States)

    Madrigal, G; Odio, C M; Mohs, E; Guevara, J; McCracken, G H

    1988-05-01

    One hundred thirty-two children with acute urinary tract infection were randomly assigned to receive trimethoprim-sulfamethoxazole in one dose, two doses daily for 3 days or two doses daily for 7 days. The patient characteristics, etiologic agents and frequency of roentgenologic abnormalities were similar for the three treatment groups. There was no significant difference in bacteriologic cure rates for the single dose regimen (93%) and multidose regimens (96%). The difference in rates of recurrent urinary tract infection between the single dose (20.5%) and 3-day (5.6%) and 7-day (8%) regimens was statistically significant (P = 0.033). A single dose of trimethoprim-sulfamethoxazole is inadequate treatment for infants and children with acute urinary tract infection.

  10. Pathogenesis of acute radiation effects in the urinary bladder. Experimental results

    Energy Technology Data Exchange (ETDEWEB)

    Doerr, W.; Eckhardt, M.; Ehme, A.; Koi, S. [Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie, Technische Univ. Dresden (Germany)

    1998-11-01

    Purpose: The present review summarizes experimental studies of the pathogenesis of acute radiation-induced changes in urinary bladder function. Material and methods: Transurethral cystometry was used for longitudinal assessment of bladder function in mice. With this technique, radition-induced changes in storage capacity can be quantified. In histological studies, changes in urothelial cell density and in urothelial protein expression during the acute radiation response were determined. Acetylsalicylic acid (ASA) was used for the treatment of acute functional changes. Results: The histological studies did not reveal any systematic fluctuations in urothelial cell density during the time of the acute radiation response. However, characteristic changes in the expression of proteins associated with urothelial cell function, differentiation and cell contact were observed, which correlated with the functional impairment. By local or systemical application of ASA, a significant restoration of bladder function compared to placebo treatment could be achieved. Conclusion: Acute functional radiation effects in the urinary bladder are not based on urothelial denudation. However, changes in protein expression indicate an impairment of the urothelial barrier function. The results of ASA treatment demonstrate that prostaglandins are involved in the response. Alterations in urothelial or endothelial prostaglandin metabolism may be primarily radiation-induced or secondary because of the impaired urothelial barrier. (orig.) [Deutsch] Ziel: Die vorliegende Arbeit soll tierexperimentelle Ergebnisse zur Pathogenese akuter Funktionsstoerungen der Harnblase nach Bestrahlung zusammenfassen. Material und Methoden: Transurethrale zystometrische Messungen dienen zur longitudinalen Erfassung der Harnblasenfunktion bei der Maus. Mit dieser Methode koennen strahlenbedingte Stoerungen der Speicherkapazitaet quantifiziert werden. In histologischen Untersuchungen wurden Veraenderungen in der

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

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    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.

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

    Science.gov (United States)

    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. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Urinary retention in women

    African Journals Online (AJOL)

    .[7] Tension- free vaginal ... The history should also include questioning about bowel habits, visual and/or gait abnormalities, muscle weakness and/or sensory disturbances of the lower extremities.[6]. The previous medical history is important,.

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

    International Nuclear Information System (INIS)

    Tappin, D.M; Murphy, A.V.; Mocan, H.; Shaw, R.; Beattie, T.J.; McAllister, T.A.; Mackenzie, J.R.

    1989-01-01

    Between 1985 and 1987 102 children, age 0-14 years, presented with a first acute symptomatic E. coli urinary tract infection. Investigations included early 99m technetium dimercaptosuccinic acid (DMSA) scan, ultrasonography, micturating cysto-urethrography and indirect voiding radionuclide cystography using 99m Tc 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

  15. Clinical and Laboratory Characteristics of Acute Community-Acquired Urinary Tract Infections in Adult Hospitalised Patients

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    Dilista Piljić

    2010-02-01

    Full Text Available Urinary tract infections (UTI cause a great number of morbidity and mortality. These infections are serious complications in pregnancy, patients with diabetes, polycystic kidneys disease, sickle cell anaemia, kidney transplant and in patients with functional or structural anomalies of the urinary tract. The aim of this investigation was to determine a dominant causative agents of UTI and some of the clinical and laboratory characteristics of acute community-acquired UTI in adult hospitalised patients. We studied 200 adult patients with acute community-acquired UTI hospitalised in the Clinic for Infectious Diseases Tuzla from January 2006 to December 2007. The patients were divided into two groups: a group of patients with E. coli UTI (147 and a group of patients with non-E. coli UTI (53. In these two groups, the symptoms and signs of illness, blood test and urine analysis results were analysed. Our results have shown that the patients with E. coli UTI frequently had fever higher than 38,5 degrees C (p<0,0001, chills (p=0,0349, headache (p=0,0499, cloudy urine (p<0,0001, proteinuria (p=0,0011 and positive nitrite-test (p=0,0002. The patients with non-E. coli UTI frequently had fever lower than 38,5 degrees C (p<0,0001 and urine specific gravity <1015 (p=0,0012. There was no significant difference in blood test results between patients with E. coli and non-E. coli UTI. These clinical and laboratory findings can lead us to early etiological diagnosis of these UTI before urine culture detection of causative agents, which takes several days. Early etiological diagnosis of the E. coli and non-E. coli UTI is necessary for an urgent administration of appropriate empirical antibiotic treatment. This is very important in prevention of irreversible kidney damage, prolonged treatment, complications, as well as recidives and chronicity of the illness.

  16. Urinary markers of acute kidney injury in newborns with perinatal asphyxia (.).

    Science.gov (United States)

    Oncel, Mehmet Yekta; Canpolat, Fuat Emre; Arayici, Sema; Alyamac Dizdar, Evrim; Uras, Nurdan; Oguz, Serife Suna

    2016-07-01

    Acute kidney injury (AKI) affects up to 60% of severely asphyxiated neonates. The diagnosis of AKI can be and is further challenged by a lack of good biomarkers. We studied the role of novel markers for AKI, neutrophil gelatinase-associated lipocalin (NGAL), interleukin-8 (IL-18), Netrin-1 (NTN-1), and sodium hydrogen exchanger isoform 3 (NHE3) on development and early diagnosis of AKI in newborns with perinatal asphyxia (PA). Forty-one newborns with a diagnosis of PA (15 with AKI and 26 without AKI) and 20 healthy matched controls were involved to the study. Urinary samples were obtained on postnatal days 1 and 4 for patients with PA and on postnatal day 1 for the control subjects. AKI was defined using a serum creatinine-based modification of the acute kidney injury network criteria. The levels of NGAL, NTN-1, NHE3, and IL-18 on the first postnatal day urine samples were higher in patients compared to controls (p < 0.001, p <0.001, p  <0.02, p  <0.001, respectively). In patients with AKI, the levels of NGAL and IL-18 were higher when compared to patients without AKI (p = 0.002, p  <0.001, respectively). The levels of NTN-1 and NHE3 were similar in both groups. For the samples obtained on postnatal day 4, only NGAL levels were significantly higher in patients with AKI (p = 0.004) compared to those without AKI. To our knowledge, this is the largest study, which evaluated the utility of urinary biomarkers in the diagnosis of AKI in newborns with PA. First day, urine NGAL and IL-18 levels have an important diagnostic power in such patients.

  17. TO EVALUATE THE EFFICACY OF URINARY TRYPSINOGEN 2 DIPSTICK TEST IN DIAGNOSING ACUTE PANCREATITIS

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    Prem Anandh

    2016-08-01

    Full Text Available BACKGROUND Pancreatitis is a common cause of abdominal pain in the emergency room. Serum amylase and lipase are the initial screening investigations. A rapid urine analysis by a dipstick to detect urinary trypsinogen is a good screening test. MATERIALS AND METHODOLOGY This study was conducted after obtaining the Institutional Ethics Committee (IEC clearance, Reference No.: CSP - MED/14/FEB12/50. Informed consent was obtained from all study participants and ICH/GCP guidelines were followed. The present prospective study was done during the period of June 2013 to October 2015, which involved a group of 98 patients with upper abdominal pain (Reporting within 36 hours of onset of pain who came to the Department of Surgery of Sri Ramachandra Medical College and Research Institute. RESULTS A total of 98 consecutive patients with upper abdominal pain who fulfilled the inclusion criteria and exclusion criteria were enrolled in the study during the period of June 2013 - October 2015. When we analysed the patients with upper abdominal pain we found that in the age group 21-30, there were 22 patients (22.9%; in 31-40 years, there were 28 patients (29.2%; in 41-50 years, there were 17 patients (17.7%; in 51-60 years, there were 18 patients (18.8%; and in between 61-70 years, there were 11 patients (11.5% of study group (1, 2. CONCLUSIONS The analysis of the demographics of our study showed that 40.8% of acute upper abdominal pains were due to acute pancreatitis and 59.2% were non-pancreatic in origin. Male Patients accounted for 75.0% and 65.5% respectively in the acute pancreatitis and non-pancreatic groups. In both acute pancreatitis and non-pancreatic groups, major clustering of patients was seen in the age group of 31-40 yrs.

  18. [Diagnostic values of urinary netrin-1 and kidney injury molecule-1 for acute kidney injury induced by neonatal asphyxia].

    Science.gov (United States)

    Cao, Xiao-Yan; Zhang, Hui-Rong; Zhang, Wei; Chen, Bo

    2016-01-01

    To investigate the values of urinary netrin-1 and kidney injury molecule-1 (KIM-1) in the early diagnosis of acute kidney injury (AKI) induced by neonatal asphyxia. A total of 80 full-term neonates with asphyxia were enrolled (mild asphyxia: 34 neonates; severe asphyxia: 46 neonates). Forty normal full-term neonates were selected as the control group. Urinary samples were collected from the neonates in the three groups within 12 hours and 13-48 hours after birth. ELISA was applied to measure urinary levels of netrin-1 and KIM-1. Peripheral venous blood samples were also collected to measure serum creatinine (Scr) level. Compared with the control group, the asphyxia group had significantly higher urinary levels of netrin-1 and KIM-1 within 48 hours after birth and a significantly higher Scr level within 13-48 hours after birth (Pneonates in the AKI group had significantly higher urinary levels of netrin-1 and KIM-1 and Scr level within 48 hours after birth than those in the non-AKI group (Pasphyxia were 0.878 (95% CI: 0.775-0.981; Pneonatal asphyxia had a positive correlation (Pneonates with asphyxia develop AKI. Urinary netrin-1 and KIM-1 can be used as indicators for the early diagnosis of AKI after asphyxia.

  19. Acute and chronic urine retention among adults at the urology section of the Accident and Emergency Unit of Komfo Anokye Teaching Hospital, Kumasi, Ghana

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    E.M.T. Yenli

    2015-06-01

    Conclusions: Acute and chronic urine retention is not uncommon, but credible baseline data on this condition is nonexistent at KATH, Kumasi. Urine retention found among the participants was mainly AUR. Men were the most affected with benign prostatic enlargement, being the leading cause. Among women, acute or chronic urine retention was caused mainly by bladder cancer and neurogenic bladder. Initial and definitive management were varied between causes, gender and age.

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

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    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.

  1. Comparison of Norfloxacin Versus Nalidixic Acid in Therapy of Acute Urinary Tract Infections

    Directory of Open Access Journals (Sweden)

    Liisa K Selin

    1990-01-01

    Full Text Available Thirty-seven adult patients with acute urinary tract infections (UTI were randomized to receive either a seven day (lower UTI or a 14 day (upper UTI course of norfloxacin 400 mg orally twice daily, or nalidixic acid 1 g orally four times per day. Mean age, underlying disease and infecting organisms were similar in the two groups. Nine patients in the norfloxacin group and seven in the nalidixic acid group had presumptive evidence of upper UTI. Overall, 12 patients had antibody-coated bacteria-positive infections. The infecting organisms were: Escherichia coli (27, coagulase-negative staphylococci (four, Citrobacter freundii (three, Klebsiella pneumoniae (three, and Proteus mirabilis, Proteus vulgaris, Pseudomonas aeruginosa, Enterobacter agglomerans, Streptococcus agalactiae, Enterococcus faecalis (one of each. All of the organisms were susceptible to norfloxacin, while 81% were susceptible to nalidixic acid. The effects on the periurethral and anal canal flora were similar in both groups. Five patients in each group experienced adverse clinical effects. The cure rates for norfloxacin and nalidixic acid were 79 and 83%, respectively. There were two failures, two relapses and four reinfections in the norfloxacin group. In the nalidixic acid group, there were two failures, one relapse and four reinfections. One of the failure patients in the nalidixic acid group developed resistance to the drug, and two of the four reinfections were due to organisms resistant to nalidixic acid. In this patient population it was concluded that nalidixic acid may be as effective as norfloxacin in the treatment of acute, symptomatic UTI.

  2. The Important Liaison Between Onuf Nucleus-Pudendal Nerve Ganglia Complex Degeneration and Urinary Retention in Spinal Subarachnoid Hemorrhage: An Experimental Study.

    Science.gov (United States)

    Yolas, Coskun; Kanat, Ayhan; Aydin, Mehmet Dumlu; Ozturk, Cengiz; Kabalar, Esref; Akca, Nezih; Eren, Huseyin; Gundogdu, Cemal; Kotan, Dilcan; Aydin, Nazan

    2016-05-01

    The Adamkiewicz artery (AKA) supplies pudendal nerve roots and conus medullaris. The aim of this study was to elucidate if there is any relationship between neurodegenerative changes of the Onuf nucleus (ON)-pudendal nerve ganglia complex secondary to vasospasm of the AKA after spinal subarachnoid hemorrhage (SAH). This study was conducted on 22 rabbits, which were randomly divided into 3 groups: control (n = 5), sham (n = 5), and spinal SAH (n = 12). Experimental spinal SAH was induced at the L2 level. After 2 weeks, the ON-pudendal nerve ganglia complex and AKA were examined histopathologically. Bladder volume values were estimated, and results were analyzed statistically. Two animals died within the first week of experiment. Histopathologically, severe vasospasm of the AKA and neuronal degeneration and neuronal apoptosis were observed in the ON-pudendal nerve ganglia complex in 5 animals of the SAH group. The mean volume of the imaginary AKA, mean bladder volumes, and degenerated neuron densities of ON and pudendal nerve ganglia were estimated. We found that vasospasm of the AKA led to numerous neuron degenerations in ON and pudendal ganglia and consequently urinary retention (P < 0.005). ON-pudendal nerve ganglia complex degeneration secondary to vasospasm of the AKA may be a cause of urinary retention after spinal SAH. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Patient-related risk factors for urinary retention following ambulatory general surgery: a systematic review and meta-analysis.

    Science.gov (United States)

    Mason, Sam E; Scott, Alasdair J; Mayer, Erik; Purkayastha, Sanjay

    2016-06-01

    Postoperative urinary retention (POUR) is a source of avoidable patient harm. The aim of this review is to identify and quantify the role of patient-related risk factors in the development of POUR following ambulatory general surgery. Studies published until December 2014 were identified by searching MEDLINE, EMBASE, and PsycINFO databases. Risk factors assessed in 3 or more studies were meta-analyzed. Twenty-one studies were suitable for inclusion consisting of 7,802 patients. The incidence of POUR was 14%. Increased age and the presence of lower urinary tract symptoms significantly increased risk with odds ratios [ORs] of 2.11 (95% confidence interval [CI] 1.15 to 3.86) and 2.83 (1.57 to 5.08), respectively. Male sex was not associated with developing POUR (OR .96, 95% CI .62 to 1.50). Preoperative α-blocker use significantly decreased the incidence of POUR with an OR of .37 (95% CI .15 to .91). Increased age and the presence of lower urinary tract symptoms increase the risk of POUR, while α-blocker use confers protection. Male sex was not associated with POUR. These findings assist in preoperative identification of patients at high risk of POUR. Copyright © 2015 Elsevier Inc. All rights reserved.

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

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    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.

  5. Treatment of acute periprosthetic infections with prosthesis retention: Review of current concepts.

    Science.gov (United States)

    Kuiper, Jesse Wp; Willink, Robin Tjeenk; Moojen, Dirk Jan F; van den Bekerom, Michel Pj; Colen, Sascha

    2014-11-18

    Periprosthetic joint infection (PJI) is a devastating complication after total joint arthroplasty, occurring in approximately 1%-2% of all cases. With growing populations and increasing age, PJI will have a growing effect on health care costs. Many risk factors have been identified that increase the risk of developing PJI, including obesity, immune system deficiencies, malignancy, previous surgery of the same joint and longer operating time. Acute PJI occurs either postoperatively (4 wk to 3 mo after initial arthroplasty, depending on the classification system), or via hematogenous spreading after a period in which the prosthesis had functioned properly. Diagnosis and the choice of treatment are the cornerstones to success. Although different definitions for PJI have been used in the past, most are more or less similar and include the presence of a sinus tract, blood infection values, synovial white blood cell count, signs of infection on histopathological analysis and one or more positive culture results. Debridement, antibiotics and implant retention (DAIR) is the primary treatment for acute PJI, and should be performed as soon as possible after the development of symptoms. Success rates differ, but most studies report success rates of around 60%-80%. Whether single or multiple debridement procedures are more successful remains unclear. The use of local antibiotics in addition to the administration of systemic antibiotic agents is also subject to debate, and its pro's and con's should be carefully considered. Systemic treatment, based on culture results, is of importance for all PJI treatments. Additionally, rifampin should be given in Staphylococcal PJIs, unless all foreign material is removed. The most important factors contributing to treatment failure are longer duration of symptoms, a longer time after initial arthroplasty, the need for more debridement procedures, the retention of exchangeable components, and PJI caused by Staphylococcus (aureus or

  6. Urinary [TIMP-2]·[IGFBP7] - Novel Biomarkers to Predict Acute Kidney Injury.

    Science.gov (United States)

    Kimmel, Martin; Shi, Jing; Wasser, Christoph; Biegger, Dagmar; Alscher, Mark Dominik; Schanz, Moritz Bastian

    2016-01-01

    Urine microscopy is an established technique to assess kidney disease, and can add valuable information about the mechanism of damage. However, it requires the time and expertise of an experienced nephrologist and, therefore, is typically used for a limited number of patients in practice. A rapid biomarker test that identifies patients from the emergency department (ED) who are likely to have positive urine microscopy findings would enable more efficient use of this technique. Four hundred patients were enrolled in the ED; thereof 362 patients had available both tissue inhibitor of metalloproteinases-2 and insulin-like growth factor-binding protein 7 [TIMP-2]·[IGFBP7] and urine score (U-Score) data at enrollment. U-Score was assessed through urine microscopy as described previously. Fifteen (4%) of 362 patients had a U-Score >0. When patients were stratified into 3 groups using the validated [TIMP-2]·[IGFBP7] cutoffs of 0.3 and 2.0, the proportion of patients with a positive U-Score increased across the 3 strata from 1 to 6 to 24% (p technique to assess acute kidney injury and can add valuable information about the mechanism of damage; however it requires the time and expertise of an experienced nephrologist and, therefore, is typically used for a limited number of patients in clinical practice. We have shown in ED patients, urinary [TIMP-2]·[IGFBP7] had a high NPV (99%) for ruling out a positive U-Score using the 0.3 cutoff and had a PPV of 24% (6-fold greater than the pre-test probability) using the 2.0 cutoff. As such, urinary [TIMP-2]·[IGFBP7] may enable more effective use of urine microscopy in these patients and thereby save time and personnel resources. © 2016 S. Karger AG, Basel.

  7. The inadequacy of urinary dipstick and microscopy as surrogate markers of urinary tract infection in urological outpatients with lower urinary tract symptoms without acute frequency and dysuria.

    Science.gov (United States)

    Khasriya, Rajvinder; Khan, Shozab; Lunawat, Rahul; Bishara, Samuel; Bignall, Jenine; Bignal, Jenine; Malone-Lee, Matthew; Ishii, Hiro; O'Connor, Dominic; Kelsey, Michael; Malone-Lee, James

    2010-05-01

    Diagnosing urinary infection in patients with chronic lower urinary tract symptoms without dysuria is a critical step. In this study we scrutinize the sensitivity and specificity of dipstick urinalysis and microscopic pyuria (10 or more white blood cells per microl) to identify infection in such patients. This was a prospective, blinded, observational cohort study of urological outpatients with painless lower urinary tract symptoms. Midstream and catheter urine samples were analyzed. A total of 508 midstream urine samples were used to compare leukocyte esterase, nitrite dipstick and urine microscopy with cultures seeking 10(5) cfu/ml. Similarly 470 catheter urine samples were used to compare the same surrogates with 10(5) cfu/ml and with an enhanced culture method seeking 10(2) cfu/ml. A comparison of leukocyte esterase against microscopic pyuria was made using the 508 midstream and 470 catheter specimens of urine. Midstream urine specimens were provided by 42 normal volunteers for comparison. For a midstream urine culture at 10(5) cfu/ml leukocyte esterase was 56% sensitive, nitrite was 10% sensitive and microscopic pyuria was 56% sensitive. Specificities were 66%, 99% and 72%, respectively. For a catheter specimen of urine culture at 10(5) cfu/ml leukocyte esterase was 59% sensitive, nitrite was 20% sensitive and microscopic pyuria was 66% sensitive. Specificities were 84%, 97% and 73%, respectively. The enhanced culture of catheter specimen of urine at 10(2) cfu/ml was positive in 29% of patients vs 15% at 10(5) cfu/ml. Despite official guidelines and widespread use these tests cannot be considered appropriate for diagnosing urinary tract infection in patients with lower urinary tract symptoms, and should be abandoned in this context. American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  8. The combination of urinary IL - 6 and renal biometry as useful diagnostic tools to differentiate acute pyelonephritis from lower urinary tract infection

    Directory of Open Access Journals (Sweden)

    Sherif Azab

    Full Text Available ABSTRACT Objective: To evaluate the role of renal ultrasound (RUS and urinary IL-6 in the differentiation between acute pyelonephritis (APN and lower urinary tract infection (LUTI. Patients and methods: This prospective study was carried out at the Pediatric and urology outpatient and inpatient departments of Cairo University Children's Hospital as well as October 6 University Hospital and it included 155 children between one month and fourteen years old with positive culture UTI. Patients were categorized into APN and LUTI based on their clinical features and laboratory parameters. Thirty healthy children, age and sex matched constituted the control group. Children with positive urine cultures were treated with appropriate antibiotics. Before treatment, urinary IL-6 was measured by enzyme immunoassay technique (ELISA, and renal ultrasound (RUS was done. CRP (C-reactive protein, IL-6 and RUS were repeated on the 14th day of antibiotic treatment to evaluate the changes in their levels in response to treatment. Results: UIL-6 levels were more significantly higher in patients with APN than in patients with LUTI (24.3±19.3pg/mL for APN vs. 7.3±2.7pg/mL in LUTI (95% CI: 2.6-27.4; p20pg/mL and serum CRP >20μg/mL were highly reliable markers of APN. Mean renal volume and mean volume difference between the two kidneys in the APN group were more than that of the LUTI and control groups (P<0.001. Renal volume between 120-130% of normal was the best for differentiating APN from LUTI. Conclusions: RUS and urinary IL-6 levels have a highly dependable role in the differentiation between APN and LUTI especially in places where other investigations are not available and/ or affordable.

  9. Predicting Severity of Acute Kidney Injury in Term Neonates with Perinatal Asphyxia Using Urinary Neutrophil Gelatinase Associated Lipocalin.

    Science.gov (United States)

    Tanigasalam, Vasanthan; Bhat, Ballambattu Vishnu; Adhisivam, Bethou; Sridhar, Magadi Gopalakrishna; Harichandrakumar, Kottyen Thazath

    2016-11-01

    To evaluate the utility of urinary Neutrophil Gelatinase Associated Lipocalin (NGAL) as a biomarker for predicting Acute Kidney Injury (AKI) and its severity among neonates with perinatal asphyxia. This descriptive study included 120 term neonates with perinatal asphyxia. Renal parameters of neonates were monitored and AKI was ascertained as per Acute Kidney Injury Network criteria. Urinary NGAL was estimated and correlated with severity of AKI. Among the 120 neonates with perinatal asphyxia, 55(46 %) had AKI. The median urinary NGAL level was 165 ng/ml (88.8-245.8) in neonates with AKI compared to 58.97(42.8-74.7) in those without AKI. The median NGAL was 134.45(112.2-162.5), 301.2(255.5-361.2), 416.2(412.2-465.5) in AKI stages 1, 2 and 3 respectively. An NGAL cut off value of 86.82 ng/ml had 87 % sensitivity and 87.7 % specificity in predicting AKI. Urinary NGAL is a useful biomarker for predicting AKI and its severity among neonates with perinatal asphyxia.

  10. Urinary catecholamines in patients with acute stroke, in reference to CT scan findings

    International Nuclear Information System (INIS)

    Yoshino, Kimiaki

    1985-01-01

    The amount of norepinephrine (NE) and epinephrine (E) in the urine of 160 stroke patients were measured both at the acute stage and at the chronic stage (31 days or later) of the diseases and a CT scan was taken simultaneously. The urinary NE and E were separated by the high performance liquid chromatography and measured by trihydroxyindole method. Forty five healthy subjects were employed as a control group. The results were as follows: 1) In subarachnoid hemorrhage and intracerebral hemorrhage the NE and E and in cerebral infarction the NE were significantly increased in the acute stage. But, when divided by CT scan findings, the group of intracerebral hemorrhage without perforation into the ventricles showed increases of NE only and those without deviation of midline showed no significant increase of the NE and E. In cases of large cerebral infarction, both NE and E were significantly increased. It is supposed that not only the type of the disease but also the facfors such as its size, perforation into the ventricles and deviation of the midline may change activities of secretion of NE and E. 2) The NE/E ratio was significantly low in the group of intracerebral hemorrhage with perforation into the ventricles (p < 0.001) and the ratio was significantly lower in the thalamic hemorrhage than in the putaminal hemorrhage (p < 0.02). The rate of perforation into the ventricles was significantly higher in the thalamic hemorrhage (78.6 %) than that of the putaminal hemorrhage (10.5 %). 3) In the chronic stage of the stroke, the NE and E (especially E) were decreased and showed a high NE/E. ratio. (author)

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

    DEFF Research Database (Denmark)

    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...

  12. The combination of urinary IL - 6 and renal biometry as useful diagnostic tools to differentiate acute pyelonephritis from lower urinary tract infection.

    Science.gov (United States)

    Azab, Sherif; Zakaria, Mostafa; Raafat, Mona; Seief, Hadeel

    2016-01-01

    To evaluate the role of renal ultrasound (RUS) and urinary IL-6 in the differentiation between acute pyelonephritis (APN) and lower urinary tract infection (LUTI). This prospective study was carried out at the Pediatric and urology outpatient and inpatient departments of Cairo University Children's Hospital as well as October 6 University Hospital and it included 155 children between one month and fourteen years old with positive culture UTI. Patients were categorized into APN and LUTI based on their clinical features and laboratory parameters. Thirty healthy children, age and sex matched constituted the control group. Children with positive urine cultures were treated with appropriate antibiotics. Before treatment, urinary IL-6 was measured by enzyme immunoassay technique (ELISA), and renal ultrasound (RUS) was done. CRP (C-reactive protein), IL-6 and RUS were repeated on the 14th day of antibiotic treatment to evaluate the changes in their levels in response to treatment. UIL-6 levels were more significantly higher in patients with APN than in patients with LUTI (24.3±19.3pg/mL for APN vs. 7.3±2.7pg/mL in LUTI (95% CI: 2.6-27.4; p20pg/mL and serum CRP >20μg/mL were highly reliable markers of APN. Mean renal volume and mean volume difference between the two kidneys in the APN group were more than that of the LUTI and control groups (Purinary IL-6 levels have a highly dependable role in the differentiation between APN and LUTI especially in places where other investigations are not available and/ or affordable. Copyright© by the International Brazilian Journal of Urology.

  13. Stroke patients who regain urinary continence in the first week after acute first-ever stroke have better prognosis than patients with persistent lower urinary tract dysfunction.

    Science.gov (United States)

    Rotar, Melita; Blagus, Rok; Jeromel, Miran; Skrbec, Miha; Tršinar, Bojan; Vodušek, David B

    2011-09-01

    Urinary incontinence (UI) is a predictor of greater mortality and poor functional recovery; however published studies failed to evaluate lower urinary tract (LUT) function immediately after stroke. The aim of our study was to evaluate the course of LUT function in the first week after stroke, and its impact on prognosis. We included 100 consecutively admitted patients suffering first-ever stroke and evaluated them within 72 hours after stroke, after 7 days, 6 months, and 12 months. For LUT function assessment we used ultrasound measurement. The patients were divided into three groups: (i) patients who remained continent after stroke, (ii) patients who had LUT dysfunction in the acute phase but regained continence in the first week, and (iii) patients who did not regain normal LUT control in the first week. We assessed the influence of variables on death using the multiple logistic regression model. Immediately after stroke 58 patients had LUT dysfunction. The odds of dying in group with LUT dysfunction were significantly larger than odds in group without LUT dysfunction. Odds for death for patients who regained LUT function in 1 week after stroke were comparable to patients without LUT dysfunction. We confirmed that post-stroke UI is a predictor of greater mortality at 1 week, 6 months and 12 months after stroke. However, patients who regain normal bladder control in the first week have a comparable prognosis as the patients who do not have micturition disturbances following stroke. Copyright © 2011 Wiley-Liss, Inc.

  14. Daily urinary creatinine predicts the weaning of renal replacement therapy in ICU acute kidney injury patients.

    Science.gov (United States)

    Viallet, Nicolas; Brunot, Vincent; Kuster, Nils; Daubin, Delphine; Besnard, Noémie; Platon, Laura; Buzançais, Aurèle; Larcher, Romaric; Jonquet, Olivier; Klouche, Kada

    2016-12-01

    In acute kidney injury (AKI), useless continuation of renal replacement therapy (RRT) may delay renal recovery and impair patient's outcome. In this study, we aimed to identify predictive parameters that may help to a successful RRT weaning for AKI patients. We studied 54 surviving AKI patients in which a weaning of RRT was attempted. On the day of weaning (D0) and the following 2 days (D1 and D2), SAPS II and SOFA scores, 24-h diuresis, 24-h urinary creatinine and urea (UCr and UUr), creatinine and urea generation rates (CrGR and UrGR) and clearances (CrCl and UrCl) were collected. Patients who remained free of RRT 15 days after its discontinuation were considered as successfully weaned. Twenty-six RRT weaning attempts succeeded (S+) and 28 failed (S-). Age, previous renal function, SAPS II and SOFA scores were comparable between groups. At D0, 24-h diuresis was 2300 versus 1950 ml in S+ and S-, respectively, p = 0.05. At D0, D1 and D2, 24-h UUr and UCr levels, UrCl and CrCl, and UUr/UrGR and UCr/CrGR ratios were significantly higher in S+ group. By multivariate analysis, D1 24-h UCr was the most powerful parameter that was associated with RRT weaning success with an area under the ROC curve of 0.86 [0.75-0.97] and an odds ratio of 2.01 [1.27-3.18], p = 0.003. In ICU AKI, 24-h UCr appeared as an efficient and independent marker of a successful weaning of RRT. A 24-h UCr ≥5.2 mmol was associated with a successful weaning in 84 % of patients.

  15. Urinary parameters predictive of cisplatin-induced acute renal injury in dogs.

    Science.gov (United States)

    McDuffie, J Eric; Sablad, Marciano; Ma, JingYing; Snook, Sandra

    2010-12-01

    A 28-day study was conducted to evaluate changes in urinary cytokine/chemokine expression levels in dogs with renal injury due to administration of cisplatin. Animals (n=17) were administered cisplatin at 0.75 mg/kg/day (i.v.) for five consecutive days. Urine/serum were collected at pre-dosing, 4h post-dosing and on days 2, 3, 4, 8, 10, 14, 16, 18, 21, 23, 25, 28 and unscheduled terminations. Animals were euthanized when serum creatinine (sCr) levels measured at ≥ 1.9 mg/dL, indicating significant loss of renal function (decreased glomerular filtration rate). Relevant clinical observations included lethargy and dehydration. Pre-study sCr levels ranged from 0.6 to 0.8 mg/dL; on days 1 through 4, sCr levels ranged from 0.5 and 1.1mg/dL; and terminal sCr levels ranged from 0.6 and 6.6 mg/dL. Histologically, cisplatin-related renal changes were characterized as proximal tubule dilatation, vacuolization, degeneration, regeneration, and interstitial inflammation. Increased interleukin (IL)-2, IL-8, monocyte chemoattractant protein-1 (MCP-1), granulocyte-macrophage colony-stimulating factor (GMCSF) and keratinocyte-derived chemokine (KC) occurred on days 3 through 4. Increased IL-7 occurred on day 4. This study showed for the first time that inflammatory cytokines/chemokines in urine positively identified acute renal tubular injury in dogs at time points earlier than sCr, a traditional marker of nephrotoxicity. Copyright © 2010 Elsevier Ltd. All rights reserved.

  16. Urinary protein profiles in ketorolac-associated acute kidney injury in patients undergoing orthopedic day surgery

    Directory of Open Access Journals (Sweden)

    Mariano F

    2017-09-01

    Full Text Available Filippo Mariano,1 Chiara Cogno,1 Fulvia Giaretta,2,3 Ilaria Deambrosis,2,3 Simona Pozza,4 Maurizio Berardino,5 Giuseppe Massazza,6 Luigi Biancone1,3 1Department of General and Specialist Medicine, Nephrology, Dialysis and Transplantation Unit, City of Health and Science, CTO Hospital, Turin, 2Department of General and Specialist Medicine, Laboratory of Nephrology and Immunopathology, City of Health and Science, Molinette Hospital, Turin, 3Department of Medical Sciences, University of Turin, Turin, 4Department of Radiology and Radiotherapy, CTO Radiology, City of Health and Science, CTO Hospital, Turin, 5Department of Anesthesiology and Intensive Care, Anesthesiology and Intensive Care 5, City of Health and Science, CTO Hospital, Turin, 6Department of Orthopedics and Traumatology, Week Hospital Unit, City of Health and Science, CTO Hospital, and University of Turin, Turin, Italy Background: Parenteral administration of ketorolac is very effective in controlling postoperative pain for orthopedic surgery. Ketorolac can induce clinically relevant renal alterations in elderly patients, whereas its short course is considered safe for young adults with normal preoperative renal function. In this study, of a cohort of young adults undergoing elective orthopedic day surgery, we sought cases complicated by readmission due to acute kidney injury (AKI.Patients and methods: Among 1397 young adults, aged 18–32 years who were admitted to undergo orthopedic day surgery from 2013 to 2015, four patients (0.29%, three males/one female treated in postprocedure with ketorolac (from 60 to 90 mg/day for 1–2 days were readmitted for suspected severe AKI. We evaluated functional outcome, urinary protein profiles and kidney biopsy (1 patient.Results: After day surgery discharge, they experienced gastrointestinal disturbances, flank pain and fever. Readmitted on post-surgery days 3–4, they presented with oliguric AKI (creatinine range 158.4–466.4 µmol/L and

  17. Case report: Acute peritonitis from non-traumatic rupture of the bladder

    African Journals Online (AJOL)

    Spontaneous bladder rupture (SBR) is rare. This entity occurs outside of any traumatic context. A 70 years-old man was admitted for acute peritonitis, acute urinary retention and hematuria. Laparotomy and exploration showed acute generalized peritonitis related to a centimeter hole in the bladder dome. Peritoneal lavage ...

  18. Prostate Artery Embolization for Complete Urinary Outflow Obstruction Due to Benign Prostatic Hypertrophy

    OpenAIRE

    Yu, Simon Chun Ho; Cho, Carmen Chi Min; Hung, Esther Hiu Yee; Chiu, Peter Ka Fung; Yee, Chi Hang; Ng, Chi Fai

    2016-01-01

    Background We aimed to evaluate the effectiveness of PAE in weaning of catheter and relieving obstructive urinary symptoms in patients with acute urinary retention (AUR) due to benign prostatic hypertrophy (BPH) and failed trial without catheter (TWOC). Materials and Methods In this prospective study approved by the institutional review board, a signed informed consent was obtained. Eighteen consecutive patients with AUR due to BPH and failed TWOC were recruited. Nineteen consecutive patients...

  19. Irrigation and Debridement with Component Retention for Acute Infection After Hip Arthroplasty: Improved Results with Contemporary Management.

    Science.gov (United States)

    Bryan, Andrew J; Abdel, Matthew P; Sanders, Thomas L; Fitzgerald, Steven F; Hanssen, Arlen D; Berry, Daniel J

    2017-12-06

    There are conflicting data on the results of irrigation and debridement with component retention in patients with acute periprosthetic hip infections. The goals of this study were to examine contemporary results of irrigation and debridement with component retention for acute infection after primary hip arthroplasty and to identify host, organism, antibiotic, or implant factors that predict success or failure. Ninety hips (57 total hip arthroplasties and 33 hemiarthroplasties) were diagnosed with acute periprosthetic hip infection (using strict criteria) and were treated with irrigation and debridement and component retention between 2000 and 2012. The mean follow-up was 6 years. Patients were stratified on the basis of McPherson criteria. Hips were managed with irrigation and debridement and retention of well-fixed implants with modular head and liner exchange (70%) or irrigation and debridement alone (30%). Seventy-seven percent of patients were treated with chronic antibiotic suppression. Failure was defined as failure to eradicate infection, characterized by a wound fistula, drainage, intolerable pain, or infection recurrence caused by the same organism strain; subsequent removal of any component for infection; unplanned second wound debridement for ongoing deep infection; and/or occurrence of periprosthetic joint infection-related mortality. Treatment failure occurred in 17% (15 of 90 hips), with component removal secondary to recurrent infection in 10% (9 of 90 hips). Treatment failure occurred in 15% (10 of 66 hips) after early postoperative infection and 21% (5 of 24 hips) after acute hematogenous infection (p = 0.7). Patients with McPherson host grade A had a treatment failure rate of 8%, compared with 16% (p = 0.04) in host grade B and 44% in host grade C (p = 0.006). Most treatment failures (12 of 15 failures) occurred within the initial 6 weeks of treatment; failures subsequent to 6 weeks occurred in 3% of those treated with chronic antibiotic

  20. Effect of fruit on net acid and urinary calcium excretion in an acute feeding trial of women.

    Science.gov (United States)

    Bell, Janet Amy; Whiting, Susan Joyce

    2004-05-01

    Consumption of fruits and vegetables has been implicated in lowering net acid excretion (NAE), but few studies have directly examined NAE and urinary calcium effects. Further, there is no evidence that only fresh fruits and vegetables must be consumed for a beneficial effect on bone. A crossover, acute-load study was designed to investigate whether processed fruit was as effective as fresh fruit in reducing NAE and protein-induced hypercalciuria. Fifteen women completed three dietary treatments on three different mornings. A fasting urine sample was collected before consuming one of the following three isocaloric high-protein treatments: control, fresh apples, and processed applesauce. The serving size for the applesauce treatment was 2.5 times that for fresh apples. Urine was collected at baseline (0 h) and at 1.5, 3.0, and 4.5 h. Compared with baseline, NAE increased after control treatment but decreased after fresh or processed apple treatment (P = 0.041). Calcium excretion increased with all treatments by 3 h; however, the increase was less for fresh apple and applesauce (P = 0.024). In an acute feeding model, fruit intake reduced NAE and urinary calcium excretion. Processed fruit appears to be effective, although a larger serving size was needed than with fresh fruit.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Comparative retention of 60Co, 109Cd, and 137Cs following acute and chronic feeding in Bobwhite quail

    International Nuclear Information System (INIS)

    Anderson, S.H.; Dodson, G.J.; Van Hook, R.I.

    1975-01-01

    Tissue distribution of the radionuclides were found in the groups given the chronic exposure. Under chronic exposure to 60 Co, 109 Cd, and 137 Cs, quail rapidly accumulated these radioisotopes and the respective body burden concentrations began to level off after 11, 21, and 21 days of exposure. The biological half-lives for radioisotopes accumulated during the chronic feedings were 13 days for 60 Co, 8 days for 109 Cd, and 11 days for 137 Cs. In contrast, biological half-lives for these radioisotopes under acute feeding conditions (single four-hour feeding) were 15 days for 60 Co, 3 days for 109 Cd, and 10 days for 137 Cs. These results indicate that food chain behavior of 60 Co and 137 Cs in Bobwhite is similar following either acute or chronic exposure to contaminated food. For 109 Cd, biological retention in Bobwhite was longer under chronic exposure conditions. (U.S.)

  3. Prise en charge de la retention aigue d'urine au CHU Sylvanus ...

    African Journals Online (AJOL)

    Before acute urinary retention, 55% of patients had dysuria, 12% and 04% had respestively antecedent of urethritis and traumatism of urethra. The lower abdominal pain with inability to pass urine (90%), pelvic trauma (06%) and rachis trauma (04%) were the main reasons for consultation. Only 12% of patients could pass ...

  4. Human resource management strategies for the retention of nurses in acute care settings in hospitals in Australia.

    Science.gov (United States)

    Hogan, Pamela; Moxham, Lorna; Dwyer, Trudy

    2007-04-01

    It is paramount that there is an adequate nursing workforce supply for now and in the future, to achieve equitable and quality health outcomes and consumer access to healthcare, regardless of geographic location. Nursing forms the largest body of employees in the health care system, spanning all segments of care. A shortage of nurses, particularly in the acute care settings in hospitals, jeopardizes the provision of quality health care to consumers. This article provides a literature review of Australian State and Federal Government reports into nurse retention. All reports discuss staff turnover rates; the average age of nurses; enrolment numbers in nursing courses; workloads; nursing workforce shortfalls and the effect on the work environment; leadership and management styles; organizational culture; change management; the mobility of nursing qualifications both locally and internationally and the critical need to value nurses. Then why has the situation of nurse retention not improved? Possible reasons for the continued nurse shortage and the promise of strategic HRM in addressing nurse retention are discussed.

  5. Wegener′s granulomatosis of urinary tract presenting as bladder outlet obstruction

    Directory of Open Access Journals (Sweden)

    V Suryaprakash

    2006-01-01

    Full Text Available We report a rare case of Wegener′s granulomatosis involving the prostate gland in a 45-year-old male who presented with acute urinary retention. Treatment was initiated with oral cyclophosphamide and steroids. The prostate size regressed in four weeks and patient voided well after removal of catheter.

  6. Antimicrobial Resistance of Urinary Tract Isolates in Acute Uncomplicated Cystitis among College-Aged Women: Choosing a First-Line Therapy

    Science.gov (United States)

    Hames, Leesa; Rice, Craig E.

    2007-01-01

    Objective and Participants: The authors of this retrospective case study focused on antimicrobial susceptibility of urinary tract isolates in cases of acute uncomplicated cystitis in college-aged women, aged 18 to 24 years, diagnosed at a major south-central university student health center. Methods: The authors obtained pertinent data from…

  7. Urinary NGAL Ratio Is Not a Sensitive Biomarker for Monitoring Acute Tubular Injury in Kidney Transplant Patients: NGAL and ATI in Renal Transplant Patients

    Directory of Open Access Journals (Sweden)

    Jessica K. Kaufeld

    2012-01-01

    Full Text Available Urinary neutrophil gelatinase-associated lipocalin (uNGAL is known to predict the prolonged delayed graft function after kidney transplantation. We examined the relation of uNGAL with histological findings of acute tubular injury (ATI. Analyses were made in biopsies taken at 6 weeks, 3 months, and 6 months after kidney transplantation. uNGAL was measured in the spot urines, normalized to urinary creatinine excretion, and correlated to biopsy findings and clinical, laboratory, and demographic variables. Controls included healthy individuals, individuals after kidney donation and ICU patients with acute kidney failure. Renal transplant recipients without ATI did not display elevated uNGAL levels compared to the healthy controls. Transplant patients with ATI had a higher uNGAL excretion at 6 weeks than patients without ATI (27,435 versus 13,605 ng/g; P=0.031. This increase in uNGAL was minor compared to ICU patients with acute renal failure (2.05×106 ng/g. Patients with repeated findings of ATI or severe ATI did not have higher urinary NGAL levels compared to those with only one ATI finding or moderate ATI. Female recipient gender and urinary tract infection were identified as potential confounders. uNGAL has a relation with histological signs of acute tubular injury. The usability of this biomarker in renal allograft recipients is limited because of the low sensitivity.

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    TEST OR OUTCOME: Serum creatinine-based definition for AKI (increase in serum creatinine from preoperative values by >50% or >0.3 mg/dL within 48 hours). RESULTS: Mean urinary NGAL level was 165 +/- 663 (SD) ng/mL preoperatively, peaked immediately after cardiac surgery at 1,490 +/- 102 ng.......603 (95% CI, 0.533 to 0.674), 0.611 (95% CI, 0.544 to 0.679), and 0.584 (95% CI, 0.510 to 0.657), respectively. Urinary NGAL, but not serum creatinine, level correlated significantly with cardiopulmonary bypass and aortic cross-clamp times. Areas under receiver operating characteristic curves...... for 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...

  9. [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].

    Science.gov (United States)

    Liu, Ye-zhou; Wu, Jing-jing; Zhang, Ling; Xu, Hao; Liu, Zheng; Lu, Jia-peng; Zhang, Jie; Feng, Liang; Guo, Qi; Zhao, Chen-mei; Liu, Ji-xia; Wei, Hong; Cao, Shuo; Zhao, Hui

    2013-12-01

    To explore the influence factors of salt-sensitive 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. 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 and furosemide volume-depletion tests. Binary logistic regression analysis was applied to explore influence factors of salt-sensitive hypertension. Acute oral saline loading induced changes on blood pressures and urinary sodium and potassium excretion were observed. Sixty-three salt-sensitive hypertensive patients were classified out of a total of 342(18.4%) essential hypertensive patients. Salt-sensitive patients were elder than the non-salt-sensitive patients (P 0.05) , gender (OR = 0.728, 95%CI:0.374-1.415, P > 0.05) , total cholesterol level (OR = 1.168, 95%CI:0.882-1.547, P > 0.05) and 24-hour urinary sodium (OR = 0.998, 95%CI:0.995-1.002, P > 0.05) were not influencing factors of salt-sensitivity among essential hypertensive patients. Bivariate general linear models for repeated measures showed that there were significant statistical differences on blood pressures and urinary electrolytes concentrations between the beginning of trials, 2 hours after acute saline loading and 2 hours after furosemide volume-depletion(all P salt-sensitive patients than in non-salt-sensitive patients(all P 0.05). Age, gender, total cholesterol level and 24-hour urinary sodium are not influencing factors of salt-sensitivity among essential hypertensive patients in this study. Impaired pressure natriuresis during acute oral saline loading and furosemide volume-depletion tests is presented in salt-sensitive essential hypertensive patients.

  10. Prevalence of urinary tract infection in acutely unwell children in general practice: a prospective study with systematic urine sampling

    Science.gov (United States)

    O’Brien, Kathryn; Edwards, Adrian; Hood, Kerenza; Butler, Christopher C

    2013-01-01

    Background Urinary tract infection (UTI) in children may be associated with long-term complications that could be prevented by prompt treatment. Aim To determine the prevalence of UTI in acutely ill children ≤ 5 years presenting in general practice and to explore patterns of presenting symptoms and urine sampling strategies. Design and setting Prospective observational study with systematic urine sampling, in general practices in Wales, UK. Method In total, 1003 children were recruited from 13 general practices between March 2008 and July 2010. The prevalence of UTI was determined and multivariable analysis performed to determine the probability of UTI. Result Out of 597 (60.0%) children who provided urine samples within 2 days, the prevalence of UTI was 5.9% (95% confidence interval [CI] = 4.3% to 8.0%) overall, 7.3% in those infection was associated with UTI (P = 0.64; P = 0.69, respectively). The probability of UTI in children aged ≥3 years without increased urinary frequency or dysuria was 2%. The probability of UTI was ≥5% in all other groups. Urine sampling based purely on GP suspicion would have missed 80% of UTIs, while a sampling strategy based on current guidelines would have missed 50%. Conclusion Approximately 6% of acutely unwell children presenting to UK general practice met the criteria for a laboratory diagnosis of UTI. This higher than previously recognised prior probability of UTI warrants raised awareness of the condition and suggests clinicians should lower their threshold for urine sampling in young children. The absence of fever or presence of an alternative source of infection, as emphasised in current guidelines, may not rule out UTI in young children with adequate certainty. PMID:23561695

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

    Science.gov (United States)

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

    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 for each study and were compared to other systems/biomarkers if mentioned within the same study. Summary receiver-operating curves were conducted and the area under the curve (AUC) was evaluated. RESULTS: In total, six studies of uTAP with a cut-off value of 35 nmol/L were included in this meta-analysis. Overall, the pooled sensitivity and specificity of uTAP for predicting severity of acute pancreatitis, at time of admission, was 71% and 75%, respectively (AUC = 0.83, DOR = 8.67, 95%CI: 3.70-20.33). When uTAP was compared with plasma C-reactive protein, the pooled sensitivity, specificity, AUC and DOR were 0.64 vs 0.67, 0.77 vs 0.75, 0.82 vs 0.79 and 6.27 vs 6.32, respectively. Similarly, the pooled sensitivity, specificity, AUC and DOR of uTAP vs Acute Physiology and Chronic Health Evaluation II within the first 48 h of admission were found to be 0.64 vs 0.69, 0.77 vs 0.61, 0.82 vs 0.73 and 6.27 vs 4.61, respectively. CONCLUSION: uTAP has the potential to act as a stratification marker on admission for differentiating disease severity of acute pancreatitis. PMID:23901239

  12. [Chronic monstrous urine retention].

    Science.gov (United States)

    Thomsen, Frederik Gustav; Holm, Mette Lind

    2015-01-26

    A 75-year-old male was diagnosed with renal mass at a computed tomography during an examination for extended abdominal girth. A large mesenterical cyst was also detected. The patient had infrequent voiding, which he had trained over many years as a taxi driver. A basic physical examination led to suspect urinary retention. His creatinine level was normal and he had no hydronephrosis. A renography showed equal function, but prolonged bilateral outflow. The volume extracted by urethral catheter passed 15 l. Absence of hydronephrosis and normal S-creatinine level has not been described in chronic urinary retention of this extent. Hydronephrosis is seen, but in much smaller volume of retention. Infrequent voiding is easily diagnosed. Urinary retention should be suspected when finding median cystic processes.

  13. Alfa-2-glicoproteína rica en leucina urinaria en pacientes con apendicitis aguda (Urinary leucine-rich alpha-2-glycoprotein in patients with acute appendicitis

    Directory of Open Access Journals (Sweden)

    Heberto Machado-Montero

    2015-04-01

    Full Text Available The objective of research was to determine diagnostic efficacy of urinary concentrations of leucine-rich alpha-2-glycoprotein (A2GRL in patients with acute appendicitis. There were included patients with high suspicion of acute appendicitis (group A; cases, n = 30. In group B (controls, n = 30 were included patients with non-surgical abdominal pain who attended to Hospital Central “Dr. Urquinaona”, Maracaibo, Zulia. General characteristics, urinary concentrations of A2GRL and diagnostic efficacy of assay were evaluated. Mean age of patients in group A was 36.3 +/- 8.8 years-old and in group B was 35.8 +/- 9.6 years-old (p = ns. There were not found significant differences in sex distribution, weight and height between groups (p = ns. Urinary concentrations of A2GRL were significantly higher in group A (1543.8 +/- 762.7 ng/mL compared with mean value in patients of group B (774.1 +/- 356.1 ng/mL; p < 0.0001. A2GRL presented a value below curve 0.81. A cut-off value of 1000 ng/mL, showed sensivity 73.3%, specificity 70.9%, positive predictive value 72.4% and negative predictive value 72.4%. It is concluded that urinary concentrations of A2GRL have a high diagnostic efficacy in patients with acute appendicitis

  14. Essential role of transient receptor potential M8 (TRPM8) in a model of acute cold-induced urinary urgency.

    Science.gov (United States)

    Uvin, Pieter; Franken, Jan; Pinto, Silvia; Rietjens, Roma; Grammet, Luc; Deruyver, Yves; Alpizar, Yeranddy A; Talavera, Karel; Vennekens, Rudi; Everaerts, Wouter; De Ridder, Dirk; Voets, Thomas

    2015-10-01

    Acute exposure of part of the skin to cold stimuli can evoke urinary urgency, a phenomenon termed acute cold-induced urgency (ACIU). Despite its high prevalence, particularly in patients with overactive bladder, little is known about the mechanisms that induce ACIU. To develop an animal model of ACIU and test the involvement of cold-activated ion channels transient receptor potential (TRP) M8 and TRPA1. Intravesical pressure and micturition were monitored in female mice (wild-type C57BL/6J, Trpa1(-/-), Trpm8(+/+), and Trpm8(-/-)) and Sprague Dawley rats. An intravesical catheter was implanted. Localized cooling of the skin was achieved using a stream of air or topical acetone. The TRPM8 antagonist (N-(3-aminopropyl)-2-{[(3-methylphenyl) methyl]oxy}-N-(2-thienylmethyl)benzamide (AMTB) or vehicle was injected intraperitoneally. Frequencies of bladder contractions and voids in response to sensory stimuli were compared using the Mann-Whitney or Kruskal-Wallis test. Brief, innocuously cold stimuli applied to different parts of the skin evoked rapid bladder contractions and voids in anesthetized mice and rats. These responses were strongly attenuated in Trpm8(-/-) mice and in rats treated with AMTB. As rodent bladder physiology differs from that of humans, it is difficult to directly extrapolate our findings to human patients. Our findings indicate that ACIU is an evolutionarily conserved reflex rather than subconscious conditioning, and provide a useful in vivo model for further investigation of the underlying mechanisms. Pharmacological inhibition of TRPM8 may be useful for treating ACIU symptoms in patients. Brief cold stimuli applied to the skin can evoke a sudden desire to urinate, which can be highly bothersome in patients with overactive bladder. We developed an animal model to study this phenomenon, and found that it depends on a specific molecular cold sensor, transient receptor potential M8 (TRPM8). Pharmacological inhibition of TRPM8 may alleviate acute cold

  15. Consequences of adolescent or adult ethanol exposure on tone and context fear retention: effects of an acute ethanol challenge during conditioning.

    Science.gov (United States)

    Broadwater, Margaret; Spear, Linda P

    2014-05-01

    An acute ethanol (EtOH) challenge prior to fear conditioning typically disrupts fear retention to contextual cues to a greater degree than fear retention to a discrete tone cue, and adolescent rats are less sensitive than adults to these EtOH-induced disruptions of context fear memory. Given that some research suggests that repeated EtOH exposure during adolescence may "lock-in" adolescent-typical EtOH sensitivity into adulthood, the purpose of this study was to determine whether adults exposed to EtOH as adolescents would be less sensitive to EtOH-induced disruptions of context fear. Male Sprague-Dawley rats were given 4 g/kg intragastric EtOH (25% v/v) or water every 48 hours for a total of 11 exposures during adolescence (postnatal day [P] 28 to 48) or adulthood (P70-90). After a 22-day non-EtOH period, animals were acutely challenged with 1 g/kg intraperitoneal EtOH or saline 10 minutes prior to tone or context (noncued) fear conditioning. Tone and context fear retention was subsequently examined. Regardless of age or exposure history, typical deficits in context fear retention were evident after EtOH challenge during conditioning. Similarly, tone fear retention was disrupted in all animals that were trained in the presence of EtOH, which was somewhat surprising given the relative resistance of tone fear retention to an acute EtOH challenge. These results do not support the notion of a "lock-in" of adolescent-typical EtOH sensitivity as there was no influence of exposure age on sensitivity to the disruptive effects of an acute EtOH challenge. Thus, it appears that not all adolescent-like EtOH sensitivities persist into adulthood after prior EtOH exposure during adolescence. Copyright © 2014 by the Research Society on Alcoholism.

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

    International Nuclear Information System (INIS)

    Baik, Jun Hyun; Park, Young Ha; Hwang, Sung Su; Jeon, Jung Su; Kim, Sung Hoon; Lee, Seong Yong; Chung, Soo Kyo

    2003-01-01

    The purpose of this study was to evaluate the usefulness of 99m Tc 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. 99m Tc 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

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

    DEFF Research Database (Denmark)

    Skriver, Kasper Christen

    ) or after (POST) training of a motor task, while a third group served as control group (CON). The subjects’ ability to perform the task was tested one hour, 24 hours and seven days after learning the task. Study I showed that PRE and POST both performed better than CON after 24 hours and seven days...... of the motor task one hour, 24 hours and seven days after acquisition. Both exercise groups performed better than CON seven days after learning, thereby replicating the results of Study I. There was no difference between HOC and RUN at any time points, thus implying that a team sport can lead to the same...... performed before or after acquisition of a novel motor task would improve long-term retention of the motor skill. Forty-eight young men were recruited to the study. The subjects were divided into three experimental groups. Two groups performed 20 minutes of intense bike ergometer exercise either before (PRE...

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

    Directory of Open Access Journals (Sweden)

    Uma B Maheswari

    2013-01-01

    Full Text Available 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 determine the expression of Haemagglutinins, (Type 1 and P fimbriae , Biofilm production and resistance pattern to common antibiotics of Uropathogenic E.coli (UPEC isolates from Community acquired Acute Urinary Tract Infection(CAUTI and Urolithiasis. Materials and Methods: A total of 43 UPEC isolates , 23 mid-stream urine (MSU samples from patients with CAUTI attending Out Patient Departments and 20 from renal calculi of urolithiasis patients at the time of Percutaneous nephrolithostomy (PCNL were included in the study and the expression of Haemagglutinins,(Type 1 and P fimbriae , Biofilm production and resistance pattern to common antibiotics was assessed. Results: A total of 43 UPEC isolates 23 from CAUTI and 20 from renal calculi were tested for production of biofilm and hemagglutinins. In CAUTI, biofilm producers were 56.52% and hemagglutinins were detected in all isolates 100%. In urolithiasis, biofilm producers were 100% but hemagglutinins were detected only in 70% of isolates. All isolates were resistant to multiple antibiotics used. CAUTI isolates were susceptible to 3 rd generation cephalosporins, whereas urolithiasis isolates were resistant to 3 rd generation cephalosporins and 25% were Extended Spectrum Beta Lactamases ESBL producers. Conclusions: HA mediated by type 1 fimbriae plays an important role in CAUTI (P < 0.001 highly significant, whereas, in chronic conditions like urolithiasis, biofilm plays an important role in persistence of infection and

  19. Urinary neutrophil gelatinase-associated lipocalin is an early predictor of acute kidney injury in premature infants

    Science.gov (United States)

    Kuribayashi, Ryota; Suzumura, Hiroshi; Sairenchi, Toshimi; Watabe, Yoshiyuki; Tsuboi, Yayoi; Imataka, George; Kurosawa, Hidemitsu; Arisaka, Osamu

    2016-01-01

    Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is produced in response to tubular epithelial injury and is a biomarker of tubulointerstitial injury. The aim of the present study was to examine whether acute kidney injury (AKI) could be predicted by measuring uNGAL in very low-birth weight (VLBW) infants. Forty VLBW infants with birthweight below 1,500 g were enrolled in the present study. uNGAL and serum creatinine (sCre) were measured daily from postnatal days 0 to 8. Infants with sCre ≥1.2 mg/dl were diagnosed with AKI. The relationship of uNGAL with sCre was measured on the day after uNGAL measurement (next-day sCre) was examined. The results showed that 16 infants had sCre ≥1.2 mg/dl in this period. Logistic regression analysis revealed that uNGAL on postnatal days 2, 3, 4, 5 and 6 was correlated with next-day sCre (P<0.05). uNGAL corrected by urinary Cre (uCre) (uNGAL/uCre) was only correlated with an increase in next-day sCre on postnatal days 5 and 6 (P<0.05). For the logistic analysis, subjects with high and low uNGAL levels based on the median value for each day, uNGAL on postnatal days 2, 3 and 6 in the high uNGAL group was correlated with an increase in next-day sCre. Thus, AKI may be predicted by measuring uNGAL in VLBW infants. This measurement was non-invasive, and is potentially useful for the evaluation of renal function in VLBW infants. PMID:28105101

  20. Primary diffuse large B-Cell lymphoma of the prostate presenting with urinary retention and dyschezia for which rituximab-combined CHOP therapy was effective-a case presentation.

    Science.gov (United States)

    Manabe, Masahiro; Hayashi, Yoshiki; Yoshii, Yumi; Mukai, Satoru; Sakamoto, Erina; Kanashima, Hiroshi; Nakao, Takafumi; Hayama, Takuma; Fukushima, Hiroko; Inoue, Takeshi; Yamane, Takahisa; Teshima, Hirofumi

    2012-11-01

    We report the case of a 66-year-old man with primary diffuse large B-cell lymphoma of the prostate presenting with urinary retention and dyschezia as first manifestation. Although a colostomy was needed due to rectal obstruction, rituximab-combined chemotherapy resulted in complete remission. He underwent stoma closure safely and has remained in complete remission for over 3years. Primary prostatic lymphoma is extremely rare, presenting as 0.1% of newly diagnosed lymphomas, but rituximab-containing chemotherapy seems to be as effective as for nodal lymphoma.

  1. Evaluation of Vancomycin Exposures Associated with Elevations in Novel Urinary Biomarkers of Acute Kidney Injury in Vancomycin-Treated Rats

    Science.gov (United States)

    Prozialeck, Walter C.; Lodise, Thomas P.; Venkatesan, Natarajan; O'Donnell, J. Nicholas; Pais, Gwendolyn; Cluff, Cameron; Lamar, Peter C.; Neely, Michael N.; Gulati, Anil

    2016-01-01

    Vancomycin has been associated with acute kidney injury (AKI). However, the pharmacokinetic/toxicodynamic relationship for AKI is not well defined. Allometrically scaled vancomycin exposures were used to assess the relationship between vancomycin exposure and AKI. Male Sprague-Dawley rats received clinical-grade vancomycin in normal saline (NS) as intraperitoneal (i.p.) injections for 24- to 72-h durations with doses ranging 0 to 200 mg/kg of body weight divided once or twice daily. Urine was collected over the protocol's final 24 h. Renal histopathology was qualitatively scored. Urinary biomarkers (e.g., cystatin C, clusterin, kidney injury molecule 1 [KIM-1], osteopontin, lipocalin 2/neutrophil gelatinase-associated lipocalin 2) were assayed using a Luminex xMAP system. Plasma vancomycin concentrations were assayed by high-performance liquid chromatography with UV detection. A three-compartment vancomycin pharmacokinetic model was fit to the data with the Pmetrics package for R. The exposure-response in the first 24 h was evaluated using Spearman's nonparametric correlation coefficient (rs) values for the area under the concentration-time curve during the first 24 h (AUC0–24), the maximum concentration in plasma during the first 24 h (Cmax0–24), and the lowest (minimum) concentration in plasma after the dose closest to 24 h (Cmin0–24). A total of 52 rats received vancomycin (n = 42) or NS (n = 10). The strongest exposure-response correlations were observed between AUC0–24 and Cmax0–24 and urinary AKI biomarkers. Exposure-response correlations (rs values) for AUC0–24, Cmax0–24, and Cmin0–24 were 0.37, 0.39, and 0.22, respectively, for clusterin; 0.42, 0.45, and 0.26, respectively, for KIM-1; and 0.52, 0.55, and 0.42, respectively, for osteopontin. However, no differences in histopathological scores were observed. Optimal sampling times after administration of the i.p. dose were 0.25, 0.75, 2.75, and 8 h for the once-daily dosing schemes and 0.25, 1

  2. Can low urinary tract symptoms influence postprostatectomy urinary incontinence?

    Science.gov (United States)

    Tienza, Antonio; Hevia, Mateo; Merino, Imanol; Diez-Caballero, Fernando; Rosell, David; Pascual, Juan I; Zudaire, Juan J; Robles, José E

    2016-08-01

    The aim of this study was to analyze what kind of urinary symptoms patients have before receiving treatment by radical prostatectomy (RP), and to evaluate their influence on urinary incontinence (UI). Between 2002 and 2012, 758 consecutive patients underwent RP for clinically localized prostate cancer (PCa). Surgery was carried out by open retropubic RP in 545 (73.1%) of patients and laparoscopic RP in 201 (27%) by 5 surgeons who were excluded from data collection and analysis. The following symptoms were collected from the last urological check-ups or pre-operative consultation and classified as: storage symptoms, voiding symptoms, post micturition symptoms, history of acute urinary retention, benign prostatic hyperplasia treatment, history of transurethral resection of the prostate (TURP). A total of 661 patients were included on analysis: 136 (20.6%) patients reported low urinary tract symptoms (LUTS), 162 (24.5%) were considered incontinent after RP, and 45 (33.1%) of them reported LUTS before surgery. Postprostatectomy urinary incontinence (PPUI) was significantly different in patients with LUTS (117 [22.3%] vs. 45 [33.1%], P=0.009). The presence of any LUTS influence significantly in the appearance of PPUI (OR=1.72 [95% CI: 1.14-2.6), P=0.01). TURP is independently influential in PPUI (OR=6.13 [95% CI: 1.86-20.18], P=0.003). A patient with LUTS before surgery has an increased risk of 70% or even 200% to suffer PPUI and a patient who received treatment by TURP is 6 times at higher risk of PPUI. In conclusion, patients with LUTS are likely to present PPUI. History of TURP is influential by itself over PPUI. A good preoperative consultation is important to assess continence status and to create realistic expectations to patients before RP.

  3. Urinary TIMP2·IGFBP7 for the prediction of platinum-induced acute renal injury

    Directory of Open Access Journals (Sweden)

    Schanz M

    2017-06-01

    Full Text Available Moritz Schanz,1 Anette Hoferer,2 Jing Shi,3 Mark Dominik Alscher,1 Martin Kimmel1 1Division of General Internal Medicine and Nephrology, Department of Internal Medicine, 2Division of Oncology, Department of Internal Medicine, Robert-Bosch Hospital, Stuttgart, Germany; 3Walker Bioscience, Carlsbad, CA, USA Introduction: Platinum-based chemotherapy (PBC is a potent antineoplastic treatment, but cisplatin nephrotoxicity is often the limiting factor. Identifying the patients who are at risk for developing platinum-induced renal injury is an important issue. We tested urinary TIMP2·IGFBP7, a new US Food and Drug Administration (FDA-cleared test to assess the risk of acute kidney injury (AKI, in a cohort of patients with malignant neoplastic disease receiving PBC.Patients and methods: A total of 58 patients with malignant neoplastic disease were enrolled in this study, of whom 32 patients had both urine samples and subsequent serum creatinine values available for detecting AKI within 72 hours. Urine samples were collected within 6 hours prior to PBC application and within 12 hours after the end of chemotherapy administration. We examined the predictive ability of TIMP2·IGFBP7 for the development of AKI as defined by KDIGO (Kidney Disease: Improving Global Outcomes criteria within 72 hours after the administration of chemotherapy. Operating characteristics were determined for the previously validated TIMP2·IGFBP7 cutoff of 0.3 (ng/mL2/1000.Results: Four (12.5% patients developed AKI within 72 hours. Primary disease was lymphoma in 13 patients (40.6% and solid tumors in 19 patients (59.4%. Eight patients (25.0% received carboplatin and 24 (75.0% cisplatin. TIMP2·IGFBP7 after PBC administration discriminated for the risk of AKI with an area under the receiver operating characteristic curve (AUC; 95% confidence interval of 0.92 (0.80–1.00. At the cutoff of 0.3 for TIMP2·IGFBP7, sensitivity was 50%, specificity was 87%, negative predictive

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Risk of stroke in first-ever acute urinary retention: A 10-year population-based study

    Directory of Open Access Journals (Sweden)

    Chih-Shou Chen

    2016-06-01

    Conclusion: There was significant difference in the risk of stroke between patients with and without AUR. Preventive measures should be taken for patients with AUR, which may be associated with an increased risk of subsequent stroke. Large-scale population-based studies in other countries and regions are recommended.

  6. [Urinary incontinence in degenerative spinal disease].

    Science.gov (United States)

    De Riggo, J; Benčo, M; Kolarovszki, B; Lupták, J; Svihra, J

    2011-01-01

    The aim of the study was to evaluate the presence of urinary incontinence in patients with chronic degenerative spinal disease and to identify factors affecting the occurrence and changes in urinary incontinence after surgery. The group evaluated comprised 214 patients undergoing surgery for degenerative spinal disease at our department between January 1 and December 31, 2008. The patients were categorised according to the type of their degenerative disease (cervical disc herniation, lumbar disc herniation, spinal stenosis, spinal instability or olisthesis) and the spine level involved (cervical or lumbar spine). The symptoms of urinary incontinence included leakage of urine and non-obstructive chronic urinary retention developing in association with the manifestation of vertebrogenic disorder. Patients with diseases known to increase the risk of incontinence were not included in the study. Based on a retrospective analysis of the patients' clinical notes, the occurrence of urinary incontinence in each type of degenerative spinal disease was assessed. The effect of gender, age, body mass index (BMI), neurological status and spinal disease type on the development of incontinence was statistically evaluated. The efficacy of surgical treatment was assessed on the basis of the patients' subjective complaints at the first follow-up one month after surgery. The data were evaluated by the statistical programme InSTAT (analysis of variance ANOVA, t-test). All tests were two-sided; a 0.05 level of statistical significance was used. Of the 214 patients with degenerative spinal disease, 27 (12.6%) had urinary incontinence. A higher risk of developing incontinence was found in women (p = 0.008) and in patients with radicular weakness (p = 0.023). The patients with urinary incontinence had their BMI significantly lower than patients without this disorder (p = 0.019). Age had no effect. The differences in the occurrence of urinary incontinence amongst the different types of

  7. Urinary Metabolite Profiles May be Predictive of Cognitive Performance Under Conditions of Acute Sleep Deprivation

    Science.gov (United States)

    2016-01-01

    Cognitive Performance Under Conditions of Acute Sleep Deprivation 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER Nicholas J...cognitive assessments as having a high tolerance (n=6) or low tolerance (n=6) to sleep deprivation could be classified separately with statistical...at early (0-12h) and late (28h) times during the 36-h sleep deprivation period. Man of these metabolites (11 of 20) appeared to be associated with

  8. [Clinical analysis of 41 children's urinary calculus and acute renal failure].

    Science.gov (United States)

    Li, Lu-Ping; Fan, Ying-Zhong; Zhang, Qian; Zhang, Sheng-Li

    2013-04-01

    To analyze the treatment of acute renal failure caused by irrational drug use. Data of 41 cases of acute renal failure seen from July 2008 to June 2012 in our hospital were reviewed. Bilateral renal parenchymas diffuse echo was found enhanced by ultrasound in all cases. Calculus image was not found by X-ray. All children had medical history of using cephalosporins or others. Alkalinization of urine and antispasmodic treatment were given to all children immediately, 17 children were treated with hemodialysis and 4 children accepted intraureteral cannula placement. In 24 children who accepted alkalinization of urine and antispasmodic treatment micturition could be restored within 24 hours, in 11 children micturition recovered after only one hemodialysis treatment and 2 children gradually restored micturition after hemodialysis twice, 4 children who accepted intraureteral cannula immediately restored micturition. In all children micturition recovered gradually after a week of treatment. Ultrasound examination showed that 39 children's calculus disappeared totally and renal parenchymas echo recovered to normal. The residual calculi with diameter less than 5 mm were found in 2 children, but they had no symptoms. The children received potassium sodium hydrogen citrate granules per os and were discharged from hospital. Ultrasound showed calculus disappeared totally one month later. Irrational drug use can cause children urolithiasis combined with acute renal failure, while renal dysfunction can reverse by drug withdrawal and early alkalinization of urine, antispasmodic treatment, intraureteral cannula or hemodialysis when necessary, most calculus can be expelled after micturition recovered to normal.

  9. Imperforate hymen complicated by obstructive acute renal failure ...

    African Journals Online (AJOL)

    Imperforate hymen is a rare malformation (1/ 1000 female births). It is diagnosed most often during puberty. Early diagnosis of hematocolpos and evacuation is necessary to avoid any consequences. We report a rare case of an imperforate hymen complicated with acute urinary retention, hydronephrosis and renal failure in ...

  10. The ischemic/nephrotoxic acute kidney injury and the use of renal biomarkers in clinical practice.

    Science.gov (United States)

    Andreucci, Michele; Faga, Teresa; Pisani, Antonio; Perticone, Maria; Michael, Ashour

    2017-04-01

    The term Acute Renal Failure (ARF) has been replaced by the term Acute Kidney Injury (AKI). AKI indicates an abrupt (within 24-48h) decrease in Glomerular Filtraton Rate, due to renal damage, that causes fluid and metabolic waste retention and alteration of electrolyte and acid-base balance. The renal biomarkers of AKI are substances or processes that are indicators of normal or impaired function of the kidney. The most used renal biomarker is still serum creatinine that is inadequate for several reasons, one of which is its inability to differentiate between hemodynamic changes of renal function ("prerenal azotemia") from intrinsic renal failure or obstructive nephropathy. Cystatin C is no better in this respect. After the description of the pathophysiology of "prerenal azotemia" and of Acute Kidney Injury (AKI) due to ischemia or nephrotoxicity, the renal biomarkers are listed and described: urinary NAG, urinary and serum KIM-1, serum and urinary NGAL, urinary IL-18, urinary L-FABP, serum Midkine, urinary IGFBP7 and TIMP2, urinary α-GST and π-GST, urinary ɣGT and AP, urinary β 2 M, urinary RBP, serum and urinary miRNA. All have been shown to appear much earlier than the rise of serum Creatinine. Some of them have been demonstrated to predict the clinical outcomes of AKI, such as the need for initiation of dialysis and mortality. Copyright © 2016. Published by Elsevier B.V.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Urinary apolipoprotein M as a biomarker of acute kidney injury in children undergoing heart surgery

    DEFF Research Database (Denmark)

    Svarrer, Eva Martha Madsen; Andersen, Henrik Ørbæk; Helvind, Morten

    2016-01-01

    AIM: To investigate whether apoM is excreted in urine of children undergoing heart surgery and the potential of apoM as early biomarker of acute kidney injury (AKI). MATERIALS & METHODS: Urine was collected in children undergoing heart surgery. ApoM was measured with ELISA. U-apoM was characterized.......018). Sensitivity was 0.71 and specificity was 0.68 at a cutoff level at 1.45 nmol/l. CONCLUSION: ApoM is excreted in the urine of children after cardiac surgery. Its potential as biomarker of AKI deserves exploration....

  13. Urinary composition and postprandial blood changes in H-secoisolariciresinol diglycoside (SDG) metabolites in rats do not differ between acute and chronic SDG treatments.

    Science.gov (United States)

    Rickard, S E; Thompson, L U

    2000-09-01

    Although chronic exposure to secoisolariciresinol diglycoside (SDG) was shown to alter (3)H-SDG metabolite disposition in rats, the proportion of measured radioactivity attributed to known or unknown SDG metabolites was not determined. Using HPLC and GC-MS, two experiments were conducted to determine the effect of acute (1 d) vs. chronic (10 d) SDG treatment on major urinary metabolites of (3)H-SDG in female, Sprague-Dawley rats (70-72-d-old) over a 48-h period and if new urinary metabolites were detectable in rats fed nonradioactive flaxseed or SDG. A third experiment was conducted to determine changes in postprandial blood levels of (3)H-SDG metabolites over a 24-h period with acute or chronic SDG treatment. Regardless of treatment, enterodiol, enterolactone and secoisolariciresinol accounted for 75-80% of urine radioactivity. Four potential new lignan metabolites, two of which were detected in the urine of rats fed nonradioactive flaxseed or SDG, were found. Type of treatment had no effect on levels of individual urinary metabolites of (3)H-SDG. As observed for plasma lignans in women fed flaxseed, blood radioactivity peaked at 9 h and remained high until 24 h in both treatment groups, suggesting that blood lignan kinetics might be similar with flaxseed or SDG consumption and that they were comparable between humans and rats. In conclusion, the main urinary lignan metabolites were enterodiol, enterolactone and secoisolariciresinol. Urinary composition or blood levels of radioactive lignans were not affected by the duration of SDG exposure. Thus, while chronic SDG exposure alters lignan disposition in rats, it does not change the metabolite profile.

  14. Effective strategies for nurse retention in acute hospitals: a mixed method study.

    Science.gov (United States)

    Van den Heede, Koen; Florquin, Mieke; Bruyneel, Luk; Aiken, Linda; Diya, Luwis; Lesaffre, Emmanuel; Sermeus, Walter

    2013-02-01

    The realization of an organizational context that succeeds to retain nurses within their job is one of the most effective strategies of dealing with nursing shortages. First, to examine the impact of nursing practice environments, nurse staffing and nurse education on nurse reported intention to leave the hospital. Second, to provide understanding of which best practices in the organization of nursing care are being implemented to provide sound practice environments and to retain nurses. 3186 bedside nurses of 272 randomly selected nursing units in 56 Belgian acute hospitals were surveyed. A GEE logistic regression analysis was used to estimate the impact of organization of nursing care on nurse reported intention to leave controlling for differences in region (Walloon, Flanders, and Brussels), hospital characteristics (technology level, teaching status, and size) and nurse characteristics (experience, gender, and age). For the second objective, in-depth semi-structured interviews with the chief nursing officers of the three high and three low performing hospitals on reported intention to leave were held. 29.5% of Belgian nurses have an intention-to-leave the hospital. Patient-to-nurse staffing ratios and nurse work environments are significantly (pretention were--in contrast to the low performing hospitals--characterized by a flat organization structure with a participative management style, structured education programs and career opportunities for nurses. This study, together with the international body of evidence, suggests that investing in improved nursing work environments is a key strategy to retain nurses. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Sayani, Raza; Ali, Muhammad; Shazlee, Kashif; Hamid, Rana Shoaib; Hamid, Kamran

    2012-01-01

    To determine the role of duplex Doppler ultrasonography (DDU) in patients with acute unilateral renal obstruction. 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. 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 IVU as the standard imaging technique.

  16. Acute Kidney Injury and Urinary Biomarkers in Human Immunodeficiency Virus-Associated Cryptococcal Meningitis.

    Science.gov (United States)

    Schutz, Charlotte; Boulware, David R; Huppler-Hullsiek, Katherine; von Hohenberg, Maximilian; Rhein, Joshua; Taseera, Kabanda; Thienemann, Friedrich; Muzoora, Conrad; Meya, David B; Meintjes, Graeme

    2017-01-01

    Cryptococcus is the most common etiology of adult meningitis in Africa. Amphotericin B deoxycholate remains paramount to treatment, despite toxicities, including acute kidney injury (AKI). We assessed the ability of the following urine markers to predict AKI in patients who received amphotericin B: urine neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (CysC), tissue inhibitor of metalloproteinases-2 (TIMP-2), and protein. One hundred and thirty human immunodeficiency virus (HIV)-infected participants with cryptococcal meningitis were enrolled and received amphotericin and fluconazole for 2 weeks. We defined AKI as glomerular filtration rate (GFR) < 60 mL/min/1.73 m 2 ; measured urine NGAL, CysC, TIMP-2, and protein; and explored AKI incidence, risk factors, and associations with mortality using Cox proportional hazards models. Participants were 48% female with a median age of 35 years, a median CD4 count of 21 cells/μL, and 44% died within 12 months. Incident AKI occurred in 42% and was associated with mortality (adjusted hazard ratio [aHR] = 2.8; P < .001). Development of AKI was associated with female sex ( P = .04) and with higher CD4 count (49 vs 14 cells/μL; P < .01). Urine protein level in the highest quartile independently predicted AKI and mortality (aHR = 1.64, P = .04; aHR = 2.13, P = .02, respectively). Urine NGAL levels in the highest quartile independently predicted AKI (aHR = 1.65; P = .04). Acute kidney injury occurred in 42% of patients, and AKI was associated with mortality. Urine biomarkers, specifically urine protein, may be useful for antecedent prediction of amphotericin-associated AKI but need further evaluation.

  17. Acute Delayed or Late Infection of Revision Total Hip Arthroplasty Treated with Debridement/Antibiotic-loaded Cement Beads and Retention of the Prosthesis

    OpenAIRE

    Chang, Jun-Dong; Kim, In-Sung; Lee, Sang-Soo; Yoo, Je-Hyun

    2017-01-01

    Purpose The treatment of infected revision total hip arthroplasty (THA) is very challenging due to retained revision prosthesis, poor bone stock and soft tissue condition derived from previous revision surgeries, and comorbidities. The purpose of this study was to investigate the effectiveness and short-term outcomes of aggressive debridement and use of antibiotic-loaded cement beads with retention of the prosthesis for acute delayed or late infection of revision THAs. Materials and Methods T...

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

    Directory of Open Access Journals (Sweden)

    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

  19. Urinary tract effects after multifocal nonthermal irreversible electroporation of the kidney: acute and chronic monitoring by magnetic resonance imaging, intravenous urography and urinary cytology.

    Science.gov (United States)

    Wendler, Johann Jakob; Pech, Maciej; Porsch, Markus; Janitzky, Andreas; Fischbach, Frank; Buhtz, Peter; Vogler, Klaus; Hühne, Sarah; Borucki, Katrin; Strang, Christof; Mahnkopf, Dirk; Ricke, Jens; Liehr, Uwe-Bernd

    2012-08-01

    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). 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. 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. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  1. Can Computed Tomography Scout Radiography Replace Plain Film in the Evaluation of Patients with Acute Urinary Tract Colic?

    Energy Technology Data Exchange (ETDEWEB)

    Ege, G.; Akman, H.; Kuzucu, K.; Yildiz, S. [Istanbul International Hospital, Istanbul (Turkey). Dept. of Radiology

    2004-07-01

    Purpose: To determine the sensitivity of computed tomography (CT) scout view in detecting ureteral stones and whether CT scout radiography can replace plain film in the evaluation of patients with acute urinary tract colic. Material and Methods: Between January 2000 and 2002, 110 patients with ureterolithiasis were prospectively evaluated for the detection of ureteral stones on CT scout radiographs. The findings were compared with those of plain films. All patients were examined with plain film, CT scout radiography, and unenhanced helical CT. CT scans were performed within 24 h of plain films. Each CT scout radiograph was interpreted without knowledge of the findings on plain film. Results: 111 stones were detected by unenhanced helical CT. Mean stone size was 3.9 mm (range 1-10 mm). Of all stones, 57 (52%) were visible on plain film; 44 (40%) were seen on CT radiographs. The sensitivity of 79 small stones (<5 mm) on CT scout radiography was 29% and of abdominal radiography 37%. For 32 big stones (>5 mm), the sensitivity of CT scout radiography was 66% and of abdominal radiography 87.5%. Conclusion: In this study, plain film was more sensitive than CT scout radiography in revealing ureteral calculi. However, the detection of stones 5 mm or larger had a sensitivity of 66% on CT scout radiographs; 77% (44/57) of the stones visible on plain films were also seen on CT scout radiographs. We therefore believe that CT scout radiography can be used as a baseline study in most patients with big ureteral stones.

  2. Prevalence of Concomitant Acute Bacterial Meningitis in Neonates with Febrile Urinary Tract Infection: A Retrospective Cross-Sectional Study.

    Science.gov (United States)

    Wallace, Sowdhamini S; Brown, Danielle N; Cruz, Andrea T

    2017-05-01

    To describe the frequency of concomitant acute bacterial meningitis (ABM) in neonates with febrile urinary tract infection (UTI). This was a retrospective cross-sectional study from 2005 to 2013 of infants ≤30 days old evaluated in the emergency department of a quaternary care children's hospital with fever and laboratory-confirmed UTI. Definite ABM was defined as cerebrospinal fluid (CSF) culture with growth of pathogenic bacteria and probable ABM if pleocytosis with ≥ 20 white blood cell was present in an antibiotic-pretreated patient. The timing of lumbar puncture and first antibiotic dose was recorded to assess for antibiotic pretreatment. A total of 236 neonates with UTI were included. Mean age was 18.6 days (SD 6.2); 79% were male infants. Twenty-three (9.7%) had bacteremia. Fourteen (6%) were pretreated. No neonate (0%; 95% CI 0%-1.6%) had definite ABM and 2 (0.8%; 95% CI 0.1%-3.0%) neonates with bloody CSF had probable ABM. CSF white blood cell count was 25 and 183 for these 2 infants, and CSF red blood cell count was 3100 and 61 932, respectively. Another neonate had herpes simplex virus meningoencephalitis. The frequency of ABM in neonates with febrile UTI is low. Further prospective studies are needed to evaluate the safety of a tiered approach to evaluate for serious bacterial infection, in which lumbar puncture potentially could be avoided in well-appearing febrile neonates with suspected UTI. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Retention and Functional Effect of Adipose-Derived Stromal Cells Administered in Alginate Hydrogel in a Rat Model of Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Bjarke Follin

    2018-01-01

    Full Text Available Background. Cell therapy for heart disease has been proven safe and efficacious, despite poor cell retention in the injected area. Improving cell retention is hypothesized to increase the treatment effect. In the present study, human adipose-derived stromal cells (ASCs were delivered in an in situ forming alginate hydrogel following acute myocardial infarction (AMI in rats. Methods. ASCs were transduced with luciferase and tested for ASC phenotype. AMI was inducted in nude rats, with subsequent injection of saline (controls, 1 × 106 ASCs in saline or 1 × 106 ASCs in 1% (w/v alginate hydrogel. ASCs were tracked by bioluminescence and functional measurements were assessed by magnetic resonance imaging (MRI and 82rubidium positron emission tomography (PET. Results. ASCs in both saline and alginate hydrogel significantly increased the ejection fraction (7.2% and 7.8% at 14 days and 7.2% and 8.0% at 28 days, resp.. After 28 days, there was a tendency for decreased infarct area and increased perfusion, compared to controls. No significant differences were observed between ASCs in saline or alginate hydrogel, in terms of retention and functional salvage. Conclusion. ASCs improved the myocardial function after AMI, but administration in the alginate hydrogel did not further improve retention of the cells or myocardial function.

  4. Both absolute and relative quantification of urinary mRNA are useful for non-invasive diagnosis of acute kidney allograft rejection.

    Directory of Open Access Journals (Sweden)

    Jung-Woo Seo

    Full Text Available Urinary mRNA analysis with three-gene set (18S rRNA, CD3ε, and IP-10 has been suggested as a non-invasive biomarker of acute rejection (AR in kidney transplant recipients using quantitative real-time PCR (qPCR. Application of droplet digital PCR (ddPCR, which has been suggested to provide higher sensitivity, accuracy, and absolute quantification without standard curves, could be a useful method for the quantifying low concentration of urinary mRNA. We investigated the urinary expression of these three genes in Korean patients with kidney transplantation and also evaluated the usefulness of ddPCR. 90 urine samples were collected at time of allograft biopsy in kidney recipients (n = 67 and from patients with stable renal function more than 10 years (n = 23. Absolute quantification with both PCR system showed significant higher mRNA levels of CD3ε and IP-10 in AR patients compared with stable transplants (STA, but there was no difference in 18S rRNA expression across the patient groups. To evaluate discrimination between AR and STA, ROC curve analyses of CTOT-4 formula yielded area under the curve values of 0.72 (95% CI 0.60-0.83 and 0.77 (95% CI 0.66-0.88 for qPCR and ddPCR, respectively. However, 18S normalization of absolute quantification and relative quantification with 18S showed better discrimination of AR from STA than those of the absolute method. Our data indicate that ddPCR system without standard curve would be useful to determine the absolute quantification of urinary mRNA from kidney transplant recipients. However, comparative method also could be useful and convenient in both qPCR and ddPCR analysis.

  5. Urinary biomarker incorporation into the renal angina index early in intensive care unit admission optimizes acute kidney injury prediction in critically ill children: a prospective cohort study.

    Science.gov (United States)

    Menon, Shina; Goldstein, Stuart L; Mottes, Theresa; Fei, Lin; Kaddourah, Ahmad; Terrell, Tara; Arnold, Patricia; Bennett, Michael R; Basu, Rajit K

    2016-04-01

    The inconsistent ability of novel biomarkers to predict acute kidney injury (AKI) across heterogeneous patients and illnesses limits integration into routine practice. We previously retrospectively validated the ability of the renal angina index (RAI) to risk-stratify patients and provide context for confirmatory serum biomarker testing for the prediction of severe AKI. We conducted this first prospective study of renal angina to determine whether the RAI on the day of admission (Day0) risk-stratified critically ill children for 'persistent, severe AKI' on Day 3 (Day3-AKI: KDIGO Stage 2-3) and whether incorporation of urinary biomarkers in the RAI model optimized AKI prediction. A total of 184 consecutive patients (52.7% male) were included. Day0 renal angina was present (RAI ≥8) in 60 (32.6%) patients and was associated with longer duration of mechanical ventilation (P = 0.04), higher number of organ failure days (P = 0.003) and increased mortality (P renal angina. Day3-AKI was present in 15/156 (9.6%) patients; 12/15 (80%) fulfilled Day0 renal angina. Incorporation of urinary biomarkers into the RAI model increased the specificity and positive likelihood, and demonstrated net reclassification improvement (P < 0.001) for the prediction of Day3-AKI. Inclusion of urinary neutrophil gelatinase-associated lipocalin increased the area under the curve receiver-operating characteristic of RAI for Day3-AKI from 0.80 [95% confidence interval (CI): 0.58, 1.00] to 0.97 (95% CI: 0.93, 1.00). We have now prospectively validated the RAI as a functional risk stratification methodology in a heterogeneous group of critically ill patients, providing context to direct measurement of novel urinary biomarkers and improving the prediction of severe persistent AKI. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

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

    LENUS (Irish Health Repository)

    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

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

    DEFF Research Database (Denmark)

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

    1998-01-01

    was independent of blood pressure, body weight, smoking, diabetes mellitus, renal disease, and thrombolytic treatment. There was a positive correlation between urinary albumin excretion and thickness of the left ventricle wall (R = 0.28; p = 0.001) which was independent of blood pressure. Follow-up examination...

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

    NARCIS (Netherlands)

    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

  9. Elevated Urinary Methylmalonic Acid/creatinine ratio and Serum Sterol levels in Patients with Acute Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Sivrikaya Abdullah

    2018-01-01

    Full Text Available Introduction: Sitosterolemia, defined as phytosterolemia, is a rare autosomal recessive disease characterized by elevated blood sterol levels. Our aim was to investigate serum plant sterols, methylmalonic acid, vitamin B12, oxidized-LDL and homocysteine levels in ischemic and hemorrhagic stroke patients and healthy subjects. Material and Methods: 50 healthy subjects (without a family history of coronary artery disease and 89 patients hospitalized in the Selcuk University neurology clinic or intensive care unit with a diagnosis of stroke were included in this study. Serum plant sterols, homocysteine and methylmalonic acid, oxidized-LDL, total cholesterol, triglycerides, HDL-Cholesterol and vitamin B12 levels were analyzed by gas chromatography-mass spectrometry, liquid-chromatography tandem mass spectrometry, commercially available ELISA kit, spectrophotometry and chemiluminescence methods, respectively. Results: Urinary methylmalonic acid/creatinine ratio (p< 0.05, serum β-sitosterol levels and β-sitosterol/ cholesterol ratio were significantly higher (p <0.01 in patients compared to the control group. There was a significant positive correlation between the serum OxLDL- methylmalonic acid, serum homocysteine- urinary methylmalonic acid /creatinine ratio, serum methylmalonic acid - Urinary methylmalonic acid (p<0.05, serum homocysteine- urinary methylmalonic acid, urinary methylmalonic acid-methylmalonic acid/creatinine ratio, serum methylmalonic acid- methylmalonic acid/creatinine ratio, serum beta-sitosterol- beta-sitosterol /cholesterol, total cholesterol-HDL, total cholesterol-LDL (p <0.01 levels and negative correlation between vitamin B12- serum methylmalonic acid (p<0.05, cholesterol-stigmasterol/cholesterol, LDL- stigmasterol/cholesterol (p <0.01 levels in the patient group. Conclusion: Our findings presented that the serum sitosterol levels were significantly higher in stroke patients compared to controls.

  10. Sinusoidal 50 Hz, 500 {micro}T magnetic field has no acute effect on urinary 6-sulphatoxymelatonin in Wistar rats

    Energy Technology Data Exchange (ETDEWEB)

    Bakos, J.; Nagy, N.; Thuroczy, G.; Szabo, L.D. [National Frederic Joliot-Curie Research Inst. for Radiobiology and Radiohygiene, Budapest (Hungary)

    1995-12-31

    The effect of a 50 Hz, vertical magnetic field on the excretion of urinary 6-sulphatoxymelatonin (aMT6s) of male and female Wistar rats was studied in a self-controlled experiment. Twenty rats were kept in metabolic cages under 9:15 h light:dark conditions. The urine of the animals was collected twice per day for 5 consecutive days. The concentration of aMT6s in the rat urine was measured by {sup 125}I radioimmunoassay. The rats were exposed to 5 and 500 {micro}T flux density for 24 h. The excretion of urinary aMT6s did not show significant changes during or after magnetic field exposure.

  11. Urinary Neutrophil Gelatinase–Associated Lipocalin (NGAL Distinguishes Sustained From Transient Acute Kidney Injury After General Surgery

    Directory of Open Access Journals (Sweden)

    Valerie Au

    2016-05-01

    Discussion: Urinary NGAL levels measured 2 to 3 hours after surgery were able to distinguish the kinetics of creatinine (sustained AKI vs. transient AKI over the subsequent week. Transient AKI is an easily reversible state that is likely not associated with substantial tubular injury and therefore NGAL release. Using AKIN criteria, both transient and sustained AKI are classified as AKI even though our data demonstrate that they are possibly different entities.

  12. Laser-induced synlabia, cryptomenorrhea, and urine retention: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Thoraya Fadul-Elahi

    2017-01-01

    Full Text Available Cosmetic laser use has many pros and cons. The worldwide use of laser for body hair removal has led to many medical complications. Unsupervised use of the laser for hair removal in vulva may result in many problems and can merely damage the vulva, although rarely, affecting the body image. This rare and novel case report is a 21 year old virgin who presented with acute urinary retention and cryptomenorrhea due to complete synlabia secondary to unsupervised vulval laser hair removal. The urinary retention was relieved by suprapubic catheterization initially. During examination under anesthesia, the fused labia were separated by a surgical incision with drainage of hematocolpos and then, a Foley's urethral catheter was inserted. She had an uneventful recovery. We report this case to emphasize on the supervised use of laser by trained and qualified personnel for hair removal in vulva to minimize its complications.

  13. Urinary tract infections in women

    African Journals Online (AJOL)

    Urinary tract infections (UTIs) are common bacterial infections in women, with half of all women experiencing at least one in their lifetime.1 Of the women affected, 25-30% develop recurrent infections unrelated to any functional or anatomical abnormality of the urinary tract.2 Most UTIs in women are episodes of acute.

  14. [Urinary tract dysfunction in older patients].

    Science.gov (United States)

    Verdejo, Carlos; Méndez, Santiago; Salinas, Jesús

    2016-11-18

    Urinary tract dysfunction in older patients has a multifactorial aetiology and is not a uniform clinical condition. Changes due to physiological ageing as well as comorbidity and polypharmacy, can produce several dynamic conditions such as urinary incontinence and urinary retention. Lower urinary tract symptoms increase with age in both sexes and are a major problem in older patients due to their medical and psychosocial consequences. For these reasons, in assessing urinary dysfunction in older patients, we should consider external circumstances such as polypharmacy, poor mobility, affective and cognitive disorders and also accessibility to housing. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  15. Choreito, a formula from Japanese traditional medicine (Kampo medicine), for massive hemorrhagic cystitis and clot retention in a pediatric patient with refractory acute lymphoblastic leukemia.

    Science.gov (United States)

    Kawashima, Nozomu; Deveaux, Teykia E; Yoshida, Nao; Matsumoto, Kimikazu; Kato, Koji

    2012-09-15

    Hemorrhagic cystitis is critical in patients with hemato-oncological disorders. Unlike adult patients, there are limited modalities and invasive procedures are often not well tolerated in children with poor general conditions. We report a pediatric patient with refractory acute lymphoblastic leukemia who developed life-threatening massive gross hematuria. Along with platelet infusion every other day due to suppressed hematopoiesis, his gross hematuria and clot retention in the bladder were successfully treated with choreito, a formula from Japanese traditional medicine (Kampo medicine). He survived free from hematuria for more than four months. Choreito was well tolerated, and no adverse effects were observed throughout the course. Copyright © 2012 Elsevier GmbH. All rights reserved.

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

    DEFF Research Database (Denmark)

    Bredsdorff, Lea; Obel, Tina; Dethlefsen, Claus

    2013-01-01

    with ACS were identified and matched to 393 noncases by using incidence density sampling. For kaempferol, most of the individual ORs were statistically significant and from 42% to 61% lower when the higher 4 quintiles were compared with the lowest quintile. The P-trend was not significant. For daidzein......, individual ORs were 5–38% lower. None of the individual ORs were significant, but the P-trend was 0.041. For the remaining flavonoids, there were no significant relations between urinary excretion and risk of ACS. Conclusions: Except for kaempferol and daidzein, there were no significant associations between...

  17. Urinary Incontinence

    Science.gov (United States)

    ... Carpal tunnel syndrome Depression Irritable bowel syndrome Migraine Thyroid disease Urinary tract infections All A-Z health topics ... Carpal tunnel syndrome Depression Irritable bowel syndrome Migraine Thyroid disease Urinary tract infections All A-Z health topics ...

  18. Urinary Incontinence

    Science.gov (United States)

    ... in bladder control, causing urinary incontinence. Risk factors Factors that increase your risk of developing urinary incontinence include: Gender. Women are more likely to have stress incontinence. Pregnancy, childbirth, menopause and normal female anatomy account for ...

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  20. D-dimer as a marker of acute pyelonephritis in infants younger than 24 months with urinary tract infection.

    Science.gov (United States)

    Lee, Jung Won; Her, Sun Mi; Kim, Ji Hong; Lee, Keum Hwa; Eisenhut, Michael; Park, Se Jin; Shin, Jae Il

    2018-01-06

    D-dimer, as well as other biomarkers related to coagulation, is significantly increased during severe bacterial infection and sepsis. The aim of this study was to evaluate the usefulness of serum D-dimer as a biological marker in diagnosing acute pyelonephritis (APN) and in predicting vesicoureteric reflux (VUR) in infants with urinary tract infection (UTI). We retrospectively analyzed the data of 177 young infants (D-dimer were measured. The WBC counts (P = 0.002), ESR (P P D-dimer levels (P = 0.006) and the presence of VUR (P D-dimer (odds ratio [OR]:1.003, 95% CI: 1.001-1.006, P = 0.002) was an independent predictive factor for VUR in young children with UTI. The area under the curve (AUC) value from the receiver operating characteristic (ROC) curve of D-dimer (0.621, P = 0.046, 95% CI: 0.499-0.743) for prediction of VUR was higher than other inflammatory markers, but was inferior to CRP in predicting APN. Our results demonstrate that D-dimer can be used as an inflammatory marker in infants with febrile UTI in addition to other inflammatory markers.

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

    Energy Technology Data Exchange (ETDEWEB)

    Brader, Peter; Riccabona, Michael [Medical University Graz, Division of Pediatric Radiology, Department of Radiology, Graz (Austria); Schwarz, Thomas [Medical University Graz, Division of Nuclear Medicine, Department of Radiology, Graz (Austria); Seebacher, Ursula [Medical University Graz, Department of Pediatric Surgery, Graz (Austria); Ring, Ekkehard [Medical University Graz, Department of Pediatrics, Graz (Austria)

    2008-12-15

    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) {sup 99m}Tc 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.)

  2. Urinary Bladder Problems in Parkinson's disease

    OpenAIRE

    Jesudasan, Ajantha

    2012-01-01

    Ajantha Jesudasan, Mohammed A. Rana Parkinson’s Clinic of Eastern Toronto, Toronto, Canada Prevalence of lower urinary tract symptoms (LUTS) in Parkinson’s disease (PD) patients is reported to range from 38% to 71%.1 Common symptoms include nocturia, urinary urgency, incomplete bladder emptying and urinary retention. These symptoms may also be caused by urinary tract infection, prostatic hypertrophy, diabetes mellitus or medications used for other medical conditions.

  3. Prognostic Factors Associated with Recovery of Ambulation and Urinary Continence in Dogs with Acute Lumbosacral Spinal Cord Injury.

    Science.gov (United States)

    Shaw, T A; De Risio, L; Laws, E J; Rose, J H; Harcourt-Brown, T R; Granger, N

    2017-05-01

    Limited information is available about prognostic factors for recovery after spinal cord injury (SCI) to the L4-S3 segments. Previous research suggests that L4-S3 SCI does not have a worse prognosis than T3-L3 SCI. To elucidate prognostic factors for regaining urinary continence and ambulation in dogs with L4-S3 SCI and compare prognosis to T3-L3 SCI. A retrospective study on 61 nonambulatory dogs with L4-S3 SCI, matched to dogs with T3-L3 SCI, compared 3 weeks after onset. Prognostic factors explored using logistic regression and used for matching: nonchondrodystrophic dogs >15 kg versus dogs that were chondrodystrophic or dogs regained continence compared to T3-L3 dogs (64 vs 85%, P = .0033), but no difference existed for regaining ambulation (66 vs 75%, P = .1306). In L4-S3 SCI dogs, fewer dogs regained continence with loss of CPP (P Dogs with L4-S3 SCI have a poorer short-term prognosis than do dogs with T3-L3 SCI. Dogs with L4-S3 SCI had a poor prognosis with loss of CPP, or noncompressive lesions combined with LMN incontinence. Small-breed or chondrodystrophic dogs with retained CPP, compressive lesions, and UMN incontinence had an excellent prognosis. These findings may help guide decision-making in L4-S3 SCI. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

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

    International Nuclear Information System (INIS)

    Ishida, Yoshio; Hirose, Yoshiaki; Maeno, Masakazu

    1995-01-01

    To characterize regional cardiac sympathetic dysfunction due to myocardial ischemia, we examined 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 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)

  5. Urinary incontinence

    Science.gov (United States)

    Loss of bladder control; Uncontrollable urination; Urination - uncontrollable; Incontinence - urinary ... Karram MM, eds. Atlas of Pelvic Anatomy and Gynecologic Surgery . 4th ed. Philadelphia, PA: Elsevier; 2016:chap ...

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

    International Nuclear Information System (INIS)

    Moon, Seong Won; Lim, Gye Yeon; Jang, Hae Suk; Lee, Eun Ja; Sohn, Hyung Sun; Hahn, Sung Tae

    2000-01-01

    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 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 significantly related to age

  7. IL-35 mitigates murine acute graft-versus-host disease with retention of graft-versus-leukemia effects.

    Science.gov (United States)

    Liu, Y; Wu, Y; Wang, Y; Cai, Y; Hu, B; Bao, G; Fang, H; Zhao, L; Ma, S; Cheng, Q; Song, Y; Liu, Y; Zhu, Z; Chang, H; Yu, X; Sun, A; Zhang, Y; Vignali, D A A; Wu, D; Liu, H

    2015-04-01

    IL-35 is a newly discovered inhibitory cytokine secreted by regulatory T cells (Tregs) and may have therapeutic potential in several inflammatory disorders. Acute graft-versus-host disease (aGVHD) is a major complication of allogeneic hematopoietic stem cell transplantation and caused by donor T cells and inflammatory cytokines. The role of IL-35 in aGVHD is still unknown. Here we demonstrate that IL-35 overexpression suppresses CD4(+) effector T-cell activation, leading to a reduction in alloreactive T-cell responses and aGVHD severity. It also leads to the expansion of CD4(+)Foxp3(+) Tregs in the aGVHD target organs. Furthermore, IL-35 overexpression results in a selective decrease in the frequency of Th1 cells and an increase of IL-10-producing CD4(+) T cells in aGVHD target tissues. Serum levels of TNF-α, IFN-γ, IL-6, IL-22 and IL-23 decrease and IL-10 increases in response to IL-35. Most importantly, IL-35 preserves graft-versus-leukemia effect. Finally, aGVHD grade 2-4 patients have decreased serum IL-35 levels comparing with time-matched patients with aGVHD grade 0-1. Our findings indicate that IL-35 has an important role in reducing aGVHD through promoting the expansion of Tregs and repressing Th1 responses, and should be investigated as the therapeutic strategy for aGVHD.

  8. Urinary Biomarkers IGFBP7 and TIMP-2 for the Diagnostic Assessment of Transient and Persistent Acute Kidney Injury in Critically Ill Patients.

    Science.gov (United States)

    Daubin, Delphine; Cristol, Jean Paul; Dupuy, Anne Marie; Kuster, Nils; Besnard, Noémie; Platon, Laura; Buzançais, Aurèle; Brunot, Vincent; Garnier, Fanny; Jonquet, Olivier; Klouche, Kada

    2017-01-01

    The capability of urinary TIMP-2 (tissue inhibitor of metalloproteinase) and IGFBP7 (insulin-like growth factor binding protein)-NephroCheck Test (NC) = ([TIMP-2] x [IGFBP7]) / 1000)-to predict renal recovery from acute kidney injury (AKI) has been poorly studied. The aim of this study was to assess the performance of measurements of ([TIMP-2] x [IGFBP7]) / 1000) over 24 hours to differentiate transient from persistent AKI. Of 460 consecutive adult patients admitted to the ICU, 101 were prospectively studied: 56 men, 62 (52-71) years old. A fresh urine sample was collected at H0, H4, H12 and H24 to determine ([TIMP-2] x [IGFBP7]) / 1000) levels. Areas under the curves of Delta NC H4-Ho and H12-H4 and serum creatinine (sCr) for detection of AKI recovery were compared. Forty-one (40.6%) patient were diagnosed with AKI: 27 transient and 14 persistent AKI. At admission (H0), AKI patients had a significantly higher NC score than patients without AKI (0.43 [0.07-2.06] vs 0.15 [0.07-0.35], p = 0.027). In AKI groups, transient AKI have a higher NC, at H0 and H4, than persistent AKI (0.87 [0.09-2.82] vs 0.13 [0.05-0.66] p = 0.035 and 0.13 [0.07-0.61] vs 0.05 [0.02-0.13] p = 0.013). Thereafter, NC level decreased in both AKI groups with a Delta NC score H4-H0 and H12-H4 significantly more important in transient AKI. Roc curves showed however that delta NC scores did not discriminate between transient and persistent AKI. In our population, absolute urinary levels of NC score were higher at early hours after ICU admission (H0 and H4) in transient AKI as compared to persistent AKI patients. NC variations (Delta NC scores) over the first 12 hours may indicate the AKI's evolving nature with a more significant decrease in case of transient AKI but were not able to differentiate transient from persistent AKI.

  9. Urinary Biomarkers IGFBP7 and TIMP-2 for the Diagnostic Assessment of Transient and Persistent Acute Kidney Injury in Critically Ill Patients

    Science.gov (United States)

    Daubin, Delphine; Cristol, Jean Paul; Dupuy, Anne Marie; Kuster, Nils; Besnard, Noémie; Platon, Laura; Buzançais, Aurèle; Brunot, Vincent; Garnier, Fanny; Jonquet, Olivier; Klouche, Kada

    2017-01-01

    Objective The capability of urinary TIMP-2 (tissue inhibitor of metalloproteinase) and IGFBP7 (insulin-like growth factor binding protein)—NephroCheck Test (NC) = ([TIMP-2] x [IGFBP7]) / 1000)—to predict renal recovery from acute kidney injury (AKI) has been poorly studied. The aim of this study was to assess the performance of measurements of ([TIMP-2] x [IGFBP7]) / 1000) over 24 hours to differentiate transient from persistent AKI. Methods Of 460 consecutive adult patients admitted to the ICU, 101 were prospectively studied: 56 men, 62 (52–71) years old. A fresh urine sample was collected at H0, H4, H12 and H24 to determine ([TIMP-2] x [IGFBP7]) / 1000) levels. Areas under the curves of Delta NC H4-Ho and H12-H4 and serum creatinine (sCr) for detection of AKI recovery were compared. Results Forty-one (40.6%) patient were diagnosed with AKI: 27 transient and 14 persistent AKI. At admission (H0), AKI patients had a significantly higher NC score than patients without AKI (0.43 [0.07–2.06] vs 0.15 [0.07–0.35], p = 0.027). In AKI groups, transient AKI have a higher NC, at H0 and H4, than persistent AKI (0.87 [0.09–2.82] vs 0.13 [0.05–0.66] p = 0.035 and 0.13 [0.07–0.61] vs 0.05 [0.02–0.13] p = 0.013). Thereafter, NC level decreased in both AKI groups with a Delta NC score H4-H0 and H12-H4 significantly more important in transient AKI. Roc curves showed however that delta NC scores did not discriminate between transient and persistent AKI. Conclusion In our population, absolute urinary levels of NC score were higher at early hours after ICU admission (H0 and H4) in transient AKI as compared to persistent AKI patients. NC variations (Delta NC scores) over the first 12 hours may indicate the AKI’s evolving nature with a more significant decrease in case of transient AKI but were not able to differentiate transient from persistent AKI. PMID:28085896

  10. Urinary Biomarkers IGFBP7 and TIMP-2 for the Diagnostic Assessment of Transient and Persistent Acute Kidney Injury in Critically Ill Patients.

    Directory of Open Access Journals (Sweden)

    Delphine Daubin

    Full Text Available The capability of urinary TIMP-2 (tissue inhibitor of metalloproteinase and IGFBP7 (insulin-like growth factor binding protein-NephroCheck Test (NC = ([TIMP-2] x [IGFBP7] / 1000-to predict renal recovery from acute kidney injury (AKI has been poorly studied. The aim of this study was to assess the performance of measurements of ([TIMP-2] x [IGFBP7] / 1000 over 24 hours to differentiate transient from persistent AKI.Of 460 consecutive adult patients admitted to the ICU, 101 were prospectively studied: 56 men, 62 (52-71 years old. A fresh urine sample was collected at H0, H4, H12 and H24 to determine ([TIMP-2] x [IGFBP7] / 1000 levels. Areas under the curves of Delta NC H4-Ho and H12-H4 and serum creatinine (sCr for detection of AKI recovery were compared.Forty-one (40.6% patient were diagnosed with AKI: 27 transient and 14 persistent AKI. At admission (H0, AKI patients had a significantly higher NC score than patients without AKI (0.43 [0.07-2.06] vs 0.15 [0.07-0.35], p = 0.027. In AKI groups, transient AKI have a higher NC, at H0 and H4, than persistent AKI (0.87 [0.09-2.82] vs 0.13 [0.05-0.66] p = 0.035 and 0.13 [0.07-0.61] vs 0.05 [0.02-0.13] p = 0.013. Thereafter, NC level decreased in both AKI groups with a Delta NC score H4-H0 and H12-H4 significantly more important in transient AKI. Roc curves showed however that delta NC scores did not discriminate between transient and persistent AKI.In our population, absolute urinary levels of NC score were higher at early hours after ICU admission (H0 and H4 in transient AKI as compared to persistent AKI patients. NC variations (Delta NC scores over the first 12 hours may indicate the AKI's evolving nature with a more significant decrease in case of transient AKI but were not able to differentiate transient from persistent AKI.

  11. The Diagnosis of Urinary Tract infection in Young children (DUTY): a diagnostic prospective observational study to derive and validate a clinical algorithm for the diagnosis of urinary tract infection in children presenting to primary care with an acute illness.

    Science.gov (United States)

    Hay, Alastair D; Birnie, Kate; Busby, John; Delaney, Brendan; Downing, Harriet; Dudley, Jan; Durbaba, Stevo; Fletcher, Margaret; Harman, Kim; Hollingworth, William; Hood, Kerenza; Howe, Robin; Lawton, Michael; Lisles, Catherine; Little, Paul; MacGowan, Alasdair; O'Brien, Kathryn; Pickles, Timothy; Rumsby, Kate; Sterne, Jonathan Ac; Thomas-Jones, Emma; van der Voort, Judith; Waldron, Cherry-Ann; Whiting, Penny; Wootton, Mandy; Butler, Christopher C

    2016-07-01

    It is not clear which young children presenting acutely unwell to primary care should be investigated for urinary tract infection (UTI) and whether or not dipstick testing should be used to inform antibiotic treatment. To develop algorithms to accurately identify pre-school children in whom urine should be obtained; assess whether or not dipstick urinalysis provides additional diagnostic information; and model algorithm cost-effectiveness. Multicentre, prospective diagnostic cohort study. Children blind to the reference standard, defined as a pure or predominant uropathogen cultured at ≥ 10(5) colony-forming units (CFU)/ml in a single research laboratory. Urine was collected by clean catch (preferred) or nappy pad. Index tests were sequentially evaluated in two groups, stratified by urine collection method: parent-reported symptoms with clinician-reported signs, and urine dipstick results. Diagnostic accuracy was quantified using area under receiver operating characteristic curve (AUROC) with 95% confidence interval (CI) and bootstrap-validated AUROC, and compared with the 'clinician diagnosis' AUROC. Decision-analytic models were used to identify optimal urine sampling strategy compared with 'clinical judgement'. A total of 7163 children were recruited, of whom 50% were female and 49% were children provided clean-catch samples, 94% of whom were ≥ 2 years old, with 2.2% meeting the UTI definition. Among these, 'clinical diagnosis' correctly identified 46.6% of positive cultures, with 94.7% specificity and an AUROC of 0.77 (95% CI 0.71 to 0.83). Four symptoms, three signs and three dipstick results were independently associated with UTI with an AUROC (95% CI; bootstrap-validated AUROC) of 0.89 (0.85 to 0.95; validated 0.88) for symptoms and signs, increasing to 0.93 (0.90 to 0.97; validated 0.90) with dipstick results. Nappy pad samples were provided from the other 2277 children, of whom 82% were children where clean catch is possible. Dipstick testing can

  12. Urinary Tract Infection (UTI)

    Science.gov (United States)

    ... Home A-Z Health Topics Urinary tract infections Urinary tract infections > A-Z Health Topics Urinary tract infections (PDF, ... To receive Publications email updates Enter email Submit Urinary tract infections Urinary tract infections (UTIs) are most often caused ...

  13. 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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  14. Urinary Tract Infections in Older Women

    Science.gov (United States)

    Mody, Lona; Juthani-Mehta, Manisha

    2014-01-01

    IMPORTANCE Asymptomatic bacteriuria and symptomatic urinary tract infections (UTIs) in older women are commonly encountered in outpatient practice. OBJECTIVE To review management of asymptomatic bacteriuria and symptomatic UTI and review prevention of recurrent UTIs in older community-dwelling women. EVIDENCE REVIEW A search of Ovid (Medline, PsycINFO, Embase) for English-language human studies conducted among adults aged 65 years and older and published in peer-reviewed journals from 1946 to November 20, 2013. RESULTS The clinical spectrum of UTIs ranges from asymptomatic bacteriuria, to symptomatic and recurrent UTIs, to sepsis associated with UTI requiring hospitalization. Recent evidence helps differentiate asymptomatic bacteriuria from symptomatic UTI. Asymptomatic bacteriuria is transient in older women, often resolves without any treatment, and is not associated with morbidity or mortality. The diagnosis of symptomatic UTI is made when a patient has both clinical features and laboratory evidence of a urinary infection. Absent other causes, patients presenting with any 2 of the following meet the clinical diagnostic criteria for symptomatic UTI: fever, worsened urinary urgency or frequency, acute dysuria, suprapubic tenderness, or costovertebral angle pain or tenderness. A positive urine culture (≥105 CFU/mL) with no more than 2 uropathogens and pyuria confirms the diagnosis of UTI. Risk factors for recurrent symptomatic UTI include diabetes, functional disability, recent sexual intercourse, prior history of urogynecologic surgery, urinary retention, and urinary incontinence. Testing for UTI is easily performed in the clinic using dipstick tests. When there is a low pretest probability of UTI, a negative dipstick result for leukocyte esterase and nitrites excludes infection. Antibiotics are selected by identifying the uropathogen, knowing local resistance rates, and considering adverse effect profiles. Chronic suppressive antibiotics for 6 to 12 months and

  15. The Diagnosis of Urinary Tract infection in Young children (DUTY): a diagnostic prospective observational study to derive and validate a clinical algorithm for the diagnosis of urinary tract infection in children presenting to primary care with an acute illness.

    Science.gov (United States)

    Hay, Alastair D; Birnie, Kate; Busby, John; Delaney, Brendan; Downing, Harriet; Dudley, Jan; Durbaba, Stevo; Fletcher, Margaret; Harman, Kim; Hollingworth, William; Hood, Kerenza; Howe, Robin; Lawton, Michael; Lisles, Catherine; Little, Paul; MacGowan, Alasdair; O'Brien, Kathryn; Pickles, Timothy; Rumsby, Kate; Sterne, Jonathan Ac; Thomas-Jones, Emma; van der Voort, Judith; Waldron, Cherry-Ann; Whiting, Penny; Wootton, Mandy; Butler, Christopher C

    2016-01-01

    BACKGROUND It is not clear which young children presenting acutely unwell to primary care should be investigated for urinary tract infection (UTI) and whether or not dipstick testing should be used to inform antibiotic treatment. OBJECTIVES To develop algorithms to accurately identify pre-school children in whom urine should be obtained; assess whether or not dipstick urinalysis provides additional diagnostic information; and model algorithm cost-effectiveness. DESIGN Multicentre, prospective diagnostic cohort study. SETTING AND PARTICIPANTS Children < 5 years old presenting to primary care with an acute illness and/or new urinary symptoms. METHODS One hundred and seven clinical characteristics (index tests) were recorded from the child's past medical history, symptoms, physical examination signs and urine dipstick test. Prior to dipstick results clinician opinion of UTI likelihood ('clinical diagnosis') and urine sampling and treatment intentions ('clinical judgement') were recorded. All index tests were measured blind to the reference standard, defined as a pure or predominant uropathogen cultured at ≥ 10(5) colony-forming units (CFU)/ml in a single research laboratory. Urine was collected by clean catch (preferred) or nappy pad. Index tests were sequentially evaluated in two groups, stratified by urine collection method: parent-reported symptoms with clinician-reported signs, and urine dipstick results. Diagnostic accuracy was quantified using area under receiver operating characteristic curve (AUROC) with 95% confidence interval (CI) and bootstrap-validated AUROC, and compared with the 'clinician diagnosis' AUROC. Decision-analytic models were used to identify optimal urine sampling strategy compared with 'clinical judgement'. RESULTS A total of 7163 children were recruited, of whom 50% were female and 49% were < 2 years old. Culture results were available for 5017 (70%); 2740 children provided clean-catch samples, 94% of whom were ≥ 2 years old

  16. Accuracy of Urinary Neutrophil Gelatinase-Associated Lipocalin in Quantifying Acute Kidney Injury after Partial Nephrectomy in Patients with Normal Contralateral Kidney.

    Directory of Open Access Journals (Sweden)

    Kyo Chul Koo

    Full Text Available To evaluate the efficacy of urinary neutrophil gelatinase-associated lipocalin (uNGAL for predicting the degree of acute kidney injury (AKI in patients following partial nephrectomy (PN.This prospective study included 176 patients who underwent open or laparoscopic PN for solid renal tumors between June 2013 and May 2014. Urine samples were collected preoperatively and at 3, 24, and 48 h after renal pedicle clamp removal. Changes in uNGAL levels were analyzed for all patients and between subgroups that were dichotomized based on preoperative eGFR values of <60 and ≥60 mL/min/1.73m2, open and laparoscopic surgery, and according to the onset of AKI. Linear mixed models were used to investigate preoperative and perioperative features associated with postoperative uNGAL and eGFR changes at 6 months postoperatively.Among 146 patients included in the final analysis, 10 (6.8% patients had preoperative eGFR <60 mL/min/1.73m2. In the overall group, uNGAL levels increased following PN. However, all subgroups demonstrated comparable changes in uNGAL levels over time. Multivariate analyses failed to reveal any correctable clinical features associated with postoperative uNGAL changes, whereas preoperative serum creatinine levels and the onset of AKI correlated with eGFR at 6 months postoperatively.uNGAL levels may increase following PN. However, it does not appear to be a useful marker for quantifying the degree of AKI or predicting postoperative renal function in patients with normal contralateral kidney and relatively good preoperative renal function. Further analysis is necessary to assess the usefulness of uNGAL in patients with poor preoperative renal function.

  17. Serum cystatin C and urinary neutrophil gelatinase-associated lipocalin in pediatric acute kidney injury; a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Neamatollah Ataei

    2017-10-01

    Full Text Available Background: Acute kidney injury (AKI refers to insults that lead to decreased kidney function within hours to weeks and can be associated with complications including chronic kidney failure, end-stage renal disease and even death. Although various biomarkers have been proposed to predict AKI in children, but no consensus has been reached on the best diagnostic method. Accordingly, the present study aimed to assess the correlation between urine NGAL levels and development of AKI in children and determine which one of the biomarkers of urine NGAL, serum Cystatin C and serum creatinine has a stronger association with AKI in the pediatric population. Methods: The present cross-sectional study was conducted on children younger than 14 years of age, hospitalized in the intensive care unit of Children’s Medical Centre in Tehran, Iran, during 2016. Urine NGAL, serum Cystatin C and serum creatinine levels of these subjects were measured on admission to the intensive care unit. The concentrations of serum Cystatin C and serum creatinine were measured again after 48 hours to determine the AKI status of the subjects. Data were analyzed to determine the association between GFR and the concentrations of evaluated biomarkers and to compare the levels of biomarkers between the four groups of no AKI, injury, failure, loss and end-stage. Results: A total of 104 children (59 boys and 45 girls, average age=28.0±3.5 months were included in this study. The mean level of uNGAL on admission in the No-AKI group (153.79±29.82 was significantly lower than the children in the injury (1225.0 ±275.0 and failure (756.56±147.79 groups (df:3, 100; F=10.74; p<0.0001. The mean concentration of Cystatin C on admission in the three groups of risk (0.94±0.30, injury (1.75±0.05 and failure (1.75±0.36 was also significantly higher than the No-AKI (0.27±0.04 (df:3, 100; F=19.21; p<0.0001. However, there was no significant correlation between the level of serum creatinine on

  18. Bladder Control Problems: Medications for Treating Urinary Incontinence

    Science.gov (United States)

    ... Other less common side effects include heartburn, blurry vision, rapid heartbeat (tachycardia), flushed skin, urinary retention and cognitive side effects, such as impaired memory and confusion. If you use the oxybutynin skin ...

  19. 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

    Directory of Open Access Journals (Sweden)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  1. Dosimetric Coverage of the Prostate, Normal Tissue Sparing, and Acute Toxicity with High-Dose-Rate Brachytherapy for Large Prostate Volumes

    Directory of Open Access Journals (Sweden)

    George Yang

    2015-06-01

    Full Text Available ABSTRACTPurposeTo evaluate dosimetric coverage of the prostate, normal tissue sparing, and acute toxicity with HDR brachytherapy for large prostate volumes.Materials and MethodsOne 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.ResultsMedian 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.ConclusionsDosimetric 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.

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

    Science.gov (United States)

    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.

  3. Development and validation of a condition-specific diary to measure severity, bothersomeness and impact on daily activities for patients with acute urinary tract infection in primary care

    DEFF Research Database (Denmark)

    Holm, Anne; Cordoba, Gloria; Siersma, Volkert

    2017-01-01

    Background: Urinary tract infection (UTI) is a common condition in primary care. Patient-reported outcome measures (PROMs) are crucial in the evaluation of interventions to improve diagnosis, treatment and prognosis of UTI. The aim of this study was to identify an existing condition-specific PROM...... to measure symptom severity, bothersomeness and impact on daily activities for adult patients with suspected urinary tract infection in primary care; or, in the absence of such a PROM, to test items identified from existing PROMs for coverage and relevance in single and group interviews...

  4. URINARY TRACT INFECTIONS IN PREGNANCY

    Directory of Open Access Journals (Sweden)

    N Sivalingam

    2007-01-01

    Full Text Available 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 diagnosing UTIs. Without treatment, asymptomatic bacteriuria in pregnancy is associated with preterm delivery, intrauterine growth retardation, low birth weight, maternal hypertension, pre-eclampsia and anaemia. Acute pyelonephritis can lead to maternal sepsis. Recurrent UTIs in pregnancy require prophylactic antibiotic treatment.

  5. The use of an advanced medical-surgical course for the retention and professional development of medical-surgical nurses in an acute care hospital.

    Science.gov (United States)

    Gutekunst, Marie-Claude; Delucca, Jeanine; Kessler, Beth A

    2012-07-01

    The retention and professional development of the medical-surgical nurse is a challenging endeavor. Voluntary nurse turnover affects the collective costs of direct and indirect recruiting, productivity and training, and termination. These costs are estimated to be 0.75 to 1.30 times a nurse's average departing salary. The multifactorial dimensions of nursing retention remain a challenge for leaders at the organizational level. This article describes an educational strategy in the form of an advanced medical-surgical course used by a multicampus academic community Magnet® hospital to increase the retention and professional development of medical-surgical nurses. The authors report the goals, content, and outcomes of this advanced medical-surgical course. Copyright 2012, SLACK Incorporated.

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

    International Nuclear Information System (INIS)

    Duarte Perez, Maria Caridad; Piedra Bello, Misleidys; Guillen Dosal, Ana

    2010-01-01

    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

  7. The Economic Burden of Urinary Tract Infection and Pressure Ulceration in Acute Traumatic Spinal Cord Injury Admissions: Evidence for Comparative Economics and Decision Analytics from a Matched Case-Control Study.

    Science.gov (United States)

    White, Barry A B; Dea, Nicolas; Street, John T; Cheng, Christiana L; Rivers, Carly S; Attabib, Najmedden; Kwon, Brian K; Fisher, Charles G; Dvorak, Marcel F

    2017-10-15

    Secondary complications of spinal cord injury (SCI) are a burden to affected individuals and the rest of society. There is limited evidence of the economic burden or cost of complications in SCI populations in Canada, however, which is necessary for comparative economic analyses and decision analytic modeling of possible solutions to these common health problems. Comparative economic analyses can inform resource allocation decisions, but the outputs are only as good as the inputs. In this article, new evidence of the excess or incremental costs of urinary tract infection (UTI) and pressure ulceration (PU) in acute traumatic SCI from an exploratory case series analysis of admissions to a Level I specialized Canadian spine facility (2008-2013) is presented. Participants in a national SCI registry were case-control matched (1:1) on the predicted probability of experiencing UTI or PU during initial acute SCI admission. The excess costs of UTI and PU are estimated as the mean of the differences in total direct acute SCI admission costs (length of stay, accommodation, nursing, pharmacy) from the perspective of the admitting facility between participants matched or paired on demographic and SCI characteristics. Even relatively minor UTI and PU, respectively, added an average of $7,790 (standard deviation [SD] $6,267) and $18,758 (SD $27,574) to the direct cost of acute SCI admission in 2013 Canadian dollars (CAD). This case series analysis established evidence of the excess costs of UTI and PU in acute SCI admissions, which will support decision-informing analyses in SCI.

  8. Urinary catheter - infants

    Science.gov (United States)

    Bladder catheter - infants; Foley catheter - infants; Urinary catheter - neonatal ... A urinary catheter is a small, soft tube placed in the bladder. This article addresses urinary catheters in babies. WHY IS ...

  9. Urinary tract infection - adults

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000521.htm Urinary tract infection - adults To use the sharing features on this page, please enable JavaScript. A urinary tract infection, or UTI, is an infection of the urinary ...

  10. Urinary tract infection - children

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000505.htm Urinary tract infection - children To use the sharing features on this page, please enable JavaScript. A urinary tract infection is an infection of the urinary tract. This ...

  11. Urinary calprotectin and posttransplant renal allograft injury

    DEFF Research Database (Denmark)

    Tepel, Martin; Borst, Christoffer; Bistrup, Claus

    2014-01-01

    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.......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...

  12. Acute syringomyelia: case report.

    Science.gov (United States)

    Milhorat, Thomas H; Bolognese, Paolo A; Black, Karen S; Woldenberg, Rona F

    2003-11-01

    Syringomyelia is generally regarded as a chronic, slowly progressive disorder. We describe a case of acute dilation of the central canal of the spinal cord that presented with rapidly progressive segmental signs. A 29-year-old female patient who had previously undergone surgical treatment for a Chiari I malformation, syringomyelia, and hydrocephalus presented with an 8-day history of headaches, progressive paraparesis, and urinary retention. Magnetic resonance imaging scans demonstrated panventricular hydrocephalus in association with a holocord syrinx that extended to the obex. Magnetic resonance imaging scans that had been coincidentally obtained just 3 days before the onset of symptoms had revealed no evidence of hydrocephalus or syringomyelia. The patient underwent emergency revision of a failed ventriculoperitoneal shunt. Postoperatively, there was prompt resolution of the syringomyelia, hydrocephalus, and associated neurological deficits. Among patients with communicating syringomyelia, the central canal of the spinal cord participates as a "fifth ventricle" and can undergo rapid dilation in association with acute hydrocephalus. Appropriate treatment in such cases involves placement of a ventriculoperitoneal shunt.

  13. 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

    Directory of Open Access Journals (Sweden)

    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.

  14. OnabotulinumtoxinA in urinary incontinence: Prospective Study of a Case Series.

    Science.gov (United States)

    Martín-Martínez, A; Fernández-Mederos, A; García-Hernández, J Á

    2017-09-01

    To assess the safety and efficacy of a single intravesical injection of onabotulinumtoxinA (OnaBTA) for treating urge urinary incontinence (UUI) in women. We performed a prospective case-series study of consecutive patients with refractory UUI treated with an intravesical injection of OnaBTA. The patients were administered 100 units of OnaBTA injected into the bladder wall following 4 weeks of flushing with anticholinergic agents or beta 3 agonists. The urodynamic and clinical endpoints were evaluated before and 6 months after the injection of OnaBTA. The primary study endpoint was the number of episodes of urinary leakage. A total of 204 of the 210 selected patients conducted a valid visit 6 months after the therapeutic application. At 6 months of treatment with OnaBTA, 110 (53.9%) patients remained continent and were considered a success. However, 57 (27.9%) patients experienced one episode of urinary leakage per day, and 37 (18.2%) had 2 or more. In terms of the urodynamic parameters, we observed the following changes: increase in maximum bladder capacity (P<.0001) and reduced maximum pressure of the detrusor (P<.0001). In terms of the safety profile, 8 (3.9%) patients had self-limiting haematuria during the procedure, which resolved spontaneously, and 9 (4.4%) patients had acute urinary retention that required intermittent catheterisation. This study supports the use of OnabotulinumtoxinA in patients with urge urinary incontinence that does not respond to medical treatment. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Glucagon-like peptide-1 acutely affects renal blood flow and urinary flow rate in spontaneously hypertensive rats despite significantly reduced renal expression of GLP-1 receptors

    DEFF Research Database (Denmark)

    Ronn, Jonas; Jensen, Elisa P; Wewer Albrechtsen, Nicolai J

    2017-01-01

    in the kidney from SHR. However, acute intrarenal infusion of GLP-1 increased MAP, RBF, dieresis, and natriuresis without affecting heart rate in both rat strains. These results suggest that the acute renal effects of GLP-1 in SHR are caused either by extrarenal GLP-1 receptors activating other mechanisms (e...... to increased mean arterial pressure (MAP) and increased renal blood flow (RBF). In hypertensive animal models, GLP-1 has been reported both to increase and decrease MAP. The aim of this study was to examine expression of renal GLP-1 receptors in spontaneously hypertensive rats (SHR) and to assess the effect...... of acute intrarenal infusion of GLP-1. We hypothesized that GLP-1 would increase diuresis and natriuresis and reduce MAP in SHR. Immunohistochemical staining and in situ hybridization for the GLP-1 receptor were used to localize GLP-1 receptors in the kidney. Sevoflurane-anesthetized normotensive Sprague...

  16. Urinary Tract Infections in Children with Primary Nephrotic ...

    African Journals Online (AJOL)

    Urinary Tract Infections in Children with Primary Nephrotic Syndrome and Acute Glomerulonephritis. ... West African Journal of Medicine ... Abstract. BACKGROUND: The occurrence of urinary tract infection (UTI) in children with Nephrotic syndrome (NS) has been widely reported by various workers, but not much has been ...

  17. Association Between Urinary Symptoms and Urinary Tract Infection in Patients With Multiple Sclerosis.

    Science.gov (United States)

    Nikseresht, Alireza; Salehi, Haideh; Foroughi, Amin Abolhasani; Nazeri, Masoumeh

    2015-09-28

    Urinary dysfunctions occur in the majority of MS patients and these patients are at higher risks of developing UTI due to multiple reasons. We determined to study the association between different urinary symptoms and UTI in MS patients. Eighty seven MS patients that referred to our medical care center with an acute attack of the disease, from November 2012 to April 2014, were included in the study. Patients were classified into two groups based on their urine culture results: UTI positive and non-UTI patients. The prevalence of different types of urinary symptoms was then compared among the two groups. The mean age of our patients was 36.8 years old. From the total 87 patients, 83 (95.4%) were female. Overall 56.3% of patients displayed urinary symptoms. The most prevalent urinary problems were urinary incontinence and frequency (25.3% and 24.1%, respectively). A positive urinary culture was seen in 71.3% of the patients. The prevalence of urinary problems was significantly higher in UTI patients in comparison to non-UTI patients (64.5% and 40% in UTI and non-UTI patients, respectively; p=0.036). Separately none of the different urinary symptoms displayed a significant difference between UTI and non-UTI patients (p>0.05). Not a single symptom can be diagnostic of UTI, but MS patient with urinary tract infections do present more urinary symptoms and this can be an indication for further urine analysis and screening measures for MS patients who display more urinary symptoms.

  18. Managing retention.

    Science.gov (United States)

    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).

  19. Post-stroke urinary incontinence.

    Science.gov (United States)

    Mehdi, Z; Birns, J; Bhalla, A

    2013-11-01

    To provide a comprehensive review of the current evidence on post-stroke urinary incontinence. An electronic database search was performed to identify relevant studies and review articles related to Urinary Incontinence (UI) in the stroke population between the years 1966 and 2012. Urinary incontinence following stroke is a common problem affecting more than one-third of acute stroke patients and persisting in up to a quarter at 1 year. It is well established that this condition is a strong marker of stroke severity and is associated with poorer functional outcomes and increased institutionalisation and mortality rates compared with those who remain continent. Despite evidence linking better outcomes to those patients who regain continence, the results of national audits have demonstrated that the management of UI following stroke is suboptimal, with less than two-thirds of stroke units having a documented plan to promote continence. Current evidence supports a thorough assessment to categorise the type and severity of post-stroke urinary incontinence. An individually tailored, structured management strategy to promote continence should be employed. This has been associated with better stroke outcomes and should be the aim of all stroke health professionals. © 2013 John Wiley & Sons Ltd.

  20. Surgery for Stress Urinary Incontinence

    Science.gov (United States)

    ... Surgery for Stress Urinary Incontinence Page Navigation ▼ ACOG Pregnancy Book Surgery for Stress Urinary Incontinence Patient Education FAQs Surgery for Stress Urinary Incontinence Patient Education ...

  1. 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

    Directory of Open Access Journals (Sweden)

    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

  2. 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.

    Science.gov (United States)

    Downing, Harriet; Thomas-Jones, Emma; Gal, Micaela; Waldron, Cherry-Ann; Sterne, Jonathan; Hollingworth, William; Hood, Kerenza; Delaney, Brendan; Little, Paul; Howe, Robin; Wootton, Mandy; Macgowan, Alastair; Butler, Christopher C; Hay, Alastair D

    2012-07-19

    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. 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 then use economic evaluation to compare the cost

  3. 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

    Directory of Open Access Journals (Sweden)

    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

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

    International Nuclear Information System (INIS)

    Duarte Perez, Maria Caridad; Guillen Dosal, Ana; Martinez Silva, Magaly; Hernandez Robledo, Ernesto

    2012-01-01

    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)

  5. Glucagon-like peptide-1 acutely affects renal blood flow and urinary flow rate in spontaneously hypertensive rats despite significantly reduced renal expression of GLP-1 receptors.

    Science.gov (United States)

    Ronn, Jonas; Jensen, Elisa P; Wewer Albrechtsen, Nicolai J; Holst, Jens Juul; Sorensen, Charlotte M

    2017-12-01

    Glucagon-like peptide-1 (GLP-1) is an incretin hormone increasing postprandial insulin release. GLP-1 also induces diuresis and natriuresis in humans and rodents. The GLP-1 receptor is extensively expressed in the renal vascular tree in normotensive rats where acute GLP-1 treatment leads to increased mean arterial pressure (MAP) and increased renal blood flow (RBF). In hypertensive animal models, GLP-1 has been reported both to increase and decrease MAP. The aim of this study was to examine expression of renal GLP-1 receptors in spontaneously hypertensive rats (SHR) and to assess the effect of acute intrarenal infusion of GLP-1. We hypothesized that GLP-1 would increase diuresis and natriuresis and reduce MAP in SHR. Immunohistochemical staining and in situ hybridization for the GLP-1 receptor were used to localize GLP-1 receptors in the kidney. Sevoflurane-anesthetized normotensive Sprague-Dawley rats and SHR received a 20 min intrarenal infusion of GLP-1 and changes in MAP, RBF, heart rate, dieresis, and natriuresis were measured. The vasodilatory effect of GLP-1 was assessed in isolated interlobar arteries from normo- and hypertensive rats. We found no expression of GLP-1 receptors in the kidney from SHR. However, acute intrarenal infusion of GLP-1 increased MAP, RBF, dieresis, and natriuresis without affecting heart rate in both rat strains. These results suggest that the acute renal effects of GLP-1 in SHR are caused either by extrarenal GLP-1 receptors activating other mechanisms (e.g., insulin) to induce the renal changes observed or possibly by an alternative renal GLP-1 receptor. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  6. Glucagon‐like peptide‐1 acutely affects renal blood flow and urinary flow rate in spontaneously hypertensive rats despite significantly reduced renal expression of GLP‐1 receptors

    OpenAIRE

    Ronn, Jonas; Jensen, Elisa P.; Wewer Albrechtsen, Nicolai J.; Holst, Jens Juul; Sorensen, Charlotte M.

    2017-01-01

    Abstract Glucagon‐like peptide‐1 (GLP‐1) is an incretin hormone increasing postprandial insulin release. GLP‐1 also induces diuresis and natriuresis in humans and rodents. The GLP‐1 receptor is extensively expressed in the renal vascular tree in normotensive rats where acute GLP‐1 treatment leads to increased mean arterial pressure (MAP) and increased renal blood flow (RBF). In hypertensive animal models, GLP‐1 has been reported both to increase and decrease MAP. The aim of this study was to ...

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

    Energy Technology Data Exchange (ETDEWEB)

    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 Infections (For Kids)

    Medline Plus

    Full Text Available ... Urinary Tract? Your urinary tract is actually a system made up of these main parts: two kidneys ... ON THIS TOPIC Chronic Kidney Diseases Movie: Urinary System Your Urinary System Bedwetting Contact Us Print Resources ...

  9. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Urinary Tract? Your urinary tract is actually a system made up of these main parts: two kidneys ... topic for: Kids Chronic Kidney Diseases Movie: Urinary System Your Urinary System Bedwetting View more Partner Message ...

  10. Analysis of lower urinary tract disease of dogs

    Directory of Open Access Journals (Sweden)

    Claudia Iveth Mendóza-López

    Full Text Available ABSTRACT: Lower urinary tract diseases (LUTD include different conditions that affect the urinary bladder, urethra and prostate. The objective of this study was to determine the frequency of different related diseases, to characterize the population affected, and to determine risk factors in dogs. The clinical cases were diagnosed with LUTD through physical examination, and clinical laboratory and imaging studies. Male dogs had a greater predisposition to present a LUTD. Dogs from 3 months to 18 years with a median of 8 years were affected, and the most affected breeds were Poodle, Labrador, German shepherd, Schnauzer, Cocker Spaniel and Chihuahua. The LUTD presented with the following frequencies: bacterial urinary tract infection 34.02%; micturition disorders 22.68%; urolithiasis 20.61%; prostatic disease 14.43%; traumatic problems 8.24%. Sixty-seven per cent of the cases were specific diseases, such as uncomplicated and complicated bacterial urinary tract infections, urinary retention of neurologic origin and silica urolithiasis.

  11. [Urinary lithiasis in the child (author's transl)].

    Science.gov (United States)

    Gosalbez, R; Garat, J M; Piro, C; Martin, J A

    1980-01-01

    The authors report a series of 130 children suffering from urinary lithiasis (essentially between the age of 4 to 6 years) and particularly in boys (2.5 to 1). There were 108 cases of reno-ureteric lithiasis as against 23 vesico-urethral. In 69 cases, pyelocalyceal lithiasis predominated. Thirty per cent of the children had bilateral lithiasis, and 19% of all cases of lithiasis were staghorn calculi. Presenting symptoms : haematuria, diffuse abdominal pain, anuria (6 cases), complete urinary retention (5 cases). Study of these cases failed to indicate whether obstruction of the upper urinary tract (14%) or infection (27%) was the cause or the effect of the lithiasis. Particularly notable were 8 cases of cystinuria (6%), 1 of glycinuria, 1 of hyperoxaluria and 7 of hypercalciuria. At least in Spain, lithiasis in children would appear to be essentially idiopathic. However, 40% of these cases of lithiasis were secondary to obstruction of the excretory tract and/or urinary infection. All types of entero-uroplasty were lithogenic (6 cases). 32% of the children had a proteus infection. Treatment : 14 children were treated medically as against 125 surgically. 70% are free of any recurrence. 7% have a residual lithiasis. The rarity of recurrences and the quality of the results obtained indicate that complete surgical treatment represents the essential feature of the treatment of urinary lithiasis in children.

  12. Fuel nozzle tube retention

    Energy Technology Data Exchange (ETDEWEB)

    Cihlar, David William; Melton, Patrick Benedict

    2017-02-28

    A system for retaining a fuel nozzle premix tube includes a retention plate and a premix tube which extends downstream from an outlet of a premix passage defined along an aft side of a fuel plenum body. The premix tube includes an inlet end and a spring support feature which is disposed proximate to the inlet end. The premix tube extends through the retention plate. The spring retention feature is disposed between an aft side of the fuel plenum and the retention plate. The system further includes a spring which extends between the spring retention feature and the retention plate.

  13. Urinary NGAL deficiency in recurrent urinary tract infections.

    Science.gov (United States)

    Forster, Catherine S; Johnson, Kathryn; Patel, Viral; Wax, Rebecca; Rodig, Nancy; Barasch, Jonathan; Bachur, Richard; Lee, Richard S

    2017-06-01

    Children with recurrent urinary tract infections (rUTI) often show no identifiable cause of their infections. Neutrophil gelatinase-associated lipocalin (NGAL) is known to be upregulated within the uroepithelium and kidney of patients with UTI and exhibits a localized bacteriostatic effect through iron chelation. We hypothesize that some patients with rUTI without an identifiable cause of their recurrent infections have locally deficient NGAL production. We therefore explored whether a lack of NGAL production may be a factor in the pathogenesis of rUTI. Patients seen in the urology clinic for rUTI who were tract, or other reasons that predispose to UTI, such as neurogenic bladder, the need for intermittent catheterization, or unrepaired posterior urethral valves. Control patients were healthy children enrolled from the emergency department with no history of UTI or renal dysfunction, normal urinalysis at the time of enrollment, and presenting no diagnosis associated with increased NGAL levels, such as acute kidney injury or infection. NGAL was measured by immunoblot. Fifteen cases and controls were enrolled. Median urinary NGAL levels were significantly decreased in rUTI patients compared with controls [15 (14-29) ng/ml vs 30 (27-61) ng/ml; p = 0.002)] Although comparatively diminished, measurable NGAL levels were present in all patients with rUTI. Urinary NGAL is significantly decreased in patients with compared with patients without rUTI. These data suggest that some patients with rUTI may be predisposed to UTI because of a relative local deficiency in urinary NGAL production.

  14. Prolonged use of indwelling urinary catheter following acute urinary ...

    African Journals Online (AJOL)

    J.O. Bello

    duration of catheter use and median out-of-pocket payment per catheter change was 65 years (range 20–90 years), 12 months (range .... pocket payments per catheter change and reasons for prolonged catheter use was collected. ... ing almost half (44.7%) of the average annual income of an adult in the study region of ...

  15. Population Pharmacokinetic Analysis of Cefiderocol, a Parenteral Siderophore Cephalosporin, in Healthy Subjects, Subjects with Various Degrees of Renal Function, and Patients with Complicated Urinary Tract Infection or Acute Uncomplicated Pyelonephritis.

    Science.gov (United States)

    Kawaguchi, Nao; Katsube, Takayuki; Echols, Roger; Wajima, Toshihiro

    2018-02-01

    Cefiderocol, a novel parenteral siderophore cephalosporin, exhibits potent efficacy against most Gram-negative bacteria, including carbapenem-resistant strains. The aim of this study was to perform a population pharmacokinetic (PK) analysis based on plasma cefiderocol concentrations in healthy subjects, subjects with various degrees of renal function, and patients with complicated urinary tract infection (cUTI) or acute uncomplicated pyelonephritis (AUP) caused by Gram-negative pathogens and to calculate the fraction of the time during the dosing interval where the free drug concentration in plasma exceeds the MIC ( fT MIC ). Population PK models were developed with three renal function markers, body surface area-adjusted estimated glomerular filtration rate (eGFR), absolute eGFR, and creatinine clearance, on the basis of 2,571 plasma concentrations from 91 subjects without infection and 238 patients with infection. The population PK models with each renal function marker adequately described the plasma cefiderocol concentrations. Clear relationships of total clearance (CL) to all renal function markers were observed. Body weight and disease status (with or without infection) were also significant covariates. The CL in patients with infection was 26% higher than that in subjects without infection. The fT MIC values were more than 75% in all patients (and were 100% in most patients), suggesting that a sufficient exposure to cefiderocol was provided by the tested dose regimens (2 g every 8 h as the standard dose regimen) for the treatment of cUTI or AUP caused by Gram-negative pathogens. Copyright © 2018 Kawaguchi et al.

  16. Fall 1982 Retention Study.

    Science.gov (United States)

    Peralta Community Coll. District, Oakland, CA. Office of Research, Planning and Development.

    In fall 1982, a study was conducted in the Peralta Community College District (PCCD) using withdrawal and grade distribution data to analyze student retention patterns. Successful retention rates were based on the percentage of students who received a passing grade, while total retention rates were based on the percentage of students who received…

  17. Fall 1984 Retention Study.

    Science.gov (United States)

    Peralta Community Coll. District, Oakland, CA. Office of Research, Planning and Development.

    A study was conducted of the retention patterns of students enrolled in the Peralta Community College District (PCCD) in fall 1984 using college reports on withdrawals and grade distributions. The study focused on successful retention (i.e., all students who received a passing grade) and on total retention (i.e., all students who received any…

  18. /sup 99m/Tc-MDP retention in osteoporosis: Relationship to other indices of bone cell activity and response to calcium and vitamin D therapy

    Energy Technology Data Exchange (ETDEWEB)

    Davie, M.W.J.; Britton, J.M.; Haddaway, M.; McCall, I.W.

    1987-12-01

    Serum calcium, albumin, phosphorus, and alkaline phosphatase, urinary creatinine and retention of /sup 99m/Tc-methylene bisphosphonate (/sup 99m/Tc-MDP) were measured in 61 subjects with osteoporosis and the values compared with those obtained in normal subjects. /sup 99m/Tc-MDP retention was inversely related with urinary creatinine output in normal subjects. In osteoporotic sujects urinary creatinine output was lower and /sup 99m/Tc-MDP retention higher even when urinary creatinine output was taken into account. Other measurements were similar. In 21 subjects these measurements together with urinary hydroxyproline were performed before and after treatment with calcium and vitamin D. /sup 99m/Tc-MDP and alkaline phosphatase fell; urinary hydroxyproline was unchanged. A single 24 h urine measurement after /sup 99m/Tc-MDP injection is a valuable method of predicting whether calcium and vitamin D therapy will be useful in a particular case of osteoporosis.

  19. Urinary nitrite in symptomatic and asymptomatic urinary infection.

    OpenAIRE

    Powell, H R; McCredie, D A; Ritchie, M A

    1987-01-01

    The dipstrip test for urinary nitrite is fairly unreliable in symptomatic urinary infections and only 104 (52%) of 200 symptomatic children with urinary infection attending an emergency department had a positive result. The test yielded positive results, however, in 83 of 100 outpatients with largely asymptomatic urinary infection attending a follow up clinic because of known predisposition to urinary infection. This difference was highly significant. The finding of urinary nitrite is highly ...

  20. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... in your urinary tract. Let's find out more. What Exactly Is a Urinary Tract? Your urinary tract ... and you should see a doctor right away. What Will the Doctor Do? First, your doctor will ...

  1. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Kids / Urinary Tract Infections (UTIs) What's in this article? What Exactly Is a Urinary Tract? Urinary Tract ... Nondiscrimination Visit the Nemours Web site. Note: All information on KidsHealth® is for educational purposes only. For ...

  2. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Kids site Sitio para niños How the Body Works Puberty & Growing Up Staying Healthy Staying Safe Recipes & ... in your urinary tract. Let's find out more. What Exactly Is a Urinary Tract? Your urinary tract ...

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

    Science.gov (United States)

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

    2014-07-01

    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 disease, tissue destruction and overwhelming infection. The objective of this review is to provide an overview of the innate immune response in the urinary tract in response to microbial assault. In doing so, we focus on the role of antimicrobial peptides-a ubiquitous component of the innate immune response.

  4. Serum and Urinary NGAL in Septic Newborns

    Directory of Open Access Journals (Sweden)

    Mike Smertka

    2014-01-01

    Full Text Available Neutrophil gelatinase-associated lipocalin (NGAL is postulated to be a potentially new and highly specific/sensitive marker of acute kidney injury (AKI. The aim of this study was to assess the impact of inflammation on serum and urine NGAL in newborns that were treated due to infection. We determined serum and urine NGAL concentrations in 73 infants (51 with sepsis; 22 with severe sepsis admitted to the Intensive Care Unit in the first month of life, for three consecutive days during the course of treatment for infection. 29 neonates without infection served as the control group. Septic patients, in particular, severe sepsis patients, had increased serum and urinary NGAL levels in the three subsequent days of observation. Five septic patients who developed AKI had elevated serum and urinary NGAL values to a similar extent as septic neonates without AKI. A strong correlation was found between the concentration of serum and urinary NGAL and inflammatory markers, such as CRP and procalcitonin. Serum and urinary NGAL levels were also significantly associated with NTISS (neonatal therapeutic intervention scoring system values. We conclude that increased serum and urinary NGAL values are not solely a marker of AKI, and more accurately reflect the severity of inflammatory status.

  5. Female urinary incontinence and sexuality

    OpenAIRE

    Mota, Renato Lains

    2017-01-01

    ABSTRACT Urinary incontinence is a common problem among women and it is estimated that between 15 and 55% of them complain of lower urinary symptoms. The most prevalent form of urinary incontinence is associated with stress, followed by mixed urinary incontinence and urge urinary incontinence. It is a symptom with several effects on quality of life of women mainly in their social, familiar and sexual domains. Female reproductive and urinary systems share anatomical structures, which promotes ...

  6. Segmental Urethral Dosimetry and Urinary Toxicity in Patients With No Urinary Symptoms Before Permanent Prostate Brachytherapy

    International Nuclear Information System (INIS)

    Thomas, Carys; Keyes, Mira; Liu, Mitchell; Moravan, Veronika

    2008-01-01

    Purpose: To determine whether segmental urethral dosimetry is predictive for the degree of urinary morbidity after prostate brachytherapy in patients with no urinary symptoms before prostate brachytherapy. Methods and Materials: Between May 2000 and November 2005, 1,107 patients underwent iodine-125 monotherapy with urethral sparing techniques. A total of 166 patients fulfilled the selection criteria: baseline (International Prostate Symptom Score) IPSS ≤5, no androgen deprivation therapy, and prostate ultrasound planning volumes (PUTV) <45 mL. The median follow-up was 44 months. Urinary morbidity was defined by maximum increase in IPSS, time to IPSS resolution, maximum Radiation Therapy Oncology Group (RTOG) score, time to RTOG resolution, and urinary retention. Surrogate deviated urethra was contoured and doses calculated at the base, mid-prostate, apex, and urogenital diaphragm. Univariate and multivariate analysis was used to evaluate urethral and prostate dosimetry, age, PUTV, and number of needles for their association with urinary morbidity. Results: Urethral dose was fairly constant in all urethra segments except prostate base, where the variation in does was large. On multivariate analysis, higher urethral base D50, V100, and larger PUTV were predictive for higher maximum increase in IPSS. Higher urethral base V100 and larger PUTV predicted for prolonged IPSS resolution. Higher urethral base D50 and larger needle number predicted for longer RTOG resolution. Higher urethral base V100 predicted for RTOG ≥2 toxicity. Conclusions: Radiation dose to the urethral base, larger PUTV, and needle number, predicted for increased urinary toxicity after prostate brachytherapy. Correlation between urinary morbidity and urethral base dosimetry may reflect a large variation in urethral dose observed at the prostate base

  7. Varicella zoster virus infection causing urinary retention in a child ...

    African Journals Online (AJOL)

    2012-11-02

    Nov 2, 2012 ... ophthalmological and neurological complications may occur in patients with HIV infection.3 We describe the case ... on neurological examination of his lower limbs. An 8F Foley catheter was inserted transurethrally ... later, the perineal skin had healed and a trial without catheter was repeated. He was able.

  8. Management of Lower Urinary Retention in a Limited Resource ...

    African Journals Online (AJOL)

    The results of investigations done such as: urinalysis, full blood count, electrolytes, urea and creatinine, intravenous urography, trans- abdominal ultrasonography, chest X-ray and histology of trans-rectal biopsies of the prostate . The total number of new patients ... The male: female ratio was 39:1.The patients ages ranged ...

  9. Urinary stones following renal transplantation.

    Science.gov (United States)

    Kim, H; Cheigh, J S; Ham, H W

    2001-06-01

    The formation of urinary tract stones following renal transplantation is a rare complication. The clinical features of stones after transplantation differ from those of non-transplant patients. Renal colic or pain is usually absent and rarely resembles acute rejection. We retrospectively studied 849 consecutive kidney transplant patients in The Rogosin Institute/The Weill-Cornell Medical Center, New York who were transplanted between 1980 and 1997 and had functioning grafts for more than 3 months, to determine the incidence of stone formation, composition, risk factors and patient outcome. At our center, urinary stones were diagnosed in 15 patients (1.8%) of 849 functioning renal grafts for 3 or more months. Of the 15 patients, 10 were males and 5 were females in their third and fourth decade. Eight patients received their transplant from living donors and 7 from cadaveric donors. The stones were first diagnosed between 3 and 109 months after transplantation (mean 17.8 months) and 5 patients had recurrent episodes. The stones were located in the bladder in 11 cases (73.3%), transplanted kidney in 3 cases and in multiple sites in one case. The size of stones varied from 3.4 mm to 40 mm (mean 12 mm). The composition of stones was a mixed form of calcium oxalate and calcium phosphate in 5 cases and 4 patients had infected stones consisting of struvite or mixed form of struvite and calcium phosphate. Factors predisposing to stone formation included tertiary hyperparathyroidism (n = 8), hypercalciuria (n = 5), recurrent urinary tract infection (n = 5), hypocitraturia (n = 4), and obstructive uropathy (n = 2). Many cases had more than one risk factor. Clinically, painless hematuria was observed in 6 patients and dysuria without bacteriuria in 5 patients. None had renal colic or severe pain at any time. There were no changes in graft function at diagnosis and after removal of stones. Five patients passed stones spontaneously and 8 patients underwent cystoscopy for stone

  10. Prostate Artery Embolization for Complete Urinary Outflow Obstruction Due to Benign Prostatic Hypertrophy

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Simon Chun Ho, E-mail: simonyu@cuhk.edu.hk; Cho, Carmen Chi Min; Hung, Esther Hiu Yee [The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology (Hong Kong); Chiu, Peter Ka Fung; Yee, Chi Hang; Ng, Chi Fai [The Chinese University of Hong Kong, Department of Surgery, Prince of Wales Hospital (Hong Kong)

    2017-01-15

    BackgroundWe aimed to evaluate the effectiveness of PAE in weaning of catheter and relieving obstructive urinary symptoms in patients with acute urinary retention (AUR) due to benign prostatic hypertrophy (BPH) and failed trial without catheter (TWOC).Materials and MethodsIn this prospective study approved by the institutional review board, a signed informed consent was obtained. Eighteen consecutive patients with AUR due to BPH and failed TWOC were recruited. Nineteen consecutive patients with BPH but without AUR were recruited as a control. Patients with CTA evidence of arterial occlusion or significant stenosis along the prostate artery access path were excluded. PAE was performed using microspheres (100–300 μm diameter). Outcome assessment included successful weaning of catheter in 2 weeks, procedure-related complications, change of symptomatology and urodynamic findings at 1 month as compared to baseline, percent non-perfused prostate volume, and prostate volume reduction on MRI at 2 weeks.ResultsTwo patients in the study group and four in the control group were excluded due to arterial pathology. Embolization of bilateral prostate arteries was achieved in all patients in both the groups (100%). There was no complication. The catheter was successfully weaned in 87.5% (14/16) of patients within 14 days in the treatment group. There was no significant difference in patient demographics, prostate characteristics, and all outcome assessment parameters between both the groups.ConclusionsPAE was probably safe and effective in weaning of catheter and relieving obstructive urinary symptoms in patients due to BPH, with treatment outcomes comparable to those without AUR.

  11. Prostate Artery Embolization for Complete Urinary Outflow Obstruction Due to Benign Prostatic Hypertrophy.

    Science.gov (United States)

    Yu, Simon Chun Ho; Cho, Carmen Chi Min; Hung, Esther Hiu Yee; Chiu, Peter Ka Fung; Yee, Chi Hang; Ng, Chi Fai

    2017-01-01

    We aimed to evaluate the effectiveness of PAE in weaning of catheter and relieving obstructive urinary symptoms in patients with acute urinary retention (AUR) due to benign prostatic hypertrophy (BPH) and failed trial without catheter (TWOC). In this prospective study approved by the institutional review board, a signed informed consent was obtained. Eighteen consecutive patients with AUR due to BPH and failed TWOC were recruited. Nineteen consecutive patients with BPH but without AUR were recruited as a control. Patients with CTA evidence of arterial occlusion or significant stenosis along the prostate artery access path were excluded. PAE was performed using microspheres (100-300 μm diameter). Outcome assessment included successful weaning of catheter in 2 weeks, procedure-related complications, change of symptomatology and urodynamic findings at 1 month as compared to baseline, percent non-perfused prostate volume, and prostate volume reduction on MRI at 2 weeks. Two patients in the study group and four in the control group were excluded due to arterial pathology. Embolization of bilateral prostate arteries was achieved in all patients in both the groups (100%). There was no complication. The catheter was successfully weaned in 87.5% (14/16) of patients within 14 days in the treatment group. There was no significant difference in patient demographics, prostate characteristics, and all outcome assessment parameters between both the groups. PAE was probably safe and effective in weaning of catheter and relieving obstructive urinary symptoms in patients due to BPH, with treatment outcomes comparable to those without AUR.

  12. URINARY STONES IN CHIULDREN

    African Journals Online (AJOL)

    Philip

    Urinary stones were previously thought to be uncommon in the paediatric age however this may be due to differences in presentation and evaluation of children with stones. There are variations in the incidence worldwide; affected by diet and climate. Common aetiological factors are metabolic changes, urinary tract ...

  13. Pediatric Urinary Tract Infection

    Science.gov (United States)

    SBA National Resource Center: 800-621-3141 Pediatric Urinary Tract Infections and Catheterization in Children with Neurogenic Bladder and ... To protect the kidneys from damage – By preventing urinary tract infections (UTI) – By identifying and treating vesicoureteral remux (VUR). ...

  14. Acute pyelonephritis can have serious complications.

    Science.gov (United States)

    Shields, Joanne; Maxwell, Alexander P

    2010-04-01

    Urinary tract infection (UTI) may predominantly involve the lower urinary tract, i.e. acute cystitis, or upper urinary tract consisting of the renal pelvis and kidney,, i.e. acute pyelonephritis The incidence of acute pyelonephritis is higher in young women than in men but the incidence in men over 65 is similar to that in older women. Women have up to a 10% risk of recurrent acute pyelonephritis in the year following a first acute episode. The equivalent risk in men is 6%. Acute pyelonephritis may be uncomplicated and resolve without serious sequelae. A minority of episodes may be complicated by acute kidney injury, papillary necrosis, renal or perinephric abscess or the development of emphysematous pyelonephritis. Acute pyelonephritis is generally caused by microorganisms ascending from the urethra via the bladder into the upper urinary tract. Rarely the kidney may be seeded by blood-borne infection. Ecoli is the most common uropathogen causing pyelonephritis accounting for 70-90% of infections. Species of Enterococci, Klebsiella, Pseudomonas, Proteus and Staphylococci are responsible for the remaining infections. There is a rising incidence in the community of UTI with bacteria that produce extended spectrum beta-lactamase (ESBL) enzymes. These ESBL bacteria have developed resistance to antibiotics such as penicillin, cephalosporins and increasingly to quinolones. Risk factors for uncomplicated acute pyelonephritis include recent sexual intercourse, acute cystitis, stress incontinence and diabetes and for complicated acute pyelonephritis include pregnancy, diabetes, anatomical abnormalities of the urinary tract and renal calculi.

  15. Relationship of bladder dysfunction with upper urinary tract deterioration in cerebral palsy.

    Science.gov (United States)

    Gündoğdu, Gökhan; Kömür, Mustafa; Avlan, Dinçer; Sarı, Ferda Bacaksızlar; Delibaş, Ali; Taşdelen, Bahar; Naycı, Ali; Okuyaz, Cetin

    2013-10-01

    Although lower urinary tract dysfunction (LUTD) in patients with cerebral palsy (CP) has been previously documented by clinical observations and urodynamic tests, its correlation with upper urinary tract deterioration (UUTD) has not been demonstrated. This paper documents symptoms and urodynamic findings of LUTD and their relationship with UUTD in 33 children with CP. By sonography, 4 of these children were found to have UUTD. Age was found to correlate with UUTD, but gender difference and mental or motor functions did not. When comparing urinary symptoms with UUTD, incontinence (n = 31) did not correlate, but on the other hand symptoms of detrusor sphincter dyssynergia (interrupted voiding, urinary retention, hesitancy; n = 5) and culture proven febrile urinary tract infections (n = 4) did. Abnormal urodynamics findings were not diagnostic. We conclude that, apart from incontinence, dysfunctional voiding symptoms and febrile urinary tract infections are valuable indicators of UUTD. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

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

    DEFF Research Database (Denmark)

    Henriksen, Ulrik L; Henriksen, Jens H

    2014-01-01

    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...

  17. The female urinary microbiota, urinary health and common urinary disorders

    OpenAIRE

    Brubaker, Linda; Wolfe, Alan J.

    2017-01-01

    This review provides the clinical context and updated information regarding the female urinary microbiota (FUM), a resident microbial community within the female bladder of many adult women. Microbial communities have variability and distinct characteristics in health, as well as during community disruption (dysbiosis). Information concerning characteristics of the FUM in health and disease is emerging. Sufficient data confirms that the microbes that compose the FUM are not contaminants and a...

  18. [Urinary incontinence and pregnancy].

    Science.gov (United States)

    Deffieux, X

    2009-12-01

    The goal of the current study was to systematically review the literature concerning urinary incontinence and pregnancy, in order to develop recommendations for clinical practice. The prevalence of urinary stress incontinence and overactive bladder symptoms increase with gestational age during pregnancy (from the first to the third trimester), and decrease during the third months following delivery. Obstetrics factors (position during delivery, length of the second part of the labour, forceps, episiotomy, epidural or pudendal anaesthesia) do not modify the risk of post-partum or long term urinary incontinence. At short term follow-up, caesarean delivery is associated with a lower rate of post-partum urinary incontinence. At long term follow-up, data are lacking. Non elective caesarean section is not associated with a decrease in the rate of post-partum or long-term urinary incontinence. Elective caesarean section and systematic episiotomy are not recommended methods for the prevention of post-partum urinary incontinence (grade B), even in "high risk" women. Pelvic floor muscle therapy is the first line treatment for prenatal or post-partum urinary incontinence (grade A). Copyright © 2009 Elsevier Masson SAS. All rights reserved.

  19. Urinary Tract Infections (For Teens)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Urinary Tract Infections KidsHealth / For Teens / Urinary Tract Infections What's in ... especially girls — visit a doctor. What Is a Urinary Tract Infection? A bacterial urinary tract infection (UTI) is the ...

  20. Urinary calcium, sodium, and bone mass of young females.

    Science.gov (United States)

    Matkovic, V; Ilich, J Z; Andon, M B; Hsieh, L C; Tzagournis, M A; Lagger, B J; Goel, P K

    1995-08-01

    Calcium is an important determinant of peak bone mass in young adults because of its influence on skeletal development during growth. Attainment of maximum peak bone mass requires optimal positive balance between calcium intake and obligatory losses of calcium, primarily in urine and feces. Urinary excretion is an important determinant of calcium retention in the body. Accordingly, the purpose of this study was to evaluate the influence of various nutrients on urinary calcium excretion, and to assess their impact on bone mass of young females, aged 8-13 y, during early puberty. The study was conducted in 381 healthy white females in pubertal stage 2. From each participant we collected basic anthropometric measurements, a 3-d food record, blood, a 24-h urine sample, and bone mass measurements of the total body and forearm by dual X-ray absorptiometry. Urinary sodium was found to be one of the most important determinants of urinary calcium excretion: [urinary calcium (mmol/d) = 0.01154 x urinary sodium (mmol/d) + 0.823], whereas calcium intake had relatively little impact: [urinary calcium (mmol/d) = 0.02252 x calcium intake (mmol/d) + 1.5261]. Urinary calcium was much higher at a calcium intake of approximately 37.5 mmol/d (1500 mg/d), supporting the notion that calcium is a threshold nutrient. Calcium intake had a significant positive influence on the bone mineral content and density of the whole body and radius shaft whereas urinary calcium had a negative influence, presumably by reducing calcium accretion into the skeleton.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. [Lower urinary tract dysfunction in Guillain-Barre syndrome].

    Science.gov (United States)

    Reitz, A; Mohr, M; Leistner, N; Tabaza, R; Anding, R; Brehmer, B; Kirschner-Hermanns, R

    2018-02-01

    Guillain-Barré syndrome (GBS) as acute inflammatory demyelinating polyradiculoneuropathy frequently leads to lower urinary tract dysfunction. The available knowledge in the medical literature is limited and good recommendations for diagnosis and therapy are rare. In this study, 189 patients with GBS were screened for lower urinary tract dysfunction. In symptomatic patients, a urodynamic study was performed. Detrusor contractility, post-void residual, and changes of the symptoms over time were studied. Overall Barthel index and urinary control Barthel index as well as the relationship of time after onset of the disease and post-void residual were studied as possible screening criteria for urodynamic assessment. According to the urinary control Barthel index (BI), 115 of 189 patients (61%) presented lower urinary tract symptoms sometime during the course of disease. In 28 patients, these symptoms were temporary during the acute phase. At the time of urological assessment, 87 patients had lower urinary tract symptoms. At the end of rehabilitation, 37 had no symptoms anymore (BI 10), 20 were able to control micturition to a certain extent (BI 5), and 30 had no lower urinary tract control (BI 0). There was a significant negative correlation between post-void residual volume and overall BI (ρ -0.5823, p < 0.0001) and BI for urinary tract control (ρ -0.6430, p < 0.0001). Overall BI and BI for urinary tract control are suitable screening criteria for urodynamic assessment.

  2. The diagnosis and management of lower urinary tract symptoms in multiple sclerosis patients.

    Science.gov (United States)

    Sand, Peter K; Sand, Robert I

    2013-07-01

    Sixty-five percent of multiple sclerosis patients have moderate to severe urinary symptoms and up to 14% initially present with urinary symptomatology. Urinary retention, neurogenic detrusor overactivity, and detrusor sphincter dyssynergia, all increase the risk for urinary tract infections in patients with multiple sclerosis, and these infections may exacerbate their immune response, leading to symptom progression. Fewer than half of the patients with urinary symptoms have seen a specialist and only half have been treated for their neurogenic detrusor overactivity. Several treatments including pelvic floor muscle therapy, pelvic floor electrical stimulation, anticholinergics, desmopressin, sacral nerve neuromodulation, posterior tibial nerve stimulation, cannabinoids, and intravesical therapy with vanniloids, as well as botulinum toxin, have all been shown to be effective in treating urinary symptoms in those with multiple sclerosis. Clean intermittent catheterization is invaluable in patients with persistent urinary retention to avoid infection and upper tract dysfunction. Indwelling transurethral catheterization should be avoided because of the high risk of infection. Identification and successful treatment of these urinary conditions will improve the health and quality of life for these men and women.

  3. Urinary incontinence - collagen implants

    Science.gov (United States)

    ... gov/ency/article/007373.htm Urinary incontinence - injectable implant To use the sharing features on this page, please enable JavaScript. Injectable implants are injections of material into the urethra to ...

  4. Urinary incontinence during pregnancy

    OpenAIRE

    Wesnes, Stian Langeland; Rørtveit, Guri; Bø, Kari; Hunskår, Steinar

    2007-01-01

    Objectives: To investigate incidence and prevalence of urinary incontinence during pregnancy, and associated risk factors.Method: The data collection was conducted as part of the Norwegian Mother and Child Cohort Study at the Norwegian Institute of Public Health. We present questionnaire data about urinary incontinence obtained from 43,279 women (response rate 45%) by week 30. We report data on any incontinence in addition to type, frequency and amount of incontinence. Po...

  5. Radionuclide targeting with particular emphasis on urinary bladder carcinoma

    CERN Document Server

    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. Tamsulosin combined with solifenacin versus tamsulosin monotherapy for male lower urinary tract symptoms: a meta-analysis.

    Science.gov (United States)

    Gong, Mancheng; Dong, Wenjing; Huang, Guiying; Gong, Zhaoyang; Deng, Decheng; Qiu, Shaopeng; Yuan, Runqiang

    2015-01-01

    To evaluate the efficacy and safety of tamsulosin and solifenacin combination therapy compared with tamsulosin monotherapy for male lower urinary tract symptoms (LUTS). We identified all eligible studies that compared tamsulosin and solifenacin combination therapy with tamsulosin monotherapy for male LUTS (up to January 2015). The fixed- or random-effects model was selected depending on the proportion of heterogeneity. Seven articles were identified as eligible for this meta-analysis, with a total of 3063 participants. Synthetic data showed combination therapy had significant improvements in Storage International Prostate Symptom Score (WMD = -0.60; 95% CI: -0.81 to -0.38, P tamsulosin and solifenacin combined therapy group (30.82%) was similar to the tamsulosin monotherapy group (25.75%). Acute urinary retention was seldom reported in the studies and no clinically significant changes regarding Qmax were showed in our meta-analysis. Tamsulosin and solifenacin combination therapy may be a reasonable option for male LUTS patients, especially for those who have significant storage symptoms. However, PVR should be measured during treatment to assess the increase in PVR or the incidence of AUR.

  7. The prognostic value of pyeloectasis in infants with urinary syndrome

    Directory of Open Access Journals (Sweden)

    Kozachkovsky A.E.

    2014-03-01

    Full Text Available Aim of the study was of to determine prognostic value of pyeloectasias in the structure of urinary system diseases including the frequency of pyeloectasia and its clinical significance in young children at the stage of hospital treatment at the infectious disease department. The diagnosis of the diseases and malformations of the kidneys and the urinary tract ultrasound study of 192 children at the age of 1 month to – 2,5 years was conducted. Ultrasound study of the urinary system was performed by a standardized technique using ultrasound scanner «SIEMENS SONOLINE G40» (company Siemens, Germany using a 2.5-5 MHz convex probe, and 7.5-10 MHz linear transducer. Pyeloectasias are the most often sonologic symptom in young age children presenting urinary syndrome (75% of researches. Obtained results of catamnestic follow ups showed that sizes of renal pelvis of more than 10 mm are the risk factors for acute pyelonephritis development.

  8. Liquid Effluent Retention Facility

    Data.gov (United States)

    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...

  9. Drug Retention Times

    Energy Technology Data Exchange (ETDEWEB)

    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.

  10. Clinical observation of radiation urinary bladder disease

    International Nuclear Information System (INIS)

    Jin Yuke; Liu Libo; Zhang Haiying; Liang Shuo; Chen Dawei; Wu Zhenfeng; Dong Lihua; Lu Xuejun

    2004-01-01

    Objective: Clinical characteristic, diagnosis and treatment of radiation urinary bladder disease induced by radiation therapy for cancers in the pelvis were inquired into for providing diagnostic basis. Methods: Statistical analysis for the clinical cases was carried out. Results: The incidence of radiation bladder diseases induced by radiation therapy of cervix cancer are about 0.8%-2.96%, with an average of 2.14%. Radiation bladder disease is divided into acute radiation cystitis, chronic radiation cystitis and radiation vesical fistula. Chronic radiation cystitis is seen most often in the clinic and its main clinical symptom is painless macroscopic hematuria, which is again subdivided into slight and severe degrees. Diagnosis should include history of exposure to radiation, which dose exceed the dose threshold, and typical clinical characteristics. Conclusion: The characteristics, types and diagnostic basis of radiation urinary bladder disease analyzed in this study can provide the reference for drawing up diagnostic standard

  11. Urinary Tract Infections in Children with Primary Nephrotic

    African Journals Online (AJOL)

    user1

    ABSTRACT. BACKGROUND: The occurrence of urinary tract infection. (UTI) in children with Nephrotic syndrome (NS) has been widely reported by various workers, but not much has been documented about its occurrence among children with acute glomerulonephritis (AGN). Hence, the level of susceptibility to UTI by both ...

  12. Fasting and Urinary Stones

    Directory of Open Access Journals (Sweden)

    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.

  13. [Urinary incontinence and menopause].

    Science.gov (United States)

    Legendre, G; Fritel, X; Ringa, V; Lesavre, M; Fernandez, H

    2012-10-01

    The aim of this review was to examine the relationship between menopause and urinary incontinence (UI). Our work is based on a review of the literature on the epidemiology of UI in women and the effects of hormone therapy on symptoms of urinary leakage. A search of the Medline database between January 2000 and April 2012 was performed by crossing the keywords "urinary incontinence, stress urinary incontinence (SUI), urge incontinence, over active bladder, menopause, estrogen therapy". Twenty-nine articles over the 482 articles were initialy selected. The UI was a common symptom during menopause, with a prevalence of 15 to 30% and an annual incidence of 5 to 10%. The association between UI and menopause was controversial. Indeed, although underpinned by pathophysiological mechanisms such as the sensitivity of tissues of the urogenital sinus to estrogen, the epidemiological data available were contradictory and should be interpreted, if possible, depending on the type of UI. Thus, it remained difficult to distinguish the effect of menopause of the aging. The effects of estrogen on IU differed depending on the route of administration and of the type of UI. Randomized trials showed that oral administration of estrogen after menopause increased the occurrence of UI or SUI. However a vaginal administration of estrogen improved urge urinary incontinence (UUI) and overactive bladder. The data of this review were consistent with the French and European guidelines. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  14. Female urinary incontinence and sexuality

    Science.gov (United States)

    Mota, Renato Lains

    2017-01-01

    ABSTRACT Urinary incontinence is a common problem among women and it is estimated that between 15 and 55% of them complain of lower urinary symptoms. The most prevalent form of urinary incontinence is associated with stress, followed by mixed urinary incontinence and urge urinary incontinence. It is a symptom with several effects on quality of life of women mainly in their social, familiar and sexual domains. Female reproductive and urinary systems share anatomical structures, which promotes that urinary problems interfere with sexual function in females. This article is a review of both the concepts of female urinary incontinence and its impact on global and sexual quality of life. Nowadays, it is assumed that urinary incontinence, especially urge urinary incontinence, promotes anxiety and several self-esteem damages in women. The odour and the fear of incontinence during sexual intercourse affect female sexual function and this is related with the unpredictability and the chronicity of incontinence, namely urge urinary incontinence. Female urinary incontinence management involves conservative (pelvic floor muscle training), surgical and pharmacological treatment. Both conservative and surgical treatments have been studied about its benefit in urinary incontinence and also the impact among female sexual function. Unfortunately, there are sparse articles that evaluate the benefits of female sexual function with drug management of incontinence. PMID:28124522

  15. Female urinary incontinence and sexuality

    Directory of Open Access Journals (Sweden)

    Renato Lains Mota

    Full Text Available ABSTRACT Urinary incontinence is a common problem among women and it is estimated that between 15 and 55% of them complain of lower urinary symptoms. The most prevalent form of urinary incontinence is associated with stress, followed by mixed urinary incontinence and urge urinary incontinence. It is a symptom with several effects on quality of life of women mainly in their social, familiar and sexual domains. Female reproductive and urinary systems share anatomical structures, which promotes that urinary problems interfere with sexual function in females. This article is a review of both the concepts of female urinary incontinence and its impact on global and sexual quality of life. Nowadays, it is assumed that urinary incontinence, especially urge urinary incontinence, promotes anxiety and several self-esteem damages in women. The odour and the fear of incontinence during sexual intercourse affect female sexual function and this is related with the unpredictability and the chronicity of incontinence, namely urge urinary incontinence. Female urinary incontinence management involves conservative (pelvic floor muscle training, surgical and pharmacological treatment. Both conservative and surgical treatments have been studied about its benefit in urinary incontinence and also the impact among female sexual function. Unfortunately, there are sparse articles that evaluate the benefits of female sexual function with drug management of incontinence.

  16. Female urinary incontinence and sexuality.

    Science.gov (United States)

    Mota, Renato Lains

    2017-01-01

    Urinary incontinence is a common problem among women and it is estimated that between 15 and 55% of them complain of lower urinary symptoms. The most prevalent form of urinary incontinence is associated with stress, followed by mixed urinary incontinence and urge urinary incontinence. It is a symptom with several effects on quality of life of women mainly in their social, familiar and sexual domains. Female reproductive and urinary systems share anatomical structures, which promotes that urinary problems interfere with sexual function in females. This article is a review of both the concepts of female urinary incontinence and its impact on global and sexual quality of life. Nowadays, it is assumed that urinary incontinence, especially urge urinary incontinence, promotes anxiety and several self-esteem damages in women. The odour and the fear of incontinence during sexual intercourse affect female sexual function and this is related with the unpredictability and the chronicity of incontinence, namely urge urinary incontinence. Female urinary incontinence management involves conservative (pelvic floor muscle training), surgical and pharmacological treatment. Both conservative and surgical treatments have been studied about its benefit in urinary incontinence and also the impact among female sexual function. Unfortunately, there are sparse articles that evaluate the benefits of female sexual function with drug management of incontinence. Copyright® by the International Brazilian Journal of Urology.

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

    DEFF Research Database (Denmark)

    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......BACKGROUND AND OBJECTIVES: Postoperative urinary retention may occur in between 10% and 60% of patients after major surgery. Continuous lumbar epidural analgesia, in contrast to thoracic epidural analgesia, may inhibit urinary bladder function. Postoperative urinary drainage has been common...... in patients with continuous epidural analgesia, despite the lack of scientific evidence for its indication after thoracic epidural analgesia. This study describes 100 patients who underwent elective colonic resection with 48 hours of continuous thoracic epidural analgesia and only 24 hours of urinary drainage...

  18. Indwelling versus Intermittent Urinary Catheterization following Total Joint Arthroplasty: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Wei Zhang

    Full Text Available The purpose of this study is to compare the rates of urinary tract infection (UTI and postoperative urinary retention (POUR in patients undergoing lower limb arthroplasty after either indwelling urinary catheterization or intermittent urinary catheterization.We conducted a meta-analysis of relevant randomized controlled trials (RCT to compare the rates of UTI and POUR in patients undergoing total joint arthroplasty after either indwelling urinary catheterization or intermittent urinary catheterization. A comprehensive search was carried out to identify RCTs. Study-specific risk ratios (RR with 95% confidence intervals (CI were pooled. Additionally, a meta-regression analysis, as well as a sensitivity analysis, was performed to evaluate the heterogeneity.Nine RCTs with 1771 patients were included in this meta-analysis. The results showed that there was no significant difference in the rate of UTIs between indwelling catheterization and intermittent catheterization groups (P>0.05. Moreover, indwelling catheterization reduced the risk of POUR, versus intermittent catheterization, in total joint surgery (P<0.01.Based on the results of the meta-analysis, indwelling urinary catheterization, removed 24-48 h postoperatively, was superior to intermittent catheterization in preventing POUR. Furthermore, indwelling urinary catheterization with removal 24 to 48 hours postoperatively did not increase the risk of UTI. In patients with multiple risk factors for POUR undergoing total joint arthroplasty of lower limb, the preferred option should be indwelling urinary catheterization removed 24-48 h postoperatively.Level I.

  19. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... site Sitio para adolescentes Body Mind Sexual Health Food & Fitness Diseases & ... KidsHealth / For Kids / Urinary Tract Infections (UTIs) What's in this article? What Exactly Is a Urinary ...

  20. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Videos for Educators Search English Español Urinary Tract Infections (UTIs) KidsHealth / For Kids / Urinary Tract Infections (UTIs) What's in this article? What Exactly Is ...

  1. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Staying Safe Videos for Educators Search English Español Urinary Tract Infections (UTIs) KidsHealth / For Kids / Urinary Tract Infections (UTIs) What's in this article? What Exactly Is ...

  2. Urinary Tract Infections (For Kids)

    Medline Plus

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

  3. Urinary Tract Infections (For Kids)

    Medline Plus

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

  4. Acute encephalomyelitis complicated with severe neurological sequelae after intrathecal administration of methotrexate in a patient with acute lymphoblastic leukemia.

    Science.gov (United States)

    Nishikawa, Takuro; Okamoto, Yasuhiro; Maruyama, Shinsuke; Tanabe, Takayuki; Kurauchi, Koichiro; Kodama, Yuichi; Nakagawa, Shunsuke; Shinkoda, Yuichi; Kawano, Yoshifumi

    2014-11-01

    A four-year-old girl on maintenance therapy for acute lymphoblastic leukemia (ALL) complained of a headache and low back pain on the day she received her 21st intrathecal methotrexate (it-MTX) administration, and the next day experienced numbness and pain in her foot. This numbness gradually spread to her hand. She thereafter developed a fever and was hospitalized on day 8. After antibiotic therapy, the fever disappeared. However, her lower limbs became paralyzed, and she also developed urinary retention. On day 12, her paralysis progressed upwards, and she also developed paralysis of the upper limbs. Finally, she experienced convulsions with an impairment of consciousness. A magnetic resonance imaging study of the brain and spinal cord showed abnormal signals in the brain cortex and anterior horn. Accordingly, we diagnosed acute encephalomyelitis associated with it-MTX. High-dose intravenous immunoglobulin, steroid pulse therapy, plasma exchange, and dextromethorphan administration were initiated, while she received mechanical ventilation. Despite this intensive treatment, she suffered severe neurological damage and had to be maintained on mechanical ventilation due to persistent flaccid quadriplegia one year after the onset. When patients have symptoms of ascending paralysis during it-MTX treatment, clinicians should carefully consider the possibility of acute encephalomyelitis due to it-MTX.

  5. Paraganglioma of urinary bladder

    Directory of Open Access Journals (Sweden)

    Vinod Priyadarshi

    2015-01-01

    Full Text Available Paraganglioma of the urinary bladder are tumors of chromaffin tissue originating from the sympathetic innervations of the urinary bladder wall and are extremely rare. Being functional, in most of the cases they are recognized by their characteristic presentation of hypertensive crisis and postmicturition syncope. A silent presentation of a bladder paraganglioma is very unusual but quite dangerous as they are easily misdiagnosed and adequate peri-operative attention is not provided. Here, we are presenting one such silent paraganglioma in adult women who presented with only a single episode of hematuria and severe hypertensive crisis occur during its trans-urethral resection.

  6. Urinary albumin in space missions

    DEFF Research Database (Denmark)

    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)....

  7. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Kids / Urinary Tract Infections (UTIs) What's in this article? What Exactly Is a Urinary Tract? Urinary Tract ... KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor. © 1995- ...

  8. Urinary Tract Infection: Pathogenesis and Outlook.

    Science.gov (United States)

    McLellan, Lisa K; Hunstad, David A

    2016-11-01

    The clinical syndromes comprising urinary tract infection (UTI) continue to exert significant impact on millions of patients worldwide, most of whom are otherwise healthy women. Antibiotic therapy for acute cystitis does not prevent recurrences, which plague up to one fourth of women after an initial UTI. Rising antimicrobial resistance among uropathogenic bacteria further complicates therapeutic decisions, necessitating new approaches based on fundamental biological investigation. In this review, we highlight contemporary advances in the field of UTI pathogenesis and how these might inform both our clinical perspective and future scientific priorities. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Urinary tract infections in the elderly population.

    Science.gov (United States)

    Matthews, S James; Lancaster, Jason W

    2011-10-01

    Urinary tract infections (UTIs) are a common problem in the elderly population. The spectrum of disease varies from a relatively benign cystitis to potentially life-threatening pyelonephritis. This review covers the management of asymptomatic bacteriuria, acute uncomplicated cystitis, acute uncomplicated pyelonephritis, antibiotic resistance, catheter-associated bacteriuria/symptomatic UTIs, and antibiotic prophylaxis for recurrent infections in elderly men and women. Literature was obtained from English-language searches of MEDLINE (1966-April 2011), Cochrane Library, BIOSIS (1993-April 2011), and EMBASE (1970-April 2011). Further publications were identified from citations of resulting articles. Search terms included, but were not limited to, urinary tract infections, asymptomatic bacteriuria, acute uncomplicated cystitis, acute uncomplicated pyelonephritis, antibiotic resistance, catheter associated urinary tract infections, recurrent urinary tract infections, and elderly. The prevalence of UTIs in elderly women depends on the location in which these women are living. For elderly women living in the community, UTIs compromise the second most common infection, whereas in residents of long-term care facilities (LTCFs) and hospitalized subjects, it is the number one cause of infection. The spectrum of patient presentation varies from classic signs and symptoms in the independent elderly population to atypical presentations, including increased lethargy, delirium, blunted fever response, and anorexia. Although there are few guidelines specifically directed toward the management of UTIs in the elderly population, therapy generally mirrors the recommendations for the younger adult age groups. When choosing a treatment regimen, special attention must be given to the severity of illness, living conditions, existing comorbidities, presence of external devices, local antibiotic resistance patterns, and the ability of the patient to comply with therapy. Improved guidelines

  10. What is Urinary Incontinence?

    Science.gov (United States)

    ... before you urinate. Urge incontinence is most common in the elderly and may be a sign of a urinary ... Mental Health Sex and Birth Control Sex and Sexuality Birth Control Family ... Men Seniors In The News Your Health Resources Healthcare Management End- ...

  11. Increased urinary orosomucoid excretion

    DEFF Research Database (Denmark)

    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...

  12. Kidneys and urinary system

    International Nuclear Information System (INIS)

    Nair, G.

    1992-01-01

    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

  13. Urinary Tract Infections.

    Science.gov (United States)

    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…

  14. The female urinary microbiome in urgency urinary incontinence.

    Science.gov (United States)

    Pearce, Meghan M; Zilliox, Michael J; Rosenfeld, Amy B; Thomas-White, Krystal J; Richter, Holly E; Nager, Charles W; Visco, Anthony G; Nygaard, Ingrid E; Barber, Matthew D; Schaffer, Joseph; Moalli, Pamela; Sung, Vivian W; Smith, Ariana L; Rogers, Rebecca; Nolen, Tracy L; Wallace, Dennis; Meikle, Susan F; Gai, Xiaowu; Wolfe, Alan J; Brubaker, Linda

    2015-09-01

    The purpose of this study was to characterize the urinary microbiota in women who are planning treatment for urgency urinary incontinence and to describe clinical associations with urinary symptoms, urinary tract infection, and treatment outcomes. Catheterized urine samples were collected from multisite randomized trial participants who had no clinical evidence of urinary tract infection; 16S ribosomal RNA gene sequencing was used to dichotomize participants as either DNA sequence-positive or sequence-negative. Associations with demographics, urinary symptoms, urinary tract infection risk, and treatment outcomes were determined. In sequence-positive samples, microbiotas were characterized on the basis of their dominant microorganisms. More than one-half (51.1%; 93/182) of the participants' urine samples were sequence-positive. Sequence-positive participants were younger (55.8 vs 61.3 years old; P = .0007), had a higher body mass index (33.7 vs 30.1 kg/m(2); P = .0009), had a higher mean baseline daily urgency urinary incontinence episodes (5.7 vs 4.2 episodes; P urinary incontinence episodes, -4.4 vs -3.3; P = .0013), and were less likely to experience urinary tract infection (9% vs 27%; P = .0011). In sequence-positive samples, 8 major bacterial clusters were identified; 7 clusters were dominated not only by a single genus, most commonly Lactobacillus (45%) or Gardnerella (17%), but also by other taxa (25%). The remaining cluster had no dominant genus (13%). DNA sequencing confirmed urinary bacterial DNA in many women with urgency urinary incontinence who had no signs of infection. Sequence status was associated with baseline urgency urinary incontinence episodes, treatment response, and posttreatment urinary tract infection risk. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Endoscopy-guided ectopic egg removal from the urinary bladder in a leopard tortoise (Stigmochelys pardalis).

    Science.gov (United States)

    Mans, Christoph; Foster, Jonathan D

    2014-06-01

    Egg retention in the urinary bladder of a leopard tortoise was diagnosed by radiography and confirmed by cystoscopy. The egg was removed with a modified polypectomy snare, aided by a flexible endoscope and insufflation. No complications occurred during the procedures and the tortoise made a complete recovery.

  16. Data on Retention

    NARCIS (Netherlands)

    van Wanrooij, Ward; Pras, Aiko; Schönwälder, Jürgen; Serrat, Joan

    2005-01-01

    Proposed EU regulations on data retention could require every provider to keep accounting logs of its customers Internet usage. Although the technical consequences of these requirements have been investigated by consultancy companies, this paper investigates what this accounting data could be, how

  17. Tritium retention in TFTR

    Energy Technology Data Exchange (ETDEWEB)

    Dylla, H.F.; Wilson, K.L. (eds.)

    1988-04-01

    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.

  18. Urinary neprilysin in the critically ill patient.

    Science.gov (United States)

    Pajenda, Sahra; Mechtler, Karl; Wagner, Ludwig

    2017-05-25

    Critically ill patients in intensive care face hazardous conditions. Among these, acute kidney injury (AKI) is frequently seen as a result of sepsis. Early diagnosis of kidney injury is of the utmost importance in the guidance of interventions or avoidance of treatment-induced kidney injury. On these grounds, we searched for markers that could indicate proximal tubular cell injury. Urine samples of 90 patients admitted to the intensive or intermediate care unit were collected over 2 to 5 days. The biomarker neprilysin (NEP) was investigated in urine using several methods such as dot blot, ELISA and immunofluorescence of urinary casts. Fifty-five healthy donors acted as controls. NEP was highly significantly elevated in the urine of patients who suffered AKI according to the KDIGO criteria in comparison to healthy controls. It was also found to be elevated in ICU patients without overt signs of AKI according to serum creatinine changes, however they were suffering from potential nephrotoxic insults. According to our findings, urinary NEP is indicative of epithelial cell alterations at the proximal tubule. This was elaborated in ICU patients when ghost fragments and NEP + microvesicles were observed in urinary sediment cytopreparations. Furthermore, NEP + immunofluorescence of healthy kidney tissue showed staining at the proximal tubules. NEP, a potential marker for proximal tubular epithelia, can be measured in urine. This does not originate from leakage of elevated serum levels, but indicates proximal tubular cell alterations such as brush border severing, which can heal in most cases.

  19. Urinary tract infections in multiple sclerosis.

    Science.gov (United States)

    Phé, Véronique; Pakzad, Mahreen; Curtis, Carmel; Porter, Bernadette; Haslam, Collette; Chataway, Jeremy; Panicker, Jalesh N

    2016-06-01

    Urinary tract infections (UTIs) are commonly reported by people with multiple sclerosis (PwMS) and significantly impact quality of life. To provide an overview of the problem of UTIs in PwMS and offer a practical approach for the diagnosis and management. A review of the literature through a Pubmed search up to October 2015 was performed using the following keywords: multiple sclerosis, neurogenic bladder, urinary tract infections, relapse, dipsticks, culture, recurrent and prevention. Noteworthy topics include the definition of a confirmed symptomatic UTI as a positive urine culture defined by >10(5) colony-forming units (CFU)/mL or >10(4) CFU/mL if a urethral catheter urine sample is taken, or any count of bacteria in a suprapubic bladder puncture specimen, both in addition to symptoms including fever, pain, changes in lower urinary tract symptoms or neurological status. Urinalysis is useful to exclude a UTI; however, on its own is insufficient to confirm a UTI, for which urine culture is required. Experts advise asymptomatic UTIs should not be treated except in the context of an acute relapse. From international guidelines, there is no validated strategy to prevent recurrent UTIs in PwMS. This review provides an overview of the diagnosis, treatment and prevention of UTIs in the setting of multiple sclerosis (MS). © The Author(s), 2016.

  20. No. 250-Recurrent Urinary Tract Infection.

    Science.gov (United States)

    Epp, Annette; Larochelle, Annick

    2017-10-01

    To provide an update of the definition, epidemiology, clinical presentation, investigation, treatment, and prevention of recurrent urinary tract infections in women. Continuous antibiotic prophylaxis, post-coital antibiotic prophylaxis, and acute self-treatment are all efficient alternatives to prevent recurrent urinary tract infection. Vaginal estrogen and cranberry juice can also be effective prophylaxis alternatives. A search of PubMed and The Cochrane Library for articles published in English identified the most relevant literature. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date restrictions. This update is the consensus of the Sub-Committee on Urogynaecology of the Society of Obstetricians and Gynaecologists of Canada. Recommendations were made according to the guidelines developed by the Canadian Task Force on Preventive Health Care (Table 1). Recurrent urinary tract infections need careful investigation and can be efficiently treated and prevented. Different prophylaxis options can be selected according to each patient's characteristics. Copyright © 2017. Published by Elsevier Inc.

  1. An abattoir survey of urinary bladder lesions in cattle

    Science.gov (United States)

    Herenda, Drago; Dukes, Thomas W.; Feltmate, Thomas E.

    1990-01-01

    Postmortem examination of 21,340 cattle at an Ontario abattoir over a one-year period revealed macroscopic lesions in urinary bladders of 2,296 animals (10.8%). Chronic cystitis, the most frequent finding, was observed in 2,209 cases (10.4%); uroliths were found in 994 (4.7%) of the cattle with chronic cystitis. Other types of urinary bladder lesions included acute cystitis, developmental abnormalities, hyperplasia, neoplasia, emphysema, and a parasitic cystitis. ImagesFigure 1.Figure 2.Figure 3.Figure 4. PMID:17423629

  2. PATHOPHYSIOLOGY AND PRINCIPLES OF THERAPY OF A NEUROGENIC HYPERACTIVE URINARY BLADDER IN PATIENTS AFTER CEREBROVASCULAR ACCIDENT

    Directory of Open Access Journals (Sweden)

    P. G. Shchvartz

    2017-01-01

    Full Text Available Neurogenic hyperactiv e bladder in different clinical variations is a characteristic com plication of restorativ e and residual periods of ischemic stroke and an important diagnostic criterion in vascular dementia. Mechanisms of formation of individual symptoms included in this syndrome is due to ischemic damage to cortical, subcortical and brainstem (the nucleus of Barrington centres of urination and associative areas of the brain, and the functional dissociation of these structures due to demyelination of the Central conductors of the afferent and efferent impulses. As a result of deficit of cerebral effects (such as brake and activating, is a violation of the implementation of the reflexes of urination (including carrying out continence, ongoing spinal (sympathetic, parasympathetic and somatic. The article presents a new concept of formation of the syndrome of hyperactive bladder on the basis of violations of the implementation of the 4 reflexes of urination, which provides the normal retention of urine and are responsible for the accumulation function of the bladder. First we analyzed the main point of application of drugs of anticholinergic and sympathomimetic actions in the reflexes of urination and mechanisms of restoration of function of the lower urinary tract in patients with acute and chronic v ascular diseases of the brain.

  3. [Sacral nerve stimulation in the treatment of the lower urinary tract function disorders].

    Science.gov (United States)

    Miotła, Paweł; Kulik-Rechberger, Beata; Skorupski, Paweł; Rechberger, Tomasz

    2011-11-01

    Functional disorders of the female lower urinary tract like urge incontinence, idiopathic urinary retention and symptoms of urgency-frequency occasionally do not respond properly to classical behavioral and pharmacological therapy Therefore, additional alternative therapies are needed to alleviate these bothersome symptoms. Sacral neuromodulation (SNS) utilize mild electrical pulses which activate or suppress neural reflexes responsible for voiding by stimulating the sacral nerves that innervate the bladder, external urethral sphincter and pelvic floor muscles. The exact mechanism of SNS action is not yet fully understood but it is assumed that it influences the neuroaxis at different levels of the central nervous system and restores the balance between inhibitory and activatory control over the voiding reflex. There is numerous evidence on the success of SNS not only in the treatment of refractory urge incontinence in adult and children but also in idiopathic urinary retention and symptoms of urgency-frequency

  4. Clinical analysis of urinary tract infection in patients undergoing transurethral resection of the prostate.

    Science.gov (United States)

    Li, Y-H; Li, G-Q; Guo, S-M; Che, Y-N; Wang, X; Cheng, F-T

    2017-10-01

    To analyze the related influencing factors of urinary tract infection in patients undergoing transurethral resection of the prostate (TURP). A total of 343 patients with benign prostatic hyperplasia admitted to this hospital from January 2013 to December 2016, were selected and treated by TURP. Patients were divided into infection group and non-infection group according to the occurrence of urinary tract infection after operation. The possible influencing factors were collected to perform univariate and multivariate logistic regression analysis. There were 53 cases with urinary tract infection after operation among 343 patients with benign prostatic hyperplasia, accounting for 15.5%. The univariate analysis displayed that the occurrence of urinary tract infection in patients undergoing TURP was closely associated with patient's age ≥ 65 years old, complicated diabetes, catheterization for urinary retention before operation, no use of antibiotics before operation and postoperative indwelling catheter duration ≥ 5 d (p urinary tract infection in patients receiving TURP (p urinary tract infection after TURP, while preoperative prophylactic utilization of anti-infective drugs can reduce the occurrence of postoperative urinary tract infection.

  5. phosphorus retention data and metadata

    Data.gov (United States)

    U.S. Environmental Protection Agency — phosphorus retention in wetlands data and metadata. This dataset is associated with the following publication: Lane , C., and B. Autrey. Phosphorus retention of...

  6. Retention Measures and Reporting Systems

    National Research Council Canada - National Science Library

    Ropp, Gary

    2003-01-01

    ...) and performed by the Navy Personnel Research and Development Center (NPRDC) to: (1) review current retention measures in use in the Navy, as well as the system used to distribute retention statistics, and (2...

  7. Urinary Incontinence in Elderly

    Directory of Open Access Journals (Sweden)

    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. Soil Water Retention Curve

    Science.gov (United States)

    Johnson, L. E.; Kim, J.; Cifelli, R.; Chandra, C. V.

    2016-12-01

    Potential water retention, S, is one of parameters commonly used in hydrologic modeling for soil moisture accounting. Physically, S indicates total amount of water which can be stored in soil and is expressed in units of depth. S can be represented as a change of soil moisture content and in this context is commonly used to estimate direct runoff, especially in the Soil Conservation Service (SCS) curve number (CN) method. Generally, the lumped and the distributed hydrologic models can easily use the SCS-CN method to estimate direct runoff. Changes in potential water retention have been used in previous SCS-CN studies; however, these studies have focused on long-term hydrologic simulations where S is allowed to vary at the daily time scale. While useful for hydrologic events that span multiple days, the resolution is too coarse for short-term applications such as flash flood events where S may not recover its full potential. In this study, a new method for estimating a time-variable potential water retention at hourly time-scales is presented. The methodology is applied for the Napa River basin, California. The streamflow gage at St Helena, located in the upper reaches of the basin, is used as the control gage site to evaluate the model performance as it is has minimal influences by reservoirs and diversions. Rainfall events from 2011 to 2012 are used for estimating the event-based SCS CN to transfer to S. As a result, we have derived the potential water retention curve and it is classified into three sections depending on the relative change in S. The first is a negative slope section arising from the difference in the rate of moving water through the soil column, the second is a zero change section representing the initial recovery the potential water retention, and the third is a positive change section representing the full recovery of the potential water retention. Also, we found that the soil water moving has traffic jam within 24 hours after finished first

  9. Urinary incontinence during pregnancy.

    Science.gov (United States)

    Wesnes, Stian Langeland; Rortveit, Guri; Bø, Kari; Hunskaar, Steinar

    2007-04-01

    To investigate incidence and prevalence of urinary incontinence during pregnancy and associated risk factors. The data collection was conducted as part of the Norwegian Mother and Child Cohort Study at the Norwegian Institute of Public Health. We present questionnaire data about urinary incontinence obtained from 43,279 women (response rate 45%) by week 30. We report data on any incontinence, in addition to type, frequency, and amount of incontinence. Potential risk factors were investigated by logistic regression analyses. The prevalence of incontinence increased from 26% before pregnancy to 58% in week 30. The corresponding figures for nulliparous women were 15% and 48%, and for parous women 35% and 67%. The cumulative incidence was 46%. Stress urinary incontinence was the most common type of incontinence in week 30 of pregnancy, experienced by 31% of nulliparous and 42% of parous women. The majority of pregnant women had leakage less than once per week and droplets only, both before and during pregnancy. Parity was a strong and significant risk factor for incontinence in adjusted analyses both before pregnancy (odds ratio [OR] 2.5, 95% confidence interval [CI] 2.4-2.7 for primiparous and OR 3.3, 95% CI 3.1-3.5 for multiparous women) and during pregnancy (ORs 2.0, 95% CI 1.9-2.1 and 2.1, 95% CI 2.0-2.2, respectively). Age and body mass index were weaker, but still statistically significant, risk factors. The prevalence of urinary incontinence increases substantially during pregnancy. Incontinence both before and during pregnancy seems to be associated with parity, age, and body mass index. II.

  10. Enhancing retention of partial dentures using elastomeric retention rings

    Directory of Open Access Journals (Sweden)

    Kakkirala Revathi

    2015-01-01

    Full Text Available This report presents an alternative method for the retention of partial dentures that relies on the engagement of tooth undercuts by a lining material. The lab procedures are also presented. A new maxillary and mandibular acrylic partial dentures were fabricated using elastomeric retention technique for a partially dentate patient. A partially dentate man reported difficulty in retaining his upper removable partial denture (RPD. The maxillary RPD was designed utilizing elastomeric retention technique. During follow-up, it was necessary to replace the retention rings due to wear. The replacement of the retention rings, in this case, was done through a chairside reline technique. Elastomeric retention technique provides exceptionally good retention can be indicated to stabilize, cushion, splint periodontally involved teeth, no enough undercut for clasps, eliminate extractions, single or isolated teeth.

  11. Pathophysiology and diagnostic value of urinary trypsin inhibitors.

    Science.gov (United States)

    Pugia, Michael J; Lott, John A

    2005-01-01

    Inflammation is an important indicator of tissue injury. In the acute form, there is usually accumulation of fluids and plasma components in the affected tissues. Platelet activation and the appearance in blood of abnormally increased numbers of polymorphonucleocytes, lymphocytes, plasma cells and macrophages usually occur. Infectious disorders such as sepsis, meningitis, respiratory infection, urinary tract infection, viral infection, and bacterial infection usually induce an inflammatory response. Chronic inflammation is often associated with diabetes mellitus, acute myocardial infarction, coronary artery disease, kidney diseases, and certain auto-immune disorders, such as rheumatoid arthritis, organ failures and other disorders with an inflammatory component or etiology. The disorder may occur before inflammation is apparent. Markers of inflammation such as C-reactive protein (CRP) and urinary trypsin inhibitors have changed our appraisal of acute events such as myocardial infarction; the infarct may be a response to acute infection and (or) inflammation. We describe here the pathophysiology of an anti-inflammatory agent termed urinary trypsin inhibitor (uTi). It is an important anti-inflammatory substance that is present in urine, blood and all organs. We also describe the anti-inflammatory agent bikunin, a selective inhibitor of serine proteases. The latter are important in modulating inflammatory events and even shutting them down.

  12. Simultaneous metastases of clear cell renal cell carcinoma to the urinary bladder and left retroperitoneal space: A case report and review of the literature.

    Science.gov (United States)

    Li, Hengping; Wang, Jianzhong; Wei, Qiang; Wang, Huan

    2016-07-01

    The present study describes an extremely rare case of simultaneous metastases of clear cell renal cell carcinoma (ccRCC) to the urinary bladder and left retroperitoneal space, occurring subsequent to an open radical nephrectomy. A review of the literature is also considered. A 70-year-old man presenting with diabetes mellitus and hypertension was referred to West China Hospital (Chengdu, China) with constant left flank pain that had been apparent for 2 months. Ultrasonography identified a heterogeneous tumor with a solid component measuring 4.4×3.4×5.0 cm, and computed tomography (CT) revealed a circumscribed and contrast-enhanced tumor in the left kidney. Subsequent pathological analysis of the specimen, obtained from an open radical nephrectomy, confirmed the presence of ccRCC. At 1 month after the radical nephrectomy, an abdominopelvic CT scan identified tumors located on the posterior bladder wall and also in the left retroperitoneal space, forming due to hematuria and acute urinary clot retention. There was no evidence of metastasis to the lungs, bones or other organs. A transurethral resection of the bladder tumor was performed and pathological analysis of the bladder specimen demonstrated metastatic ccRCC. Extensive hydrothorax and general anasarca presented half a month after the transurethral resection, with the patient subsequently succumbing 15 days later.

  13. Neonatal Staphylococcus lugdunensis urinary tract infection.

    Science.gov (United States)

    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. © 2015 Japan Pediatric Society.

  14. [Clinical significance of determining urinary podocalyxin level in children with primary nephrotic syndrome].

    Science.gov (United States)

    Liu, Tao; Zhang, Bi-Li; Li, Li

    2012-05-01

    To study the clinical significance of urinary podocyte marker protein podocalyxin (PCX) in the diagnosis of primary nephrotic syndrome (PNS) in children and the evaluation of disease severity. PCX levels in the first morning urine were measured by turbidimetric immunoassay (TIA) in 175 children, including 53 children with acute PNS [36 cases of simple nephrotic syndrome (NS) and 17 cases of nephritic NS], 56 children with PNS in the remission stage (relapsed: 42 cases) and 66 healthy children (control group). Twenty-four hour urinary protein was measured in the 53 children with acute PNS. The optimal operating points for the diagnosis of acute PNS and nephritic NS were determined using the receiver-operating characteristic curve (ROC curve). Significant increasd levels of urinary PCX were found in children with acute PNS compared with those in the remission stage and the control group (Pnephritic NS group than in the simple NS group (Pnephritic NS was 0.915 and 0.784 respectively. The optimal operating point for the diagnosis of acute PNS and nephritic NS was 7.97 and 10.28 ng/mL respectively, with a sensitivity and specificity of 81.1% and 93.4% respectively for acute PNS and of 94.1% and 52.8% respectively for nephritic NS. The quantitative detection of urinary PCX is useful in the evaluation of podocyte dynamic changes. It is helpful in the diagnosis of acute PNS and in the differentiation of nephritic NS and simple NS.

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

    Directory of Open Access Journals (Sweden)

    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. Role of pelvic floor in lower urinary tract function.

    Science.gov (United States)

    Chermansky, Christopher J; Moalli, Pamela A

    2016-10-01

    The pelvic floor plays an integral part in lower urinary tract storage and evacuation. Normal urine storage necessitates that continence be maintained with normal urethral closure and urethral support. The endopelvic fascia of the anterior vaginal wall, its connections to the arcus tendineous fascia pelvis (ATFP), and the medial portion of the levator ani muscles must remain intact to provide normal urethral support. Thus, normal pelvic floor function is required for urine storage. Normal urine evacuation involves a series of coordinated events, the first of which involves complete relaxation of the external urethral sphincter and levator ani muscles. Acquired dysfunction of these muscles will initially result in sensory urgency and detrusor overactivity; however, with time the acquired voiding dysfunction can result in intermittent urine flow and incomplete bladder emptying, progressing to urinary retention in severe cases. This review will start with a discussion of normal pelvic floor anatomy and function. Next various injuries to the pelvic floor will be reviewed. The dysfunctional pelvic floor will be covered subsequently, with a focus on levator ani spasticity and stress urinary incontinence (SUI). Finally, future research directions of the interaction between the pelvic floor and lower urinary tract function will be discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Catheter-Associated Urinary Tract Infections

    Science.gov (United States)

    ... Vaccine Safety Frequently Asked Questions about Catheter-associated Urinary Tract Infections Recommend on Facebook Tweet Share Compartir What is ... an incision above the pubis. What is a urinary tract infection? A urinary tract infection (UTI) is an infection ...

  18. Kidneys and Urinary Tract

    Science.gov (United States)

    ... kidneys , contains the by-products of our body's metabolism — salts, toxins, and water — that end up in ... blood. Acute kidney failure may be due to bacterial infection, injury, shock, heart failure, poisoning, or drug ...

  19. Recurrent uncomplicated urinary tract infections in women: a review.

    Science.gov (United States)

    Nosseir, Sandy B; Lind, Lawrence R; Winkler, Harvey A

    2012-03-01

    Recurrent urinary tract infections most often present with symptoms of irritative voiding. In most cases, they are caused by reinfection with a previously isolated organism. Patients with one or more symptoms of uncomplicated recurrent urinary tract infection should undergo thorough examination and screening for underlying comorbidities that increase susceptibility. When frequent reinfections, empiric treatment relapse, persistent infections, or risk factors for complicated infections are encountered, patients may benefit from urodynamics, cystoscopy, renal ultrasound, intravenous urogram, or voiding cystourethrogram to evaluate for anatomic, functional, or metabolic abnormalities affecting the urinary tract (e.g., stones, stricture, obstruction, vesicoureteral reflux, lesions, detrusor underactivity). These patients may benefit from culture-guided empiric treatment and further evaluation by urology, nephrology, or infectious disease specialists. In patients with a history of uncomplicated urinary tract infections, empiric treatment guided by local antimicrobial resistance may efficiently treat a suspected recurrence. After successful treatment of the acute infection, postcoital prophylaxis, continuous prophylaxis, or self-start empiric treatment may be selected based on frequency of recurrent infections, temporal relation to intercourse, and patient characteristics. Ancillary measures such as probiotics, cranberry products, or local estrogen replacement may also be considered. This article will review the current definition, epidemiology, pathogenesis, diagnosis, work-up, treatment, treatment side effects, and prevention of recurrent urinary tract infections in women. A suggested algorithm for evaluation and treatment based on current literature is provided.

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

    International Nuclear Information System (INIS)

    Kim, Ye Lim; Kim, Kyeong Ah; Lee, Chang Hee; Choi, Jae Woong; Lee, Jong Mee; Park, Cheol Min

    2009-01-01

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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. Urinary Incontinence in Elderly

    OpenAIRE

    N. S. Neki

    2016-01-01

    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 re...

  3. Reoperation for urinary incontinence

    DEFF Research Database (Denmark)

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

    2016-01-01

    for urinary incontinence (retropubic midurethral tape, transobturator tape, urethral injection therapy, Burch colposuspension, pubovaginal slings, and miscellaneous operations). Cox proportional hazard models were used to estimate the hazard ratio (HR) with 95% confidence intervals (CIs), adjusted for factors...... risk was for urethral injection therapy (44%). In a Cox proportional hazard model that adjusted for age, department volume, and calendar effect, the transobturator tape carried a 2-fold higher risk of reoperation (HR, 2.1; 95% CI, 1.5-2.9), and urethral injection therapy carried a 12 fold-higher risk...

  4. Acute exercise improves motor memory

    DEFF Research Database (Denmark)

    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...... 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...... processes. More mechanistic studies are required to elucidate the specific role of each biomarker in the formation of motor memory....

  5. Perturbations in the Urinary Exosome in Transplant Rejection

    Energy Technology Data Exchange (ETDEWEB)

    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

  6. Renal scar formation after urinary tract infection in children

    OpenAIRE

    Park, Young Seo

    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...

  7. Acidosis and Urinary Calcium Excretion

    DEFF Research Database (Denmark)

    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...... in the renal tubule and then discuss why not all gene defects that cause renal tubular acidosis are associated with hypercalciuria and nephrocalcinosis....

  8. Urinary Tract Infections (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... English Español Urinary Tract Infections (UTIs) KidsHealth / For Kids / Urinary Tract Infections (UTIs) What's in this article? ...

  9. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... English Español Urinary Tract Infections (UTIs) KidsHealth / For Kids / Urinary Tract Infections (UTIs) What's in this article? ...

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

    Directory of Open Access Journals (Sweden)

    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

  11. Urinary tract trauma

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, J.E. (Sunnybrook Medical Centre, Toronto, Ontario (Canada))

    1983-09-01

    From a practical point of view, a woman who has blunt injury to the pelvic area with hematuria from the lower urinary tract, has a contused or ruptured bladder. In a man, such a situation calls for retrograde urethrography to determine if the injury is in the urethra or the bladder because the two organs are investigated differently. In both sexes, such injuries are usually associated with pelvic fractures. Massive bladder displacement and severe hemorrhage should alert one to the need for pelvic angiography to find and embolize the bleeding site within the first 24 hours after injury. For blunt trauma to the upper urinary tract an intravenous urogram with tomography is still the main examination. However, a normal intravenous urogram does not exclude serious injury. Therefore, if signs or symptoms persist, a computerized tomographic (CT) examination should be performed if available. Otherwise, a radionuclide study is advisable. Non-excretion on intravenous urography with tomography calls for selective renal arteriography to delineate the etiology. There can be serious renal trauma in the absence of hematuria, which may occur with renal pedicle injury or avulsion of the ureter. Minor forniceal ruptures may occasionally mask severe posterior renal lacerations.

  12. Urinary Tract Infections in Children

    Directory of Open Access Journals (Sweden)

    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

  13. Recycling retention functions

    International Nuclear Information System (INIS)

    Skrable, K.W.; Chabot, G.E.; Johnson, M.H.

    1981-01-01

    Beginning with the concept of any number of physiologically meaningful compartments that recycle material with a central extracellular fluid compartment and considering various excretion pathways, we solve the differential equations describing the kinetics by the method of Laplace to obtain concise algebraic expressions for the retentions. These expressions contain both fundamental and eigenvalue rate constants; the eigenvalue rate constants are obtained from the solution of a polynomial incorporating the fundamental rate constants. Mathematically exact expressions that predict the biodistribution resulting from continuous uptakes are used to obtain very simple mathematically exact steady state expressions as well as approximate expressions applicable to any time. These steady state and approximate expressions contain only the fundamental rate constants; also, they include a recycling factor that describes the increase in the biodistributions because of recycling. To obtain the values of the fundamental rate constants, short term kinetics studies along with data on the long term distributions are suggested. Retention functions obtained in this way predict both the short term and long term distributions; they therefore are useful in the interpretation of bioassay data and in the estimation of internal doses

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

    Science.gov (United States)

    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. © The Author(s) 2015.

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

    DEFF Research Database (Denmark)

    Andersen, Mikkel René; Buhl, Kristian B; Jensen, Boye L

    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...... and reduced ability of patients' urine to activate ENaC. METHODS: Samples were collected during active NS and at stable remission from 20 patients with idiopathic NS, aged 9.1 ± 3.2 years. Plasminogen-plasmin concentration was measured with an enzyme-linked immunosorbent assay. Western immunoblotting...

  16. Neuromodulation for the Treatment of Lower Urinary Tract Symptoms.

    Science.gov (United States)

    Yamanishi, Tomonori; Kaga, Kanya; Fuse, Miki; Shibata, Chiharu; Uchiyama, Tomoyuki

    2015-09-01

    Neuromodulation therapy incorporates electrical stimulation to target specific nerves that control lower urinary tract symptoms (LUTS). The objectives of this article are to review the mechanism of action, the type of neuromodulation, and the efficacy of neuromodulation mainly according to the results of randomized controlled trials. Neuromodulation includes pelvic floor electrical stimulation (ES) using vaginal, anal and surface electrodes, interferential therapy (IF), magnetic stimulation (MS), percutaneous tibial nerve stimulation, and sacral nerve stimulation (SNS). The former four stimulations are used for external periodic (short-term) stimulation, and SNS are used for internal, chronic (long-term) stimulation. All of these therapies have been reported to be effective for overactive bladder or urgency urinary incontinence. Pelvic floor ES, IF, and MS have also been reported to be effective for stress urinary incontinence. The mechanism of neuromodulation for overactive bladder has been reported to be the reflex inhibition of detrusor contraction by the activation of afferent fibers by three actions, i.e., the activation of hypogastric nerve, the direct inhibition of the pelvic nerve within the sacral cord and the supraspinal inhibition of the detrusor reflex. The mechanism of neuromodulation for stress incontinence is contraction of the pelvic floor muscles through an effect on the muscle fibers as well as through the stimulation of pudendal nerves. Overall, cure and improvement rates of these therapies for urinary incontinence are 30-50, and 60-90% respectively. MS has been considered to be a technique for stimulating nervous system noninvasively. SNS is indicated for patients with refractory overactive bladder and urinary retention. © 2015 Wiley Publishing Asia Pty Ltd.

  17. Urinary proteomics to support diagnosis of stroke.

    Directory of Open Access Journals (Sweden)

    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. Urinary incontinence and weight changes during pregnancy and post partum: a pending challenge.

    Science.gov (United States)

    Ruiz de Viñaspre Hernández, Regina; Rubio Aranda, Encarnación; Tomás Aznar, Concepción

    2013-12-01

    to analyse the association between urinary incontinence and maternal weight, and its variations in pregnancy and post partum. observational study of a cohort of women from the start of pregnancy until six months post partum. Hospital San Pedro in La Rioja, Spain. 402 pregnant women without urinary incontinence at the start of pregnancy. the dependent variable was urinary incontinence, assessed using the Urogenital Distress Inventory-Short Form questionnaire. The main independent variables were body mass index (BMI) at the first antenatal visit and six months post partum, weight gain during pregnancy, postpartum weight loss, and weight retained from the start of pregnancy to six months post partum. The association between urinary incontinence and the main independent variables was measured using Student's t-test. Three simple logistic regression models were used to assess the strength of this association, one for each of the independent variables that showed a significant association with urinary incontinence (ppregnancy, 20.1% of the women were overweight and 8.7% were obese. Six months post partum, 30.3% of the women were overweight and 11.4% were obese. The mean (±standard deviation) retained weight was 2 (±3.1) kg. Postpartum urinary incontinence was associated with BMI at six months post partum, postpartum weight loss and retained weight at six months post partum (purinary incontinence with these variables was significant, and remained stable in both simple and multiple regression analyses with BMI at six months post partum [odds ratio (OR) 1.09 versus 1.08], weight loss from delivery to six months post partum (OR 0.88 versus 0.88), and retained weight from the beginning of pregnancy until six months post partum (OR 1.23 versus 1.19). high BMI and weight retention at six months post partum increase the risk of urinary incontinence, whereas postpartum weight loss decreases the risk of urinary incontinence, even if other urinary incontinence risk factors co

  19. Drug Retention Times

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    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. Based on anecdotal evidence, most people “party” during extended time away from the work environment. Therefore, the following scenarios were envisioned: (1) a person uses an illicit drug at a party on Saturday night (infrequent user); (2) a person uses a drug one time on Friday night and once again on Saturday night (infrequent user); and (3) a person uses a drug on Friday night, uses a drug twice on Saturday night, and once again on Sunday (frequent user).

  20. Neurogenic Lower Urinary Tract Dysfunction in Adults with Cerebral Palsy: Outcomes following a Conservative Management Approach.

    Science.gov (United States)

    Goldfarb, Robert A; Pisansky, Andrew; Fleck, Joseph; Hoversten, Patrick; Cotter, Katherine J; Katorski, Jenna; Liberman, Daniel; Elliott, Sean P

    2016-04-01

    Cerebral palsy is characterized by motor impairment following injury to the developing brain. Neurogenic lower urinary tract dysfunction is estimated to affect at least a third of children with cerebral palsy. However there are limited data as patients transition to adulthood. We sought to describe the symptoms, sequelae and management of neurogenic lower urinary tract dysfunction in adults with cerebral palsy. We retrospectively reviewed the charts of adult patients with cerebral palsy between 2011 and 2014. Patients with prior bladder reconstruction or catheterization based bladder drainage were excluded from study. Cerebral palsy severity was determined using GMFCS (Gross Motor Function Classification System). A conservative evaluation and treatment paradigm was used. Noninvasive treatments were encouraged. Specifically clean intermittent catheterization, which is often not feasible, is avoided unless urinary retention, hydronephrosis or refractory lower urinary tract symptoms develop. There were 121 patients included in final analysis. Median age was 25 and 61 patients (50%) had GMFCS level V. Noninvasive management failed in 28 of 121 patients (23%) as defined by hydronephrosis in 9, persistent urinary retention in 10 and refractory lower urinary tract symptoms/incontinence in 9. Urethral clean intermittent catheterization was poorly tolerated. Of all patients 25% showed evidence of urolithiasis during the study period. Surgical intervention was rare and associated with significant morbidity. Adults with cerebral palsy may present with variable signs and symptoms of neurogenic lower urinary tract dysfunction. Conservative treatment was successful in more than 75% of patients. Clean intermittent catheterization was poorly tolerated in patients in whom conservative treatment failed. Surgical intervention was rarely indicated and it should be reserved for select individuals. Copyright © 2016 American Urological Association Education and Research, Inc

  1. Outcomes of pregnancy following surgery for stress urinary incontinence: a systematic review.

    Science.gov (United States)

    Pollard, Matthew E; Morrisroe, Shelby; Anger, Jennifer T

    2012-06-01

    Although few data have been published on the safety of childbearing after surgery for stress urinary incontinence, a large proportion of physicians recommend that women wait to complete childbearing before pursuing surgical treatment for stress urinary incontinence. We systematically reviewed the available literature to examine the safety of pregnancy after stress urinary incontinence surgery, and to measure the effect of such pregnancy on continence outcomes. The review was conducted according to the recommendations of the MOOSE (Meta-Analysis of Observational Studies in Epidemiology) group. We performed a systematic review to identify articles published before January 2011 on pregnancy after incontinence surgery. Databases searched include PubMed®, EMBASE® and the Cochrane Review. Our literature search identified 592 titles, of which 20 articles were ultimately included in the review. Data were tabulated from case reports, case series and physician surveys. The final analysis in each category included 32, 19 and 67 patients, respectively. Urinary retention developed during pregnancy in 2 women, 1 of whom was treated with a sling takedown and the other with intermittent catheterization. Of these 2 women 1 also had an episode of pyelonephritis during pregnancy, possibly related to the intermittent catheterization. The incidence of postpartum stress urinary incontinence ranged from 5% to 18% after cesarean delivery and from 20% to 30% after vaginal delivery. Although the data on outcomes in the literature are limited and further studies need to be performed on the subject, the current data suggests that any increase in risks for pregnancy after surgery for stress incontinence may be small. A low risk of urinary retention during pregnancy may exist. Although some data suggest that cesarean deliveries may result in a lower rate of recurrent stress urinary incontinence than vaginal deliveries, a formal analysis could not be performed with the available data

  2. Research Synopsis: Spring 1983 Retention.

    Science.gov (United States)

    Peralta Community Coll. District, Oakland, CA. Office of Research, Planning and Development.

    An analysis of spring 1983 retention rates and grade distributions within the Peralta Community College District (PCCD) revealed: (1) College of Alameda had the highest successful retention rate in the PCCD, defined as the total of all students who completed the term with a grade of A, B, C, D, or CR (credit); (2) the PCCD's successful retention…

  3. Preventing urinary incontinence in women.

    Science.gov (United States)

    Newman, Diane K; Cardozo, Linda; Sievert, Karl-Dietrich

    2013-10-01

    This review examines the evidence to date, analyzes specific risk factors and assesses the ability to prevent urinary incontinence in women, while providing clinical recommendations. More extraordinary risk factors such as ethnicity and race, mixed and fecal incontinence, iatrogenic and neurogenic factors should be discussed in a follow-up report. Studies have revealed that certain factors place women at risk for developing urinary incontinence, including age, obesity, diabetes, pregnancy and delivery, high-impact physical exercise factors and estrogen deficiency. Healthcare providers should screen women who are at risk for developing urinary incontinence and institute specific interventions, specifically behavioral and even rehabilitative techniques, to prevent this prevalent and distressing condition.

  4. Imaging Findings of the Unusual Presentations, Associations and Clinical Mimics of Acute Appendicitis.

    Science.gov (United States)

    Demir, Mustafa Kemal; Savas, Yildiray; Furuncuoglu, Yavuz; Cevher, Tarik; Demiral, Serdar; Tabandeh, Babek; Aslan, Melisa

    2017-10-01

    There are many kinds of unusual presentations or associations and clinical mimics of acute appendicitis, and definitive diagnosis requires knowledge of the imaging findings in some cases. The unusual presentations and associations of acute appendicitis included in this study are perforated appendicitis, acute appendicitis occurring in hernias, acute appendicitis with cystic endosalpingiosis, intussusception of appendix, and acute appendicitis with pregnancy. We also present uncommon gastrointestinal, urinary and gynecologic clinical mimics of acute appendicitis including anomalous congenital band, duplication cysts, giant Meckel's diverticulitis, inflammatory fibroid polyp, renal artery thrombosis, spontaneous urinary extravasation and OHVIRA syndrome. Familiarity with these entities may improve diagnostic accuracy and enable the quickest and most appropriate clinical management.

  5. Lower Urinary Tract Symptoms and Urinary Incontinence During Pregnancy.

    Science.gov (United States)

    Balik, Gülşah; Güven, Emine Seda G; Tekin, Yeşim B; Şentürk, Şenol; Kağitci, Mehmet; Üstüner, Işık; Mete Ural, Ülkü; Şahin, Figen K

    2016-05-01

    Lower urinary tract symptoms (LUTS) can frequently be seen in pregnant women. Pregnancy and delivery have been considered as risk factors in the occurrence of pelvic floor dysfunction and determinants of LUTS. The main associated risk factor is parity. In the present study, we aim to determine the frequency of LUTS and urinary incontinence (UI) during pregnancy and the associated risk factors. This prospective study was carried out in a total of 250 women during their 28- and 40-gestational week checks. The Urinary Distress Inventory-6, the Incontinence Impact Questionnaire-7, and International Consultation on Incontinence Questionnaire-Short Form were used to determine LUTS and its effect on quality of life. The mean age and gestational age of the participants were 29.41 ± 5.70 year (range 18-44) and 35.45 ± 2.98 weeks (range 28-40), respectively. The prevalence of LUTS was 81.6%. The prevalence of UI during pregnancy was 37.2%. Stress urinary incontinence, urge urinary incontinence and mixed urinary incontinence were diagnosed as 15.6, 4.8 and 16.8%, respectively. We found that advanced age, smoking and multiparity were risk factors associated with incontinence. Incontinence reduced pregnant women's quality of life. Lower urinary tract symptoms are commonly seen among pregnant women and these symptoms negatively affect the quality of life of pregnant women. Advanced age, smoking and multiparity were risk factors associated with urinary incontinence and LUTS. Obstetricians should be on the lookout for individual urological problems in pregnancy. Resolving any urological issues and cessation of smoking for the affected individuals will help alleviate the problem. © 2014 Wiley Publishing Asia Pty Ltd.

  6. Military Retention. A Comparative Outlook

    Directory of Open Access Journals (Sweden)

    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.

  7. Urinary tract infections in children: EAU/ESPU guidelines.

    Science.gov (United States)

    Stein, Raimund; Dogan, Hasan S; Hoebeke, Piet; Kočvara, Radim; Nijman, Rien J M; Radmayr, Christian; Tekgül, Serdar

    2015-03-01

    In 30% of children with urinary tract anomalies, urinary tract infection (UTI) can be the first sign. Failure to identify patients at risk can result in damage to the upper urinary tract. To provide recommendations for the diagnosis, treatment, and imaging of children presenting with UTI. The recommendations were developed after a review of the literature and a search of PubMed and Embase. A consensus decision was adopted when evidence was low. UTIs are classified according to site, episode, symptoms, and complicating factors. For acute treatment, site and severity are the most important. Urine sampling by suprapubic aspiration or catheterisation has a low contamination rate and confirms UTI. Using a plastic bag to collect urine, a UTI can only be excluded if the dipstick is negative for both leukocyte esterase and nitrite or microscopic analysis is negative for both pyuria and bacteriuria. A clean voided midstream urine sample after cleaning the external genitalia has good diagnostic accuracy in toilet-trained children. In children with febrile UTI, antibiotic treatment should be initiated as soon as possible to eradicate infection, prevent bacteraemia, improve outcome, and reduce the likelihood of renal involvement. Ultrasound of the urinary tract is advised to exclude obstructive uropathy. Depending on sex, age, and clinical presentation, vesicoureteral reflux should be excluded. Antibacterial prophylaxis is beneficial. In toilet-trained children, bladder and bowel dysfunction needs to be excluded. The level of evidence is high for the diagnosis of UTI and treatment in children but not for imaging to identify patients at risk for upper urinary tract damage. In these guidelines, we looked at the diagnosis, treatment, and imaging of children with urinary tract infection. There are strong recommendations on diagnosis and treatment; we also advise exclusion of obstructive uropathy within 24h and later vesicoureteral reflux, if indicated. Copyright © 2014 European

  8. Perturbations in the Urinary Exosome in Transplant Rejection

    Directory of Open Access Journals (Sweden)

    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.

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

    DEFF Research Database (Denmark)

    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)....

  10. Aceptabilidad del tratamiento "empírico" de la infección urinaria aguda en el niño Acceptability of the "empirical" treatment of acute urinary infection in children

    Directory of Open Access Journals (Sweden)

    Sandalio Durán Álvarez

    2011-03-01

    Full Text Available Las guías propuestas por grupos internacionales enfatizan en la importancia del diagnóstico de la infección del tracto urinario en la atención primaria de salud, para poder iniciar un tratamiento precoz con antibióticos en los casos de mayor riesgo. El médico de atención primaria en ocasiones realiza su trabajo lejos de los laboratorios de microbiología y no puede realizar el urocultivo con la rapidez necesaria para un tratamiento adecuado. Este médico necesita disponer de pruebas diagnósticas rápidas que le ayuden a tomar la decisión médica más adecuada, aunque ninguna combinación de ellas puede sustituir al urocultivo. En esta propuesta se analizan las situaciones en las que el médico debe esperar el resultado del estudio bacteriológico y en las que puede iniciar un tratamiento «empírico» después de tomar la muestra para el urocultivo, si este puede realizarse. En los casos excepcionales de imposibilidad de realizar el estudio bacteriológico, el médico tiene que actuar utilizando los llamados métodos de «diagnóstico rápido».The guidances proposed for international groups emphasize the significance of diagnosis of the urinary tract infection in primary health care to start an early antibiotics treatment in cases of a major risk. The primary care physician sometimes works far from the microbiology laboratories and can not to carry out a fast uroculture for an appropriate treatment. This physician needs to have available fast diagnostic tests helping him to make a more suitable medical decision, although any combination of them may to replace the uroculture. In present proposal are analyzed those situations where the physician must to await for bacteriological study results to start the "empirical" treatment after the sample take for uroculture if it may to be carry out. In exceptional cases of impossibility to conduct the bacteriological study, the physician must to act using the so called "fast diagnosis" methods.

  11. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Your pee smells bad. These things happen 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)

    Medline Plus

    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. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... a urinary tract infection before anyone else can see there's anything wrong with you. That's why it's ... signs of a kidney infection and you should see a doctor right away. What Will the Doctor ...

  14. Urinary Tract Infections - Multiple Languages

    Science.gov (United States)

    ... UTI (Urinary Tract Infection) - 简体中文 (Chinese, Simplified (Mandarin dialect)) Bilingual PDF Health Information Translations Urine Sample -- Female (Clean Catch) - 简体中文 (Chinese, Simplified ( ...

  15. [Ultrasound of the urinary system].

    Science.gov (United States)

    Segura-Grau, A; Herzog, R; Díaz-Rodriguez, N; Segura-Cabral, J M

    2016-09-01

    Ultrasound techniques are able to provide a fairly complete examination of the urinary system, achieving a high sensitivity in relevant-pathology detection, especially in the kidney, bladder and prostate. Early detection of pathologies such as tumors or urinary tract obstructions, sometimes even before their clinical manifestation, has improved their management and prognosis in many cases. This, added to its low cost and harmlessness, makes ultrasound ideal for early approaches and follow-up of a wide number of urinary system pathologies. In this article, the ultrasound characteristics of the main urinary system pathologies that can be diagnosed by this technique, are reviewed. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... para niños How the Body Works Puberty & Growing Up Staying Healthy Staying Safe Recipes & Cooking Health Problems ... Your urinary tract is actually a system made up of these main parts: two kidneys two ureters ( ...

  17. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... if I Have a UTI? You may notice signs of a urinary tract infection before anyone else ... it smell bad when you pee? These are signs that you might have a bladder infection, so ...

  18. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Urinary Tract Infections (UTIs) KidsHealth / For Kids / ...

  19. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... body. Ahhh! That feels better. Urinary Tract Troubles Girls are more likely than boys to get a ... away properly, they stay on your skin. In girls, this means they can grow near the opening ...

  20. Candida Urinary Tract Infection: Pathogenesis

    OpenAIRE

    Fisher, John F.; Kavanagh, Kevin; Sobel, Jack D.; Kauffman, Carol A.; Newman, Cheryl A.

    2011-01-01

    Candida species are unusual causes of urinary tract infection (UTI) in healthy individuals, but common in the hospital setting or among patients with predisposing diseases and structural abnormalities of the kidney and collecting system. The urinary tract may be invaded in either an antegrade fashion from the bloodstream or retrograde via the urethra and bladder. Candida species employ a repertoire of virulence factors, including phenotypic switching, dimorphism, galvano - and thi...

  1. Controversies in urinary iodine determinations

    OpenAIRE

    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...

  2. Job embeddedness and nurse retention.

    Science.gov (United States)

    Reitz, O Ed; Anderson, Mary Ann; Hill, Pamela D

    2010-01-01

    Nurse retention is a different way of conceptualizing the employer-employee relationship when compared with turnover. Job embeddedness (JE), a construct based on retention, represents the sum of reasons why employees remain at their jobs. However, JE has not been investigated in relation to locale (urban or rural) or exclusively with a sample of registered nurses (RNs). The purpose of this study was to determine what factors (JE, age, gender, locale, and income) help predict nurse retention. A cross-sectional mailed survey design was used with RNs in different locales (urban or rural). Job embeddedness was measured by the score on the composite, standardized instrument. Nurse retention was measured by self-report items concerning intent to stay. A response rate of 49.3% was obtained. The typical respondent was female (96.1%), white, non-Hispanic (87.4%), and married (74.9%). Age and JE were predictive of nurse retention and accounted for 26% of the explained variance in intent to stay. Although age was a significant predictor of intent to stay, it accounted for only 1.4% of the variance while JE accounted for 24.6% of the variance of nurse retention (as measured by intent to stay). Older, more "embedded" nurses are more likely to remain employed in their current organization. Based on these findings, JE may form the basis for the development of an effective nurse retention program.

  3. Hyperammonemia associated with distal renal tubular acidosis or urinary tract infection: a systematic review.

    Science.gov (United States)

    Clericetti, Caterina M; Milani, Gregorio P; Lava, Sebastiano A G; Bianchetti, Mario G; Simonetti, Giacomo D; Giannini, Olivier

    2018-03-01

    Hyperammonemia usually results from an inborn error of metabolism or from an advanced liver disease. Individual case reports suggest that both distal renal tubular acidosis and urinary tract infection may also result in hyperammonemia. A systematic review of the literature on hyperammonemia secondary to distal renal tubular acidosis and urinary tract infection was conducted. We identified 39 reports on distal renal tubular acidosis or urinary tract infections in association with hyperammonemia published between 1980 and 2017. Hyperammonemia was detected in 13 children with distal renal tubular acidosis and in one adult patient with distal renal tubular acidosis secondary to primary hyperparathyroidism. In these patients a negative relationship was observed between circulating ammonia and bicarbonate levels (P urinary tract infection was complicated by acute hyperammonemia and symptoms and signs of acute neuronal dysfunction, such as an altered level of consciousness, convulsions and asterixis, often associated with signs of brain edema, such as anorexia and vomiting. Urea-splitting bacteria were isolated in 28 of the 31 cases. The urinary tract was anatomically or functionally abnormal in 30 of these patients. This study reveals that both altered distal renal tubular acidification and urinary tract infection may be associated with relevant hyperammonemia in both children and adults.

  4. Artificial urinary sphincter implantation: an important component of complex surgery for urinary tract reconstruction in patients with refractory urinary incontinence.

    Science.gov (United States)

    Zhang, Fan; Liao, Limin

    2018-01-08

    We review our outcomes and experience of artificial urinary sphincter implantation for patients with refractory urinary incontinence from different causes. Between April 2002 and May 2017, a total of 32 patients (median age, 40.8 years) with urinary incontinence had undergone artificial urinary sphincter placement during urinary tract reconstruction. Eighteen patients (56.3%) were urethral injuries associated urinary incontinence, 9 (28.1%) had neurogenic urinary incontinence and 5 (15.6%) were post-prostatectomy incontinence. Necessary surgeries were conducted before artificial urinary sphincter placement as staged procedures, including urethral strictures incision, sphincterotomy, and augmentation cystoplasty. The mean follow-up time was 39 months. At the latest visit, 25 patients (78.1%) maintained the original artificial urinary sphincter. Four patients (12.5%) had artificial urinary sphincter revisions. Explantations were performed in three patients. Twenty-four patients were socially continent, leading to the overall success rate as 75%. The complication rate was 28.1%; including infections (n = 4), erosions (n = 4), and mechanical failure (n = 1). The impact of urinary incontinence on the quality of life measured by the visual analogue scale dropped from 7.0 ± 1.2 to 2.2 ± 1.5 (P urinary sphincter implantation in our center are unique, and the procedure is an effective treatment as a part of urinary tract reconstruction in complicated urinary incontinence cases with complex etiology.

  5. [Functional state of upper urinary tract in urgent extracorporeal lithotripsy].

    Science.gov (United States)

    Dzeranov, N K; Mudraia, I S; Volkov, I N; Moskalenko, S A; Kirpatovskiĭ, V I

    2000-01-01

    Seven patients have undergone urgent extracorporeal lithotripsy (UEL) for renal colics. 3 patients were cured. Before UEL they had insignificant defects of urodynamics and ureteral contraction. 3 patients with initial dilation of the upper urinary tracts > 2 cm and reflux ureteral motility, residual concrements eliminated spontaneously or after additional UEL procedures or combined treatment. One female with initial pelvic and uretral dilation and disturbed motility of the upper urinary tracts was treated for 6 months. 1-2.5-year follow-up detected neither concrements nor marked dilation of the calyceropelvic system. Patients with renal colics have more pronounced local defects of contraction rhythm and activity, peristaltic direction. Peristaltic disorders in the upper urinary tracts in patients with renal colics are local and may be related to acute occlusion and neuroreflex effects. This explains why UEL produces good results in renal colics, especially in patients with minimal defects of urodynamics. Complicated course after UEL early after the operation occurred in patients with dilated upper urinary tracts, high contraction amplitude registered by high tonicity of the ureteral wall and the presence of retrograde peristaltic waves.

  6. Payload retention device

    Science.gov (United States)

    Monford, Leo G., Jr.

    1992-06-01

    A payload retention device for grappling and retaining a payload in docked position on a supporting structure in the cargo bay of a space vehicle is presented. The device comprises a two-fault tolerant electromagnetic grappling system comprising electromagnets for attracting and grappling a grapple strike plate affixed to the payload when in proximity thereto and an electromechanical latching assembly comprising a pair of independent latching subassemblies. Each subassembly comprises a set of latching pawls which are driven into latching and unlatching positions relative to a grappled payload by a pair of gearmotors, each equipped with a ratchet clutch drive mechanism which is two-fault tolerant with respect to latching such that only one gearmotor of the four needs to be operational to effect a latch of the payload but is single fault tolerant with respect to release of a latched payload. Sensors are included for automatically sensing the magnetic grappling of a payload and for automatically de-energizing the gearmotors of the latching subassemblies when a latch condition is achieved.

  7. Does the Urinary Microbiome Play a Role in Urgency Urinary Incontinence and Its Severity?

    OpenAIRE

    Karstens, Lisa; Asquith, Mark; Davin, Sean; Stauffer, Patrick; Fair, Damien; Gregory, W. Thomas; Rosenbaum, James T.; McWeeney, Shannon K.; Nardos, Rahel

    2016-01-01

    Objectives: Traditionally, the urinary tract has been thought to be sterile in the absence of a clinically identifiable infection. However, recent evidence suggests that the urinary tract harbors a variety of bacterial species, known collectively as the urinary microbiome, even when clinical cultures are negative. Whether these bacteria promote urinary health or contribute to urinary tract disease remains unknown. Emerging evidence indicates that a shift in the urinary microbiome may play an ...

  8. Does the urinary microbiome play a role in urgency urinary incontinence and its severity?

    OpenAIRE

    Lisa Karstens; Lisa Karstens; Mark Asquith; Sean Davin; Patrick Stauffer; Damien Fair; Damien Fair; Damien Fair; W Thomas Gregory; James T Rosenbaum; James T Rosenbaum; Shannon K McWeeney; Rahel Nardos; Rahel Nardos

    2016-01-01

    Objectives: Traditionally, the urinary tract has been thought to be sterile in the absence of a clinically identifiable infection. However, recent evidence suggests that the urinary tract harbors a variety of bacterial species, known collectively as the urinary microbiome, even when clinical cultures are negative. Whether these bacteria promote urinary health or contribute to urinary tract disease remains unknown. Emerging evidence indicates that a shift in the urinary microbiome may play an ...

  9. Data Retention and Anonymity Services

    Science.gov (United States)

    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.

  10. Retention capacity of random surfaces.

    Science.gov (United States)

    Knecht, Craig L; Trump, Walter; Ben-Avraham, Daniel; Ziff, Robert M

    2012-01-27

    We introduce a "water retention" model for liquids captured on a random surface with open boundaries and investigate the model for both continuous and discrete surface heights 0,1,…,n-1 on a square lattice with a square boundary. The model is found to have several intriguing features, including a nonmonotonic dependence of the retention on the number of levels: for many n, the retention is counterintuitively greater than that of an (n+1)-level system. The behavior is explained using percolation theory, by mapping it to a 2-level system with variable probability. Results in one dimension are also found.

  11. Acute pancreatitis

    Science.gov (United States)

    ... its blood vessels. This problem is called acute pancreatitis. Acute pancreatitis affects men more often than women. Certain ... well it can be treated. Complications of acute pancreatitis may include: Acute kidney failure Long-term lung damage (ARDS) Buildup ...

  12. Clinical and diagnostic significance of urinary neutrophil gelatinase-associated lipocalin-2 measurement in children with microbial inflammatory kidney and urinary tract diseases

    Directory of Open Access Journals (Sweden)

    A. V. Eremeeva

    2015-01-01

    Full Text Available Objective: to study the clinical and diagnostic significance of urinary neutrophil gelatinase-associated lipocalin-2 (NGAL measurement in children with urinary tract infection (я=15 and pyelonephritis (я=15. The patients' age was 1 to 16 years (mean age, 7.32+4.52 years. The diagnosis was verified on the basis of clinical and laboratory findings and medical history and instrumental examination data. Urinary NGAL levels were measured by enzyme immunoassay (a Bio\\fendor Laboratory Medicine kit and calculated with reference to mg of creatinine. Urinary NGAL levels were established to depend on the degree of renal parenchymal damage. The investigation showed a relationship between the excretion of NGAL during the acute phase of pyelonephritis and the detection of renal scarring, as evidenced by statistical DMCA nephroscintigraphy. The acute pyelonephritis group exhibited a moderate direct correlation between the renal excretion of NGAL and the degree of leukocytosis and the blood levels of C-reactive protein. The findings allow recommendations for measuring urinary NGAL levels as an additional noninvasive marker for the early detection of renal parenchymal damage.

  13. [Amoniuria, urinary gap and osmolal in patients with moderate renal insufficiency].

    Science.gov (United States)

    Guzmán, Laura K; Ruiz Pecchio, Adriana M; Munizaga, Marcela; Ponte, María G; Meunier, Edith G; Canzonieri, Romina A; Asia, Susana

    2012-01-01

    The chronic metabolic acidosis induces increase in the urinary ammonium production (NH4+u) like equalizer, reflected in major or measured minor, if the process is chronic or acute. The objective of the present work was to study the capacity of urinary acidification in patients with Failure Renal Chronic (FRC), stage II and III measuring NH4+u and to compare results with GAP urinary (GAPu), GAP urinary modified (GAPu mod), GAP Osmolal (GAPosm) and GAP Osmolal modified (GAPosm modif.) like indirect indices of amoniuria. Samples Venous/arterial blood and a draft fresh urine of 34 patients were analyzed. Statistically significant correlation was obtained (p excretion of NH4+u, having given this last protein nutritional information. A value of p < 0.05 was considered statistically significant.

  14. Diagnosis and management of urinary tract infections in the emergency department.

    Science.gov (United States)

    Best, Jessica; Kitlowski, Andrew David; Ou, Derek; Bedolla, John

    2014-07-01

    Urinary tract infections are a heterogeneous group of disorders, involving infection of all or part of the urinary tract, and are defined by bacteria in the urine with clinical symptoms that may be acute or chronic. Approximately 1 million urinary tract infections are treated every year in United States emergency departments. The female-to-male ratio is 6:1. Urinary tract infections are categorized as upper versus lower tract involvement and as uncomplicated versus complicated. The emergency clinician must carefully categorize the infection and take into account patient host factors to optimally treat and disposition patients. A working knowledge of local or at least national susceptibility patterns of the most likely pathogens is essential. A variety of special populations exist that require special management, including pregnant females, patients with anatomic abnormalities, and instrumented patients.

  15. [Bacterial culture and drug sensitivity analysis of upper urinary tract calculi complicating with infection].

    Science.gov (United States)

    Wang, Shu; Shi, Yong-kang; Huang, Xiao-bo; Ma, Kai; Xu, Qing-quan; Xiong, Lin-lin; Li, Jian-xing; Wang, Xia-feng

    2014-10-18

    To investigate the bacteriology and drug sensitivity of upper urinary tract calculi patients, and to provide information for choosing suitable antibiotics. In the study, 21 patients who suffered from lithiasis in upper urinary tract and required an emergency drainage for acute obstruction and infection were the "acute group"; 64 patients with calculi in upper urinary tract and accompanied with no infectious symptoms were the "common group". The bacteriology and drug sensitivity of the two groups were investigated. Gram-negative bacteria infected the most common of upper urinary tract calculi patients with infection, accounting for 71.4% in the acute group and 65.7% in the common group, among which Escherichia coli were the predominant ones (35.7% in the acute group and 32.9% in the common group). No difference was found between these two groups in bacterial distribution (P>0.05). Although the average drug resistance rate of Gram-negative bacteria in the acute group was higher than that in the common group, it revealed no significant difference (P>0.05). The drug resistance rate to semisynthetic penicillin, cefuroxime and ceftriaxone were more than 50%, 60%, and 50%, respectively. Quinolones, such as ciprofloxacin and levofloxacin, got a 45% drug resistance. Aminoglycoside, carbapenema were sensitive to Gram-negative bacteria. Cefoperazone/sulbactam and piperacillin/tazobactam were more effective than ceftriaxone and piperacillin, respectively. There was no significant difference between upper urinary tract calculi patients with acute infection and common infection in bacteriology and drug sensitivity. Semisynthetic penicillin, the second generation of cephalosporin and quinolone were no longer the good choices of empirical use. Antibiotics combined with β-lactamase inhibitors would be an ideal empirical therapeutic choice.

  16. [Autonomic nervous system alteration in multiple sclerosis patients with urinary symptoms. Clinical, urodynamic and cardiovascular study].

    Science.gov (United States)

    Amarenco, G; Raibaut, P; Hubeaux, K; Jousse, M; Sheikh Ismaël, S; Lapeyre, E

    2013-12-01

    To assess symptoms related to autonomic nervous system alteration in a population of patients suffering from multiple sclerosis (MS) and presenting with urinary symptoms. We investigated 65 patients (mean age 47.5 years) suffering from MS, and presenting with urological dysfunction by means of symptom scores, urodynamic investigation, cardiovascular autonomic function tests (orthostatic hypotension testing, Valsalva test, deep breath test, cold pressor test) and sympathetic skin responses. Forty-five (69%) patients suffered from overactive bladder, 48 (73%) from voiding dysfunction, 14 (21%) from urinary retention and 13 (20%) from fecal incontinence. Urodynamic investigation demonstrated overactive detrusor in 46 (70%) cases, and underactive detrusor in four (6%) cases. Twenty-five (38%) patients had dysautonomia without correlation neither with clinical or urodynamic data, nor gravity of multiple sclerosis (EDSS). In this series, the prevalence of dysautonomia was high in patients suffering from MS and presenting with urinary disorders. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  17. Population-based estimate of urinary stones from Ballabgarh, northern India.

    Science.gov (United States)

    Lohiya, Ayush; Kant, Shashi; Kapil, Arti; Gupta, Sanjeev Kumar; Misra, Puneet; Rai, Sanjay K

    2017-01-01

    Stones in the urinary tract are a common condition but there is paucity of data on their population-based estimates in India. We describe our findings of the burden of urinary stones during a cross-sectional study with another primary goal. We conducted the study at Ballabgarh Health and Demographic Surveillance System, Haryana, among residents aged 18 years or above. We used simple random sampling to enrol participants. Self-reported history of urinary stones was elicited through an interview schedule. Results of the descriptive analysis were described as proportions with 95% confidence intervals (CI) or as mean wherever applicable. Bivariate analysis was done using t-test and chi-square test as applicable. The response rate for our study was 86.6%; lifetime prevalence (95% CI) of urinary stones was 7.9% (5.7, 10.8). In a majority of participants, urinary stones were diagnosed at an age of 20-40 years (55.9%), mostly by an ultrasonography examination (94.1%). A high burden of urinary stones is indicated in the working-age population in northern India at the community level. Untreated urinary stones can lead to an acute emergency (colic) or may have long-term adverse consequences, e.g. hydronephrosis, which have implications for the healthcare delivery system.

  18. Transit ridership, reliability, and retention.

    Science.gov (United States)

    2008-10-01

    This project explores two major components that affect transit ridership: travel time reliability and rider : retention. It has been recognized that transit travel time reliability may have a significant impact on : attractiveness of transit to many ...

  19. EA Shuttle Document Retention Effort

    Science.gov (United States)

    Wagner, Howard A.

    2010-01-01

    This slide presentation reviews the effort of code EA at Johnson Space Center (JSC) to identify and acquire databases and documents from the space shuttle program that are adjudged important for retention after the retirement of the space shuttle.

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

    Directory of Open Access Journals (Sweden)

    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. phosphorus retention data and metadata

    Science.gov (United States)

    phosphorus retention in wetlands data and metadataThis dataset is associated with the following publication:Lane , C., and B. Autrey. Phosphorus retention of forested and emergent marsh depressional wetlands in differing land uses in Florida, USA. Wetlands Ecology and Management. Springer Science and Business Media B.V;Formerly Kluwer Academic Publishers B.V., GERMANY, 24(1): 45-60, (2016).

  2. Grade Retention and Unobserved Heterogeneity

    OpenAIRE

    Robert J. Gary-Bobo; Marion Gousse; Jean-Marc Robin

    2014-01-01

    We study the treatment effect of grade retention using a panel of French junior high-school students, taking unobserved heterogeneity and the endogeneity of grade repetitions into account. We specify a multistage model of human-capital accumulation with a finite number of types representing unobserved individual characteristics. Class-size and latent student-performance indices are assumed to follow finite mixtures of normal distributions. Grade retention may increase or decrea...

  3. Control of pathogen growth and biofilm formation using a urinary catheter that releases antimicrobial nitrogen oxides.

    Science.gov (United States)

    Kishikawa, Hiroaki; Ebberyd, Anette; Römling, Ute; Brauner, Annelie; Lüthje, Petra; Lundberg, Jon O; Weitzberg, Eddie

    2013-12-01

    Antibacterial nitrogen oxides including nitric oxide are formed from nitrite under acidic conditions. In a continuous-flow model of the urinary bladder we used the retention cuff of an all-silicone Foley catheter as a depot for export of nitrogen oxides. The cuff was filled with sodium nitrite (50mM) and an acidic buffer solution (pH 3.6) and the growth of nine common uropathogens in the surrounding artificial urine was measured along with biofilm formation on the catheter surface. In experiments with control catheters (NaCl) bacteria grew readily and biofilm developed within hours in five of nine strains. In contrast, with test catheters bacterial counts were markedly reduced and biofilm formation by Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enterobacter cloace was prevented, whereas Escherichia coli and Staphylococcus aureus were unaffected. We conclude that antibacterial nitrogen oxides generated in the retention cuff of a urinary catheter diffuse into urine and prevent the growth of urinary pathogens and biofilm formation. Although promising, future studies will reveal if this novel approach can be clinically useful for the prevention of catheter-associated urinary tract infections. © 2013 Elsevier Inc. All rights reserved.

  4. Bladder Infection (Urinary Tract Infection - UTI) in Adults

    Science.gov (United States)

    ... The Urinary Tract & How It Works Bladder Infection (Urinary Tract Infection—UTI) in Adults View or Print All Sections ... Bladder infections are the most common type of urinary tract infection (UTI), but any part of your urinary tract ...

  5. Increased urinary zinc excretion after thermal injury.

    Science.gov (United States)

    Boosalis, M G; Solem, L D; Cerra, F B; Konstantinides, F; Ahrenholz, D H; McCall, J T; McClain, C J

    1991-12-01

    Urinary zinc excretion normally plays a minor role in zinc homeostasis; however, urinary zinc excretion is markedly elevated after trauma or surgery, and mechanism(s) for this zinc loss are poorly defined. In this study we evaluated multiple potential mechanisms for increased urinary zinc excretion in patients with thermal injury. We documented that patients with severe thermal injury had markedly elevated urinary zinc excretion. Above 20% total body surface area burn, however, the severity of thermal injury did not correlate with urinary zinc excretion. Serum zinc concentrations were depressed on initial evaluation and gradually increased during the hospital course, whereas peak urinary zinc excretion occurred 2 to 5 weeks after injury. Thus the depression in serum zinc concentration did not temporally relate to the observed pattern of hyperzincuria. Increased urinary zinc excretion also did not temporally relate to urinary excretion of the amino acids cysteine and histidine (both of which tightly bind zinc) nor to urinary 3-methylhistidine excretion, a marker of muscle breakdown. Urinary amylase excretion, a marker of renal tubular dysfunction, did follow the pattern of urinary zinc loss to some extent, although this correlation was not perfect. Increased oral intake of zinc via zinc supplements resulted in significantly increased urinary zinc excretion. Patients receiving total parenteral nutrition (TPN) did not have significantly increased urinary zinc excretion when compared with people receiving their total nutrient intake by mouth.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. [Retention and biomechanics of retentive complexes. 3. The Kratochvil school and current retentive complexes].

    Science.gov (United States)

    Enrique Fernández, M; Jacques Grimonster, L

    1989-04-01

    The authors analyse the biomechanical bases of the Kratochvil "retentive complex" and show how they have induced the nowadays north-american propositions (RPI & RPA). They compare them to the european ones (Nally-Martinet).

  7. Urinary ATP as an indicator of infection and inflammation of the urinary tract in patients with lower urinary tract symptoms

    OpenAIRE

    Gill, Kiren; Horsley, Harry; Kupelian, Anthony S; Baio, Gianluca; De Iorio, Maria; Sathiananamoorthy, Sanchutha; Khasriya, Rajvinder; Rohn, Jennifer L; Wildman, Scott S.P.; Malone-Lee, James

    2015-01-01

    BACKGROUND:\\ud Adenosine-5'-triphosphate (ATP) is a neurotransmitter and inflammatory cytokine implicated in the pathophysiology of lower urinary tract disease. ATP additionally reflects microbial biomass thus has potential as a surrogate marker of urinary tract infection (UTI). The optimum clinical sampling method for ATP urinalysis has not been established. We tested the potential of urinary ATP in the assessment of lower urinary tract symptoms, infection and inflammation, and validated sam...

  8. Efficacy and Safety of Initial Combination Treatment of an Alpha Blocker with an Anticholinergic Medication in Benign Prostatic Hyperplasia Patients with Lower Urinary Tract Symptoms: Updated Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Hyun Jung Kim

    Full Text Available There is still controversy as to whether initial combination treatment is superior to serial addition of anticholinergics after maintenance or induction of alpha blockers in benign prostatic hyperplasia (BPH/lower urinary tract symptoms (LUTS.The objective of this study was to determine the benefits and safety of initial combination treatment of an alpha blocker with anticholinergic medication in BPH/LUTS through a systematic review and meta-analysis.We conducted a meta-analysis of improvement in LUTS using International Prostate Symptom Score (IPSS, maximal urinary flow rate (Qmax, post-voided residual volume (PVR, and quality of life (QoL.In total, 16 studies were included in our analysis, with a total sample size of 3,548 subjects (2,195 experimental subjects and 1,353 controls. The mean change in total IPSS improvement from baseline in the combination group versus the alpha blocker monotherapy group was -0.03 (95% CI: -0.14-0.08. The pooled overall SMD change of storage IPSS improvement from baseline was -0.28 (95% CI: -0.40 - -0.17. The pooled overall SMD changes of QoL, Qmax, and PVR were -0.29 (95% CI: -0.50 - -0.07, 0.00 (95% CI: -0.08-0.08, and 0.56 (95% CI: 0.23-0.89, respectively. There was no significant difference in the number of acute urinary retention (AUR events or PVR.Initial combination treatment of an alpha blocker with anticholinergic medication is efficacious for in BPH/ LUTS with improved measures such as storage symptoms and QoL without causing significant deterioration of voiding function.

  9. Acute Diacetylmorphine (Heroin Intoxication (Review

    Directory of Open Access Journals (Sweden)

    A. T. Loladze

    2016-01-01

    Full Text Available This review presents current data on the mechanism of action, selective toxicity, toxicokinetics and toxicodynamics of diacetylmorphine (heroin. Acute diacetylmorphine poisoning is considered under taking into account the developing a critical state, in which the poisoning severity is determined by severe metabolic disorders associated with the progression of hypoxia. The main lifethreatening complications of acute diacetyl morphine poisoning are described including those associated with the nervous system, respiratory, circulatory and urinary systems. Since hypoxia is the principal damaging factor, the the mechanisms of oxygen transport disorders and the pathogenesis of activation of free radical oxidation in acute diacetylmorphine poisoning are discussed. The improvement of intensive care strategy for severe forms of acute diacetylmorphine poisoning by the inclusion of a substrate antihypoxant Reamberin into the list of routine critical care prescriptions is emphesized.

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

    International Nuclear Information System (INIS)

    Bayet-Papin, B.; Decomps-Hofmann, A.; Bovier-Lapierre, M.

    2001-01-01

    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)

  11. Urinary tract infection in older adults.

    Science.gov (United States)

    Rowe, Theresa A; Juthani-Mehta, Manisha

    2013-10-01

    Urinary tract infection and asymptomatic bacteriuria are common in older adults. Unlike in younger adults, distinguishing symptomatic urinary tract infection from asymptomatic bacteriuria is problematic, as older adults, particularly those living in long-term care facilities, are less likely to present with localized genitourinary symptoms. Consensus guidelines have been published to assist clinicians with diagnosis and treatment of urinary tract infection; however, a single evidence-based approach to diagnosis of urinary tract infection does not exist. In the absence of a gold standard definition of urinary tract infection that clinicians agree upon, overtreatment with antibiotics for suspected urinary tract infection remains a significant problem, and leads to a variety of negative consequences including the development of multidrug-resistant organisms. Future studies improving the diagnostic accuracy of urinary tract infections are needed. This review will cover the prevalence, diagnosis and diagnostic challenges, management, and prevention of urinary tract infection and asymptomatic bacteriuria in older adults.

  12. Urinary incontinence - what to ask your doctor

    Science.gov (United States)

    ... 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 - ...

  13. Urinary Incontinence: MedlinePlus Health Topic

    Science.gov (United States)

    ... your doctor, or surgery. NIH: National Institute of Diabetes and Digestive and Kidney Diseases Start Here Urinary Incontinence (Mayo Foundation for Medical Education and Research) Urinary Tract Health (National Institute of Child Health and Human Development) ...

  14. Anatomy and Physiology of the Urinary Tract: Relation to Host Defense and Microbial Infection.

    Science.gov (United States)

    Hickling, Duane R; Sun, Tung-Tien; Wu, Xue-Ru

    2015-08-01

    The urinary tract exits to a body surface area that is densely populated by a wide range of microbes. Yet, under most normal circumstances, it is typically considered sterile, i.e., devoid of microbes, a stark contrast to the gastrointestinal and upper respiratory tracts where many commensal and pathogenic microbes call home. Not surprisingly, infection of the urinary tract over a healthy person's lifetime is relatively infrequent, occurring once or twice or not at all for most people. For those who do experience an initial infection, the great majority (70% to 80%) thankfully do not go on to suffer from multiple episodes. This is a far cry from the upper respiratory tract infections, which can afflict an otherwise healthy individual countless times. The fact that urinary tract infections are hard to elicit in experimental animals except with inoculum 3-5 orders of magnitude greater than the colony counts that define an acute urinary infection in humans (105 cfu/ml), also speaks to the robustness of the urinary tract defense. How can the urinary tract be so effective in fending off harmful microbes despite its orifice in a close vicinity to that of the microbe-laden gastrointestinal tract? While a complete picture is still evolving, the general consensus is that the anatomical and physiological integrity of the urinary tract is of paramount importance in maintaining a healthy urinary tract. When this integrity is breached, however, the urinary tract can be at a heightened risk or even recurrent episodes of microbial infections. In fact, recurrent urinary tract infections are a significant cause of morbidity and time lost from work and a major challenge to manage clinically. Additionally, infections of the upper urinary tract often require hospitalization and prolonged antibiotic therapy. In this chapter, we provide an overview of the basic anatomy and physiology of the urinary tract with an emphasis on their specific roles in host defense. We also highlight the

  15. Urinary tract infection in the neurogenic bladder

    Science.gov (United States)

    Vigil, Humberto R.

    2016-01-01

    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 ≥103 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

  16. Urinary tract infection in the neurogenic bladder.

    Science.gov (United States)

    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.

  17. Childhood Acute Glomerulonepbritis in Benin City

    African Journals Online (AJOL)

    2000-12-31

    Dec 31, 2000 ... Haematuria and proteinuria of varying degrees occurred in all the patients, while antecedent infections were noted in 49.2 percent. Complications included congestive cardiac failure (39.7 percent), urinary tract infection (20.6 percent), acute renal failure (12.7 percent), and hypertensive encephalopathy.

  18. Divertor retention for recycling impurities

    International Nuclear Information System (INIS)

    Krieger, K.; Roth, J.; Fussmann, G.

    1992-01-01

    As an important issue for fusion devices with divertor configurations the retention capability for both recycling and non-recycling impurities receives increasing interest. In the case of recycling, gaseous, impurities the retention capability is usually investigated by means of short impurity gas puffs into the plasma vessel and the analysis of the time dependence of the observed line radiation. The detailed understanding of the impurity transport processes related to the retention capability of a certain divertor structure will require modelling of the experimental results with 2D or 3D transport code simulations. However, for the comparison of the global behavior of different configurations a much simpler description of the divertor retention in terms of global time constants may be sufficient. We will give a summary of experimental results from ASDEX for the dependence of the retention capability on parameters like divertor plasma density and temperature and the distance along field lines between main plasma and divertor. In addition we will compare some of these results with similar experiments on DIIID. (author) 8 refs., 2 figs., 2 tabs

  19. Does Urinary Bladder Shape Affect Urinary Flow Rate in Men with Lower Urinary Tract Symptoms?

    Directory of Open Access Journals (Sweden)

    Yusuf Ziya Ateşçi

    2014-01-01

    Full Text Available We aimed to investigate the role of urinary bladder shape which may potentially change with advancing age, increased waist circumference, pelvic ischemia, and loosening of the urachus on bladder emptying and UFR. We retrospectively investigated the medical records of 76 men. The patients were divided into two groups according to bladder shapes in MRI scan (cone and spheric shapes. There was a significant difference between the two groups in terms of IPSS, Qmax, Qave, and waist circumference. A positive correlation has been demonstrated between mean peak urinary flow rate measured with UFM and mean flow rate calculated using the CP. There was a significant difference between mean urinary flow rates calculated with CP of cone and sphere bladder shapes. The change in the bladder shape might be a possible factor for LUTS in men and LUTS may be improved if modifiable factors including increased waist circumference and loosening of the urachus are corrected.

  20. Frank hematuria as the presentation feature of acute leukemia

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    Jamila Chahed; Riadh Jouini; Imed Krichene; Kaies Maazoun; Mohamed Ben Brahim; Abdellatif Nouri

    2011-01-01

    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%). Uri...

  2. TVT versus TVT-O for minimally invasive surgical correction of stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Vicente Sola

    2007-04-01

    Full Text Available OBJECTIVE: The present work describes our experience in surgical correction of stress urinary incontinence, comparing both the TVT and the TVT-O techniques. METHOD: Between October 2001 and March 2004, 76 patients underwent the TVT procedure. Between January 2004 and January 2005, 98 surgical corrections of urinary incontinence were carried out using the TVT-O technique. RESULTS: Median operative time was 28 minutes for TVT and 7 minutes for TVT-O. Intraoperative complications for TVT occurred in 4 patients (6.6%: urinary bladder perforation in 3 patients (5%, p = 0.0228 and parietal peritoneum perforation in 1 case (1.6%. No intraoperative complications took place during TVT-O. Immediate postoperative complications: transient urinary retention in TVT, 2 cases (2.6% and overcorrection in TVT-O (1% which was readjusted within 24 hours. There were no late complications after TVT. There were 2 cases (2.04% with late complications in TVT-O. TVT and TVT-O resulted in correction of incontinence in 100% of the patients. CONCLUSION: TVT and TVT-O are two effective techniques for the correction of stress urinary incontinence. TVT-O would seem to be a technique much easier to perform resulting in less intraoperative complications.

  3. Spectrum of bacterial colonization associated with urothelial cells from patients with chronic lower urinary tract symptoms.

    Science.gov (United States)

    Khasriya, Rajvinder; Sathiananthamoorthy, Sanchutha; Ismail, Salim; Kelsey, Michael; Wilson, Mike; Rohn, Jennifer L; Malone-Lee, James

    2013-07-01

    Chronic lower urinary tract symptoms (LUTS), such as urgency and incontinence, are common, especially among the elderly, but their etiology is often obscure. Recent studies of acute urinary tract infections implicated invasion by Escherichia coli into the cytoplasm of urothelial cells, with persistence of long-term bacterial reservoirs, but the role of infection in chronic LUTS is unknown. We conducted a large prospective study with eligible patients with LUTS and controls over a 3-year period, comparing routine urine cultures of planktonic bacteria with cultures of shed urothelial cells concentrated in centrifuged urinary sediments. This comparison revealed large numbers of bacteria undetected by routine cultures. Next, we typed the bacterial species cultured from patient and control sediments under both aerobic and anaerobic conditions, and we found that the two groups had complex but significantly distinct profiles of bacteria associated with their shed bladder epithelial cells. Strikingly, E. coli, the organism most responsible for acute urinary tract infections, was not the only or even the main offending pathogen in this more-chronic condition. Antibiotic protection assays with shed patient cells and in vitro infection studies using patient-derived strains in cell culture suggested that LUTS-associated bacteria are within or extremely closely associated with shed epithelial cells, which explains how routine cultures might fail to detect them. These data have strong implications for the need to rethink our common diagnoses and treatments of chronic urinary tract symptoms.

  4. Urinary lithiasis and urinary tract malformations in children: a retrospective study of 34 cases.

    Science.gov (United States)

    Chahed, Jamila; Jouini, Riadh; Krichene, Imed; Maazoun, Kaies; Brahim, Mohamed Ben; Nouri, Abdellatif

    2011-01-01

    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. In conclusion, urinary lithiasis and urinary tract malformation association is a frequent eventuality. Surgical intervention is the usual mode of treatment.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Treatment of stress urinary incontinence

    DEFF Research Database (Denmark)

    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-t...

  7. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... a kidney infection , and it's serious because it can damage the kidneys and make you very sick. How Do I Know if I Have a UTI? You may notice signs of a urinary tract infection before anyone else can see there's anything wrong with you. That's why ...

  8. Drug-induced urinary incontinence

    NARCIS (Netherlands)

    Tsakiris, Peter; Oelke, Matthias; Michel, Martin C.

    2008-01-01

    Physiological urinary continence depends on many factors that are potentially vulnerable to adverse drug effects, which may lead to incontinence. In principle, drugs could cause incontinence by lowering bladder outlet resistance and/or by increasing intravesical pressure, which disrupts the normal

  9. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Answers (Q&A) Staying Safe Videos for Educators Search English Español Urinary Tract Infections (UTIs) KidsHealth / For ... Nondiscrimination Visit the Nemours Web site. Note: All information on KidsHealth® is for educational purposes only. For ...

  10. Urinary tract infections in children

    African Journals Online (AJOL)

    (cystitis or urethritis) with no urological anomalies and mostly affects girls over the age of 2 years. Complicated UTIs involve the renal parenchyma (pyelonephritis), and are usually associated with underlying congenital anomalies of the kidneys and urinary tract.9 These UTIs may result in significant short-term morbidity,.

  11. Candida urinary tract infection: pathogenesis.

    Science.gov (United States)

    Fisher, John F; Kavanagh, Kevin; Sobel, Jack D; Kauffman, Carol A; Newman, Cheryl A

    2011-05-01

    Candida species are unusual causes of urinary tract infection (UTI) in healthy individuals, but common in the hospital setting or among patients with predisposing diseases and structural abnormalities of the kidney and collecting system. The urinary tract may be invaded in either an antegrade fashion from the bloodstream or retrograde via the urethra and bladder. Candida species employ a repertoire of virulence factors, including phenotypic switching, dimorphism, galvano - and thigmotropism, and hydrolytic enzymes, to colonize and then invade the urinary tract. Antegrade infection occurs primarily among patients predisposed to candidemia. The process of adherence to and invasion of the glomerulus, renal blood vessels, and renal tubules by Candida species was elegantly described in early histopathologic studies. Armed with modern molecular biologic techniques, the various virulence factors involved in bloodborne infection of the kidney are gradually being elucidated. Disturbances of urine flow, whether congenital or acquired, instrumentation of the urinary tract, diabetes mellitus, antimicrobial therapy, and immunosuppression underlie most instances of retrograde Candida UTI. In addition, bacterial UTIs caused by Enterobacteriaceae may facilitate the initial step in the process. Ascending infections generally do not result in candidemia in the absence of obstruction.

  12. Hemodialysis: a therapeutic option for severe attacks of acute intermittent porphyria in developing countries.

    Science.gov (United States)

    Prabahar, Murugesan R; Manorajan, Rajendran; Sathiyakumar, Devasahayam; Soundararajan, Periyasamy; Jayakumar, Matcha

    2008-01-01

    Acute intermittent prophyria (AIP) is an autosomal dominant disease that results from a defect in the enzyme porphobilinogen deaminase. Acute intermittent porphyria is the most common of hepatic porphyrias and can tax the therapeutic capabilities of the physician to the limit. Motor weakness is a major feature of an acute attack, and flaccid paralysis of all extremities can occur rapidly, within a matter of days. The acute attacks may be life threatening. Hematin (Heme Arginate) should be given early during an acute attack to prevent neurologic sequel. Hemodialysis and hemoperfusion have been tried in the treatment of acute attacks of AIP with success. As hematin is not available in India, a severe acute attack of AIP in a patient was managed with hemodialysis successfully. Later, hematin was imported and provided to the patient. An 18-year-old girl was admitted to our hospital with recurrent abdominal pain and 2 episodes of convulsions. She had undergone an appendectomy earlier at another hospital for abdominal pain. On evaluation, she had hyponatremia, episodic abnormal behavior, generalized muscle pain, hypertension, and sinus tachycardia. In view of the above clinical picture, a clinical diagnosis of acute intermittent porphyria was made. Her 24-hr urinary porphobilinogen was 90.8 mg/day (<2 mg-normal) and alpha amino levalunic acid was 108.8 mg/day (1-7 mg-normal), consistent with the diagnosis. Her hyponatremia was corrected. Arrangements were made to import hematin and she was managed with dextrose infusion. Meanwhile, she developed flaccid quardriparesis with urinary incontinence and bulbar palsy. Her brain MRI was normal. Her nerve conduction study was suggestive of motor radiculoneuropathy. Specific treatment for severe porphyric crisis was planned. She failed to improve with dextrose infusion alone. As hematin was not readily available in the country, other therapeutic options were considered. As few case reports of AIP being successfully treated with

  13. Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections

    Science.gov (United States)

    Ha, U-Syn; Lee, Seung-Ju; Yeo, Jeong Kyun; Min, Seung Ki; Lee, Heeyoung

    2018-01-01

    Urinary tract infections (UTIs) are infectious diseases that commonly occur in communities. Although several international guidelines for the management of UTIs have been available, clinical characteristics, etiology and antimicrobial susceptibility patterns may differ from country to country. This work represents an update of the 2011 Korean guideline for UTIs. The current guideline was developed by the update and adaptation method. This clinical practice guideline provides recommendations for the diagnosis and management of UTIs, including asymptomatic bacteriuria, acute uncomplicated cystitis, acute uncomplicated pyelonephritis, complicated pyelonephritis related to urinary tract obstruction, and acute bacterial prostatitis. This guideline targets community-acquired UTIs occurring among adult patients. Healthcare-associated UTIs, catheter-associated UTIs, and infections in immunocompromised patients were not included in this guideline. PMID:29637759

  14. Recovery of renal function after seven weeks of anuric acute kidney ...

    African Journals Online (AJOL)

    Background: Acute Kidney Injury (AKI) is rapid decline in kidney function with rising creatinine and/or reduced urinary output. The urinary manifestation ranges from oliguria to anuria. Although the anuric AKI tends to have prolonged course, most are expected to recover within two to three weeks. We present the case of a 2 ...

  15. Cross-sectional imaging of complicated urinary infections affecting the lower tract and male genital organs

    Directory of Open Access Journals (Sweden)

    Massimo Tonolini

    2016-06-01

    Full Text Available Abstract Complicated urinary tract infections (C-UTIs are those associated with structural or functional genitourinary abnormalities or with conditions that impair the host defence mechanisms, leading to an increased risk of acquiring infection or failing therapy. C-UTIs occur in patients with risk factors such as neurogenic dysfunction, bladder outlet obstruction, obstructive uropathy, bladder catheterisation, urologic instrumentation or indwelling stent, urinary tract post-surgical modifications, chemotherapy- or radiation-induced damage, renal impairment, diabetes and immunodeficiency. Multidetector CT and MRI allow comprehensive investigation of C-UTIs and systemic infection from an unknown source. Based upon personal experience at a tertiary care hospital focused on the treatment of infectious illnesses, this pictorial essay reviews with examples the clinical features and cross-sectional imaging findings of C-UTIs affecting the lower urinary tract and male genital organs. The disorders presented include acute infectious cystitis, bladder mural abscesses, infections of the prostate and seminal vesicles, acute urethritis and related perineal abscesses, funiculitis, epididymo-orchitis and scrotal abscesses. Emphasis is placed on the possible differential diagnoses of lower C-UTIs. The aim is to provide radiologists greater familiarity with these potentially severe disorders which frequently require intensive in-hospital antibiotic therapy, percutaneous drainage or surgery. Teaching Points • Complicated urinary tract infections occur in patients with structural or functional risk factors. • CT and MRI comprehensively investigate complicated urinary infections and sepsis from unknown sources. • Infections of the urinary bladder, prostate, seminal vesicles, urethra and scrotum are presented. • Emphasis is placed on differential diagnoses of complicated lower urogenital infections. • Unsuspected urinary infections may be detected on CT

  16. Urinary glicosaminoglycans levels in women with urinary tract infection and non urinary tract infection

    Science.gov (United States)

    Pasaribu, H. P.; Hanifa, A.; Tala, R. Z.; Ardiansyah, E.; Simanjuntak, R. Y.; Effendy, I. H.

    2018-03-01

    UTI is an infection that occurs in the urinary tract due to the proliferation of a microorganism. Female is fourteen times more vulnerable to UTI than male, because their urethra is shorter. Bladder epithelium is coated with a thin layer of glycosaminoglycans which act as a non-specific anti-adherence factor and nonspecific defense mechanisms against infection and can be found in the urine. An analytic study with cross sectional approach was conducted in 46 patients (23 with UTI and 23 non UTI) from June 2016 to determine differences in levels of urinary glycosaminoglycans between two groups. Urine samples were taken and tested for UTI and non UTI strips test. Laboratory examination of urine GAGs levels using ELISA kit for Human Glycosaminoglycans, then tabulated and analyzed using SPSS. The result showed no significant differences in the characteristics of women between two groups. There are significant differences in the mean levels of urinary GAGs in women with UTI compared with Non-UTI (69.74 ± 21.34; 21.39 ± 2.61 mg/l; p <0.001). There was no significant relationship between the sexual status and UTI incidence, with low odds ratio values and no significant difference in the mean of urinary glicosaminoglycans level based on sexual status.

  17. The Effects of Oxidative Stress in Urinary Tract Infection

    Directory of Open Access Journals (Sweden)

    Ergul Belge Kurutas

    2005-01-01

    Full Text Available We aimed to determine the effects of oxidative stress in urinary tract infection (UTI. One hundred sixty-four urine samples obtained from patients with the prediagnosis of acute UTI admitted to the Faculty of Medicine, Kahramanmaras Sutcu Imam University, were included in this study. Urine cultures were performed according to standard techniques. Urinary isolates were identified by using API ID 32E. The catalase and superoxide dismutase activity and the lipid peroxidation levels known as oxidative stress markers were measured in all urine samples. Thirty-six pathogen microorganisms were identified in positive urine cultures. These microorganisms were as follows: 23 (63.8% E coli, 5 (13.8% P mirabilis, 4 (11.1% K pneumoniae, 2 (5.5% Candida spp, 1 (2.7% S saprophyticus, and 1 (2.7% P aeruginosa. It was observed that lipid peroxidation levels were increased while catalase and superoxide dismutase activities were decreased in positive urine cultures, compared to negative cultures. We conclude that urinary tract infection causes oxidative stress, increases lipid peroxidation level, and leads to insufficiency of antioxidant enzymes.

  18. Comparison of Tension-free Vaginal Tape Versus Transobturator Tape in Women with Stress Urinary Incontinence

    Directory of Open Access Journals (Sweden)

    Zinat Ghanbari

    2007-06-01

    Full Text Available Objective: This study compared the Tension-free vaginal tape (TVT and Transobturator tape (TOT procedures for surgical treatment of stress urinary incontinence in women.Materials and methods: This prospective non randomized clinical trial was conducted in Vali-e-asr hospital from March 2001 to March 2005. A total of 71 patients with clinical and urodynamic diagnosis of Stress urinary incontinence (SUI were enrolled in the study. Patients were divided into two groups and underwent TVT or TOT procedures. Mean operation time, cure rate, post operative urinary retention, bleeding and infection were compared between two groups. SPSS software was used for statistical analysis. Chi square and fisher exact test calculated the effects of the nominal variables. Mean difference of quantitative variables were compared by student's T- test. P ≤0.05 was considered statistically significant. Results: There was no significant difference in mean time of operation and peri-operative complications among groups. Urinary retention was 13.8% (n=5 in the TVT group versus 2.8% (n=1 in TOT group (NS. The rates of cure (91.6% vs 91.4%, improvement (5.6% vs 8.6% and failure (2.8% vs 0 were similar for the TVT and TOT groups. The rate of hemorrhagic complications was 5.5% in TVT and 2.8% in TOT group (NS.Conclusion: TOT appears to be equally efficient to TVT for surgical treatment of stress urinary incontinence after 30 months follow-up.

  19. Retention-Oriented Curricular Design

    Science.gov (United States)

    Milanovic, Ivana; Eppes, Tom A.; Girouard, Janice; Townsend, Lee

    2010-01-01

    This paper presents a retention-oriented approach to the educational value stream within the STEM undergraduate area. Faced with several strategic challenges and opportunities, a Flex Advantage Plan was developed to enhance the undergraduate engineering technology programs and better utilize the curricular flexibilities inherent in the current…

  20. Strategies for improving employee retention.

    Science.gov (United States)

    Verlander, Edward G; Evans, Martin R

    2007-03-28

    This article proposes a solution to the perennial problem of talent retention in the clinical laboratory. It includes the presentation of 12 strategies that may be used to significantly improve institutional identity formation and establishment of the psychological contract that employees form with laboratory management. Identity formation and psychological contracting are deemed as essential in helping reduce employee turnover and increase retention. The 12 conversational strategies may be used as a set of best practices for all employees, but most importantly for new employees, and should be implemented at the critical moment when employees first join the laboratory. This time is referred to as "retention on-boarding"--the period of induction and laboratory orientation. Retention on-boarding involves a dialogue between employees and management that is focused on the psychological, practical, cultural, and political dimensions of the laboratory. It is placed in the context of the modern clinical laboratory, which is faced with employing and managing Generation X knowledge workers. Specific topics and broad content areas of those conversations are outlined.

  1. Institutionalization of a Retention Model

    Science.gov (United States)

    Davis, E. J.; Campbell, A.

    2006-05-01

    Bowie State University and NASA Goddard Space Flight Center have, for the past 10 years, worked diligently together to enhance the science, mathematics, engineering and technology (SMET) domain. Efforts made, because of a Model Institutions for Excellence (MIE) Award, have changed the landscape of the SMET domain by increasing the retention and graduation rates, the number of students entering graduate and professional schools, and the number of students entering SMET related careers for minorities and women. Several initiatives a Scholarship Program, PRISEM Tutoring Center, Safety-net Program, Research emphasis, Focused Mentoring, a Summer Academy for accepted incoming students, a Bridge Program for students needing assistance being admitted to the University, the RISE Program and the Bowie State Satellite Operations and Control Center (BSOCC) provide the nurturing, mentoring, and opportunities for our students. As a result of efforts made, the retention rate has increase to approximately 80%, the graduation rate has increased 40%, and 85% of the SMET students are now interested or entering graduate and professional schools. Successes that have been documented by various assessment activities have led to the institutionalization of the Retention Model of the MIE Initiative. It is anticipated that University-wide application of the retention model will prove the incentives necessary to obtain similar results as the MIE Initiative.

  2. Exploring General Education Development Retention

    Science.gov (United States)

    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…

  3. Maslow's Hierarchy and Student Retention.

    Science.gov (United States)

    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…

  4. [Gastroduodenal intussusception causing gastric retention.

    DEFF Research Database (Denmark)

    Alamili, M.; Berg, J.O.; Lindstrom, C.

    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...

  5. Predictors of septic shock in obstructive acute pyelonephritis

    OpenAIRE

    Tambo, Mitsuhiro; Okegawa, Takatsugu; Shishido, Toshihide; Higashihara, Eiji; Nutahara, Kikuo

    2013-01-01

    Purpose Acute pyelonephritis (APN) with obstructive uropathy is not uncommon and often causes serious conditions including sepsis and septic shock. We assessed the risk factors for septic shock in patients with obstructive APN associated with upper urinary tract calculi. Methods We retrospectively studied 69 patients with obstructive APN associated with upper urinary tract calculi who were admitted to our hospital. Emergency drainage for decompression of the renal collecting system was perfor...

  6. [An investigation of normal urinary manganese value in healthy adults in different places in Guangxi, China].

    Science.gov (United States)

    Qin, L M; Li, R J; Ning, P L; Li, Y; Li, X P

    2017-10-20

    Objective: To investigate the normal urinary manganese value in healthy adults in Guangxi, China and its distribution characteristics. Methods: From 2015 to 2016, stratified random sampling based on age and sex was performed to select 1533 healthy adults aged 18-60 years in Nanning,Liuzhou,Guilin,Hezhou,Wuzhou,Yulin,Guigang,Beihai,Qinzhou,Laibin,Hechi Nandan,Bose Jingxi,Chongzuo Daxin,and Fangchenggang.All of them had no history of occupational manganese exposure or acute or chronic liver/renal diseases and had lived in the local area for more than one year. A total of 1417 urine samples with normal specific gravity and complete data were obtained, and graphite furnace atomic absorption spectrometry was used to measure urinary manganese.The distribution characteristics of urinary manganese level were analyzed among adults with different ages,sexes,or presence or absence of smoking habits or among those who lived or did not live in the mining area. Results: The geometric mean of urinary manganese among healthy adults in Guangxi was 0.52 μg/L,and the upper limit of normal was 5.68μg/L. There was no significant difference in urinary manganese level between the healthy adults with different ages, sexes,or presence or absence of smoking habits ( P >0.05).The healthy adults who lived in the mining area of nonferrous metal mines had a significantly higher geometric mean of urinary manganese than those who did not live in such areas(1.65μg/L vs 0.34μg/L, P <0.01). Conclusion: The upper limit of normal of urinary manganese is 5.68 μg/L among healthy adults in Guangxi,and the healthy adults who live in the mining area of manganese mine or nonferrous metal mines have a significantly higher urinary manganese level than those who do not live in such areas.

  7. Water Retention: Relieve This Premenstrual Symptom

    Science.gov (United States)

    ... help relieve this premenstrual symptom. By Mayo Clinic Staff Is water retention a regular premenstrual symptom for you? Here's help to feel better. Premenstrual water retention is likely caused by ...

  8. "Urinary Tract Infection"-Requiem for a Heavyweight.

    Science.gov (United States)

    Finucane, Thomas E

    2017-08-01

    "Urinary tract infection" ("UTI") is an ambiguous, expansive, overused diagnosis that can lead to marked, harmful antibiotic overtreatment. "Significant bacteriuria," central to most definitions of "UTI," has little significance in identifying individuals who will benefit from treatment. "Urinary symptoms" are similarly uninformative. Neither criterion is well defined. Bacteriuria and symptoms remit and recur spontaneously. Treatment is standard for acute uncomplicated cystitis and common for asymptomatic bacteriuria, but definite benefits are few. Treatment for "UTI" in older adults with delirium and bacteriuria is widespread but no evidence supports the practice, and expert opinion opposes it. Sensitive diagnostic tests now demonstrate that healthy urinary tracts host a ubiquitous, complex microbial community. Recognition of this microbiome, largely undetectable using standard agar-based cultures, offers a new perspective on "UTI." Everyone is bacteriuric. From this perspective, most people who are treated for a "UTI" would probably be better off without treatment. Elderly adults, little studied in this regard, face particular risk. Invasive bacterial diseases such as pyelonephritis and bacteremic bacteriuria are also "UTIs." Mindful decisions about antibiotic use will require a far better understanding of how pathogenicity arises within microbial communities. It is likely that public education and meaningful informed-consent discussions about antibiotic treatment of bacteriuria, emphasizing potential harms and uncertain benefits, would reduce overtreatment. Emphasizing the microbiome's significance and using the term "urinary tract dysbiosis" instead of "UTI" might also help and might encourage mindful study of the relationships among host, aging, microbiome, disease, and antibiotic treatment. © 2017, Copyright the Author Journal compilation © 2017, The American Geriatrics Society.

  9. The DMSA scan in paediatric urinary tract infection

    International Nuclear Information System (INIS)

    Ditchfield, M.R.; Nadel, H.R.

    1998-01-01

    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

  10. Artificial urinary sphincters for male stress urinary incontinence: current perspectives

    Directory of Open Access Journals (Sweden)

    Cordon BH

    2016-07-01

    Full Text Available Billy H Cordon,1 Nirmish Singla,1 Ajay K Singla2 1Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, 2Department of Urology, University of Toledo College of Medicine, Toledo, OH, USA Abstract: The artificial urinary sphincter (AUS, which has evolved over many years, has become a safe and reliable treatment for stress urinary incontinence and is currently the gold standard. After 4 decades of existence, there is substantial experience with the AUS. Today AUS is most commonly placed for postprostatectomy stress urinary incontinence. Only a small proportion of urologists routinely place AUS. In a survey in 2005, only 4% of urologists were considered high-volume AUS implanters, performing >20 per year. Globally, ~11,500 AUSs are placed annually. Over 400 articles have been published regarding the outcomes of AUS, with a wide variance in success rates ranging from 61% to 100%. Generally speaking, the AUS has good long-term outcomes, with social continence rates of ~79% and high patient satisfaction usually between 80% and 90%. Despite good outcomes, a substantial proportion of patients, generally ~25%, will require revision surgery, with the rate of revision increasing with time. Complications requiring revision include infection, urethral atrophy, erosion, and mechanical failure. Most infections are gram-positive skin flora. Urethral atrophy and erosion lie on a spectrum resulting from the same problem, constant urethral compression. However, these two complications are managed differently. Mechanical failure is usually a late complication occurring on average later than infection, atrophy, or erosions. Various techniques may be used during revisions, including cuff relocation, downsizing, transcorporal cuff placement, or tandem cuff placement. Patient satisfaction does not appear to be affected by the need for revision as long as continence is restored. Additionally, AUS following prior sling surgery has comparable

  11. Acute Bronchitis

    Science.gov (United States)

    ... Table of Contents1. Overview2. Symptoms3. Diagnosis4. Prevention5. Treatment6. Everyday Life7. Questions8. Resources What is acute bronchitis? Acute ... heartburn, you can get acute bronchitis when stomach acid gets into the bronchial tree. How is acute ...

  12. Urinary tract infections and Candida albicans.

    Science.gov (United States)

    Behzadi, Payam; Behzadi, Elham; Ranjbar, Reza

    2015-01-01

    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 of the three most frequent Candida species contributing to urinary tract candidiasis in different countries around the world. For writing this review, Google Scholar -a scholarly search engine- (http://scholar.google.com/) and PubMed database (http://www.ncbi.nlm.nih.gov/pubmed/) were used. The most recently published original articles and reviews of literature relating to the first three Candida species causing urinary tract infections in different countries and the pathogenicity of Candida albicans were selected and studied. Although some studies show rapid changes in the uropathogenesis of Candida species causing urinary tract infections in some countries, Candida albicans is still the most important cause of candidal urinary tract infections. Despite the ranking of Candida albicans as the dominant species for urinary tract candidiasis, specific changes have occurred in some countries. At this time, it is important to continue the surveillance related to Candida species causing urinary tract infections to prevent, control and treat urinary tract candidiasis in future.

  13. Lower urinary tract dysfunction in patients with functional movement disorders.

    Science.gov (United States)

    Batla, Amit; Pareés, Isabel; Edwards, Mark J; Stamelou, Maria; Bhatia, Kailash P; Panicker, Jalesh N

    2016-02-15

    Functional movement disorders (FMD) are not associated with the kind of structural or biochemical alterations seen in other movement disorders and therefore would be unlikely to be associated with lower urinary tract (LUT) dysfunction. However, LUT symptoms have been observed in patients with FMD. To evaluate the frequency and pattern of LUT symptoms, their possible nature and the impact they have on the quality of life of patients with FMD. The clinical records of patients with FMD were reviewed retrospectively and patients reporting LUT symptoms were invited to complete standardised validated questionnaires-Urinary Symptom Profile (USP) and Short Form-Qualiveen (SFQ). Management of LUT dysfunction was also reviewed. Out of the 150 patients with clinically established (n=97) or probable (n=53) FMDs, thirty (20%) self-reported LUT symptoms. Twenty two of these completed the USP and SFQ questionnaires. Overactive bladder symptoms were most commonly reported (n=14; 63.6%). Patients with fixed dystonia reported more severe LUT symptoms and had higher SFQ scores as compared to patients with other FMDs (p=0.01). Five patients with significant LUT symptoms had been referred to uroneurology. Of them, three had urinary retention managed with sacral neuromodulation, two had overactive bladder and were managed conservatively. LUT dysfunction can be seen in 20% patients with FMD. Patients with fixed dystonia are more likely to report LUT dysfunction which can be severe. It may be advisable to ask for LUT symptoms in all patients with FMD and be more proactive in referring them for specialist investigation and treatment. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. [Urinary diversion in elderly patients].

    Science.gov (United States)

    Spahn, M; Boxler, S

    2015-12-01

    Bladder cancer represents one of the ten most prevalent cancers worldwide. More than 400,000 people worldwide are newly diagnosed every year. Within 2 years after diagnosis, 80% of patients with muscle invasive bladder cancer without treatment die. The aggressive local surgical approach with a cystectomy is the therapy of choice. The median age of patients with de novo bladder cancer is 70 years. Thus bladder cancer is a cancer of the elderly. For demographical reasons, the number of eldery patients undergoing radical cystectomy will rise in the next few years. The type of urinary diversion is a major factor influencing perioperative morbidity and quality of life in these patients. Incontinent urinary diversions are preferentially used in daily practice. There are only a few contraindications for orthotopic neobladder; however, age alone is not a contraindication. Patient selection and a nerve sparing approach are crucial in men and women to achieve excellent functional results with orthotopic neobladder in elderly patients.

  15. The menopause and urinary incontinence

    DEFF Research Database (Denmark)

    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...... the year of final menstruation. The findings suggest perimenopausal processes rather than the menopause in general to be responsible for an increased risk of developing UI. The elevation of UI prevalence in the perimenopause may reflect the adjustment of the female continence mechanism to function...

  16. Female mixed urinary incontinence: a clinical review.

    Science.gov (United States)

    Myers, Deborah L

    2014-05-21

    Mixed urinary incontinence, a condition of both stress and urge urinary incontinence, is prevalent in 20% to 36% of women and is challenging to diagnosis and treat because urinary symptoms are variable and guidelines for treatment are not clear. To review the diagnosis and management of mixed urinary incontinence in women, with a focus on current available evidence. MEDLINE was searched from January 1, 1992, to December 31, 2013. Additional citations were obtained from references of the selected articles and reviews. Articles that discussed the prevalence, diagnosis, results, and treatment of mixed urinary incontinence were selected for review. Evidence was graded using Oxford Centre for Evidence-Based Medicine levels of evidence for treatment recommendations. The MEDLINE search resulted in 785 articles. After selection and obtainment of additional citations, a total of 73 articles were reviewed. There is high-quality (level 1) evidence for treating urinary incontinence with weight loss, for treating stress urinary incontinence by performing anti-incontinence procedures of both traditional and mid-urethral slings and retropubic urethropexies, and for managing urge urinary incontinence with anticholinergic medications. However, direct high-quality evidence for treatment of women with mixed urinary incontinence is lacking, as are clear diagnostic criteria and management guidelines. High-quality, level 1 evidence for urinary incontinence therapy can guide clinicians in the treatment of the components of mixed urinary incontinence. Because high-quality evidence is lacking regarding the treatment of mixed urinary incontinence, treatment generally begins with conservative management emphasizing the most bothersome component. Randomized trials in women with mixed urinary incontinence populations are needed.

  17. Acute Urinary Tract Infections in Children in Khartoum State ...

    African Journals Online (AJOL)

    Arab Journal of Nephrology and Transplantation. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 2, No 2 (2009) >. Log in or Register to get access to full text downloads.

  18. Urinary Tract Infection In Children With Acute Nephritic Syndrome ...

    African Journals Online (AJOL)

    Escherichia coli (61.5%) Klebsiella pneumoniae (15.4%) and Staphylococcus aureus (23.1%) were the bacterial isolates that demonstrated appreciable in-vitro sensitivity to ofloxacin, gentamycin, ceftriazone, ceftazidime and azithromycin only. Some interaction may exist between UTI and ANS but further studies are ...

  19. Kidney and Urinary Tract Involvement in Kawasaki Disease

    Directory of Open Access Journals (Sweden)

    Toru Watanabe

    2013-01-01

    Full Text Available Kawasaki disease (KD is a systemic vasculitis and can develop multiple organ injuries including kidney and urinary tract involvement. These disorders include pyuria, prerenal acute kidney injury (AKI, renal AKI caused by tubulointerstitial nephritis (TIN, hemolytic uremic syndrome (HUS, and immune-complex mediated nephropathy, renal AKI associated with either Kawasaki disease shock syndrome or unknown causes, acute nephritic syndrome (ANS, nephrotic syndrome (NS, renal tubular abnormalities, renal abnormalities in imaging studies, and renal artery lesions (aneurysms and stenosis. Pyuria is common in KD and originates from the urethra and/or the kidney. TIN with AKI and renal tubular abnormalities probably result from renal parenchymal inflammation caused by T-cell activation. HUS and renal artery lesions are caused by vascular endothelial injuries resulting from vasculitis. Some patients with ANS have immunological abnormalities associated with immune-complex formation. Nephromegaly and renal parenchymal inflammatory foci are detected frequently in patients with KD by renal ultrasonography and renal scintigraphy, respectively. Although the precise pathogenesis of KD is not completely understood, renal vasculitis, immune-complex mediated kidney injuries, or T-cell immune-regulatory abnormalities have been proposed as possible mechanisms for the development of kidney and urinary tract injuries.

  20. Kidney and Urinary Tract Involvement in Kawasaki Disease

    Science.gov (United States)

    Watanabe, Toru

    2013-01-01

    Kawasaki disease (KD) is a systemic vasculitis and can develop multiple organ injuries including kidney and urinary tract involvement. These disorders include pyuria, prerenal acute kidney injury (AKI), renal AKI caused by tubulointerstitial nephritis (TIN), hemolytic uremic syndrome (HUS), and immune-complex mediated nephropathy, renal AKI associated with either Kawasaki disease shock syndrome or unknown causes, acute nephritic syndrome (ANS), nephrotic syndrome (NS), renal tubular abnormalities, renal abnormalities in imaging studies, and renal artery lesions (aneurysms and stenosis). Pyuria is common in KD and originates from the urethra and/or the kidney. TIN with AKI and renal tubular abnormalities probably result from renal parenchymal inflammation caused by T-cell activation. HUS and renal artery lesions are caused by vascular endothelial injuries resulting from vasculitis. Some patients with ANS have immunological abnormalities associated with immune-complex formation. Nephromegaly and renal parenchymal inflammatory foci are detected frequently in patients with KD by renal ultrasonography and renal scintigraphy, respectively. Although the precise pathogenesis of KD is not completely understood, renal vasculitis, immune-complex mediated kidney injuries, or T-cell immune-regulatory abnormalities have been proposed as possible mechanisms for the development of kidney and urinary tract injuries. PMID:24288547

  1. Effect of PEEP ventilation on renal function, plasma renin, aldosterone, neurophysins and urinary ADH, and prostaglandins.

    Science.gov (United States)

    Annat, G; Viale, J P; Bui Xuan, B; Hadj Aissa, O; Benzoni, D; Vincent, M; Gharib, C; Motin, J

    1983-02-01

    To explore the main factors which could be involved in the fluid retention induced by continuous positive pressure ventilation (CPPV), hemodynamics, renal, and hormonal parameters were measured in seven intensive care patients during three consecutive 60-min periods; one of intermittent positive pressure ventilation (IPPV), one of CPPV (PEEP 10 cmH2O), and finally one of IPPV. During CPPV, a 15% decrease in cardiac output was observed, without alteration in arterial pressure or right atrial transmural pressure. In addition, decreases were observed in urinary output by 34%, glomerular filtration rate by 19%, renal blood flow by 32%, sodium excretion by 33%, and potassium excretion by 26%. There was no change in the fractional excretion of sodium and free water. Institution of PEEP also led to a significant increase in plasma renin activity, plasma aldosterone, and urinary antidiuretic hormone, without significant variation in plasma neurophysins and urinary prostaglandins E and F alpha. All of the changes that occurred during CPPV were reversed when PEEP was withdrawn. It is concluded that the short-term antidiuretic effect of PEEP is mainly due to a hemodynamic impairment of renal function. The water- and sodium-retaining hormonal systems also are stimulated and could participate in the fluid retention during more prolonged respiratory support with PEEP.

  2. [Urinary lithiasis: history and ethics].

    Science.gov (United States)

    Jichlinski, P

    2006-12-06

    This paper surveys the evolution of urinary stone treatment, primarily in the bladder, from ancient times to the 19th century, taking into consideration, not only technical breakthroughs, but also the moral sense of therapists, the social, political and religious context of the studied periods, the appreciation of symptoms and pain meaning by doctors or barber-surgeons; finally, a set of factors which contributes to the evolution of the medical thought.

  3. Epitheloid hemangioendothelioma of urinary bladder

    Directory of Open Access Journals (Sweden)

    Narmada P Gupta

    2008-01-01

    Full Text Available Epitheloid hemangioendothelioma is an uncommon vascular neoplasm and has an unpredictable clinical behavior. It is characterized by round or spindle-shaped endothelial cells with cytoplasmic vacuolation. Most often, epitheloid hemangioendothelioma arise from the soft tissues of the upper and lower extremities and it has borderline malignant potential. We describe the first reported case of epitheloid hemangioendothelioma in the urinary bladder, which was treated by transurethral resection. The diagnosis was confirmed by immunohistochemistry.

  4. Etiologies of community-onset urinary tract infections requiring hospitalization and antimicrobial susceptibilities of causative microorganisms

    Directory of Open Access Journals (Sweden)

    Chih-Chien Chiu

    2017-12-01

    Full Text Available Background: Community-onset urinary tract infections (CoUTIs are the most common bacterial infections, and a decline in antibiotic susceptibility causes many clinical challenges. Adequate empiric antibiotic treatment can decrease unnecessary hospital stays and complications, while reducing the antimicrobial resistance progression. Methods: From October 2014 to April 2015, we retrospectively enrolled patients who were at least 18 years old and required hospitalization for CoUTIs. Demographic variables of these patients, and uropathogens and their antimicrobial susceptibilities were evaluated. Results: In total, 457 patients were enrolled in this study. Their mean age was 71.9 years, and 35.2% of the patients were male. Escherichia coli (54.5% was the most common uropathogen, followed by Klebsiella pneumoniae (13.1%, Enterococcus spp. (7.1%, Pseudomonas aeruginosa (4.6%, and Proteus mirabilis (3.5%. Bacteremia was present in 25.2% of patients. Diabetes mellitus and acute kidney injury at admission were risk factors for CoUTIs with concomitant bacteremia. Among the UTI-associated bloodstream strains, E. coli (53.1% was also the most predominant pathogen, followed by K. pneumoniae (11.3%, Staphylococcus aureus (6.1%, and P. mirabilis (4.3%. The overall susceptibility of cefazolin was 62.8%, ceftriaxone 71.4%, ceftazidime 82.8%, flomoxef 82%, cefepime 94.5%, ampicillin–sulbactam 41.6%, piperacillin–tazobactam 85%, levofloxacin 65.2%, trimethoprim–sulfamethoxazole 61.5%, imipenem 92.3%, gentamicin 76.1%, and amikacin 97.5%. Cefazolin-susceptible isolates could be found more frequently among patients who are less than 65 years of age and without diabetes mellitus, had no UTI episode in the past year, and have no bacteremia risk. Patients with nasogastric tube retention more commonly experienced antimicrobial resistance to all the third-generation cephalosporins. Conclusion: Third-generation cephalosporins effectively treated Co

  5. Retention of lipiodol after parotid gland sialography

    NARCIS (Netherlands)

    Schortinghuis, J.; Pijpe, J.; Spijkervet, F. K. L.; Vissink, A.

    There is limited information about the retention of lipiodol in the parotid gland after parotid gland sialography. This study assesses the prevalence of lipiodol retention after parotid sialography and determines if retention of lipiodol is related to the sialography technique or the underlying

  6. Designing Online Courses to Promote Student Retention

    Science.gov (United States)

    Dietz-Uhler, Beth; Fisher, Amy; Han, Andrea

    2008-01-01

    Although the issue of student retention is a campus-wide one, it is of special interest in online distance learning courses, where retention rates are reported to be lower than in face-to-face classes. Among the explanations and theories of retention rates in online courses, one that struck us as most useful is a structural one, namely, course…

  7. 78 FR 57927 - Credit Risk Retention

    Science.gov (United States)

    2013-09-20

    ..., Collateral B. Proposed General Definitions III. General Risk Retention Requirement A. Minimum Risk Retention... Commercial Real Estate Loans 1. Ability To Repay 2. Loan-to-Value Requirement 3. Collateral Valuation 4. Risk... 43, 244, 373, et al. 17 CFR Part 246 24 CFR Part 267 Credit Risk Retention; Proposed Rule #0;#0...

  8. Urinary Biomarkers in Lupus Nephritis

    Science.gov (United States)

    Reyes-Thomas, Joyce; Blanco, Irene

    2010-01-01

    Renal involvement in patients with systemic lupus erythematosus in the form of severe lupus nephritis is associated with a significant burden of morbidity and mortality. Conventional laboratory biomarkers in current use have not been very successful in anticipating disease flares, predicting renal histology, or decreasing unwanted outcomes. Since early treatment is associated with improved clinical results, it is thus essential to identify new biomarkers with substantial predictive power to reduce the serious sequelae of this difficult to control lupus manifestation. Indeed, considerable efforts and progress have been made over the last few years in the search for novel biomarkers. Since urinary biomarkers are more easily obtainable with much less risk to the patient than repeat renal biopsies, and these may more accurately discern between renal disease and other organ manifestations than their serum counterparts, there has been tremendous interest in studying new candidate urine biomarkers. Below, we review several promising urinary biomarkers under investigation, including total proteinuria and microalbuminuria, urinary proteomic signatures, and the individual inflammatory mediators interleukin-6, vascular cell adhesion molecule-1, CXCL16, IP-10, and tumor necrosis factor-like weak inducer of apoptosis. PMID:20127204

  9. URINARY TRACT INFECTION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    T. V. Margieva

    2014-01-01

    Full Text Available The issues of diagnosing and treating urinary tract infections and their role in development of renal injury are being actively discussed by scientists and practicing pediatricians. The article presents the most recent data on etiological factors, pathogenesis and clinical manifestations of this disease. It provides recommendations on diagnosis and management of patients depending on their age. The article presents a discussion of antibacterial therapy course duration and indications for anti-relapse treatment. The study demonstrates that intravenous antibacterial therapy must be launched immediately in neonates in the event of pyretic fever; empirical antibacterial therapy must be launched immediately in older children after diagnosis of the urinary tract infection has been confirmed; subsequently, treatment ought to be corrected depending on the results of a bacteriological trial, sensitivity to antibiotics and effectiveness of the prescribed antibiotic. Along with normalization of urination rhythm and water intake schedule, antibacterial preventive therapy might be considered, if effective, in the event of recurrent nature of the urinary tract infection. 

  10. Deuterium retention in liquid lithium

    International Nuclear Information System (INIS)

    Baldwin, M.J.; Doerner, R.P.; Luckhardt, S.C.; Conn, R.W.

    2002-01-01

    Measurements of deuterium retention in samples of lithium exposed in the liquid state to deuterium plasma are reported. Retention was measured as a function of plasma ion dose in the range 6x10 19 -4x10 22 D atoms and exposure temperature between 523 and 673 K using thermal desorption spectrometry. The results are consistent with the full uptake of all deuterium ions incident on the liquid metal surface and are found to be independent of the temperature of the liquid lithium over the range explored. Full uptake, consistent with very low recycling, continues until the sample is volumetrically converted to lithium deuteride. This occurs for exposure temperatures where the gas pressure during exposure was both below and slightly above the corresponding decomposition pressure for LiD in Li. (author)

  11. Retention of Root Canal Posts

    DEFF Research Database (Denmark)

    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...

  12. Serum copper and ceruloplasmin levels and urinary copper excretion in thermal injury.

    Science.gov (United States)

    Boosalis, M G; McCall, J T; Solem, L D; Ahrenholz, D H; McClain, C J

    1986-12-01

    Conflicting reports regarding copper status in thermal injury patients have been published. We determined serial serum-copper and serum-ceruloplasmin levels and 24-h urinary excretion of copper in 23 patients with second- and third-degree thermal burns. Throughout hospitalization, mean serum-copper concentration was significantly depressed; lowest levels were found in patients with greater than 40% total body surface area burns. Serum ceruloplasmin was also depressed, an unexpected finding because this protein is a positive acute-phase reactant poststress. Mean urinary excretion of copper was elevated, reaching 2.5 times the upper limit of normal 2 wk postburn. Depressed serum-copper levels paralleled the serum-ceruloplasmin levels rather than the increased urinary-copper losses. Further studies are required to determine the mechanism(s) of this altered copper metabolism and whether physiological or biochemical evidence of copper deficiency accompanies the observed hypocupremia.

  13. Acute colonic obstruction due to benign prostatic hypertrophy.

    LENUS (Irish Health Repository)

    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. Acute pyelonephritis in ER

    Directory of Open Access Journals (Sweden)

    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

  15. Cranberries and lower urinary tract infection prevention

    Directory of Open Access Journals (Sweden)

    Marcelo Hisano

    2012-01-01

    Full Text Available Lower urinary tract infections are very common diseases. Recurrent urinary tract infections remain challenging to treat because the main treatment option is long-term antibiotic prophylaxis; however, this poses a risk for the emergence of bacterial resistance. Some options to avoid this risk are available, including the use of cranberry products. This article reviews the key methods in using cranberries as a preventive measure for lower urinary tract infections, including in vitro studies and clinical trials.

  16. Modifying factors in urinary bladder carcinogenesis

    OpenAIRE

    Ito, Nobuyuki; Fukushima, Shoji; Shirai, Tomoyuki; Nakanishi, Keisuke; Hasegawa, Ryohei; Imaida, Katsumi

    1983-01-01

    N-Butyl-N-(4-hydroxybutyl)nitrosamine (BBN) is a potent carcinogen in the urinary bladder of animals. The BBN model of bladder cancer is an excellent model of human urinary bladder cancer and has already led to a greater knowledge of its pathogenesis. In our studies, histogenesis and morphological characteristics of BBN urinary bladder cancer were analyzed in different animal species such as rats, mice, hamsters and guinea pigs and also in different rat strains. Papillary or nodular hyperplas...

  17. Helical CT of the urinary organs

    Energy Technology Data Exchange (ETDEWEB)

    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

  18. Neuromodulation for fecal and urinary incontinence: functional results in 57 consecutive patients from a single institution.

    Science.gov (United States)

    Faucheron, Jean-Luc; Chodez, Marine; Boillot, Bernard

    2012-12-01

    Sacral nerve stimulation is a recognized treatment for fecal and urinary incontinence. Few articles have been published about patients presenting with both types of incontinence. The aim of this study was to report the functional results in patients operated on for simultaneous fecal and urinary incontinence by the use of sacral nerve stimulation. This study is a retrospective analysis of prospectively collected data. The investigation was conducted in the academic departments of colorectal surgery and urology. Between January 2001 and March 2010, 57 consecutive patients (54 women) with a mean age of 58 years (range, 16-76) were included. Two-stage sacral nerve modulation (test and implant) was performed. Functional study before testing, at 6 months, and at the end of follow-up after implantation included the use of the Cleveland Clinic incontinence score, Urinary Symptoms Profile, Fecal Incontinence Quality of Life score, and the Ditrovie score. Patient satisfaction with the technique was evaluated at a median follow-up of 62.8 months. : Fecal incontinence improved from 14.1/20 to 7.2/20 at 6 months and 6.9/20 at the end of follow-up. Urinary incontinence, mainly urge incontinence (47% of patients), and urgency frequency (34% of patients) improved at 6 months and end of follow-up, but not retention and dysuria. Specific quality of life was improved for fecal and urinary incontinence at 6 months and end of follow-up. At the end of follow-up, 73% patients were highly satisfied with the technique, but 9% felt their condition had deteriorated. The reoperation rate was 29%, of which 12% were indicated because of a complication. This study was limited by its retrospective nature and the multiple causes of incontinence. Fecal and urinary incontinence, studied by symptoms scores and specific quality-of-life scores, are improved in patients receiving sacral nerve stimulation for double incontinence.

  19. Antimuscarinics and α-blockers or α-blockers monotherapy on lower urinary tract symptoms--a meta-analysis.

    Science.gov (United States)

    Hao, Nan; Tian, Ye; Liu, Wei; Wazir, Romel; Wang, Jianzhong; Liu, Liangren; Wang, Kunjie; Li, Hong

    2014-03-01

    To assess the clinical efficiency and safety of combination pharmacotherapy of antimuscarinics and α-blockers vs α-blockers monotherapy on patients with moderate to severe lower urinary tract symptoms (LUTS). We searched the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, the Cochrane Database of Systematic Review, and Web of Science from their inception until June 2013 to identify all eligible studies that compare the 2 pharmacotherapy strategies on LUTS. The Cochrane Collaboration's RevMan 5.2 software was used for data analysis, and the fixed or the random effect model was selected depending on the proportion of heterogeneity. Eighteen eligible randomized controlled trials were included in this systematic review, including 2106 (51.57%) in cotherapy group and 1978 (48.43%) in monotherapy group. Synthetic data showed that there were significant improvements on Storage International Prostate Symptom Score (mean difference [MD] = -1.51; 95% confidence interval [CI] -2.10 to -0.91, P <.00001), quality of life score (MD = -0.53; 95% CI -0.89 to -0.17, P = .004), micturitions per 24 hours (MD = -1.14; 95% CI -1.84 to -0.45, P = .001), and urgency episodes per 24 hours (MD = -0.99; 95% CI -1.46 to -0.51, P <.0001) in the cotherapy group. There were no significant difference regarding maximum flow rate (MD = -0.05; 95% CI -0.27 to 0.17, P = .64), Total International Prostate Symptom Score (TIPSS) (MD = -0.88; 95% CI -1.64 to -0.12, P = .02), and Voiding International Prostate Symptom Score (VIPSS) (MD = 0.40; 95% CI -0.34 to 1.15, P = .29). As to postvoid residual volume, however, a worse condition was showed in the cotherapy group (MD = -6.53; 95% CI 3.06-10.00, P <.0002). Antimuscarinics could and should be added to the drug regimen for patients with LUTS attributed to benign prostatic hyperplasia/bladder outlet obstruction, particularly are dominated by storage symptoms. For patients with increased acute

  20. Artificial urinary sphincters for male stress urinary incontinence: current perspectives.

    Science.gov (United States)

    Cordon, Billy H; Singla, Nirmish; Singla, Ajay K

    2016-01-01

    The artificial urinary sphincter (AUS), which has evolved over many years, has become a safe and reliable treatment for stress urinary incontinence and is currently the gold standard. After 4 decades of existence, there is substantial experience with the AUS. Today AUS is most commonly placed for postprostatectomy stress urinary incontinence. Only a small proportion of urologists routinely place AUS. In a survey in 2005, only 4% of urologists were considered high-volume AUS implanters, performing >20 per year. Globally, ~11,500 AUSs are placed annually. Over 400 articles have been published regarding the outcomes of AUS, with a wide variance in success rates ranging from 61% to 100%. Generally speaking, the AUS has good long-term outcomes, with social continence rates of ~79% and high patient satisfaction usually between 80% and 90%. Despite good outcomes, a substantial proportion of patients, generally ~25%, will require revision surgery, with the rate of revision increasing with time. Complications requiring revision include infection, urethral atrophy, erosion, and mechanical failure. Most infections are gram-positive skin flora. Urethral atrophy and erosion lie on a spectrum resulting from the same problem, constant urethral compression. However, these two complications are managed differently. Mechanical failure is usually a late complication occurring on average later than infection, atrophy, or erosions. Various techniques may be used during revisions, including cuff relocation, downsizing, transcorporal cuff placement, or tandem cuff placement. Patient satisfaction does not appear to be affected by the need for revision as long as continence is restored. Additionally, AUS following prior sling surgery has comparable outcomes to primary AUS placement. Several new inventions are on the horizon, although none have been approved for use in the US at this point.