Necrotizing crescentic glomerulonephritis--a conditional knockout model discloses new therapeutic challenges.
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The sensitivity of male and female rats to Cortinarius speciosissimus toxins was compared. Dried, homogenized mushroom was given orally by stomach tubing at a dose of 250 mg dried mushroom/kg body weight. Both in males and in females, the kidneys were the only organs showing macroscopical changes. Sex differences in renal damage were observed in the area of the inner cortex.
Pretreatment with multiple doses of polymyxin B and colistimethate was evaluated as to its ability to sequester sufficient antibiotic in tissues to neutralize the effects of endotoxin in three animal models. Animals were challenged with endotoxin 24, 48, or 72 h after the last dose of antibiotic when there was minimal or not detectable drug in serum. Pretreatment with polymyxin B was successful in preventing the generalized Shwartzman reaction in rabbits and reducing endotoxin lethality in mice; however, large doses (20 mg per kg per day for 2 or 4 days) were required. Prolongation by more than 24 h of the interval between the last dose of polymyxin B and endotoxin challenge resulted in reduction or loss of protection. Dogs were unable to tolerate the high polymyxin B dosage which was protective in the mouse and rabbit. Lower, nontoxic doses of polymyxin B in dogs did not prevent endotoxin shock and lethality, even when challenged as soon as 1 h after the last dose. Pretreatment with colistimethate was ineffective in all three animal models.
Three antimicrobial agents were evaluated as to their ability to neutralize the toxic effects of endotoxin in rabbits. These consisted of two cyclic polypeptides, polymyxin B sulfate and colymycin M (sodium colistimethate), and an aminoglycoside, gentamicin sulfate. Polymyxin B regularly prevented endotoxin-induced leukopenia, thrombocytopenia, and disseminated intravascular coagulation. Colymycin M had similar activity but was not as effective as polymyxin B. Gentamicin demonstrated no neutralizing ability in this study.
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All infants and children with proven bacteriuria require urologic investigation and surveillance, but their prospects for developing chronic renal disease are variable. These differences are related to whether or not the bacteria have access to the kidneys. Such access correlates closely with the presence of an underlying congenital anomaly, particularly vesicoureteral reflux. Fever during an episode of active urinary infection is a strong indication that the patient has vesicoureteral reflux or some other significant uropathy and probably pyelonephritis.
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