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At least 883 records · Page 49Linked to original sources
PubMed1992

[Clinical studies of efficacy of imipenem/cilastatin sodium against urinary tract infections with ureterocutaneostomy].

Clinical efficacy of IPM/CS against urinary tract infections (UTI) was evaluated on 19 patients with malignancies (bladder tumor: 15, prostate cancer: 3, uterus cancer: 1) and 1 patient with a benign disorder (ureter stenosis) who had undergone ureterocutaneostomy between January, 1988 and December, 1990. Their ages ranged from 42 to 79 years. Postoperatively, they had UTI with pyuria of greater than or equal to 5/hpf and bacteriuria of greater than or equal to 10(4)/ml. IPM/CS was administered at a dose of 0.5 g (0.25g/0.25 g) twice a day through intravenous drip infusion. Its efficacy was evaluated according to the UTI criteria for clinical evaluation as ruled by the Japanese Society of Chemotherapy. Overall clinical value was rated "excellent" in 4 (20%), "moderate" in 9 (45%) and "poor" in 7 (35%) cases for a total of 65%. The efficacy by types of infection was 33% and 70.6% in the group of single infection and in the group of mixed infection, respectively. As to bacteriological efficacy 34 of the 38 strains (89.5%) isolated were eradicated following its administration. The eradication rate was 84.6% for P. aeruginosa, and 84.6% for E. faecalis. Microbes which appeared after its dosing amounted to 6 classes of 17 strains, 6 NFB strains of which were identified. As a side effect, elevation of serum GPT (5%) was noted. Regardless of the underlying conditions (malignant diseases and ureterocutaneostomy), clinical efficacy of IPM/CS was appreciable. In addition, the MIC for (P. aeruginosa, E. faecalis) of IPM/CS was lower than that of PIPC.

Adult↗
PubMed1992

[A case of ureteritis cystica].

We report a case diagnosed as bilateral ureteritis cystica by ureteroscopic examination. A 51-year-old female was admitted with pyuria and proteinuria. Retrograde pyelography revealed multiple, small, smooth and round punched-out defects in the bilateral lower ureters. Ureteroscopic examination and punch biopsy were performed with a suspected diagnosis of ureteritis cystica. The histological examination revealed chronic ureteritis. This patient was given conservative treatment (chemotherapy) and careful follow-up.

Cysts↗
PubMed1992

[Urinary tract infections in children].

The diagnosis of urinary tract infections were established on fifty children in our hospital in the last year. Most of the patients were between the age of 1-12 month (28 cases, 56%). The ratio of female/male was 3.5. Fever was the most common symptom (17 cases, 34%). In the routine urinalysis, proteinuria and pyuria were revealed in 11 cases (22%), and 44 cases (88%), respectively. E. coli was the most common microorganism isolated from urine cultures (70%). Twenty-two patients were regularly followed up and recurrence was observed in 7 patients (32%).

Child, Preschool↗
PubMed2004

[Intravesical Bacillus Calmette-Guerin (BCG: Tokyo 172 strain) instillation for carcinoma in situ of the bladder: results with 6 successive instillations of 40 mg BCG].

We performed a study to evaluate the usefulness of intravesical Bacillus Calmette-Guerin (BCG: Tokyo 172 strain) instillation on carcinoma in situ (CIS) of the bladder. Between 1998 and 2003, 43 patients were treated for CIS of the bladder with a median follow-up period of 45 months (range: 12 to 69 months). The patients (35 males and 8 females) ranged in age from 45 to 89 years (average: 67.5 years). They underwent intravesical instillation of 40 mg of BCG once a week for 6 weeks. A complete response (CR) was achieved in 83.7% of the patients. Among these patients, 97.2% and 70.7% remained recurrence-free during follow up for one year and three years, respectively. The median duration of CR was 31.5 months. Although total cystectomy was performed on 1 patient, none of the patients died of bladder cancer. Adverse effects included bladder irritability in 48.8%, pyuria in 46.5%, gross hematuria in 18.6%, and fever (temperature over 37.5 degrees C) in 9.3%. No clinically significant side effects were observed. These results indicate that intravesical instillation of BCG at a dose of 40 mg given 6 times was as effective as the routine dose of 80 mg, and could decrease systemic adverse effects such as high fever.

Administration, Intravesical↗
PubMed2004

Vesicoureteral reflux in hospitalized children with urinary tract infection: the clinical value of pelvic ectasia on renal ultrasound, inflammatory responses and demographic data.

BACKGROUND: The aims of this study were to determine whether renal pelvis dilation on ultrasound was reliable in predicting vesicoureteral reflux (VUR) and to assess the relationship of other clinical information of VUR in children with urinary tract infection (UTI). METHODS: We retrospectively reviewed clinical data, renal echo, and voiding cystourethrogram (VCUG) results in hospitalized children with their first episode of UTI, aged from 1 month to 5 years, during a 1-year period. RESULTS: There were 114 children with 228 kidneys eligible for the study. Unilateral pelvis size greater than 8 mm had 2.4 (p = 0.049, 95% CI: 1.0-5.9) and 3.7 (p = 0.025, 95% CI: 1.2-11.3) times greater risk for VUR and severe reflux, respectively. The sensitivity in detecting severe reflux was 27.8%, and the specificity was 90.5%. The positive and negative predictive values in suggesting severe VUR were 20.0% and 93.6%, respectively. The sum of bilateral pelvis sizes greater than 16 mm had higher risk for VUR and severe reflux (4.1 and 4.6 times) and similar specificity and negative predictive value for severe reflux. Age, gender, C-reactive protein, leukocytosis, pyuria and acute pyelonephritis did not show significant relationships to the reflux. CONCLUSIONS: Unilateral pelvis size greater than 8 mm or the sum of the bilateral pelvis sizes greater than 16 mm was associated with VUR, especially severe VUR. The possibility of severe reflux was lower than 10% when the reverse criteria were applied. However, the dilation of the renal pelvis did not predict all VUR precisely. We concluded that VCUG should still be performed in hospitalized children with UTI.

Acute Disease↗
PubMed2004

Cryptococcuria as a manifestation of disseminated cryptococcosis and isolated urinary tract infection.

Fungal infection of the genitourinary system is a relatively uncommon presentation. Cryptococcuria has rarely been recognized in clinical practice. Patients with positive urine culture for Cryptococcus neoformans from 1992 to 2003 were retrospectively reviewed. Sixteen patients were identified. Nine (56%) patients were male, with a mean age of 44 +/- 21 (range, 16-88) years. Fifteen (94%) patients had underlying conditions such as HIV infection, diabetes mellitus, hypertension, and/or systemic lupus erythematosus. Thirteen (81%) patients had cryptococcuria as a manifestation of disseminated cryptococcosis, and the rest had only isolated cryptococcuria. Urinary analysis revealed proteinuria (75%), pyuria (31%), and budding yeast (13%). Nine (56%) patients received antifungal therapy. Other patients were misdiagnosed or died before treatment. The mortality rate was 64%. In conclusion, cryptococcuria is not extremely rare and can present as a manifestation of disseminated cryptococcosis or isolated urinary tract infection.

Adolescent↗
PubMed2004

[Urologic work and biography of Prof. Rafael Alcalá Santaella (1896-1959). Historical document analysis].

OBJECTIVES: We find that Urology at the end of the 20th century was a consolidated speciality as a result of years of evolution and development, and the studies and works of authors whose contributions are considered today the basements of our speciality. So we think that Urology should be understood with its historical references, because, as Aristotle said "... thinks are better understood when one has got to clearly see how they were formed..." Numerous specialists contributed to this; among them we can cite Prof. Rafael Alcala Santaella, the object of this bibliographic and scientific works compilation paper. METHODS: We reviewed all his scientific works. Original articles have been obtained from Medicina Ibera, Revista Española de Cirugía y Urología, and Cirugía, Urología y Ginecología. His most important urologic work is Clinic Urology (1942), divided in 3 volumes. For his biography we used the biographic and bibliographic historical source of Spanish urology over the 20th-century and direct family members interviews. RESULTS: He analyzed topics as important as voiding disorders and the study of urine pyuria. He gave special importance to the study of prostatic pathology, its diagnosis by means of cystourethrography, and the modification of surgical techniques, as well as the results of urinary diversions performed in his department. CONCLUSIONS: Due to his extensive scientific and technical contributions he is one of the most outstanding figures of Valencia's Urology over the first half of the 20th century, together with Rafael Molla Rodrigo and Nicasio Benlloch Giner.

History, 20th Century↗
PubMed2004

[Asymptomatic bacteriuria in women. Epidemiological, pathologic and therapeutic study].

OBJECTIVES: To perform an epidemiological, pathologic and therapeutic study of asymptomatic bacteriuria (AB) in a population of outpatient women. METHODS: Transversal study for detection of AB in 1718 outpatient women 14-year-old or older. All patients complied with the inclusion/exclusion criteria for the study. Two groups of patients, with AB (n = 113) and controls without AB (n = 200), underwent: 1) urine analysis: urine sediment, biochemical analysis, and culture; 2) blood tests: hemoglobin, red blood cell count, urea, creatinine, sedimentation rate velocity, C reactive protein, immunoglobulins (IgA, IgM, and IgG), HLA-A3, blood group and Rh. The therapeutic management for AB was analyzed. Comparative statistical analyses of data were performed. RESULTS: AB prevalence was 6.34%. The most frequently isolated germ was E. coli (77.87%). Diabetes mellitus was detected in 27.43% of patients with AB and 7.01% without AB (27.43% vs. 7.01%); coronary arterial disease and other heart disorders (9.73% vs. 4%, p = 0.0206); general cardiovascular disorders excluding hypertension (46.9% vs. 31%, p = 0.0025). Urine analysis showed leukocyturia in 81.41% of the patients with AB and 17.5% without AB (p = 0.0002); positive nitrites (77.87% vs. 0%, p < 0.001); urine sediment showed bacteriuria in 86.72% of patients with AB and 0% of non-AB patients (p < 0.0001), leukocytes (93.80% vs. 6%, p < 0.0001), and pyuria (19.46% vs. 2.5%). Low water intake (50.44% vs. 9.5%, p < 0.0001) was the most significant urinary tract infection hygienic-dietetic predisposing factor. Higher levels of IgA (15% vs. 2%, p = 0.004). Positive HLA-A 3 (5% vs. 0%, p = 0.039), Rh negative (16.66% vs. 13.33%), and increased C reactive protein (15% vs. 10%). Renal abnormalities detected by radiological tests (10.29% vs. 1.47%, p = 0.014). AB disappeared after treatment with cefuroxime, ceftibuten, trimetropin/sulfametoxazole and amoxicillin in 100% of the patients receiving treatment. Topical vaginal estrogen therapy was effective in 38.09% of the patients. CONCLUSIONS: The prevalence of AB increases with age. The most frequent germ is Escherichia coli. A statistically significant greater number of coronary artery disease, other heart diseases, and cardiovascular disorders were found among patients with AB in comparison with non-AB controls. Immunoglobulins levels disturbances, and HLA-A3 positivity suggest an immune systemic imbalance in certain patients with recurrent AB. Other therapeutic alternatives such as vaginal topical estrogens, fruit juices intake, vaccinations, etc. should be pursued in addition to antimicrobial therapy.

Adolescent↗
PubMedDate not supplied

Clinical distinction and evaluation of leptospirosis in Taiwan--a case-control study.

BACKGROUND: Leptospirosis is the most widespread zoonosis. Leptospirosis remains underreported in Taiwan because of ignorance and the broad spectrum of clinical manifestations. Acute renal failure (ARF) is a prominent feature of leptospirosis. This investigation conducted a case-control study to obtain information to distinguish leptospirosis from other conditions with similar presentations. METHODS: Leptospirosis surveillance was performed at Chang Gung Memorial Hospital, Taiwan, between September 2000 and December 2001. Suspected clinical cases were included in the sample and investigated. Diagnosis was confirmed with four-fold or greater increase of microscopic agglutination test (MAT) titer in paired sera; positive immunoglobulin M (IgM) dipstick with single MAT > or =400; or isolation of leptospira. Cases were classified as excluded based on confirmed etiology other than leptospirosis or negative paired serologic test. RESULTS: Twenty-two confirmed cases and 21 excluded cases of leptospirosis were identified from among 169 suspected cases. An outbreak was observed during the flooding from Typhoon Nali. L. shermani, the most common serovar in Taiwan, was identified in 78.5% of confirmed cases. In the confirmed group, mean age was 44 +/- 14.5 (21-66) yrs similar to that of the excluded group, with male predominance (86.4 vs. 57.1%, p<0.05). The most common presentations in the confirmed group were fever (95.5%), ARF (86.4%), myalgia (72.7%) and jaundice (63.6%). Ten patients were infected through occupational or recreational exposure, and in six patients, the infection was associated with flooding. The most distinct presentations of leptospirosis cases compared with excluded cases were increased incidence of hemorrhagic diathesis (odds ratio (OR): 10, p=0.04), myalgia (OR: 8.0, p=0.02), bilateral enlarged kidneys (OR: 7.5, p=0.0004), risk factor exposure (OR: 6.9, p=0.005), sterile pyuria (OR: 6.3, p=0.017), hypokalemia (OR: 5.0, p=0.035) and thrombocytopenia (OR: 4.8, p=0.04). Hospitalization days correlated well with levels of peak creatinine (Cr) (p=0.0362) and platelet nadir (p=0.0039) reached. Penicillin treatment was followed by rapid symptoms and renal function improvement. CONCLUSIONS: Prompt recognition of the characteristic presentations of leptospirosis, followed by timely antibiotic treatment, can dramatically save the patients even with severe multiple organ damage.

Adult↗
PubMed2005

Urinalysis: a comprehensive review.

A complete urinalysis includes physical, chemical, and microscopic examinations. Midstream clean collection is acceptable in most situations, but the specimen should be examined within two hours of collection. Cloudy urine often is a result of precipitated phosphate crystals in alkaline urine, but pyuria also can be the cause. A strong odor may be the result of a concentrated specimen rather than a urinary tract infection. Dipstick urinalysis is convenient, but false-positive and false-negative results can occur. Specific gravity provides a reliable assessment of the patient's hydration status. Microhematuria has a range of causes, from benign to life threatening. Glomerular, renal, and urologic causes of microhematuria often can be differentiated by other elements of the urinalysis. Although transient proteinuria typically is a benign condition, persistent proteinuria requires further work-up. Uncomplicated urinary tract infections diagnosed by positive leukocyte esterase and nitrite tests can be treated without culture.

Humans↗
PubMedDate not supplied

Kawasaki disease.

Kawasaki disease (KD) is a common vasculitic disorder usually seen in children below 5 years of age. The disease can present with protean clinical manifestations which include high grade fever (for at least 5 days), rash, redness of the lips and a typical strawberry tongue, cervical lymph node enlargement (often unilateral), swelling over the hands/feet and, later a characteristic peripheral desquamation over the fingers and toes. These clinical features appear sequentially and the findings may change from day-to-day. Thus, all these features may not be seen together at any one point of time. The diagnosis rests on the recognition of this characteristic temporal sequence of clinical events, none of which are, by themselves, pathognomonic. Establishing a diagnosis of KD may be further complicated by the occurrence of several other, seemingly unrelated, clinical features. These include irritability, neck stiffness, sterile pyuria, pneumonitis, hydrops of the gallbladder and hepatitis among many others. There is no laboratory test that can help in confirming a diagnosis of KD. Left untreated, up to 20% of children with KD can develop coronary aneurysms with catastrophic long term sequelae. It is important to diagnose KD in the first 10 days of the illness so that appropriate therapy with intravenous immunoglobulin and aspirin can be Initiated. All paediatricians, and physicians looking after children, need to be aware of this condition which is now being increasingly recognized in India.

Diagnosis, Differential↗
PubMed2004

Nephrocalcinosis in a 2-month-old girl suffering from a mild variant of idiopathic infantile hypercalcemia.

Authors present a rare case of a mild variant of idiopathic infantile hypercalcemia (IIH), in a girl in whom nephrocalcinosis was diagnosed in the 8th week of life. Supplementation of vitamin D3 (400 i.u. per day) has been applied since the age of 3 weeks. The disease was recognised when exploring pyuria and lack of weight gain. Hypercalcemia was corrected by diet reduced in calcium, free of vitamin D3 and with high fluid intake. The first abdominal ultrasound after delivery was performed after 5 week vitamin D3 supplementation. It seems that if abdominal ultrasound scan had been done earlier it could have drawn our attention to the developing nephrocalcinosis and allowed us to start treatment more promptly.

Female↗
PubMed2005

[Vesicovaginal fistula associated with a vaginal foreign body: a case report].

A 14-year-old girl was referred to our hospital with severe pyuria pointed out in a school health check up. An intravenous pyelography and a cystography revealed a foreign body in the pelvic region outside the bladder and pooling of contrast medium in the vagina. Conputed tomography confirmed the foreign body in the vagina. About 1 year earlier, she inserted a hair spray can into the vagina but could not remove its cap. Under the diagnosis of vesicovaginal fistula due to vaginal foreign body, the cap was removed manually and transvaginal repair of the vesicovaginal fistula was performed under general anesthtesia, but it recurred twice. Finally, she underwent successful abdominovaginal repair of fistula. Although a variety of self-introduced objects in the vagina illegally used as a means of sexual gratification have been described, a vesicovaginal complication is very rare.

Adolescent↗
PubMed2005

Renal transitional cell carcinoma and choristoma in a degu (Octodon degus).

A 4.5-year-old female degu (Octodon degus) was minimally responsive with a poor body condition, a rough haircoat, and moderate dehydration. Blood was present around its urethral orifice and on the cage bedding. Laboratory analyses revealed leukocytosis with neutrophilia and anemia; hypoproteinemia and hypoalbuminemia; hyperglycemia, hyperphosphatemia, and elevated alanine aminotransferase, blood urea nitrogen, and creatinine; and hematuria and pyuria with occasional squamous and transitional epithelial cells. A urine culture was positive for coagulase-negative Staphylococcus sp. On gross necropsy, the right kidney was enlarged, cystic, and greenish-brown, with a 10-mm, hemorrhagic, granular mass extending from the renal pelvis into the cranial cortex. Only a small amount of renal cortex appeared normal. The urinary bladder had focal areas of hemorrhage and contained frank blood. Histologically, the papillary mass in the right renal pelvis comprised basophilic, moderately anaplastic, clustered epithelial transition cells consistent with a transitional cell carcinoma. Internally, the tumor showed squamous metaplasia and moderate multifocal interstitial fibrosis. The right kidney cortex contained a choristoma comprising trabecular bone, mature adipocytes, and cellular infiltrates suggestive of osteocytes, lymphocytes, and plasma cells. The urinary bladder had mild to moderate, focal, hemorrhage with neutrophilic inflammation and contained focal areas of mild transitional cell epithelial hyperplasia; these changes may have been secondary to irritation by hemorrhage in the renal pelvis. There was no evidence of metastasis. Renal transitional cell tumors are rare in rodents. This is the first report of both a renal transitional cell carcinoma and a renal choristoma in a degu.

Animals↗
PubMed2005

Spinal epidural abscess caused by group B Streptococcus in a diabetic woman presenting with febrile low back pain.

Because spinal epidural abscess is usually ignored in the preliminary differential diagnosis of low back pain, appropriate treatment may be delayed. Adult spinal epidural abscess is sparsely caused by the pathogen known as group B Streptococcus. In this paper, we report the case of a diabetic woman with lumbar epidural abscess and vertebral osteomyelitis caused by group B Streptococcus. Owing to the main manifestations of fever, pyuria and low back pain, which originally led us to suspect acute pyelonephritis, empirical antibiotics were applied. When the symptoms and signs persisted, other focal infections were considered. Magnetic resonance imaging led to the correct diagnosis. Group B Streptococcus was isolated from the blood but not from the abscess itself, probably due to the prior antibiotic treatment. The patient recovered well after surgical debridement followed by prolonged intravenous penicillin therapy. Therefore, despite the potential for fatality, our results suggest that epidural abscess can be successfully treated with surgery and antibiotic therapy provided that it is detected early enough.

Anti-Bacterial Agents↗
PubMed1992

Bone marrow hypoplasia in a feminized dog with an interstitial cell tumor.

Bone marrow hypoplasia and feminization developed in a 10-year-old male German Shepherd Dog with interstitial cell tumor. Clinical abnormalities included pyrexia, pale mucous membranes, signs of abdominal pain, large left testis, atrophied right testis, and feminization. Abnormal laboratory findings included pancytopenia, bacteremia, bacteriuria, and pyuria. Results of cytologic examination of a bone marrow aspirate were consistent with aplastic anemia. Serum estradiol concentration was high, and serum testosterone concentration was low, compared with normal values for male dogs. The left testicular mass was identified as an interstitial cell tumor. Other causes of the aplastic anemia or feminization were not found.

Anemia, Aplastic↗
PubMed2005

Tolerability of ivermectin in gnathostomiasis.

At present, no universally-accepted effective treatment for cutaneous gnathostomiasis is available. At the Hospital for Tropical Diseases, Mahidol University, albendazole 400 mg twice a day for 14 days is commonly prescribed for patients diagnosed with cutaneous gnathostomiasis. The efficacy of albendazole to induce outward migration of the parasite was less than or around 20% in 2 studies. Research for alternative, more efficacious treatment, is needed. In this prospective open-labeled study, we assessed the safety of ivermectin in 20 Thai patients diagnosed with cutaneous gnathostomiasis. Ivermectin, one time only, at dosages of 50, 100, 150, or 200 microg/kg bodyweight, was given orally to 4 groups of patients, 5 patients each group. Adverse events were recorded and laboratory tests were obtained before and after treatment. No serious adverse events occurred in this study. Forty adverse events were possibly related to ivermectin. The adverse events were malaise (35%), myalgia (30%), drowsiness (30%), pruritus (20%), nausea/vomiting (20%), dizziness (15%), diarrhea (15%), feeling of shortness of breath (10%), feeling of palpitations (10%), constipation (5%), anorexia (5%), and headache (5%). These adverse events were self-limited and not dose-related. Laboratory abnormalities were found in 3 patients (15%). Transient microscopic hematuria, pyuria, and mildly elevated liver enzymes were found in 1 patient each. Ivermectin single dose, of 50,100, 150, and 200 microg/kg bodyweight, is considered safe in Thai patients. Future trials of ivermectin on human gnathostomiasis may be performed using dosages up to 200 microg/kg bodyweight.

Adult↗
PubMed1992

[Urinary tract infections in general practice].

Urinary tract infections are a frequent problem in ambulatory practices. According to the localization of the infection and to complicating factors we differentiate between various syndromes with different clinical presentations. Relevant diagnostic criteria are a bacteriuria of greater than or equal to 100 organisms par millilitre or a pyuria of greater than or equal to 5 leukocytes per high power field. For acute cystitis, a treatment for three days is recommended. Cotrimoxazole or quinolones are effective drugs, which are more and more recommended for the treatment of acute pyelonephritis, too.

Anti-Bacterial Agents↗