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PubMed1984

[Comparative study on intravenous drip infusion of dibekacin once daily and twice daily in treatment of complicated urinary tract infections].

Dibekacin (DKB) was administered to patients with complicated urinary tract infections without any indwelling catheter to evaluate objectively and comparatively the efficacy, safety and usefulness of intravenous drip infusion once daily and twice daily in a well-controlled study. A 50 mg dose of DKB was administered twice a day to group A, and a 100 mg dose was given once a day to group B. In both groups the drug was given by 1-hr i.v. infusion for 5 consecutive days. Drug efficacy was evaluated in 72 (group A: 36, group B: 36) of the 83 patients treated, and the safety was evaluated on 81 patients (group A: 41, group B: 40). There were no significant differences in the background characteristics between the two groups. The overall clinical efficacy judged by the Committee for Evaluation of Clinical Efficacy was "excellent" in 14% and "moderate" in 50% of group A, and "excellent" in 17% and "moderate" in 64% of group B, the efficacy being higher for group B than group A, but the difference was not statistically significant. The overall drug efficacy rate for each type of infection excluding group 2, was slightly higher in group B, but this difference was not significant either. The overall clinical efficacy for each site of infection, was higher for group B but the differences were not significant. The overall clinical efficacy as judged by the attending physicians was "excellent" in 17% and "moderate" in 58% of group A, and "excellent" in 25% and "moderate" in 61% of group B. The intergroup difference was thus smaller than that judged by the Committee. The elimination rates against bacteriuria were 58% for both groups A and B, and the decrease rates including "cleared" were 42% against pyuria for both groups A and B. Bacteriological evaluation, showed that there was no significant difference in the eradication rates, between group A (65%) and group B (70%). But the eradication rate for gram-positive bacteria was 40% in group A and 81% in group B, there being a significant difference (P less than 0.05) between them. The evaluation of usefulness gave 44% and 53% "satisfactory" rates, respectively, for groups A and B. The results for the "average score" were also the same in both groups. There were no side effects in any of the 81 patients examined. Abnormal laboratory test values attributed to the drug were seen only in 3 and 2 patients in groups A and B, respectively, there being no difference between the groups.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1984

[Comparative studies of DL-8280 and pipemidic acid in complicated urinary tract infections by double-blind method].

The clinical efficacy, safety and usefulness of DL-8280 for the treatment of complicated urinary tract infections were compared with those of pipemidic acid (PPA) by a double-blind method. DL-8280 and PPA were orally administered at a daily dose of 600 mg (t.i.d.) and 2.0 g (q.i.d.) for 5 days, respectively. Of the 311 patients who received DL-8280 or PPA, clinical efficacy, safety and usefulness were evaluated in 228 patients (DL-8280, 115; PPA, 113), 306 patients (DL-8280, 153; PPA, 153) and 250 patients (DL-8280, 124; PPA, 126), respectively. There was no significant difference in the background characteristics between the two groups. In the DL-8280 group the overall clinical efficacy was excellent in 39.1% and moderate in 41.7%, the effectiveness rate being 80.9%, whereas in the PPA group it was excellent in 23.9% and moderate in 33.6%, the effectiveness rate being 57.5%. The efficacy in the DL-8280 group was significantly higher than that in the PPA group (P less than 0.001). According to classification by the type of infection, the overall clinical efficacy of DL-8280 in groups except group 2 (monomicrobial infection, post prostatectomy) and group 3 (monomicrobial infection, upper urinary tract infection) was superior to that of PPA, the difference being significant. Pyuria was cleared or improved in 59.1% of the patients treated with DL-8280 and in 46.0% of the patients with PPA. The difference was not significant. Bacteriuria was eliminated in 76.5% in the DL-8280 group and in 50.4% in the PPA group. DL-8280 demonstrated a significantly higher response than PPA (P less than 0.001). Of the bacteria isolated from the DL-8280 group and PPA group 89.0% and 72.1%, respectively, were eradicated after the treatment, a significant difference being observed between the two groups (P less than 0.001). The clinical efficacy evaluated by the doctor in charge was excellent in 46.1% and good in 37.4% of the patients treated with DL-8280 and excellent in 26.5% and good in 34.5% of the patients treated with PPA, the intergroup difference in the efficacy being significant (P less than 0.001). The evaluation of usefulness of DL-8280 and PPA was "satisfactory" for 71.8% and 47.6%, respectively, the difference being significant (P less than 0.001). Side effects were observed in 11 patients (7.2%) in the DL-8280 group and in 12 patients (7.8%) in the PPA group, but none were serious.(ABSTRACT TRUNCATED AT 400 WORDS)

Administration, Oral↗
PubMed1984

Features of residual renal function in end-stage renal failure associated with spinal cord injury.

The characteristics of end-stage renal disease (ESRD) complicating spinal cord injury (SCI) were studied retrospectively in 43 male hemodialysis patients. A control group of male patients dialyzed in the same institution were studied for comparison. The SCI patients had significantly lower serum creatinine concentrations and daily urinary creatinine excretion than the control group, despite comparable creatinine clearances. Therefore, serum creatinine, when compared with the familiar values in non-SCI patients, may greatly underestimate the severity of the renal impairment. Urine output was higher, urine specific gravity lower, and renal glucosuria more common in the SCI patients. 24-hour urinary protein excretion was higher and serum albumin was lower in the SCI patients, with 48% of the patients exhibiting nephrotic range proteinuria. Urine pH was markedly elevated, and pyuria and bacteriuria were present in all SCI patients. Fractional excretion of potassium (159 +/- 16%) exceeded its filtered load in most SCI patients.

Adult↗
PubMed1984

[Vesico-renal reflux in adults. Study of 57 ureters reimplanted by the submucosal advancement method].

Vesicorenal reflux raises specific problems in adults, as regards both the surgical indications and the operative technique. The operative results are discussed in relation to fifty seven ureters reimplanted in thirty six patients, and the indications for surgical management are outlined. Refluxes clinically associated with lumbalgia, fever and pyuria, always require surgery. The most difficult problems arise from "asymptomatic" refluxes revealed by checkups for renal insufficiency, proteinuria or arterial hypertension. In these cases, the characteristics of the ureter (e.g. wide or narrow) and the existence or absence of renal scars must be taken into consideration. Refluxes in narrow ureters should be followed closely, and the advisability of surgery should be carefully weighed in patients with a wide ureter with no visible damage to the parenchyma.

Adult↗
PubMed1984

[Bladder duplication. A case report].

Duplication of the bladder is uncommon and rarely occurs as an isolated anomaly. This anomaly is classified as complete duplication, incomplete duplication, complete sagittal septum and incomplete sagittal septum. We present the case of a 7 month old child which had recurring pyuria.

Diagnosis, Differential↗
PubMed1983

Simultaneous cystometry and uroflowmetry (micturition study) for evaluation of the caudal part of the urinary tract in dogs: studies of the technique.

A procedure similar to one used for urodynamic evaluation of persons was adapted for simultaneous cystometry and uroflowmetry in dogs. Percutaneous transabdominal urinary bladder catheterizations were used for bladder infusion and cystometry, so that urine flow during voiding would not be altered by urethra instrumentation. The technique was evaluated twice in each of 12 healthy dogs (6 males and 6 females). Studies of individual dogs were performed 1 week apart. Comparisons were made between xylazine and oxymorphone for sedation to accomplish the procedure. Although the 2 drugs provided adequate sedation, oxymorphone was unsatisfactory because it interfered with micturition, whereas xylazine generally did not. Adverse consequences of the procedure occurred infrequently and were minor. According to results of urinalyses, hematuria or pyuria, or both, appeared during the week after the procedure was done in a few dogs, and staphylococcal bacteriuria was induced in 4 dogs. Fluid leakage from urinary bladders was not demonstrated by abdominal paracentesis immediately after each procedure or by contrast radiography performed the day after the 2nd study for each animal. Micturition studies were concluded to be reasonably safe to do, especially when performed by experienced individuals. The studies were judged to have considerable potential value as a means to evaluate lower urinary tract function in dogs.

Anesthesia↗
PubMed1983

[Familial vesicoureteral reflux].

Primary vesicoureteral reflux was seen in 2 siblings in a family of 5 (1 daughter and 2 sons). Voiding cystogram of elder sister, who complained of fever and backache, showed bilateral reflux at the age of 6. Left reflux disappeared soon but right reflux persisted. Right antireflux operation was performed at the age of 9, but right renal function deteriorated gradually. Right nephrectomy was done at the age of 12 because of persistent pyuria and renal stones. The second case was her younger brother who was sent to us because of proteinuria and hypertension. Excretory urogram showed left small kidney and voiding cystogram showed bilateral reflux with moderately dilated ureter and calyceal blunting. Urinalysis revealed normal findings except for proteinuria and he had no urological symptoms. Renal angiogram and renal vein renin study were unremarkable, so bilateral antireflux operation was done. Findings of urinalysis of his parents and younger brother were normal and cystogram of his brother was normal.

Adolescent↗
PubMed1983

[Wound healing disorders in urology].

In urology wound infections are of particular importance, since they occur in more than 8 of 100 patients. Of all surgical disciplines, urology in fact, is the one with the highest incidence of secondary wound healing. Thus, defective wound healing is seen in about 20% of unselected nephrectomy cases while adenomectomies associated with pyuria and prostatic abscesses show delayed healing in about 40%. In the presence of pyonephrosis or pyelonephritis surgical wounds are infected in 50% of cases. Prolonged preoperative hospitalization increases the chances of skin contamination and, as a result, the risk of wound infection. In addition, it is associated with a higher incidence of hospital infections, which constitutes another endogenous factor underlying defective wound healing. The rate of postoperative wound infections can only be kept within reasonable limits, if close attention is paid to the many factors which contribute to wound healing (e. g. hygiene and preoperative preparation, removal of hair, skin degerming, draping, preoperative disinfection of hands, prophylactic antibiotics etc.) and if strict aseptic and antiseptic precautions are taken.

Anti-Bacterial Agents↗
PubMed1983

Complications of retrograde contrast urethrography in dogs and cats.

Urinary bladder lesions varying histologically from a focal hemorrhagic cystitis to a diffuse transmural fibrinonecrotic cystitis were encountered in 11 of 14 dogs and cats euthanatized 1 day after retrograde urethrography. Focal-to-diffuse hemorrhagic urethritis was histologically encountered in 14 of 14 dogs and cats euthanatized 1 day after retrograde urethrography. Lesions in the urinary bladder and urethra were not reversible within 14 days and were evident histologically in 10 of 15 urinary bladders and 11 of 15 urethras of dogs and cats euthanatized 14 days after retrograde urethrography. During urethrography, iatrogenic mural leakage of contrast media into the bladder wall or bladder wall rupture was encountered radiographically in 6 of 15 dogs and 3 of 14 cats. However, macroscopic evidence of bladder rupture was encountered in only 1 male dog at necropsy. Immediately after retrograde urethrography, macroscopic hematuria occurred in 12 of 15 dogs and 9 of 14 cats. Microscopic hematuria was not encountered in dogs or cats euthanatized 14 days after urethrography. Pyuria was encountered less frequently and was present in only 2 cats euthanatized 14 days after urethrography. One day after urethrography, urinary tract infection characterized by urine cultures with greater than 10(5) microbes/ml was encountered in 4 of 29 dogs and cats. All animals with urinary tract infection were female dogs or cats. At day 14, only 1 female cat had a positive urine culture. Seemingly, the technique of retrograde urethrography was the cause of the encountered lesions.

Animals↗
PubMed1984

Establishing the cause of genitourinary symptoms in women in a family practice. Comparison of clinical examination and comprehensive microbiology.

We conducted a prospective study comparing the diagnostic yield of standard clinical examinations and of comprehensive microbiological studies in establishing the etiology of genitourinary (GU) symptoms and the prevalence of GU tract infections in 204 women seen in a university-based family practice. Two thirds were initially seen with GU symptoms and one third were seen for routine examinations. In each case we obtained demographic and historical information, a physical examination, and a variety of laboratory tests, including research procedures not commonly available. Diagnoses considered were urinary tract infection and sterile pyuria; trichomonal, yeast, and nonspecific vaginitis; and GU tract infection with Neisseria gonorrhoeae, Chlamydia trachomatis, or herpes simplex virus. Using strategies commonly employed in practice, we reached a diagnosis in only 34% of symptomatic women, a figure rising to 66% when selected, nonroutine laboratory examinations were added.

Adolescent↗
PubMed1980

[Calyceal diverticula : review of 80 diverticula in 70 patients (author's transl)].

The authors review 70 patients with calyceal diverticula, 20 of these patients had an associated urological congenital malformation and 7 of them a lithiasis. The majority of these diverticula were discovered by chance but complications in the form of pain (26 cases), fever (11 cases) or macroscopic haematuria were the essential presenting symptoms. Clinical manifestations occur in relation to large diverticula and, in particular, those containing calculi. Patients with lithiasis are far more often infected than the others. The latent nature of diverticula is such that the onset of clinical symptoms and signs (lumbar pain, fever and pyuria) should lead to a search for an associated malformation, in particular vesico-ureteric reflux and direct cystography is essential. The virtually sole complication of a calyceal diverticulum is lithiasis. 43 of the 90 diverticula studied contained one or more calculi. Infectious complications may result from those diverticula containing stones and are rare in the absence of lithiasis. Only 18 patients underwent surgery (20 diverticula) : 9 by partial nephrectomy (polar in 9 cases and cuneiform in 2), 6 simple incisions of the diverticulum and 2 excisions of the diverticulum. In view of the rarity of complications, it is evident that only poorly tolerated diverticula require operation. In the view of the authors, two essential surgical techniques should be used : polar nephrectomy and resertion of the diverticular protrusion with closure of the neck. Finally, in the presence of associated vesico-ureteric reflux, it is the symptoms and signs of the latter which must influence the choice of treatment. When necessary, it would appear preferable to start by the correction of reflux.

Adult↗
PubMed1983

[A rare complication of disk surgery: ureteral fistula. Apropos of a case following counter-lateral laminectomy].

The authors report a new case (to be added to the 10 already published in the literature) of damage to the ureter during surgical treatment of a herniated disc. Instruments seeking the hernia perforate the prevertebral ligament and damage the ureter. The diagnosis should have been made rapidly in the light of a difficult postoperative course, the discovery of a pre and laterovertebral effusion by echography and the presence of haematuria and pyuria. In fact the diagnosis was made late, by urography, in the presence of a mass in the flank. Attempted treatment by insertion of a uretic catheter failed and the situation was finally resolved by a second end-to-end ureterorrhaphy after mobilisation of the kidney. The possibility of damage to the ureter during surgery for a disc hernia and the therapeutic possibilities with preservation of the kidney when the diagnosis is made sufficiently early should be familiar to all: neurosurgeon, orthopaedic surgeon and urologist.

Adult↗
PubMed1981

Evaluation of zomepirac sodium.

The chemistry, pharmacokinetics, pharmacology, clinical efficacy, adverse effects, physical dependence and tolerance, drug interactions, dosing, and cost of zomepirac sodium (Zomax, McNeil) are reviewed. Zomepirac is a new nonsteroidal anti-inflammatory agent (NSAIA) approved for the treatment of mild to moderately severe pain. The drug is well absorbed when given orally. It undergoes extensive biotransformation in the liver. Zomepirac shares the pharmacology of the other NSAIAs by decreasing prostaglandin synthesis. The efficacy of zomepirac has been demonstrated primarily in acute forms of pain with associated inflammatory processes including postdental-extraction, postpartum, and postoperative pain. Many of these studies have been single-dose evaluations. Zomepirac sodium 100 mg has been reported to be approximately equivalent to one to two tablets of aspirin-phenacetin-caffeine (APC) with codeine 30 mg. In two studies, zomepirac sodium 100 mg compared favorably with morphine sulfate 8 and 16 mg i.m. It has been shown to be superior to aspirin 650 mg in oral-surgery patients. In osteoarthritis, daily doses of zomepirac sodium 400-600 mg are approximately equivalent to aspirin 3200-4800 mg. Zomepirac has side effects similar to high-dose aspirin. Zomepirac is associated with an increased incidence of urogenital symptoms such as dysuria and pyuria. Because of tumorigenicity in rats, the drug is contraindicated in children, pregnant women, and nursing mothers. The drug has not demonstrated any potential for physical dependence, withdrawal, or tolerance. Zomepirac may provide a suitable alternative to aspirin, narcotic/NSAIA combinations, and narcotics in the treatment of mild to moderately severe pain. It is unlikely that zomepirac will replace narcotics in more severe types of pain.

Analgesics↗
PubMed1982

Gentamicin toxic nephropathy in horses with disseminated bacterial infection.

Three clinical cases of toxic nephropathy in young horses were ascribed to gentamicin toxicity. Criteria for defining gentamicin-induced nephrotoxicosis were a serum urea nitrogen value greater than the pretreatment value or cylindruria, hematuria, and proteinuria in the absence of pyuria and bacteriuria. Recommended doses of gentamicin had been given in all cases. The nephropathy was reversible in 1 case in which the toxicosis was detected early and was treated by volume diuresis and drug withdrawal.

Animals↗
PubMed1978

Enterobiasis and urinary tract infection.

The correlation between enterobiasis and urinary tract infection was studied in girls aged 6-14 years. Enterobius ova were demonstrated in anorectal scrapings, carried out three times in each case. Of the 84 patients suffering from urinary tract infection, 55 were Enterobius positive, as compared to 60 among 100 control girls. The difference was not significant. Enterobiasis was not found to be more frequent even when urinary tract infection reappeared within 6 months. There was no significant difference among patients with monosymptomatic bacteriuria and pyuria either. Enterobiasis thus seems to play no pathogenic role in urinary tract infections of girls.

Adolescent↗
PubMed1982

Antibiotic-associated colitis: clinical and epidemiological features.

Antibiotic-associated colitis is known to occur with temporal and geographic clustering. During 1979 a marked increase in the incidence of this disease was noted at our institutions. The clinical, epidemiological, and endoscopic features are reported. Typical features included the acute onset of watery diarrhea, fever, abdominal pain, tenderness, and the presence of leukocytosis. Epidemiological data revealed a nosocomial pattern of this illness and a striking female predominance. Two-thirds of the patients had an underlying gynecological or urological disorder. Dysuria and sterile pyuria were unexpected findings. It is suggested that the organism responsible for this disease may be hospital acquired and associated with underlying genitourinary disorders.

Adult↗
PubMed1981

Canine and feline urinalysis: value of macroscopic and microscopic examinations.

A retrospective survey of complete urinalyses performed on dogs and cats hospitalized at the University of Minnesota Veterinary Teaching Hospital was performed to determine the frequency of abnormal findings in urine sediment, compared with normal and abnormal macroscopic findings. One thousand consecutive urine samples collected from dogs and 1,000 consecutive urine samples collected from cats were studied. Results indicated that failure to examine urine sediment of macroscopically normal samples would have yielded false-negative results in 16.5% of the canine patients and 5.7% of the feline patients. Microscopic findings in macroscopically normal canine samples consisted primarily of pyuria and bacteriuria, whereas in cats they consisted of hematuria and bacteriuria. Microscopic abnormalities were detected in almost 50% of the canine and feline samples with macroscopic abnormalities. The results of this evaluation confirm the value of routine microscopic examination of urine sediment as a component of complete urinalysis.

Animals↗
PubMed1981

Efficacy and tolerability of CGP 9,000 ("Oraspor') in diabetic patients treated for urinary tract infections: a case control study.

The new semi-synthetic oral cephalosporin, CGP 9,000, has been evaluated in a large number of hospitalized patients with urinary infections. A total of 57 of these patients suffering from concomitant diabetes was matched with an equal number of non-diabetic patients. Patients were treated for 10 days with either 500 mg or 1.0 g CGP, or 1.0 g cephalexin. The predominant pathogens isolated were E. coli, Strep. faecalis, Proteus mirabilis and Klebsiella spp. Comparison of the results showed that the eradication rate was similar in diabetic and non-diabetic patients and there were no significant differences between the three treatment groups. There was a similar improvement in pyuria, and therapeutic response was equally as good in diabetic patients on 500 mg CGP 9,000 per day as in non-diabetic patients and in the other treatment groups. No unwanted effects on renal function were observed in the high-risk diabetic group.

Aged↗