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Reno-broncho-pyelo-cutaneous fistula.
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Appendiculo-vesical fistula with stone in the appendix.
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Microbiology of the urethral (frequency and dysuria) syndrome. A controlled study with 5-year review.
In a clinical and microbiological study of women with urinary frequency and dysuria (excluding those with bacterial cystitis), 41 patients were compared with 42 control subjects. No difference was found between patients and controls in the incidence of infection by Chlamydia trachomatis or other sexually transmitted organisms. The numbers of lactobacilli and other fastidious organisms in the urine of patients with either mild or severe symptoms were similar and did not differ from the numbers in the urine of control subjects. The numbers of leucocytes in urine were also similar in both patients and controls. Our findings support the view that the urethral syndrome is not caused by bacterial or chlamydial infection.
Broadening the concept of urinary tract infection.
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The interpretation of midstream urine microscopy and culture results in women who present acutely to the labour ward.
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The interpretation of midstream urine microscopy and culture results in women who present acutely to the labour ward.
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Evaluation of urinary catheterization and urinary incontinence in a general nursing home population.
The medical records of 412 residents of three southeastern Massachusetts nursing homes were reviewed to examine the frequency and medical management of urinary incontinence and the indications for chronic urinary catheterization. The mean age of the patients was 84.1 years. In this study 9.7% of the patients were managed with a urinary catheter, while an indication for catheterization was recorded in the medical records of only 27.5% of these patients. Half of the noncatheterized nursing home patients were transiently or permanently incontinent of urine, but were not catheterized. Incontinent patients without catheters were more likely to require assistance in toileting (75.5 v 26.1%) or to have bacteriuria (60.1 v 26.1%) than continent patients. Despite the frequency of urinary incontinence, this problem was included in the medical problem list of less than 5% of the incontinent nursing home patients. The authors conclude that urinary incontinence is a frequent medical problem in the nursing home population, but it is rarely recorded and evaluated as a medical problem. Furthermore, indications for urinary catheterization frequently are also not recorded. An explanation for this practice was not determined, but possibilities include a lack of physician knowledge of the evaluation and management of incontinence and a nonaggressive approach to such patients, given their other medical problems.
The role of mycoplasma in some unusual conditions of the kidney and the urinary tract.
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Levels of inhibitors of tumor necrosis factor alpha and interleukin 1beta in urine and sera of patients with urosepsis.
The antiinflammatory cytokine response during urosepsis was determined by measurement of concentrations of soluble tumor necrosis factor receptor (sTNFR) types I and II, interleukin 1 receptor antagonist (IL-1ra), soluble IL-1 receptor type II (sIL-1RII), and interleukin 10 in sera and urine of 30 patients with culture-proven urinary tract infections before and 4, 24, 48, and 72 h after initiation of antibiotic therapy and in 20 healthy individuals. In serum, the levels of sTNFR types I and II, IL-1ra, and IL-10 were higher in patients than in controls. In urine, only sTNFR type I and II levels were elevated in patients. The ratios of concentrations of both types of sTNFR in urine to concentrations in serum were higher in patients than in controls. These findings indicate that during urosepsis, the antiinflammatory cytokine response is generated predominantly at the systemic level.
Evaluation of leukocyte esterase activity as a rapid screening technique for bacteriuria.
Microscopy and leukocyte esterase activity, both employed as screening techniques for urine cultures, were evaluated with respect to two distinct populations, male and female. When 424 urine specimens from males were examined, 95% of the Gram-stained smears and 91% of the leukocyte esterase tests correctly correlated with culture results, indicating significant bacteriuria. There were no significant differences between the Gram stain and leukocyte esterase activity in predicting a negative culture: 99% and 98%, respectively. Neither microscopy nor esterase activity proved as sensitive or as efficient in predicting a negative culture with the female population.
Cells in the urine of newborn infants.
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Muramidase (lysozyme) excretion in children.
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Covert bacteriuria of childhood. A clinical and epidemiological study.
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Study of childhood urinary tract infection in general practice.
A study of bacteriuria was conducted among 426 of the 436 children under the age of 13 in a general practice in north-west London. Three girls and one boy were found to have asymptomatic bacteriuria, and a further girl with bacteriuria presented with abdominal pain and fever. The calculated incidence of urinary tract infection was 1.4% per annum. Most of the childhood urinary infections in this practice occurred before the age of 5 years, and the incidence of significant bacteriuria in this age group was 4.9% per annum. Five other children (four girls and one boy) in the practice were known to have had proved urinary tract infection. Of the total of eight children known to have had significant bacteriuria and investigated radiologically, three girls and two boys had radiological abnormalities in the urinary tract.Pyuria and proteinuria did not prove to be useful in the prediction of asymptomatic bacteriuria. Urinary tract infection with renal tract abnormality was found in this practice to be at least five times as common as diabetes in childhood.
The dip-slide in urology.
To assess the value of the Uricult dip-slide in a hospital urological unit, bacteriological examination of 1,033 urine specimens was compared by this technique and by conventional methods. In 87% of cases identical results were obtained using the dip-slides and the standard laboratory culture plates. Insignificant differences occurred in 10%, and a serious discrepancy between the two methods was found in only 3%. The Uricult dip-slide technique is valuable as a bacteriological screening procedure in urological practice but subculturing from the slide is not recommended except in special circumstances.
Observations on urinary white cell excretion before and after surgery.
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Asymptomatic bacteriuria in girl entrants to Dundee primary schools.
During the statutory medical examination on entrance to primary school 943 5-year-old girls were screened for asymptomatic bacteriuria. A prevalence of 2.1% was found. None of the 20 children with asymptomatic bacteriuria was recognized by the parents as having a urinary infection, though 14 of them had symptoms of lower urinary tract infection. In 16 of the children with bacteriuria either the intravenous pyelogram or the micturating cystogram was abnormal. In 12 the height and weight were below the 25th percentile, and in this group the most severe radiological changes were found.Though the significance of asymptomatic bacteriuria is unknown, these results confirm that in this age group it is often associated with a urinary tract abnormality.