SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
When properly performed and interpreted, urinalysis is one of the most useful tests available to the emergency physician. This article reviews procedures for urine collection and analysis, emphasizing inexpensive and noninvasive chemical, macroscopic, and microscopic techniques.
A well-controlled comparative study was conducted in order to evaluate the efficacy, safety and usefulness of the monobactam antibiotic aztreonam (AZT) in complicated urinary tract infections (UTI) using cefoperazone (CPZ) as the control drug. Patients with complicated UTI due to Gram-negative bacteria were examined. However, in polymicrobial infections, the cases caused by Gram-negative and Gram-positive bacteria were also examined. Both drugs were administered 1 g, twice a day by intravenous drip infusion for 5 days. Overall clinical efficacy was evaluated by the criteria proposed by the UTI committee in Japan. Of the total 394 cases, the clinical efficacy was evaluated for 152 cases in the AZT group and 143 cases in the CPZ group excluding 99 cases of exclusion or dropout. There was no statistically significant difference in the back ground characteristics between the 2 groups. The overall clinical efficacy rate was 55.3% for AZT and 55.2% for CPZ with difference not significant. As for clinical efficacy, in the monomicrobial infection after postprostatectomy (G-2), AZT was superior to CPZ (P less than 0.05), whereas in the polymicrobial infection without indwelling catheter (G-6), CPZ was superior to AZT (P less than 0.1). The overall bacteriological eradication rate was 77.2% for AZT and 74.5% for CPZ. For Gram-negative bacteria only the eradication rate for AZT (83.2%) was superior to that for CPZ (74.6%). This was probably due to the stability of AZT to beta-lactamase. Side effects were observed in 3 cases out of 201 in the AZT group and 5 cases out of 189 in the CPZ group. No severe abnormal laboratory finding was observed in any group; there was no significant difference between the 2 groups. Consequently, AZT was judged to be an antibiotic with clinical usefulness equal to, or even superior to that of CPZ.
That a female patient with abdominal pain is often considered to have pelvic inflammatory disease until proven otherwise is ubiquitous in the medical literature. This view is dangerous and should be challenged because it has resulted in episodes of ruptured appendix, death from ruptured ectopic pregnancies, and serious morbidity from delayed diagnoses of such entities as diverticulitis and endometriosis. Proper diagnostic steps should be taken for all patients with abdominal pain of unclear etiology.This article reviews the pathogenesis of tubo-ovarian abscesses so as to separate and clearly identify fact from fiction. Diagnostic steps and management guidelines are discussed.
Based on the critical analysis of their own material, the authors evaluate the different antireflux operations. The problems of surgical indication are dealt with. The principles applied in selecting the type of operation are reviewed and the experiences of the control examinations are reported.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We evaluated single-dose regimens of trimethoprim-sulfamethoxazole, amoxicillin, and cyclacillin as treatment for acute cystitis in 38 women. The trial was prematurely stopped because of frequent treatment failures. At two days after treatment, all 13 patients given trimethoprim-sulfamethoxazole were cured, while four (31%) of 13 given amoxicillin and four (33%) of 12 given cyclacillin had persistent bacteriuria. At two weeks, 11 (85%) of 13 patients given trimethoprim-sulfamethoxazole, six (50%) of 12 given amoxicillin, and three (30%) of ten given cyclacillin were cured. One patient with positive results of antibody-coated bacteria testing who was treated with cyclacillin had signs and symptoms of acute pyelonephritis three days after treatment, and two patients treated with amoxicillin and one treated with trimethoprim-sulfamethoxazole converted antibody-coated bacteria test results from negative to positive after therapy. We conclude that single-dose treatment of cystitis in unselected women with cyclacillin and amoxicillin may result in low cure rates and that progression to acute pyelonephritis may occur following ineffective single-dose therapy.
Explore the source record for details and available documents.
Postoperative urologic infection can result in morbidity and mortality. The diagnosis and management of postoperative bacterial urinary tract infections are discussed. Rational choice of antimicrobial therapy is based on the frequency at which specific bacterial pathogens are isolated and the local antimicrobial susceptibility patterns of common isolates. However, antibiotic resistance within the hospital setting is becoming a widespread problem. The wide spectrum of the third-generation cephalosporins affords them antimicrobial activity against common pathogens, and they share the low toxicity of other beta-lactam antibiotics.
Careful examination of a fresh, properly collected urine specimen can indicate the presence of urinary tract disease or uncover unsuspected local or systemic pathology. Urinalysis also can lead to a more complete understanding of a systemic disorder or can assure both the patient and the physician that urinary tract disease is absent, at least within the limitations of the examination. Performing a urinalysis takes no more than 10 minutes, is relatively inexpensive and requires minimal training in proper techniques.
Explore the source record for details and available documents.
We assessed the clinical correlates of eosinophils in the urine in 65 patients. In 16% of 470 patients whose urine was specifically examined, eosinophils were noted in the urine sediment. Review of the 65 patients with eosinophiluria demonstrated that when eosinophils were expressed as a percentage of total urine white blood cells, 85% (55/65 patients) had less than 5% urine eosinophils and 45% (29/65 patients) had less than 1%. Infection of the upper and lower urinary tract accounted for 45% of the clinical conditions associated with eosinophiluria. In nine (14%) of the 65 patients a diagnosis of acute interstitial nephritis could be made by clinical criteria or from renal biopsy specimens. We conclude that the finding of urine eosinophils is associated with a variety of clinical conditions and may be most useful when expressed as a percentage of total white blood cells in the urine. At a low-percentage positive (less than 5%), it may not be a good predictor of acute interstitial nephritis, but at a higher level (greater than 5%) it may be a more valuable predictor.
In a retrospective review of 32 consecutive patients (20 adults and 12 children) with acute appendicitis, we correlated abnormal urinalysis with the operative findings. Abnormal results on urinalysis were noted in 10 adults and 5 children. All urine specimens were collected by the clean-catch method. Abnormal findings were found more frequently in female patients. The majority of the patients with abnormal urinalysis had a ruptured or inflamed appendix in proximity to the urinary tract.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.