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1.
BMJ Case Rep ; 16(1)2023 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-36596629

RESUMEN

We report the case of a previously healthy woman in her 60s who presented to the emergency department with acute confusion, vomiting and fever. She was recently diagnosed with a urinary tract infection as an outpatient and had completed the fifth day of a 7-day course of treatment with nitrofurantoin. We maintained a wide differential diagnosis including infectious, metabolic, autoimmune and medication-related causes. She developed an acute normocytic anaemia in hospital with a haemoglobin drop from 121 g/L to 89 g/L. Further investigation revealed evidence of haemolysis with an elevated bilirubin, lactate dehydrogenase, reticulocyte count and decreased haptoglobin. She was worked up for both inherited and acquired causes of haemolysis and found to have glucose-6-phosphate dehydrogenase deficiency. Her presentation was thought to be secondary to nitrofurantoin-induced haemolysis and she recovered completely with conservative management through intravenous fluids and discontinuation of nitrofurantoin.


Asunto(s)
Deficiencia de Glucosafosfato Deshidrogenasa , Infecciones Urinarias , Femenino , Humanos , Nitrofurantoína/efectos adversos , Hemólisis , Deficiencia de Glucosafosfato Deshidrogenasa/complicaciones , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/complicaciones , Fiebre/complicaciones
3.
Surg Infect (Larchmt) ; 24(1): 75-81, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36579922

RESUMEN

Abstract Background: To investigate retrospectively whether changes in serum albumin levels within one hour of flexible ureteroscopy (fURS) lithotripsy can be used as a predictor of post-operative urosepsis. Patients and Methods: Eligible patients with unilateral upper urinary calculi who underwent fRUS lithotripsy performed by a single surgeon at our center were included in the analysis. The patients were divided into sepsis and non-sepsis groups. The change ratio of albumin and white blood cell (WBC) count was calculated by post-operative/pre-operative index*100%. Univariable and multivariable logistic regression analyses were used to assess whether there was a correlation between risk factors and post-operative urosepsis. The receiver operating characteristic (ROC) curve was used to analyze factors that showed significant differences in multivariable logistic regression analysis. Results: A total of 314 patients were included in the analysis, 20 of whom had post-operative urosepsis and five developed septic shock; no deaths occurred. Multivariable logistic regression analysis showed that urine culture results, WBC counts within one hour after surgery, post-operative albumin levels, and the degree of albumin changes after surgery were independent predictors of post-operative urosepsis. Receiver operating characteristic curve analysis showed that noteworthy hypoalbuminemia after surgery and positive pre-operative urine culture could help screen high-risk patients for post-operative urosepsis effectively. Conclusions: Hypoalbuminemia shortly after operation can be utilized as a predictor for early diagnosis of post-operative urosepsis in patients undergoing fURS lithotripsy.


Asunto(s)
Hipoalbuminemia , Litotricia , Sepsis , Infecciones Urinarias , Humanos , Estudios Retrospectivos , Ureteroscopía/efectos adversos , Ureteroscopía/métodos , Hipoalbuminemia/epidemiología , Sepsis/diagnóstico , Sepsis/epidemiología , Sepsis/etiología , Litotricia/efectos adversos , Infecciones Urinarias/etiología , Infecciones Urinarias/complicaciones , Albúminas
5.
Eur J Obstet Gynecol Reprod Biol ; 280: 160-167, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36502759

RESUMEN

OBJECTIVE: To assess the optimal time for removal of a urinary catheter (UC) following caesarean section (CS). METHODS: Several electronic databases were searched from inception to 31 December 2021 regarding the timing of UC removal following CS. The effect of UC removal at different times following CS was calculated using odds ratio (OR) or standardized mean difference and 95% confidence interval (CI). The surface under the cumulative ranking curve (SUCRA) was used to determine the best time for UC removal. All analyses were performed using Stata Version 14.0. RESULTS: In total, 19 studies including 3086 women were included in this review. Compared with UC removal 0-6 h after CS, UC removal 6.1-12 h, 12.1-24 h and > 24 h after CS were more likely to result in urinary tract infection (UTI), with pooled OR of 5.95 (95 % CI 1.58-22.38), 11.26 (95 % CI 2.99-42.44) and 27.25 (95 % CI 6.82-108.90), respectively. UC removal > 24 h after CS was more favourable to prevent urinary retention than immediate UC removal (OR 0.05, 95 % CI 0.00-0.64). UC removal 0-6 h after CS was the optimal timing to prevent UTI and frequent urination, and reduce length of hospital stay as well as time to first ambulation, with maximum SUCRA values of 92.30 %, 85.00 %, 80.60 % and 72.60 %, respectively. CONCLUSION: UC removal 0-6 h after CS may be the optimal timing to prevent several complications in the absence of a clear indication for UC removal after CS. This study may provide a scientific basis for the timing of UC removal after CS.


Asunto(s)
Retención Urinaria , Infecciones Urinarias , Femenino , Humanos , Embarazo , Cesárea/efectos adversos , Metaanálisis en Red , Catéteres Urinarios/efectos adversos , Retención Urinaria/etiología , Infecciones Urinarias/prevención & control , Infecciones Urinarias/complicaciones
6.
Am J Nurs ; 123(1): 50-55, 2023 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-36546390

RESUMEN

BACKGROUND: Catheter-associated urinary tract infections (CAUTIs) can lead to complications that prolong hospital stays and result in patient discomfort as well as increased health care costs and mortality. At our academic medical center in New York City, in 2016-17, 21 of 87 CAUTI cases (24%) were in bedbound female patients in whom indwelling catheters were used for incontinence. Although condom catheters were available as an alternative to indwelling urinary catheters for male patients, there was a lack of effective products for female patients. METHODS: A team of clinical nurse specialists (CNSs) conducted a literature search, reviewed internal data on CAUTI rates and catheter use, and searched for available catheter alternatives that would meet the needs of bedbound female patients. The team identified two different external female urinary catheters and piloted both with a focus on efficacy as well as stakeholder satisfaction. RESULTS: In 2019-20, external female catheters were used in 1,195 unique patients. Approximately 90% of external female catheter use was to avoid using an indwelling urinary catheter. With a cost avoidance of $13,786 per patient, $16,473,912 in costs to the organization were avoided. CAUTI rates in bedbound female patients decreased after implementation of the external female catheters. CONCLUSION: This initiative demonstrates that external female urinary catheters can be used at other hospitals to decrease indwelling urinary catheter use and CAUTI rates in bedbound female patients.


Asunto(s)
Infecciones Relacionadas con Catéteres , Infección Hospitalaria , Infecciones Urinarias , Humanos , Masculino , Femenino , Infecciones Relacionadas con Catéteres/prevención & control , Infecciones Relacionadas con Catéteres/etiología , Factores de Riesgo , Cateterismo Urinario/efectos adversos , Catéteres de Permanencia/efectos adversos , Infecciones Urinarias/prevención & control , Infecciones Urinarias/complicaciones
7.
Indian J Tuberc ; 69(4): 706-709, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36460413

RESUMEN

Tuberculosis is a top 10 leading cause of death worldwide. Lungs are primarily involved organs in tuberculosis. The rest of cases are extrapulmonary tuberculosis (14% reported in 2017). Extrapulmonary tuberculosis always presents with non-specific symptoms, thus at risk of delay diagnosis and management. In genitourinary tuberculosis, kidney alone and kidney with urinary bladder or ureter is affected in more than 70% of cases. The ureter and urinary bladder infections are almost always secondary to tuberculous involvement of the kidney. Bacilli haematogenic spreading is a known transmission pathway to the kidney. In this case, we diagnosed isolated urinary bladder tuberculosis caused by direct gastrointestinal tuberculosis infiltration, a rare occurrence of extrapulmonary tuberculosis. We illustrate the multiorgan involvement in tuberculosis infection including pulmonary, gastrointestinal, peritoneal and urinary bladder.


Asunto(s)
Tuberculosis Gastrointestinal , Tuberculosis Urogenital , Infecciones Urinarias , Humanos , Vejiga Urinaria , Tuberculosis Urogenital/complicaciones , Tuberculosis Urogenital/diagnóstico , Tuberculosis Urogenital/tratamiento farmacológico , Infecciones Urinarias/complicaciones , Infecciones Urinarias/diagnóstico , Infecciones Urinarias/tratamiento farmacológico , Riñón
8.
Nihon Ronen Igakkai Zasshi ; 59(4): 551-558, 2022.
Artículo en Japonés | MEDLINE | ID: mdl-36476704

RESUMEN

An 86-year-old woman who had received a V-P shunt for subarachnoid hemorrhage 23 years previously presented to the emergency room with a chief complaint of fever. The diagnosis on admission was urinary tract infection, and treatment with CMZ was started. Abdominal CT scan on admission revealed that the V-P shunt had penetrated the ascending colon; however, because there were no clinical symptoms or imaging findings suggestive of peritonitis or meningitis, the V-P shunt was not initially considered to be related to the fever. However, since the fever in the 39°C range persisted for a week despite a urine culture showing susceptible Escherichia coli, a spinal fluid examination was performed on the assumption of meningitis caused by the V-P shunt. We found elevated cell counts in the CSF and diagnosed the patient with bacterial meningitis. After shunt removal surgery was performed, the patient quickly recovered from fever. Later, Pseudomonas aeruginosa was detected at the shunt tube and in the CSF, and CFPM was administered continuously. The patient was discharged with good progress.A review of the relevant literature revealed that half of the patients with a V-P shunt penetrating the intestinal tract will pass asymptomatically and are unlikely to develop peritonitis, while half of the patients may develop meningitis. In addition, if there is an artifact in the body, it is always necessary to consider the possibility that it may be the source of infection.


Asunto(s)
Meningitis Bacterianas , Infecciones Urinarias , Humanos , Anciano , Anciano de 80 o más Años , Infecciones Urinarias/complicaciones , Colon
10.
BMC Infect Dis ; 22(1): 836, 2022 Nov 11.
Artículo en Inglés | MEDLINE | ID: mdl-36368929

RESUMEN

BACKGROUND: The COVID-19 pandemic has raised awareness of infection prevention and control. We found that the incidence of nosocomial infection in neurosurgery has changed. This study aimed to evaluate the impact of "coronavirus disease 2019 (COVID-19) prevention and control measures" on nosocomial infections in neurosurgery. METHODS: To explore changes in nosocomial infections in neurosurgery during the COVID-19 pandemic, the clinical data of inpatients undergoing neurosurgery at Taizhou Hospital of Zhejiang Province between January 1 and April 30, 2020 (COVID-19 era) were first analyzed and then compared with those from same period in 2019 (first pre-COVID-19 era). We also analyzed data between May 1 and December 31, 2020 (post-COVID-19 era) at the same time in 2019 (second pre-COVID-19 era). RESULTS: The nosocomial infection rate was 7.85% (54/688) in the first pre-COVID-19 era and 4.30% (26/605) in the COVID-19 era (P = 0.01). The respiratory system infection rate between the first pre-COVID-19 and COVID-19 eras was 6.1% vs. 2.0% (P < 0.01), while the urinary system infection rate was 1.7% vs. 2.0% (P = 0.84). Between the first pre-COVID-19 and COVID-19 eras, respiratory system and urinary infections accounted for 77.78% (42/54) vs. 46.15% (12/26) and 22.22% (12/54) vs. 46.15% (12/26) of the total nosocomial infections, respectively (P < 0.01). Between the second pre-COVID-19 and post-COVID-19 eras, respiratory system and urinary accounted for 53.66% (44/82) vs. 40.63% (39/96) and 24.39% (20/82) vs. 40.63% (39/96) of the total nosocomial infections, respectively (P = 0.02). CONCLUSIONS: The incidence of nosocomial infections in neurosurgery reduced during the COVID-19 pandemic. The reduction was primarily observed in respiratory infections, while the proportion of urinary infections increased significantly.


Asunto(s)
COVID-19 , Infección Hospitalaria , Neurocirugia , Infecciones del Sistema Respiratorio , Infecciones Urinarias , Humanos , Infección Hospitalaria/prevención & control , COVID-19/epidemiología , Pandemias , Centros de Atención Terciaria , Infecciones Urinarias/epidemiología , Infecciones Urinarias/complicaciones , Infecciones del Sistema Respiratorio/epidemiología , China/epidemiología
11.
Urologiia ; (5): 34-38, 2022 Nov.
Artículo en Ruso | MEDLINE | ID: mdl-36382815

RESUMEN

INTRODUCTION: About 200 thousand operations for urolithiasis are performed annually in Russia, but the frequency of postoperative complications reaches 30%. Infectious complications occur with a frequency of up to 40% in the form of various forms of pyelonephritis, urosepsis is recorded in 3% of patients. The aim of the study determine the intensity of blebbing of the plasma membrane of lymphocytes in infectious complications of urolithiasis. MATERIALS AND METHODS: A prospective study examined 1,240 patients with urolithiasis. Inflammatory complications were characterized by the development of bacteriuria, serous pyelonephritis, purulent pyelonephritis and urosepsis. Complications of infectious nature were characterized by the development of bacteriuria, serous pyelonephritis, purulent pyelonephritis and urosepsis. During the study, complications of an infectious nature were detected in 148 patients, which amounted to 11,93% of cases. The control group consisted of - 25 persons with urolithiasis and a favorable course of the postoperative period. Lymphocyte membrane condition was evaluated by phase contrast microscopy. RESULTS: Changes in plasma membrane structure were more frequently reported in patients with postoperative purulent pyelonephritis and urosepsis. When assessing the presence of circulating microparticles, the highest number was recorded in patients with urolithiasis complicated by purulent pyelonephritis or urosepsis - 1318 [982; 2007] and 1531 [1028; 1963], respectively. A relationship was established between the degree of severity of terminal blebbing of the plasma membrane of lymphocytes and the nature of inflammatory complications in urolithiasis.


Asunto(s)
Bacteriuria , Pielonefritis , Sepsis , Infecciones Urinarias , Urolitiasis , Humanos , Estudios Prospectivos , Urolitiasis/complicaciones , Pielonefritis/etiología , Infecciones Urinarias/complicaciones , Membrana Celular , Linfocitos , Sepsis/complicaciones
12.
Urologiia ; (5): 123-126, 2022 Nov.
Artículo en Ruso | MEDLINE | ID: mdl-36382830

RESUMEN

The review is devoted to the study of modern aspects of the etiological structure of chronic recurrent cystitis. The search was carried out using the databases Medline, PubMed, EMBASE. The data of the literature search indicate that chronic recurrent cystitis in women is one of the most common and urgent problems in modern urology, which affects all age categories and has a polyetiological structure. Issues of the pathogenesis of chronic recurrent cystitis, as well as methods of diagnosis and treatment, are closely related to the etiological factors of the disease. The success of chronic recurrent cystitis treatment mainly depends on the accurate identification of the pathogen.


Asunto(s)
Cistitis , Infecciones Urinarias , Femenino , Humanos , Infecciones Urinarias/complicaciones , Cistitis/diagnóstico , Cistitis/etiología , Cistitis/terapia , Enfermedad Crónica
13.
Minerva Pediatr (Torino) ; 74(5): 562-567, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36346379

RESUMEN

BACKGROUND: We have evaluated urinary tract infections (UTI) in neonatal indirect hyperbilirubinemia. Urine culture is not routinely requested in patients with indirect hyperbilirubinemia. However, debates continue about the frequency and investigation of UTI in neonatal indirect hyperbilirubinemia patients. The aim of this study was to determine the prevalence of UTI in neonates admitted to the hospital due to pathological indirect hyperbilirubinemia and whether a routine urine culture test is necessary in patients. METHODS: In this retrospective study, we analyzed data from 1390 patients hospitalized to the Neonatal Unit due to pathological indirect hyperbilirubinemia. One hundred and eleven of these patients with detected bacterial agents in the urine cultures were evaluated. The type of the pathogens grown in urine culture, the number of colonies, and the antibiotic resistance status were evaluated. RESULTS: Among 1390 patients screened, 111 (8%) were found to have UTI, 68 of whom (61.3%) were male. Out of the microorganisms that grew, Escherichia coli was the dominant microorganism with 36.1%, which was followed by Klebsiella species (23.4%), and Enterococcus species (18%), respectively. CONCLUSIONS: The prevalence of UTI is high in the neonatal period as in all childhood and especially in patients admitted to the Neonatal Unit due to indirect hyperbilirubinemia. Escherichia coli and Klebsiella species are the most common bacterial agents that grow. Missing the diagnosis of urinary tract infection in neonates may cause renal problems. Therefore, we recommend requesting a urine culture in routine examinations of neonates who are diagnosed with pathological indirect hyperbilirubinemia and admitted to the hospital due to the need for phototherapy.


Asunto(s)
Infecciones por Escherichia coli , Hiperbilirrubinemia Neonatal , Infecciones Urinarias , Recién Nacido , Humanos , Masculino , Niño , Femenino , Estudios Retrospectivos , Infecciones Urinarias/complicaciones , Infecciones Urinarias/diagnóstico , Infecciones Urinarias/epidemiología , Klebsiella , Escherichia coli
14.
Rev Med Suisse ; 18(806): 2270-2273, 2022 Nov 30.
Artículo en Francés | MEDLINE | ID: mdl-36448946

RESUMEN

Urinary tract infections (UTIs) are one of the main causes of morbidity and mortality in patients with neurogenic lower urinary tract dysfunction (nLUTD). In most cases, these are patients whose symptoms manifest differently from non-neurological patients, and it can be difficult to decide whether the infection should be treated or whether it is asymptomatic bacteriuria for which treatment is not indicated. Recurrent urinary tract infections should be investigated for an underlying urological cause. This article reviews the diagnosis and management of urinary tract infections in adults with neurogenic lower urinary tract dysfunction.


Les infections urinaires sont l'une des principales causes de morbidité et mortalité chez les patients souffrant d'une dysfonction neurogène du bas appareil urinaire (nLUTD) d'origine médullaire. Dans la plupart des cas, les symptômes se manifestent différemment des patients non neurologiques. Il peut être difficile de décider si l'infection doit être traitée ou s'il s'agit d'une bactériurie asymptomatique pour laquelle le traitement n'est pas indiqué. Les infections urinaires récidivantes doivent faire rechercher une cause urologique sous-jacente. Cet article revoit le diagnostic et la prise en charge des infections urinaires de l'adulte atteint d'un dysfonctionnement neurogène du bas appareil urinaire.


Asunto(s)
Infecciones Urinarias , Sistema Urinario , Adulto , Humanos , Infecciones Urinarias/complicaciones , Infecciones Urinarias/diagnóstico , Infecciones Urinarias/epidemiología
15.
Arch Argent Pediatr ; 120(5): S69-S87, 2022 10.
Artículo en Español | MEDLINE | ID: mdl-36190229

RESUMEN

In 2015, the "New recommendations regarding the current controversies in urinary infection" were published in the Archivos Argentinos de Pediatría. Given the fact that in these past years, new evidence has emerged regarding the diagnosis and treatment of urinary infection, the Pediatric Nephrology Committee of Sociedad Argentina de Pediatría has decided to update these recommendations. The main goal is to provide the pediatrician with the necessary tools to make a correct diagnosis, define the most appropriate treatment, select the patients who will benefit from antibiotic prophylaxis, and decide which imaging studies will be necessary, avoiding costly and invasive interventions. These guidelines also include the management of children with urinary tract infections associated with special situations such as: bladder bowel dysfunction, the newborn, children with neurogenic bladder, kidney transplant patients and fungal urinary tract infections.


En 2015 se publicaron en Archivos Argentinos de Pediatría las "Nuevas recomendaciones frente a las actuales controversias en infección urinaria". Dado que en estos años surgieron evidencias con respecto al diagnóstico, la forma de estudio y el tratamiento de la infección urinaria, el Comité de Nefrología Pediátrica de la Sociedad Argentina de Pediatría decidió actualizar dichas recomendaciones. El objetivo principal es brindar al pediatra las herramientas para realizar un correcto diagnóstico, definir el tratamiento más adecuado, seleccionar a los pacientes que se beneficiarán con la profilaxis antibiótica y decidir cuáles serán los estudios de imágenes necesarios, para evitar intervenciones costosas e invasivas. En estas guías se incluyen, además, los lineamientos para el manejo de niños con infecciones urinarias asociadas a situaciones especiales como la disfunción vesicointestinal, el recién nacido, los portadores de vejiga neurogénica, los receptores de trasplante renal y las infecciones urinarias micóticas.


Asunto(s)
Infecciones Urinarias , Argentina , Niño , Humanos , Recién Nacido , Infecciones Urinarias/complicaciones , Infecciones Urinarias/diagnóstico , Infecciones Urinarias/terapia
16.
J Pak Med Assoc ; 72(9): 1721-1725, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36280963

RESUMEN

OBJECTIVE: To ascertain the existence of a connection between Guy's stone score and infectious complications after percutaneous nephrolitholapaxy. METHODS: The retrospective cohort, multi-centre study was conducted in the urology departments of Prof Dr Theodor Burghele Clinical Hospital and C.I. Parhon Clinical Hospital, Romania, and included data of patients who underwent percutaneous nephrolitholapaxy from January 1, 2017, to December 31, 2019. Based on urography, the subjects were assigned to four groups, from GSS1 to GSS4, in accordance with the Guy's stone score classification. The complication rate after percutaneous nephrolitholapaxy was classified using the modified Clavien staging classification. Demographics, preoperative urine cultures, and the rate of complications were compared. Data was analysed using SPSS 24. RESULTS: Of the 246 patients, 116(47.2%) were males and 130(52.8%) were females. The overall mean age was 53.06±13.04 years (range: 18-83). The mean Guy's stone score was 1.82±0.9. The rate of percutaneous nephrolitholapaxy success was 160(65.04%). There were 105(42.68%) patients in GSS1 group, 63(25.60%) in GSS2, 24(9.75%) in GSS3 and 54(21.95%) in GSS4. There were significantly more preoperative positive urine culture in GSS3 and GSS4 groups compared to GSS1 and GSS2 groups (p<0.05). The rates of complications were statistically different among the groups (p=0.019). CONCLUSIONS: Urinary tract infections were found more frequently in patients with higher Guy's stone scores compared to those with low scores. The Guy's stone score classification were found to be a useful tool in predicting the immediate success rate of percutaneous nephrolitholapaxy.


Asunto(s)
Cálculos Renales , Nefrostomía Percutánea , Infecciones Urinarias , Masculino , Femenino , Humanos , Adulto , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Cálculos Renales/complicaciones , Infecciones Urinarias/epidemiología , Infecciones Urinarias/complicaciones , Estudios de Cohortes , Rumanía , Resultado del Tratamiento , Complicaciones Posoperatorias
17.
Int J Infect Dis ; 124: 181-186, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36209977

RESUMEN

OBJECTIVES: The objective of this study was to compare the incidence rate for complications to upper respiratory tract infections (URTIs), including acute bronchitis and lower urinary tract infections (UTIs), for those treated with antibiotics compared to those who were not. METHODS: This was a population-based retrospective cohort study in Sweden. Patients diagnosed with otitis, pharyngotonsillitis, sinusitis, acute bronchitis, and lower UTI in primary care between 2014 and 2020 were included. Data on prescribed and dispensed antibiotics and comorbidities for each subject were collected. The outcome we investigated was the number of infectious complications within 30 days and if antibiotic treatment had any effect on risk reduction. RESULTS: There were 202,995 episodes of otitis, 388,158 pharyngotonsillitis, 125,792 sinusitis, 220,960 bronchitis, and 377,954 lower UTIs in our cohort. No increased risk for complications was seen for untreated compared with treated cases with URTI. For lower UTI, the adjusted odds ratio for febrile UTI or bloodstream infection was 1.53 (95% confidence interval 1.39-1.68). CONCLUSION: The risk for infectious complications from common URTIs is low and not modified by antibiotic treatment. On the contrary, patients diagnosed with UTI in whom antibiotics were withheld had an increased 30 days risk for severe infections.


Asunto(s)
Bronquitis , Infecciones del Sistema Respiratorio , Sinusitis , Infecciones Urinarias , Humanos , Estudios Retrospectivos , Antibacterianos/uso terapéutico , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/epidemiología , Infecciones Urinarias/complicaciones , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/epidemiología , Bronquitis/tratamiento farmacológico , Bronquitis/complicaciones , Sinusitis/tratamiento farmacológico , Enfermedad Aguda , Atención Primaria de Salud
18.
J Coll Physicians Surg Pak ; 32(8): S189-S191, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-36210691

RESUMEN

The urethral diverticulum is an outpouching of the urethral wall communicating with its lumen. Acquired male urethral diverticulum is a rare entity and arises secondary to intervention or distal urethral obstruction. Most patients present with lower urinary tract symptoms (LUTS). Development of calculi is seen in 4-10% of cases. We describe a case of a 63-year gentleman who presented with urinary tract infection (UTI) and acute urinary retention (AUR). He denied history of urolithiasis. Per-urethral catheterization failed, so a supra-pubic catheter was placed and UTI was managed with broad-spectrum parenteral antibiotics. On workup, he was found to have a large tubular urethral diverticulum in the anterior urethra with multiple stones and urethral strictures. The case was managed endoscopically with optical urethrotomy and fragmentation and retrieval of stones using a semi-rigid ureteroscope and pneumatic lithoclast. Key Words: Urethra, Diverticulum, Male, urethral calculus, Lithoclast.


Asunto(s)
Divertículo , Estrechez Uretral , Cálculos Urinarios , Retención Urinaria , Infecciones Urinarias , Antibacterianos , Divertículo/complicaciones , Divertículo/diagnóstico , Humanos , Masculino , Cálculos Urinarios/complicaciones , Cálculos Urinarios/diagnóstico , Cálculos Urinarios/terapia , Retención Urinaria/etiología , Retención Urinaria/terapia , Infecciones Urinarias/complicaciones
19.
Vnitr Lek ; 68(E-4): 4-9, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36220371

RESUMEN

INTRODUCTION: Kidney transplantation is now a routine method used to treat end-stage renal disease. About 10 % of kidney transplant patients are patients with autosomal dominant polycystic kidney disease (ADPKD). After successful kidney transplantation, recurrent urinary tract infections also occur in initially asymptomatic patients. MATERIAL AND METHODS: The group included 320 patients after kidney transplantation. We compared patients with ADPKD versus patients without ADPKD in terms of the presence of recurrent urinary tract infections. THE RESULTS: The incidence of recurrent urinary tract infections (rIMCs) was 18% in patients without ADPKD and 48% in patients without ADPKD. Nephrectomy after kidney transplantation due to recurrent urinary tract infections eliminated this infectious complication (in 86% of patients). CONCLUSION: Kidney transplant patients with ADPKD have a significantly higher incidence of recurrent urinary tract infections. Removal of polycystic kidneys is a suitable solution if the infection persists.


Asunto(s)
Trasplante de Riñón , Enfermedades Renales Poliquísticas , Riñón Poliquístico Autosómico Dominante , Infecciones Urinarias , Humanos , Trasplante de Riñón/efectos adversos , Nefrectomía/métodos , Enfermedades Renales Poliquísticas/complicaciones , Enfermedades Renales Poliquísticas/cirugía , Riñón Poliquístico Autosómico Dominante/complicaciones , Riñón Poliquístico Autosómico Dominante/cirugía , Estudios Retrospectivos , Infecciones Urinarias/complicaciones , Infecciones Urinarias/epidemiología
20.
Zhonghua Yi Xue Za Zhi ; 102(38): 3001-3006, 2022 Oct 18.
Artículo en Chino | MEDLINE | ID: mdl-36229200

RESUMEN

Objective: To analyze the video-urodynamic(VUDS) and clinical features of non-neuropathic lower urinary tract dysfunction (NNLUTD) in children. Methods: Children diagnosed with NNLUTD in the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2020 were included. Children with neurological, rectal dysfunction and anatomical abnormalities were excluded. VUDS and urinalysis were performed in all children who were divided into 4 groups accordingly: normal group (Normal group), detrusor overactivity group(DO group), detrusor sphincter dyssynergia group (DSD group) and detrusor underactivity group (DU group). VUDS and clinical features, vesicoureteral reflux (VUR) and urinary tract infections (UTI) were analyzed. Results: A total of 173 children were included in this study, including 103 males and 70 females, aged (7.2±3.3) years. VUDS showed that 46 cases (26.6%) were in Normal group, 63 cases (36.4%) in DO group, 39 cases (22.5%) in DSD group and 25 cases (14.5%) in DU group. Compared with Normal group and DO group, the proportion of VUR in DSD group and DU group was significantly higher [18(46.2%) and 11(44.0%) vs 7(15.0%) and 14(22.2%), all P<0.05],and the proportion of male children was significantly higher than that of female children with VUR only in DO group [12(32.4%) vs 2(7.7%), P=0.020 ]; Compared with DO group, the proportion of UTI in DSD group and DU group was significantly higher [16(41.0%) and 12(48.0%) vs 12(19.0%), all P<0.05], and the proportion of female children was significantly higher than that of male children with UTI in normal group, DO group and DU group [9(45.0%) vs 4(15.4%), 8(30.8%) vs 4(10.8%)and 7(87.5%) vs 5(29.4%), all P<0.05]. The maximum detrusor pressure in DSD group was significantly higher than that in Normal group, DO group and DU group [(95±47) vs (43±18), (56±18) and (12±9)cmH2O, all P<0.05, 1 cmH2O=0.098 kPa).Compared with Normal group and DO group, post void residual in DSD group and DU group was significantly increased [(58±38) and (70±62) vs (8±8) and (8±7)ml, all P<0.05], and the proportion of lower bladder compliance was significantly increased [(15(38.5%) and 11(44%) vs 1(2.2%) and 10(15.9%), all P<0.05]. Compared with normal group, the maximum bladder capacity of DO, DSD and DU group were all significantly decreased [(178±61), (184±81) and (194±93) vs (256±92)ml, all P<0.05]. The proportion of urgency had significant difference in the four groups [13(28.3%) in Normal group, 41(65.1%) in DO group, 22(56.4%) in DSD group and 11(44.0%) in DU group, P=0.001], and the proportion of dysuria had significant difference too [5(10.9%) in Normal group, 18(28.6%) in DO group, 20(51.3%) in DSD group and 15(60.0%) in DU group, P<0.001]. Conclusions: Children with 4 different conditions of NNLUTD have distinct video-urodynamic features. The higher ratio of VUR and UTI in DSD and DU children may be associated with reduced bladder compliance and increased post void residual. VUDS is useful for the diagnosis and treatment of refractory children with NNLUTD.


Asunto(s)
Obstrucción del Cuello de la Vejiga Urinaria , Infecciones Urinarias , Reflujo Vesicoureteral , Niño , Femenino , Humanos , Masculino , Vejiga Urinaria , Obstrucción del Cuello de la Vejiga Urinaria/complicaciones , Infecciones Urinarias/complicaciones , Urodinámica , Reflujo Vesicoureteral/complicaciones
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