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1.
Front Public Health ; 12: 1385443, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38846611

RESUMEN

Introduction: Bladder cancer is one of the most important diseases that threatens oral and dental health due to its nature and side effects of chemotherapy. Therefore, the present study was conducted to investigate the relationship between oral health literacy and oral health-related quality of life in patients with bladder cancer. Methods: This cross-sectional study was conducted on patients with bladder cancer in Ahvaz, 2023. Subjects were selected randomly from the patients those were registered in Cancer Registry Center in Ahvaz Jundishapur University of Medical sciences and invited to Golestan Hospital for data collection through clinical evaluation, the Oral Health Literacy Adult Questionnaire (OHL-AQ), and the Oral Health Impact Profile-14 (OHIP-14PER) questionnaire. The data were analyzed using Pearson correlation coefficient, independent t-test, and analysis of variance. Results: The number of participants was 194. The mean oral health literacy in patients with bladder cancer was 9.74 ± 2.39, indicating insufficient oral health literacy. A significant association was observed between OHL-AQ and DMFT index, but no significant association was found between OHIP-14PER and DMFT index. Furthermore, a significant correlation was found between OHL-AQ and OHIP-14PER (r = -0.68) in patients with bladder cancer. Conclusion: Based on the findings of the present study, all dimensions of oral health literacy have correlation with the oral health-related quality of life in patients with bladder cancer. Therefore, adopting oral health behaviors and increasing oral health literacy can be the best way to improve the oral health-related quality of life to among patients with bladder cancer.


Asunto(s)
Alfabetización en Salud , Salud Bucal , Calidad de Vida , Neoplasias de la Vejiga Urinaria , Humanos , Calidad de Vida/psicología , Neoplasias de la Vejiga Urinaria/psicología , Salud Bucal/estadística & datos numéricos , Masculino , Femenino , Alfabetización en Salud/estadística & datos numéricos , Estudios Transversales , Persona de Mediana Edad , Encuestas y Cuestionarios , Anciano , Adulto , Irán
3.
Br J Gen Pract ; 74(743): e371-e378, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38806210

RESUMEN

BACKGROUND: Childhood urinary tract infection (UTI) can cause renal scarring, and possibly hypertension, chronic kidney disease (CKD), and end-stage renal failure (ESRF). Previous studies have focused on selected populations, with severe illness or underlying risk factors. The risk for most children with UTI is unclear. AIM: To examine the association between childhood UTI and outcomes in an unselected population of children. DESIGN AND SETTING: A retrospective population-based cohort study using linked GP, hospital, and microbiology records in Wales, UK. METHOD: Participants were all children born in 2005-2009, with follow-up until 31 December 2017. The exposure was microbiologically confirmed UTI before the age of 5 years. The key outcome measures were renal scarring, hypertension, CKD, and ESRF. RESULTS: In total, 159 201 children were included; 77 524 (48.7%) were female and 7% (n = 11 099) had UTI before the age of 5 years. A total of 0.16% (n = 245) were diagnosed with renal scarring by the age of 7 years. Odds of renal scarring were higher in children by age 7 years with UTI (1.24%; adjusted odds ratio 4.60 [95% confidence interval [CI] = 3.33 to 6.35]). Mean follow-up was 9.53 years. Adjusted hazard ratios were: 1.44 (95% CI = 0.84 to 2.46) for hypertension; 1.67 (95% CI = 0.85 to 3.31) for CKD; and 1.16 (95% CI = 0.56 to 2.37) for ESRF. CONCLUSION: The prevalence of renal scarring in an unselected population of children with UTI is low. Without underlying risk factors, UTI is not associated with CKD, hypertension, or ESRF by the age of 10 years. Further research with systematic scanning of children's kidneys, including those with less severe UTI and without UTI, is needed to increase the certainty of these results, as most children are not scanned. Longer follow-up is needed to establish if UTI, without additional risk factors, is associated with hypertension, CKD, or ESRF later in life.


Asunto(s)
Infecciones Urinarias , Humanos , Infecciones Urinarias/epidemiología , Femenino , Masculino , Gales/epidemiología , Preescolar , Niño , Estudios Retrospectivos , Factores de Riesgo , Lactante , Insuficiencia Renal Crónica/epidemiología , Atención Secundaria de Salud , Hipertensión/epidemiología , Atención Primaria de Salud , Fallo Renal Crónico/epidemiología , Cicatriz/etiología
4.
Hosp Pediatr ; 14(6): 403-412, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38708550

RESUMEN

OBJECTIVES: Urinary tract infections (UTIs) are the most common bacterial infections in young infants and are traditionally treated with longer intravenous (IV) antibiotic courses. A growing body of evidence supports shorter IV antibiotic courses for young infants. Our primary aim was to decrease the IV antibiotic treatment to 3 days over 2 years for neonates aged 0 to 28 days who have been hospitalized with UTIs. METHODS: Using quality improvement methods, our primary intervention was to implement a revised clinical pathway recommending 3 (previously 7) days of IV antibiotics. Our primary outcome measure was IV antibiotic duration, and the secondary outcomes were length of stay (LOS) and costs. The balancing measure was readmission within 30 days of discharge. Neonates were identified by using International Classification of Diseases diagnosis codes and excluded if they were admitted to the ICU or had a LOS >30 days. We used statistical process control to analyze outcome measures for 4 years before (baseline) and 2 years after the pathway revision (intervention) in February 2020. RESULTS: A total of 93 neonates were hospitalized with UTIs in the baseline period and 41 were hospitalized in the intervention period. We found special cause variation, with a significant decrease in mean IV antibiotic duration from 4.7 (baseline) to 3.1 days (intervention) and a decrease in mean LOS from 5.4 to 3.6 days. Costs did not differ between the baseline and intervention periods. There were 7 readmissions during the baseline period, and 0 during the intervention period. CONCLUSIONS: The implementation of a revised clinical pathway significantly reduced IV antibiotic treatment duration and hospital LOS for neonatal UTIs without an increase in hospital readmissions.


Asunto(s)
Antibacterianos , Vías Clínicas , Tiempo de Internación , Mejoramiento de la Calidad , Infecciones Urinarias , Humanos , Infecciones Urinarias/tratamiento farmacológico , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Recién Nacido , Tiempo de Internación/estadística & datos numéricos , Femenino , Masculino , Readmisión del Paciente/estadística & datos numéricos , Administración Intravenosa , Esquema de Medicación
5.
Cell Mol Biol (Noisy-le-grand) ; 70(5): 258-262, 2024 May 27.
Artículo en Inglés | MEDLINE | ID: mdl-38814206

RESUMEN

In recent years, bladder carcinoma (BC) has shown an increasing incidence, with poor patient outcomes. In clinical practice, BC is still mainly treated by surgery combined with chemoradiotherapy. However, as chemotherapy resistance of tumor cells becomes more and more obvious, it is urgent to find more effective BC treatment regimes. With the increasing application and growing attention paid to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in various neoplastic diseases, EGFR-TKIs have been considered as a new treatment direction in the future. In this study, the research team used AG1478, an EGFR-TKI, to intervene with the BC cell line T24. It was found that the cell activity was statistically decreased, the apoptosis was enhanced, and the cells were dominantly arrested in the G0/G1 phase, confirming the future therapeutic potential of EGFR-TKIs in BC. Besides, the research team further observed that AG1478 also promoted pyroptosis in T24 cells, and its mechanism is related to the induction of mitochondrial oxidative stress damage. The findings lay a more reliable foundation for the future application of EGFR-TKIs in BC.


Asunto(s)
Apoptosis , Puntos de Control del Ciclo Celular , Receptores ErbB , Mitocondrias , Inhibidores de Proteínas Quinasas , Quinazolinas , Tirfostinos , Neoplasias de la Vejiga Urinaria , Humanos , Receptores ErbB/metabolismo , Receptores ErbB/antagonistas & inhibidores , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Neoplasias de la Vejiga Urinaria/metabolismo , Neoplasias de la Vejiga Urinaria/patología , Mitocondrias/efectos de los fármacos , Mitocondrias/metabolismo , Apoptosis/efectos de los fármacos , Línea Celular Tumoral , Tirfostinos/farmacología , Inhibidores de Proteínas Quinasas/farmacología , Quinazolinas/farmacología , Puntos de Control del Ciclo Celular/efectos de los fármacos , Estrés Oxidativo/efectos de los fármacos , Piroptosis/efectos de los fármacos , Proliferación Celular/efectos de los fármacos
6.
J Urol ; 212(1): 41-51, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38700731

RESUMEN

PURPOSE: AUA guidelines for patients with microhematuria (≥3 red blood cells [RBC]/high-power field [hpf]) include cystoscopy for most over age 40 due to risk of urothelial cancer (UC). Cxbladder Triage (CxbT) is a urinary genomic test with UC negative predictive value of 99%. In this prospective randomized controlled trial, we compared cystoscopy use in a standard of care (SOC) arm vs a marker-based approach. MATERIALS AND METHODS: All patients with hematuria provided urine for a CxbT. Those categorized as lower risk (LR), defined as 3 to 29 RBC/hpf and minimal smoking history (<10 pack-years) were randomized between the test group provided with the CxbT result vs the SOC control group. Negative CxbT patients were offered omission of cystoscopy with surveillance. "Not lower risk" (NLR) patients (>30 RBC/hpf or >10 pack-year smoking history) had a CxbT but otherwise SOC. Patient decision and outcomes were recorded. RESULTS: Of 390 eligible patients, 255 were NLR and 135 were LR randomized to CxbT informed decision or SOC. The median age was 62 years (range 18-94) and 54% were male. Overall, 63% of CxbT tests were negative. For NLR patients, 82% had cystoscopy. In the LR control group, cystoscopy was performed in 67% of SOC and 27% in the test group (relative risk 0.41 [95% CI 0.27-0.61]). Compared to cystoscopy, CxbT had 90% sensitivity, 56% specificity, and 99% negative predictive value for UC. CONCLUSIONS: In this prospective randomized controlled trial, use of CxbT in patients with LR hematuria resulted in 59% reduction of cystoscopy use. This clinical utility of CxbT can reduce the burden of unnecessary cystoscopies.


Asunto(s)
Cistoscopía , Hematuria , Triaje , Neoplasias de la Vejiga Urinaria , Humanos , Cistoscopía/efectos adversos , Masculino , Hematuria/diagnóstico , Hematuria/etiología , Femenino , Persona de Mediana Edad , Estudios Prospectivos , Anciano , Neoplasias de la Vejiga Urinaria/diagnóstico , Triaje/métodos , Medición de Riesgo/métodos , Adulto , Enfermedades Asintomáticas
8.
J Autoimmun ; 146: 103231, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38692170

RESUMEN

OBJECTIVE: To investigate the association between autoimmune diseases (AIDs) and bladder cancer (BC) at the genetic level using Mendelian randomization (MR). METHODS: Single nucleotide polymorphisms (SNPs) associated with the seven AIDs were extracted from the IEU GWAS database, and the SNPs were quality-controlled using strict screening criteria. The association between AIDs and BC risk was assessed by inverse-variance weighted (IVW), MR-Egger regression and Weighted median method. The heterogeneity of SNPs was evaluated by Cochran Q test. MR-Egger intercept test and MR-PRESSO global test were used to test the horizontal pleiotropy of SNPs. Both sides with potential causal associations were validated using the validation set. RESULTS: Our result showed that genetically predicted RA was significantly associated with an increased risk of BC (IVW OR = 1.214, 95 % CI = 1.062-1.388, P = 0.005). MS nominally increased the risk of BC (IVW OR = 1.095, 95 % CI = 1.005-1.193, P = 0.037), consistent with the results of the MR analysis of the BC validation cohort. However SLE, T1D, UC, CD, and MG were not causally associated with BC risk (P > 0.05). The sensitivity analyses showed that there was no heterogeneity or horizontal pleiotropy in our findings. CONCLUSION: This study provides evidence of a causal relationship between AIDs and BC risk at the genetic level, confirming a causal relationship between RA and MS in increasing the risk of BC.


Asunto(s)
Enfermedades Autoinmunes , Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo , Análisis de la Aleatorización Mendeliana , Polimorfismo de Nucleótido Simple , Neoplasias de la Vejiga Urinaria , Humanos , Neoplasias de la Vejiga Urinaria/genética , Neoplasias de la Vejiga Urinaria/epidemiología , Enfermedades Autoinmunes/genética , Enfermedades Autoinmunes/epidemiología , Factores de Riesgo
9.
Sci Rep ; 14(1): 11848, 2024 05 24.
Artículo en Inglés | MEDLINE | ID: mdl-38782931

RESUMEN

Despite extensive characterisation of uropathogenic Escherichia coli (UPEC) causing urinary tract infections (UTIs), the genetic background of non-urinary extraintestinal pathogenic E. coli (ExPEC) in companion animals remains inadequately understood. In this study, we characterised virulence traits of 104 E. coli isolated from canine pyometra (n = 61) and prostatic abscesses (PAs) (n = 38), and bloodstream infections (BSIs) in dogs (n = 2), and cats (n = 3). A stronger association with UPEC of pyometra strains in comparison to PA strains was revealed. Notably, 44 isolates exhibited resistance to third-generation cephalosporins and/or fluoroquinolones, 15 were extended-spectrum ß-lactamase-producers. Twelve multidrug-resistant (MDR) strains, isolated from pyometra (n = 4), PAs (n = 5), and BSIs (n = 3), along with 7 previously characterised UPEC strains from dogs and cats, were sequenced. Genomic characteristics revealed that MDR E. coli associated with UTIs, pyometra, and BSIs belonged to international high-risk E. coli clones, including sequence type (ST) 38, ST131, ST617, ST648, and ST1193. However, PA strains belonged to distinct lineages, including ST12, ST44, ST457, ST744, and ST13037. The coreSNPs, cgMLST, and pan-genome illustrated intra-clonal variations within the same ST from different sources. The high-risk ST131 and ST1193 (phylogroup B2) contained high numbers of ExPEC virulence genes on pathogenicity islands, predominating in pyometra and UTI. Hybrid MDR/virulence IncF multi-replicon plasmids, containing aerobactin genes, were commonly found in non-B2 phylogroups from all sources. These findings offer genomic insights into non-urinary ExPEC, highlighting its potential for invasive infections in pets beyond UTIs, particularly with regards to high-risk global clones.


Asunto(s)
Absceso , Enfermedades de los Perros , Farmacorresistencia Bacteriana Múltiple , Infecciones por Escherichia coli , Piómetra , Infecciones Urinarias , Perros , Animales , Infecciones Urinarias/microbiología , Infecciones Urinarias/veterinaria , Farmacorresistencia Bacteriana Múltiple/genética , Masculino , Enfermedades de los Perros/microbiología , Gatos , Infecciones por Escherichia coli/microbiología , Infecciones por Escherichia coli/veterinaria , Piómetra/microbiología , Piómetra/veterinaria , Piómetra/genética , Absceso/microbiología , Absceso/veterinaria , Femenino , Enfermedades de los Gatos/microbiología , Escherichia coli Uropatógena/genética , Escherichia coli Uropatógena/efectos de los fármacos , Escherichia coli Uropatógena/patogenicidad , Escherichia coli/genética , Escherichia coli/patogenicidad , Escherichia coli/efectos de los fármacos , Antibacterianos/farmacología , Enfermedades de la Próstata/microbiología , Enfermedades de la Próstata/veterinaria , Enfermedades de la Próstata/genética , Virulencia/genética , Factores de Virulencia/genética
10.
Adv Rheumatol ; 64(1): 41, 2024 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-38773538

RESUMEN

OBJECTIVE: To review current literature to support the use of mesna as a preventive therapy for hemorrhagic cystitis and bladder cancer in patients with systemic autoimmune diseases and systemic vasculitis treated with cyclophosphamide. MATERIALS AND METHODS: The search for articles was conducted systematically through MEDLINE, LILACS, Cochrane Library, and Embase databases. Only articles in English were selected. For available records, titles and abstracts were selected independently by two investigators. RESULTS: Eighteen studies were selected for analysis. The known adverse effects of cyclophosphamide were hematological toxicity, infections, gonadal toxicity, teratogenicity, increased risk for malignancy and hemorrhagic cystitis. Long-term toxicity was highly dependent on cyclophosphamide cumulative dose. The risk of bladder cancer is especially higher in long-term exposure and with cumulative doses above 36 g. The risk remains high for years after drug discontinuation. Hemorrhagic cystitis is highly correlated with cumulative dose and its incidence ranges between 12 and 41%, but it seems to be lower with new regimens with reduced cyclophosphamide dose. No randomized controlled trials were found to analyze the use of mesna in systemic autoimmune rheumatic diseases and systemic vasculitis. Retrospective studies yielded conflicting results. Uncontrolled prospective studies with positive results were considered at high risk of bias. No evidence was found to support the use of mesna during the treatment with cyclophosphamide for autoimmune diseases or systemic vasculitis to prevent hemorrhagic cystitis and bladder cancer. In the scenarios of high cumulative cyclophosphamide dose (i.e., > 30 g), patients with restricted fluid intake, neurogenic bladder, therapy with oral anticoagulants, and chronic kidney disease, mesna could be considered. CONCLUSION: The current evidence was found to be insufficient to support the routine use of mesna for the prophylaxis of hemorrhagic cystitis and bladder cancer in patients being treated for systemic autoimmune diseases and systemic vasculitis with cyclophosphamide. The use may be considered for selected cases.


Asunto(s)
Enfermedades Autoinmunes , Ciclofosfamida , Cistitis , Mesna , Neoplasias de la Vejiga Urinaria , Humanos , Ciclofosfamida/efectos adversos , Ciclofosfamida/uso terapéutico , Enfermedades Autoinmunes/complicaciones , Enfermedades Autoinmunes/tratamiento farmacológico , Cistitis/prevención & control , Mesna/uso terapéutico , Mesna/administración & dosificación , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Vasculitis Sistémica/complicaciones , Vasculitis Sistémica/tratamiento farmacológico , Brasil , Inmunosupresores/efectos adversos , Inmunosupresores/uso terapéutico , Hemorragia/inducido químicamente , Sociedades Médicas , Reumatología
11.
BMC Urol ; 24(1): 109, 2024 May 18.
Artículo en Inglés | MEDLINE | ID: mdl-38762447

RESUMEN

INTRODUCTION: Abscess of the bladder wall is a rare urological disorder, with a few cases recorded in the literature. The finding of a bladder wall mass via computed tomography (CT) imaging in a visiting patient is the subject of this report. CASE DISCUSSION: A 37-year-old woman with persistent pain in the suprapubic area and lower urinary tract symptoms was examined as a case study. Through a CT scan revealed an inhomogeneous structure in the anteroinferior part of the right bladder. A cystoscopy procedure followed by transurethral resection was performed to remove the mass, which was found to be an abscess. A Foley catheter with irrigation was administered after surgery, and the patient goes home in three days. CONCLUSION: the patient had no symptoms or discomfort in the lower urinary tract after follow-up. Despite the rarity of bladder wall abscesses, cystoscopy can be used to aid diagnosis. Transurethral resection of bladder wall can reduce the mass and eliminate the possibility of malignancy.


Asunto(s)
Absceso , Enfermedades de la Vejiga Urinaria , Neoplasias de la Vejiga Urinaria , Humanos , Femenino , Adulto , Absceso/diagnóstico por imagen , Neoplasias de la Vejiga Urinaria/cirugía , Neoplasias de la Vejiga Urinaria/diagnóstico por imagen , Diagnóstico Diferencial , Enfermedades de la Vejiga Urinaria/cirugía , Enfermedades de la Vejiga Urinaria/diagnóstico por imagen , Enfermedades de la Vejiga Urinaria/diagnóstico , Cistoscopía , Tomografía Computarizada por Rayos X
12.
Medicine (Baltimore) ; 103(21): e38248, 2024 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-38788007

RESUMEN

The spread of multidrug-resistant organisms (MDROs) has resulted in a corresponding increase in the incidence of urinary tract infections (UTIs). The risk factors and hospitalization burden for community-acquired MDRO-associated UTIs are discussed herein. This retrospective study included 278 patients with community-based MDRO-associated UTIs from January 2020 to January 2022. The MDRO (n = 139) and non-MDRO groups (n = 139) were separated based on drug susceptibility results. Community-based MDRO-associated UTIs mainly occurred in the elderly and frail patients with a history of invasive urinary tract procedures. The MDRO group imposed a greater economic burden compared to the non-MDRO group. Independent risk factors for community-based MDRO-associated UTIs were as follows: white blood cell (WBC) count > 10.0 × 109/L (OR = 2.316, 95% CI = 1.316-3.252; P = .018); ≥3 kinds of urinary tract obstructive diseases (OR = 1.720, 95% CI = 1.004-2.947; P = .048); use of 3rd generation cephalosporins (OR = 2.316, 95% CI = 1.316-4.076; P = .004); and a history of invasive urologic procedures (OR = 2.652, 95% CI = 1.567-4.487; P < .001). Days of hospitalization, antibiotic use, and bladder catheter use were significantly greater in the MDRO group than the non-MDRO group (P < .05).


Asunto(s)
Infecciones Comunitarias Adquiridas , Farmacorresistencia Bacteriana Múltiple , Infecciones Urinarias , Humanos , Infecciones Urinarias/epidemiología , Infecciones Urinarias/microbiología , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/economía , Estudios Retrospectivos , Masculino , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/economía , Infecciones Comunitarias Adquiridas/microbiología , Femenino , Factores de Riesgo , Anciano , Persona de Mediana Edad , Hospitalización/economía , Hospitalización/estadística & datos numéricos , Antibacterianos/uso terapéutico , Anciano de 80 o más Años , Costo de Enfermedad , Adulto
13.
Int J Mol Sci ; 25(9)2024 Apr 29.
Artículo en Inglés | MEDLINE | ID: mdl-38732074

RESUMEN

Early diagnosis of infections in young infants remains a clinical challenge. Young infants are particularly vulnerable to infection, and it is often difficult to clinically distinguish between bacterial and viral infections. Urinary tract infection (UTI) is the most common bacterial infection in young infants, and the incidence of associated bacteremia has decreased in the recent decades. Host RNA expression signatures have shown great promise for distinguishing bacterial from viral infections in young infants. This prospective study included 121 young infants admitted to four pediatric emergency care departments in the capital region of Denmark due to symptoms of infection. We collected whole blood samples and performed differential gene expression analysis. Further, we tested the classification performance of a two-gene host RNA expression signature approaching clinical implementation. Several genes were differentially expressed between young infants with UTI without bacteremia and viral infection. However, limited immunological response was detected in UTI without bacteremia compared to a more pronounced response in viral infection. The performance of the two-gene signature was limited, especially in cases of UTI without bloodstream involvement. Our results indicate a need for further investigation and consideration of UTI in young infants before implementing host RNA expression signatures in clinical practice.


Asunto(s)
Infecciones Urinarias , Humanos , Infecciones Urinarias/genética , Lactante , Estudios Prospectivos , Femenino , Masculino , Transcriptoma , Recién Nacido , Perfilación de la Expresión Génica/métodos , Bacteriemia/genética , ARN/genética , Virosis/genética
14.
J Nippon Med Sch ; 91(2): 190-197, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38777782

RESUMEN

BACKGROUND: The appropriate duration of antimicrobial therapy for febrile urinary tract infection (fUTI) in children has not been established. This study examined the optimal duration of treatment for fUTI in children. METHODS: We created a protocol that used fever duration to determine the duration of antibiotic administration. Transvenous antibiotics were administered until 3 days after resolution of fever, followed by oral antibiotics for 1 week. Diagnosis of fUTI was based on a fever of 37.5°C or higher and a quantitative culture of catheterized urine yielded a bacteria count of ≥5 × 104. Acute focal bacterial nephritis (AFBN) and pyelonephritis (PN) were diagnosed on the basis of contrast-enhanced computed tomography (eCT) findings. We retrospectively reviewed treatment outcomes. RESULTS: Of the 78 patients treated according to our protocol, data from 58 were analyzed-49 children (30 boys) had PN and nine (three boys) had AFBN. Blood test results showed that patients with AFBN had significantly higher white blood cell counts and C-reactive protein levels than did those with PN; however, urinary findings and causative bacteria did not differ between groups. Time to resolution of fever and duration of intravenous antibiotic administration were significantly longer in patients with AFBN than in those with PN. However, average duration of AFBN treatment was 14.2 days, which was shorter than the previously reported administration period of 3 weeks. No recurrence was observed in AFBN patients. CONCLUSIONS: A protocol that used fever duration to determine the duration of antimicrobial treatment was useful. Invasive examinations, such as eCT, were not required.


Asunto(s)
Antibacterianos , Fiebre , Pielonefritis , Infecciones Urinarias , Humanos , Infecciones Urinarias/microbiología , Infecciones Urinarias/terapia , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/diagnóstico , Masculino , Femenino , Fiebre/etiología , Fiebre/terapia , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Estudios Retrospectivos , Preescolar , Factores de Tiempo , Pielonefritis/terapia , Pielonefritis/microbiología , Pielonefritis/tratamiento farmacológico , Lactante , Niño , Resultado del Tratamiento , Tomografía Computarizada por Rayos X , Proteína C-Reactiva/análisis , Nefritis/microbiología , Nefritis/terapia , Administración Oral , Enfermedad Aguda , Duración de la Terapia , Recuento de Leucocitos , Administración Intravenosa , Protocolos Clínicos
15.
Microbiome ; 12(1): 89, 2024 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-38745230

RESUMEN

BACKGROUND: Non-toxic approaches to enhance radiotherapy outcomes are beneficial, particularly in ageing populations. Based on preclinical findings showing that high-fibre diets sensitised bladder tumours to irradiation by modifying the gut microbiota, along with clinical evidence of prebiotics enhancing anti-cancer immunity, we hypothesised that dietary fibre and its gut microbiota modification can radiosensitise tumours via secretion of metabolites and/or immunomodulation. We investigated the efficacy of high-fibre diets combined with irradiation in immunoproficient C57BL/6 mice bearing bladder cancer flank allografts. RESULT: Psyllium plus inulin significantly decreased tumour size and delayed tumour growth following irradiation compared to 0.2% cellulose and raised intratumoural CD8+ cells. Post-irradiation, tumour control positively correlated with Lachnospiraceae family abundance. Psyllium plus resistant starch radiosensitised the tumours, positively correlating with Bacteroides genus abundance and increased caecal isoferulic acid levels, associated with a favourable response in terms of tumour control. Psyllium plus inulin mitigated the acute radiation injury caused by 14 Gy. Psyllium plus inulin increased caecal acetate, butyrate and propionate levels, and psyllium alone and psyllium plus resistant starch increased acetate levels. Human gut microbiota profiles at the phylum level were generally more like mouse 0.2% cellulose profiles than high fibre profiles. CONCLUSION: These supplements may be useful in combination with radiotherapy in patients with pelvic malignancy. Video Abstract.


Asunto(s)
Fibras de la Dieta , Suplementos Dietéticos , Microbioma Gastrointestinal , Inulina , Ratones Endogámicos C57BL , Psyllium , Neoplasias de la Vejiga Urinaria , Animales , Ratones , Microbioma Gastrointestinal/efectos de los fármacos , Inulina/administración & dosificación , Neoplasias de la Vejiga Urinaria/radioterapia , Neoplasias de la Vejiga Urinaria/patología , Humanos , Femenino , Traumatismos por Radiación/prevención & control , Intestinos/microbiología , Intestinos/efectos de la radiación , Linfocitos T CD8-positivos
16.
J Int Med Res ; 52(5): 3000605241244743, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38713455

RESUMEN

The world population is rapidly aging. Societal aging poses many challenges for individuals, families, nations, and the global healthcare system. Therefore, geriatric care is a crucial issue that demands our attention. In this case report, we describe a woman in her early 70s with multiple comorbidities, polypharmacy, and renal insufficiency who developed cefepime-induced encephalopathy with moderate to severe cerebral dysfunction during treatment of a urinary tract infection. The patient's consciousness level gradually improved, and no further seizures were observed following the discontinuation of cefepime for several days. This case report underscores the fact that polypharmacy and medication safety are significant concerns that are often overlooked when caring for older patients. The report also highlights the increased susceptibility of older individuals to antibiotic-associated adverse reactions during the management of infectious diseases. Therefore, optimization of antibiotic therapy for older patients is a critical issue that requires thorough investigation and consideration in geriatric care.


Asunto(s)
Antibacterianos , Encefalopatías , Cefepima , Polifarmacia , Insuficiencia Renal , Infecciones Urinarias , Humanos , Cefepima/efectos adversos , Cefepima/uso terapéutico , Femenino , Anciano , Encefalopatías/inducido químicamente , Infecciones Urinarias/tratamiento farmacológico , Insuficiencia Renal/inducido químicamente , Antibacterianos/efectos adversos , Antibacterianos/uso terapéutico
17.
Cell Mol Biol Lett ; 29(1): 66, 2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38724931

RESUMEN

The development of compact CRISPR systems has facilitated delivery but has concurrently reduced gene editing efficiency, thereby limiting the further utilization of CRISPR systems. Enhancing the efficiency of CRISPR systems poses a challenging task and holds significant implications for the advancement of biotechnology. In our work, we report a synthetic dual-antibody system that can stably exist in the intracellular environment, specifically inhibiting the functions of NF-κB and ß-catenin. This not only elevates the transgenic expression of the CRISPR system by suppressing the innate immune response within cells to enhance the gene editing efficiency but also demonstrates a notable tumor inhibitory effect. Based on the specific output expression regulation of CRISPR-CasΦ, we constructed a CRISPR-based gene expression platform, which includes sensor modules for detecting intracellular ß-catenin and NF-κB, as well as an SDA module to enhance overall efficiency. In vitro experiments revealed that the CRISPR-based gene expression platform exhibited superior CDK5 expression inhibition efficiency and specific cytotoxicity towards tumor cells. In vitro experiments, we found that CRISPR-based gene expression platforms can selectively kill bladder cancer cells through T cell-mediated cytotoxicity. Our design holds significant assistant potential of transgene therapy and may offer the capability to treat other diseases requiring transgene therapy.


Asunto(s)
Sistemas CRISPR-Cas , Edición Génica , Neoplasias de la Vejiga Urinaria , Neoplasias de la Vejiga Urinaria/genética , Neoplasias de la Vejiga Urinaria/terapia , Neoplasias de la Vejiga Urinaria/metabolismo , Humanos , Sistemas CRISPR-Cas/genética , Línea Celular Tumoral , Edición Génica/métodos , beta Catenina/metabolismo , beta Catenina/genética , FN-kappa B/metabolismo , FN-kappa B/genética , Expresión Génica/genética , Regulación Neoplásica de la Expresión Génica , Repeticiones Palindrómicas Cortas Agrupadas y Regularmente Espaciadas/genética
18.
World J Urol ; 42(1): 296, 2024 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-38709302

RESUMEN

PURPOSE: This study aimed to ascertain the prevalence and risk factors for developing staphylococcal urinary tract infections (UTIs) in the Casablanca area of Morocco. METHODS: In Casablanca, Morocco, a retrospective evaluation of 772 UTIs patients was conducted between January 2020 and December 2022. The research included two groups of patients: those with staphylococcal UTIs and those without. Sex, age, chronic illnesses, antibiotic exposure, urinary catheterization, urological surgery, and UTIs history were the risk variables assessed. We employed a logistic regression model to identify the characteristics that were predictive of staphylococcal UTIs. RESULTS: Eight staphylococcal species were responsible for 16.84% of UTIs in 772 non-repeating individuals. Patients infected with S. saprophyticus (35.38%) were the most common, followed by those infected with S. epidermidis (24.61%), S. aureus (13.85%), and S. hemolyticus (10.78%). Multivariate logistic regression analysis revealed that male sex (95% CI: 0.261-0.563), immunosuppression and immunosuppressive treatments (95% CI: 0.0068-0.64), chronic diseases (95% CI: 0.407-0.965), previous UTIs (95% CI: 0.031-0.228), frequency of urination more than 8 times a day (95% CI:1.04-3.29), frequency of urination once or twice a day (95% CI: 1.05-2.39), and urinary catheterization (95% CI: 0.02-0.22) were the most likely predictors of staphylococcal UTIs. In addition, a larger proportion of patients with staphylococcal UTIs were made aware of the risk factors associated with staphylococcal UTIs (52.31%, χ2 = 4.82, = 0.014). CONCLUSIONS: This is the first global study to evaluate the predictive factors for acquiring UTIs caused by staphylococci. Monitoring these factors will enable medical authorities to devise effective strategies for managing UTIs and combating antibiotic resistance.


Asunto(s)
Infecciones Estafilocócicas , Infecciones Urinarias , Humanos , Marruecos/epidemiología , Infecciones Urinarias/epidemiología , Infecciones Urinarias/microbiología , Masculino , Femenino , Factores de Riesgo , Infecciones Estafilocócicas/epidemiología , Estudios Retrospectivos , Persona de Mediana Edad , Adulto , Prevalencia , Anciano , Adulto Joven , Adolescente
19.
West J Emerg Med ; 25(3): 358-367, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38801042

RESUMEN

Introduction: Bacterial urinary tract infections (UTI) and some sexually transmitted infections (STI) can have overlapping signs and symptoms or nonspecific findings, such as pyuria on urinalysis. Furthermore, results from the urine culture and the nucleic acid amplification test for an STI may not be available during the clinical encounter. We sought to determine whether gonorrhea, chlamydia, and trichomoniasis are associated with bacteriuria, information that might aid in the differentiation of STIs and UTIs. Methods: We used multinomial logistic regression to analyze 9,650 encounters of female patients who were aged ≥18 years and who underwent testing for STIs. The ED encounters took place from April 18, 2014-March 7, 2017. We used a multivariable regression analysis to account for patient demographics, urinalysis findings, vaginal wet-mount results, and positive or negative (or no) findings from the urine culture and testing for Neisseria gonorrhoeae, Chlamydia trachomatis, or Trichomonas vaginalis. Results: In multivariable analysis, infection with T vaginalis, N gonorrhoeae, or C trachomatis was not associated with having a urine culture yielding 10,000 or more colony-forming units per mililiter (CFU/mL) of bacteria compared with a urine culture yielding less than 10,000 CFU/mL or no urine culture obtained. The diagnosis of a UTI in the ED was not associated with having a urine culture yielding 10,000 or more CFU/mL compared with a urine culture yielding less than 10,000 CFU/mL. Conclusion: After adjusting for covariates, no association was observed between urine culture results and testing positive for trichomoniasis, gonorrhea, or chlamydia. Our results suggest that having a concurrent STI and bacterial UTI is unlikely.


Asunto(s)
Gonorrea , Enfermedades de Transmisión Sexual , Urinálisis , Infecciones Urinarias , Humanos , Femenino , Adulto , Infecciones Urinarias/diagnóstico , Infecciones Urinarias/microbiología , Infecciones Urinarias/orina , Enfermedades de Transmisión Sexual/orina , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/microbiología , Gonorrea/diagnóstico , Gonorrea/orina , Urinálisis/métodos , Infecciones por Chlamydia/orina , Infecciones por Chlamydia/diagnóstico , Persona de Mediana Edad , Chlamydia trachomatis/aislamiento & purificación , Servicio de Urgencia en Hospital , Trichomonas vaginalis/aislamiento & purificación , Bacteriuria/diagnóstico , Bacteriuria/orina , Bacteriuria/microbiología , Adulto Joven , Neisseria gonorrhoeae/aislamiento & purificación , Orina/microbiología , Estudios Retrospectivos , Adolescente , Tricomoniasis/diagnóstico , Tricomoniasis/orina
20.
Brief Bioinform ; 25(4)2024 May 23.
Artículo en Inglés | MEDLINE | ID: mdl-38801703

RESUMEN

Micro ribonucleic acids (miRNAs) play a pivotal role in governing the human transcriptome in various biological phenomena. Hence, the accumulation of miRNA expression dysregulation frequently assumes a noteworthy role in the initiation and progression of complex diseases. However, accurate identification of dysregulated miRNAs still faces challenges at the current stage. Several bioinformatics tools have recently emerged for forecasting the associations between miRNAs and diseases. Nonetheless, the existing reference tools mainly identify the miRNA-disease associations in a general state and fall short of pinpointing dysregulated miRNAs within a specific disease state. Additionally, no studies adequately consider miRNA-miRNA interactions (MMIs) when analyzing the miRNA-disease associations. Here, we introduced a systematic approach, called IDMIR, which enabled the identification of expression dysregulated miRNAs through an MMI network under the gene expression context, where the network's architecture was designed to implicitly connect miRNAs based on their shared biological functions within a particular disease context. The advantage of IDMIR is that it uses gene expression data for the identification of dysregulated miRNAs by analyzing variations in MMIs. We illustrated the excellent predictive power for dysregulated miRNAs of the IDMIR approach through data analysis on breast cancer and bladder urothelial cancer. IDMIR could surpass several existing miRNA-disease association prediction approaches through comparison. We believe the approach complements the deficiencies in predicting miRNA-disease association and may provide new insights and possibilities for diagnosing and treating diseases. The IDMIR approach is now available as a free R package on CRAN (https://CRAN.R-project.org/package=IDMIR).


Asunto(s)
Biología Computacional , Redes Reguladoras de Genes , MicroARNs , Neoplasias de la Vejiga Urinaria , Humanos , MicroARNs/genética , MicroARNs/metabolismo , Biología Computacional/métodos , Neoplasias de la Vejiga Urinaria/genética , Neoplasias de la Vejiga Urinaria/metabolismo , Neoplasias de la Mama/genética , Neoplasias de la Mama/metabolismo , Perfilación de la Expresión Génica , Femenino , Regulación Neoplásica de la Expresión Génica
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