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PubMed2002

[Enhancing efficiency of sanatorium treatment of patients with chronic pyelonephritis using hyperbaric oxygenation].

Clinical studies were made in 117 patients with chronic pyelonephritis at the stage of sanatorium-and-health-resort treatment using hyperbaric oxygenation. Supplementing the "traditional" naftusya-based balneotherapy with hyperbaric oxygenation has been shown to potentiate the effect of the water on the course of the illness, functional condition of the urinary organs, to strengthen the potential of those systems res responsible for homeostasis of the peroxide oxygenation of lipids in the body, which fact validates a high efficiency of their combined use.

Adult↗
PubMed2003

[The respiratory system im chronic pyelonephritis].

The respiratory system was studied in 221 patients with chronic pyelonephritis (CP), satisfactory renal function and varying arterial pressure (AP) using tests of systemic hemodynamics, echocardiography, zonal rheography of the lungs and rheospirography. Ventilation-perfusion correlations were also taken into account. It is shown that the respiratory system, along with circulatory organs, is involved in the pathological process at early stages of pyelonephritic inflammation. Patients with the so-called "normal high AP" develop vascular dysfunction in the lungs manifesting in enlarged pulmonary artery base without an increase in pressure gradient in it, gradual growth of resistance of not only systemic vascular bed of the greater but lesser circulation as well, ventilation dysfunction of the lungs by the restrictive type, imbalance between the ventilatory reserve and reserve of pulmonary and systemic blood flow with progression of arterial hypertension.

Adult↗
PubMed2003

A prospective evaluation of the management of acute pyelonephritis in adults referred to urologists.

In order to assess whether it is appropriate and clinically efficient to admit adults with 'clinically diagnosed' acute pyelonephritis (APN) under urologists, as is current practice in many NHS hospitals, a prospective study was undertaken over nine months in an NHS teaching hospital. Thirty-nine patients with clinical APN were admitted to the urology unit; all were pyrexial and 30 (77%) had typical features of rigor, flank pain and irritative lower urinary tract symptoms. Twenty-one (54%) had positive urine cultures, 31 (79%) had parenteral antibiotics, while another three (7%) had oral agents initially. The remaining five (14%) were continued on agents initiated by their GPs before admission. Thirty-three (85%) had imaging procedures with eight significant anomalies being noted. Urgent invasive intervention was required in only four (10%) patients; length of stay varied from one to 25 days. Uncomplicated moderate to severe APN in adults may be treated safely without the need for admission to the urology unit, either in the outpatient setting or on an acute admissions observation ward. Complicated cases requiring intervention can be transferred to the urologist once recommended investigations have been undertaken. This care pathway may help to reduce cancellations of elective urological cases and is likely to be more cost-effective for the NHS by reducing unnecessary admissions.

Acute Disease↗
PubMedDate not supplied

Antimicrobial-induced endotoxaemia in patients with sepsis in the field of acute pyelonephritis.

BACKGROUND: In vitro results have shown that antimicrobial agents may induce the Gram-negative bacteria to release endotoxins (LPS), which in turn, could trigger the secretion of cytokines from monocytes. AIMS: To compare the effect of cefuroxime, netilmicin or ciprofloxacin on serum levels of LPS and tumour necrosis factor-alpha (TNFalpha). METHODS: Seventy-four patients with acute pyelonephritis caused by Gram-negative bacteria and signs of sepsis were randomly assigned to receive one of three intravenous regimens of cefuroxime, netilmicin or ciprofloxacin. Blood samples were collected before therapy and at specified time intervals for 96 hours after the initiation of treatment for the determination of serum levels of LPS and of TNFalpha. RESULTS: Patients treated with cefuroxime presented an early peak of LPS and of TNFalpha in serum two hours after the initiation of treatment compared to the other study groups. After that time interval, concentrations of LPS and TNFalpha were similar in all the study groups. Fever accompanied by endotoxaemia was still detected for 48 hours after the start of therapy in 36, 37.5 and 36% of patients treated with cefuroxime, netilmicin and ciprofloxacin respectively. The corresponding figures for these agents at 72 hours were 28, 12.5 and 24%, respective and 12, 4.2 and 4% at 96 hours (P value not significant). CONCLUSIONS: With the exception of an early peak in the serum levels of LPS and TNFalpha in patients treated with cefuroxime, no significant difference could be detected amongst the study groups as far as their effect on serum levels of LPS and TNFalpha were concerned. This suggests that these three antimicrobial agents may be administered safely at the early stages of sepsis.

Acute Disease↗
PubMed1992

Xanthogranulomatous pyelonephritis in pelvic ectopic kidney.

Xanthogranulomatous pyelonephritis occurred in a pelvic ectopic kidney in a 70-year-old man. Pre-operative diagnosis was possible due to the typical appearance at CT scan of central lithiasis and multiple rounded areas of low density with enhancing rims (bear paw sign).

Aged↗
PubMedDate not supplied

[Features of mental disorders in patients with chronic pyelonephritis].

To study prevalence of mental disorders in patients with chronic pyelonephritis (CP), 50 CP patients were examined clinically and with special tests (fundus of the eye, EEG. AMPI, Luscher's test). The patients were diagnosed to have a wide spectrum of mental disorders: psycho-organicsyndrome, paroxysmal disorders, hallucinations, obsessions depression, asthenic syndrome. The presence of psychoorganic syndrome, paroxysms, hallucinations point to developing organic disorders of the brain the severity of which correlates with the age. The depressions had a complicated genesis (psychogenic, somatogenic and organic). The results of the study can be used for design of therapeutic and rehabilitative measures improving quality of CP patients' life.

Adolescent↗
PubMedDate not supplied

[Abscess of the abdominal wall: a rare presentation of xanthogranulomatous pyelonephritis].

A young psychiatric patient presented with a purulent collection in the lower abdominal wall. Simple drainage failed to heal the abdominal wall abscess, and the presence of a primary septic focus was suspected. Full investigation showed a right renal pelvis calculus with xanthogranulomatous pyelonephritis complicated by a retroperitoneal abscess. Recovery was complete after a nephrectomy. A review of the published literature demonstrated the rarity of this presentation, although even more curious cases have been described, including a urinobronchial fistula, as well as catastrophic cases presenting with a massive haemorrhage. Authors are unanimous that ultrasonography should be the first examination, the scanner being also of primordial value for the diagnosis and demonstration of the retroperitoneal spaces ans fascia. Treatment requires both rapid and radical surgical intervention.

Abscess↗
PubMed2004

Quantitative analysis of 99mTc-DMSA during acute pyelonephritis for prediction of long-term renal scarring.

UNLABELLED: This study was performed to evaluate a quantitative method based on (99m)Tc-DMSA renal planar scintigraphy performed during acute pyelonephritis (APN) to detect kidneys at risk of scarring. METHODS: A total of 43 children (5.8 +/- 3.6 y old [mean +/- SD]) were examined by (99m)Tc-DMSA scintigraphy during (DMSA 1) and 8 +/- 2 mo after (DMSA 2) APN. Two levels of interpretation were performed independently: first, a semiquantitative analysis to classify the kidneys by considering the evolution between DMSA 1 and DMSA 2 (i.e., to determine which kidneys had developed scarring), and second, an automatic quantitative analysis of DMSA 1 to define and to evaluate a predictive index for kidney evolution from DMSA 1 to DMAS 2. The method consisted of determining an automatic threshold for the kidney and then calculating ratios of the count density in a given isocount n% (region of interest containing all the pixels with a value > or = n% of the value of the pixel with the maximal activity value) to the count density in a 20% isocount (C(n%)) and the number of pixels in a given isocount to the number of pixels in a 20% isocount (S(n%)). RESULTS: All kidneys normal at DMSA 1 remained normal at DMSA 2. For the automatic index, the C(70%) ratio was considered the best index for the prediction of scarring. When this C(70%) ratio was used, a cutoff value of 0.45 was able to predict scarring with a sensitivity of 0.83, a specificity of 0.78, a positive predictive value of 0.85, and a negative predictive value of 0.77. CONCLUSION: A cutoff value of 0.45 for the C(70%) ratio calculated for (99m)Tc-DMSA scintigraphy performed during APN may be useful for detecting kidneys at risk of scarring.

Acute Disease↗
PubMed2003

[Xanthogranulomatous pyelonephritis. Diagnostic and therapeutic problems. Report of three paediatric cases].

Xanthogranulomatous pyelonephritis (XGP) is an unusual and rare form of chronic renal suppuration in children, which appear to have a multifactorial pathogenesis. It is usually diffuse, but can remain localized to one part of the kidney, resulting in a misleading pseudoneoplastic appearance raising a problem of differential diagnosis with the other renal masses, particularly Wilms tumour. The authors present a retrospective analysis of three cases of XGP observed in the Monastir department of paediatric surgery. The preoperative diagnosis was pyonephrosis with perirenal abscess in two cases and Wilms tumour in the third case. The diagnosis of XGP was established on histological examination of the operative specimens. The aim of this study is to emphasize the diagnostic difficulties of this disease that, in localized forms, often lead to inappropriate treatment and to establish a treatment regimen for this rare disease.

Child, Preschool↗
PubMed2003

Co-existent massive renal replacement lipomatosis and xanthogranulomatous pyelonephritis--a case report.

Renal replacement lipomatosis is a benign condition that may assume major clinical significance by producing pyelocalyceal deformities that may be mistaken for true renal masses. While the number of reported cases of renal replacement lipomatosis has been relatively small, this entity's prevalence is probably underestimated. We report a case of co-existent massive renal replacement lipomatosis and xanthogranulomatous pyelonephritis.

Humans↗
PubMed2004

[A case of emphysematous pyelonephritis successfully treated by transurethral retrograde drainage].

A 59-year-old female was referred to our institute for urinary tract infection with septicemia, thrombocytopenia, and hyperglycemia. Plain abdominal X-ray and computed tomography (CT) showed emphysema at the left renal parenchyma and urinary tract along with the perirenal inflammatory changes. These findings suggested emphysematous pyelonephritis in the early phase of occurrence in a diabetic patient. Transurethral catheterization of the left ureter was immediately performed, and occluded cloudy urine was drained. Ureteral stent was left indwelt transurethrally for easy accession in case of occlusion. E. coli was cultured in drained urine. Administration of antibiotics, insulin, and anti-coagulant was performed, and drained urine became clear in several hours. General condition and laboratory findings were improved normally in a week, and CT did not reveal the emphysematous change of the left renal unit at the 11th hospital day.

Diabetes Complications↗
PubMedDate not supplied

Emphysematous pyelonephritis due to Aspergillus fumigatus: a case report.

A case of acute emphysematous pyelonephritis (EPN) caused by Aspergillus fumigatus is reported in a non-diabetic patient, who did not apparently have any risk factors for fungal infection. The patient refused any surgical intervention and was successfully treated with liposomal amphoteracin-B and 5-flucytocin and achieved complete recovery.

Acute Disease↗
PubMedDate not supplied

[Dopplerographic assessment of therapeutic efficacy of incoherent quantum irradiation in combined therapy of acute pyelonephritis].

The authors present a comparative estimation of therapeutic efficiency of conventional antibacterial therapy, coherent and incoherent impulse quantum irradiation at a constant magnetic field in combined therapy of 130 patients with acute pyelonephritis. Incoherent impulsive quantum irradiation at a constant magnetic field showed high clinical efficacy manifesting in early normalization of microcirculation of the affected kidney.

Acute Disease↗
PubMed1992

[A clinical study of xanthogranulomatous pyelonephritis (XGP) with special emphasis on the magnetic resonance imaging].

Xanthogranulomatous pyelonephritis (XGP) is an uncommon form of granulomatous inflammation characterized by destruction and replacement of the renal parenchyma by masses of lipid-laden macrophages. We report the first case of the pyonephrotic type of XGP in which Magnetic resonance imaging (MRI) was used in Japan, and summarize the clinical characteristics of 163 cases with XGP in the Japanese literature for age, sex, laboratory data, preoperative diagnosis and operation. A 56-year-old female was admitted with left flank pain. Left nephrectomy was performed following diagnosis of XGP by computed tomography (CT) and MRI. Histopathological findings confirmed the diagnosis of XGP. Furthermore, we evaluated the MR images in XGP. MR images correlated well with the CT images showing an enlarged multiloculated kidney. The internal portion of the loculated areas were of intermediate intensity on T1-weighted images, and became very intense on the T2-weighted sequences, indicating a long T2. MRI appears to be of value in the investigation of renal mass lesions.

Female↗
PubMed2004

[Clinical and biochemical manifestations of chronic pyelonephritis and their correction in population of the northen areas of the Tyumen Territory].

AIM: To study clinicobiochemical features of chronic pyelonephritis (CPN) in the population of northen areas of the Tyumen Territory; to determine emoxipine effects on CPN treatment efficacy. MATERIAL AND METHODS: Clinicolaboratory manifestations of CPN were studied in 246 CPN patients (126 residents of the Tyumen South and 120 residents of the Tyumen North, age 18-55, 174 females, 72 males). The control group consisted of 60 healthy subjects of the same gender and age. RESULTS: CPN in patients living in the north was characterized by more severe intoxication, dysuric disorders, piuria, arterial hypertension, more intensive restructuring of cellular membranes. Membranopathological changes depend on the phase of the pathological process and clinical form of the disease. Emoxipin addition to combined therapy of CPN promoted faster correction of basic CPN symptoms and stabilization of the lipid phase of erythrocytic membranes. CONCLUSION: Clinical and biochemical features of CPN in patients living in the Tyumen North represent additional diagnostic criteria of the disease activity. Adjuvant use of the antioxidant drug emoxipin produces a noticeable clinicobiochemical effect.

Adolescent↗
PubMedDate not supplied

[Morphofunctional placental characteristics in pregnant women with chronic pyelonephritis and urogenital chlamydia infection].

Morphological features of the placenta were studied in women with chronic pyelonephritis and urogenital chlamydial infection. There was an appreciable amount of chaotic sclerotic villi and symplastic nephroses reflecting compensatory-adaptive processes. Morphometric study of the afterbirths has shown that placenta affected with urogenital infection has large area of the intervillous space and small area of chorionic villi involved in gas exchange, supply of nutrients and other components to the fetus.

Chlamydia Infections↗
PubMed1992

[Emphysematous pyelonephritis: a case report and review of the literature].

A case is presented of an E. Coli emphysematous pyelonephritis in a 66 year old female diabetic patient who presented systemic sepsis with positive hemoculture. Diagnosis was obtained thanks to X-ray and the patient had a favorable evolution after left nephrectomy. This is a rare kidney disease (123 described cases) which evolves with necrosis of renal parenchyma and gas formation which frequently expands to the perirenal space and/or to the collector system. It presents a high mortality which can decrease according to the promptness of diagnosis based on X-ray. Thirty eight literature cases of the last decade are reviewed evaluating the efficiency of image diagnostic measures and surgical performance.

Aged↗