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A busy haematuria clinic
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
This patient’s first attack of acute pyelonephritis is clearly secondary to lower urinary tract infection. In this particular case, with prompt improvement and no relapse after stopping treatment, further investigation is not necessary. However, you could probably not be criticised for doing a renal U/S, which is safe, even if she is unknowingly pregnant.
Obstetrics: Questions
Published in Euan Kevelighan, Jeremy Gasson, Makiya Ashraf, Get Through MRCOG Part 2: Short Answer Questions, 2020
Euan Kevelighan, Jeremy Gasson, Makiya Ashraf
A primigravida attends booking clinic at eight weeks’ gestation and gives a history of polycystic kidney disease. Outline the relevant management at this booking visit? (5 marks)She is diagnosed as having moderate renal impairment. What specific risks does she have during this pregnancy? (4 marks)How will you plan the management of her pregnancy? (5 marks)At 28 weeks’ gestation she presents with fever, loin pain and rigors. A provisional diagnosis of acute pyelonephritis is made. How should this be managed? (6 marks)
Radiology of Infectious Diseases and Their Potential Mimics in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Jocelyn A. Luongo, Boris Shapiro, Orlando A. Ortiz, Douglas S. Katz
Acute pyelonephritis is a bacterial infection involving the renal pelvis, tubules, and interstitium. The most common pathogen is Escherichia coli. Infection occurs primarily via ascending spread of a urinary tract infection (UTI), although hematogenous spread can occur less frequently. Uncomplicated disease is rarely, if ever, fatal. However, complications such as emphysematous pyelonephritis in diabetics, abscess formation, or sepsis increase the morbidity and mortality substantially. Risk factors for the development of complications include age greater than 65 years, bedridden status, immunosuppression, diabetes, and a long-term indwelling urinary tract catheter [1].
Drug safety in thyroid eye disease – a systematic review
Published in Expert Opinion on Drug Safety, 2022
Jan Wolf, Kamila I. Mitka, Alicja Hubalewska-Dydejczyk, Irene Krämer, George J Kahaly
However, as of today, only one randomized multicenter study has been published [108]. 32 patients with moderate-to-severe, steroid-resistant TED were randomized 1:1 into two groups. Four monthly doses of TCZ were administered (8 mg/kg) to 15 patients while 17 patients received placebo. Subsequently, patients were monitored for 28 weeks; the total study duration was 40 weeks. 91 AE were reported (58 in the TCZ group vs 33 in the placebo group) by 27 patients, mainly graded as mild. 23 patients reported more than one AE. Patients on TCZ reported: 17x infections (especially: 3x respiratory tract infection, 3x gastroenteritis, and 2x urinary tract infection), 11x headache, 3x hypercholesterolemia, 2x eye pain, 1x neutropenia, and 1x thrombocytopenia. Two SAE occurred on TCZ: a moderate increase in transaminase levels at week eight due to a latent tuberculosis which was treated with hydrazides. Transaminase levels normalized after discontinuing hydrazides. Another patient had an acute pyelonephritis at week 30.
Rotula aquatica Lour. mitigates oxidative stress and inflammation in acute pyelonephritic rats
Published in Archives of Physiology and Biochemistry, 2022
A. Vysakh, Kuriakose Jayesh, Ninan Jisha, V. Vijeesh, Sebastian Jose Midhun, Mathew Jyothis, M. S. Latha
The notable characteristics of acute pyelonephritis were acute inflammation, renal parenchymal and pelvis infection (Uhlén et al.2000). The inflammatory response during the infection was elicited by activation of TLR-4 receptor by bacterial virulence factors. The virulence factors like P fimbriae and lipopolysaccharide (LPS) are capable to induce major inflammatory pathways such as TLR-4-mediated NF-κB pathway. The stimulation of TLR-4 leads to the activation of transcription factors which are responsible for the transcription of proinflammatory cytokines and chemokines (Vysakh et al.2018a). These result in the formation of chronic inflammation at the site of infection. The inflammatory condition associated with uropathogenic infection leads to tissue damage and renal scaring. Another important factor that contributes to renal tissue damage was leukocyte infiltration in connection with bacterial invasion.
Association of acute pyelonephritis with double-J ureteral stenting: a nationwide population-based case control study
Published in Scandinavian Journal of Urology, 2021
Szu-Ju Chen, Chi-Ping Huang, Kun-Yuan Chiu, Huey-Yi Chen, Yung-Hsiang Chen, Wen-Chi Chen
The DJ ureteral catheter was introduced by Finney [19] and Hepperlen et al. [20] in the year 1978. Due to several factors, a DJ may be associated with several adverse effects such as infection, encrustations, patient discomfort and a urothelial mucosal reaction, all of which will limit its long-term use for the purpose of drainage [7]. Upon analyzing our results, acute pyelonephritis may also occur. Therefore, ideal stent characters include no discomfort, no biofilm, no encrustations, no migration, radiopacity, being ultrasound detectable, requiring simple insertion & removal, and a high quality-of-life [21]. Although there is no absolute ideal ureteral stent, engineers continue to make the effort to design ideal stent technology through the analysis of coating and materials.