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[PMID]: 29142953
[Au] Autor:Koech MK; Owiti MOG; Owino-Ong'or WD; Koskei AK; Karoney MJ; D'Agati VD; Wyatt CM
[Ad] Address:Moi University School of Medicine, Eldoret, Kenya.
[Ti] Title:Absence of HIV-Associated Nephropathy Among Antiretroviral Naive Adults With Persistent Albuminuria in Western Kenya.
[So] Source:Kidney Int Rep;2(2):159-164, 2017 Mar.
[Is] ISSN:2468-0249
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Introduction: HIV-associated nephropathy (HIVAN) has been strongly linked to African ancestry. However, studies have demonstrated wide variability in the prevalence of HIVAN in different sub-Saharan African populations. Accurate assessment of the disease burden is important because antiretroviral therapy (ART) is increasingly available and may prevent progression to end-stage renal disease. Methods: We prospectively screened ART-naïve, afebrile, nonhypertensive, and nondiabetic adults attending a large HIV care program in Western Kenya for the presence of albuminuria (dipstick albumin ≥ trace or urine albumin to creatinine ratio [UACR] ≥ 30 mg/g). Those with albuminuria confirmed on 2 occasions, subject to consent, underwent kidney biopsy. Results: Among 523 subjects screened, 85 (16.3%) had albuminuria on the initial screen, and persistent albuminuria was confirmed in 32 of the 53 (60%) who returned for confirmatory testing. A total of 27 subjects with persistent albuminuria underwent biopsy. The median age was 34 years (interquartile range [IQR] 30-42 years), and 63% were female. The median CD4 count was 369 cells/µl (IQR 89-492 cells/µl). Renal function was normal in 92%. Median UACR was 257.5 mg/g (IQR 93.5-543 mg/g), and 92% had UACR < 1 g/g. No subject had histologic features consistent with HIVAN; 41% had acute interstitial nephritis (AIN); 33% had nonspecific findings, and 2 patients had arteriosclerosis. Focal segmental glomerulosclerosis, acute postinfectious glomerulonephritis, chronic interstitial nephritis, pyelitis, and papillary sickling were seen in 1 patient each. Discussion: Among ART-naïve adults with persistent albuminuria at a referral center in Western Kenya, we observed no cases of HIVAN. AIN was the most common cause of persistent proteinuria in this setting.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171123
[Lr] Last revision date:171123
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1016/j.ekir.2016.11.007

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[PMID]: 29098124
[Au] Autor:Wiesel S; Gutman A; Abraham JE; Kiroycheva M
[Ad] Address:Internal Medicine, Staten Island University Hospital, Northwell Health.
[Ti] Title:Foley Follies: Emphysematous Pyelitis from Instrumentation in Obstructive Uropathy.
[So] Source:Cureus;9(8):e1612, 2017 Aug 26.
[Is] ISSN:2168-8184
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Emphysematous pyelitis (EP) is a subclass of a life-threatening necrotizing infection of the urinary system called emphysematous pyelonephritis (EPN). We report a case of an 81-year-old man with emphysematous pyelitis, which occurred after urinary tract instrumentation and resolved with conservative medical management. This case highlights the potential complications of urinary tract manipulation and the importance of a prompt diagnosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171105
[Lr] Last revision date:171105
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.7759/cureus.1612

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[PMID]: 28502342
[Au] Autor:Maiti A; Saha D; Das A
[Ad] Address:Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Texas. Electronic address: abhishek.maiti87@gmail.com.
[Ti] Title:Emphysematous Pyelitis: An Entity Distinct from Emphysematous Pyelonephritis.
[So] Source:Am J Med Sci;353(5):505, 2017 May.
[Is] ISSN:1538-2990
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:LETTER
[Em] Entry month:1705
[Cu] Class update date: 170515
[Lr] Last revision date:170515
[St] Status:In-Data-Review

  4 / 481 MEDLINE  
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[PMID]: 27993715
[Au] Autor:Yecies TS; Kadow BT; Jackman SV
[Ad] Address:Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA. Electronic address: Yeciest@upmc.edu.
[Ti] Title:Appearance of Pyelitis Emphysematosa on Computed Tomography.
[So] Source:Urology;101:e3-e4, 2017 Mar.
[Is] ISSN:1527-9995
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Pyelitis emphysematosa is a gas-forming infection characterized by gas located within the wall of the collecting system and renal pelvis. There are only 2 reported cases of pyelitis emphysematosa in the literature, neither of which occurred in the era of cross-sectional imaging. Here we present a case of pyelitis emphysematosa occurring in an elderly female with congenital left renal atrophy and chronic right hydronephrosis secondary to ureteropelvic junction obstruction.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1612
[Cu] Class update date: 170308
[Lr] Last revision date:170308
[St] Status:In-Data-Review

  5 / 481 MEDLINE  
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[PMID]: 27440812
[Au] Autor:Zhao Z; Ong RM; Goh CH; Loh HL
[Ad] Address:1 Department of Anatomical Pathology, Division of Pathology, Singapore General Hospital, Singapore.
[Ti] Title:Pseudotuberculous Granulomatous Pyelitis.
[So] Source:Int J Surg Pathol;25(1):69-72, 2017 Feb.
[Is] ISSN:1940-2465
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:We report a case of pseudotuberculous granulomatous pyelitis in an elderly female patient with hydronephrotic right kidney secondary to obstructing urinary stone. Pseudotuberculous granulomatous pyelitis is a rarely reported entity, characterized by severe granulomatous inflammation limited predominantly to the renal pelvis. It is associated with urinary (pelvicalyceal) obstruction, urolithiasis well as non- Mycobacterial urinary tract infection.
[Mh] MeSH terms primary: Granuloma/pathology
Pyelitis/pathology
[Mh] MeSH terms secundary: Female
Humans
Middle Aged
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1704
[Cu] Class update date: 170419
[Lr] Last revision date:170419
[Js] Journal subset:IM
[Da] Date of entry for processing:160722
[St] Status:MEDLINE
[do] DOI:10.1177/1066896916660618

  6 / 481 MEDLINE  
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[PMID]: 27789323
[Au] Autor:Saadi A; Ayed H; Bouzouita A; Cherif M; Kerkeni W; Selmi S; Ben Slama R; Derouiche A; Chebil M
[Ad] Address:Service d'urologie, hôpital Charles-Nicolle, boulevard 9-Avril, 1006 Tunis, Tunisie. Electronic address: saadiahmedrabta@gmail.com.
[Ti] Title:Résultats du traitement conservateur de la pyélonéphrite emphysémateuse. [Results of conservative management of emphysematous pyelonephritis].
[So] Source:Nephrol Ther;12(7):508-515, 2016 Dec.
[Is] ISSN:1872-9177
[Cp] Country of publication:France
[La] Language:fre
[Ab] Abstract:INTRODUCTION: Emphysematous pyelonephritis (EPN) is a rare and severe, necrotizing infection of the kidney. Diagnosis should be precocious based on computed tomography (CT). Its management remains controversial and its treatment is currently increasingly conservative. The aim of this paper is to discuss the conservative treatment of this disease through our experience in 21 patients. MATERIAL AND METHODS: A retrospective analysis including 21 patients managed conservatively for an emphysematous pyelonephritis in our department from January 2010 to April 2015. Follow-up ranged from three to 24 months. RESULTS: Of the 24 patients, seven belonged to class 1, twelve to class 2 and two to class 4. Obstruction of the upper urinary tract was found in 16 cases. On the risk factor stratification, thrombocytopenia was found in five cases, renal function impairment in 10 cases and a septic shock in four cases. All the patients were initially managed with aggressive fluid and electrolyte resuscitation, control of blood sugar levels, and broad-spectrum antibiotics. Drainage of the urinary tract was performed by double-J stent in 14 patients and with ureteral catheter in six patients. One patient had urinary distension secondary to a urethral stricture with bilateral emphysematous pyelitis. In this case, drainage consisted in suprapubic bladder catheter only. The outcome was favorable in 18 patients and the control CT showed a decline or complete disappearance of gas in urinary tract and/or renal parenchyma after an average period of 12 days. A secondary nephrectomy was performed in two cases. Specific mortality rate was zero. CONCLUSION: PNE remains a severe infection involving the vital prognosis. Computed tomography makes an early diagnosis. Treatment should be conservative based on the association of medical intensive care and drainage, percutaneous or endoscopic, urgently. Nephrectomy should be reserved for extensive forms with multiple organ dysfunction or failure of conservative treatment.
[Pt] Publication type:JOURNAL ARTICLE; ENGLISH ABSTRACT
[Em] Entry month:1610
[Cu] Class update date: 161219
[Lr] Last revision date:161219
[St] Status:In-Process

  7 / 481 MEDLINE  
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[PMID]: 27502931
[Au] Autor:Yu TY; Kim HR; Hwang KE; Lee JM; Cho JH; Lee JH
[Ad] Address:Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, 460, Iksan-daero, Iksan, 54538, Republic of Korea.
[Ti] Title:Computed tomography findings associated with bacteremia in adult patients with a urinary tract infection.
[So] Source:Eur J Clin Microbiol Infect Dis;35(11):1883-1887, 2016 Nov.
[Is] ISSN:1435-4373
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:The use of computed tomography (CT) in the diagnosis of urinary tract infection (UTI) has rapidly increased recently at acute stage, but the CT findings associated with bacteremia in UTI patients are unknown. 189 UTI patients were enrolled who underwent a CT scan within 24 h after hospital admission. We classified CT findings into eight types: a focal or multifocal wedge-shaped area of hypoperfusion, enlarged kidneys, perinephric fat stranding, ureteritis or pyelitis, complicated renal cyst, renal papillary necrosis, hydronephrosis, and renal and perirenal abscess. A retrospective analysis was conducted to evaluate the CT findings associated with bacteremia. The mean age of these patients was 60 ± 17.2 years, and 93.1 % were women. Concurrent bacteremia was noted in 40.2 % of the patients. Abnormal CT findings were noted in 96.3 % of the patients and 62.4 % had two or more abnormal findings. The most frequent abnormal CT finding was a focal or multifocal wedge-shaped area of hypoperfusion (77.2 %), followed by perinephric fat stranding (29.1 %). Perinephric fat stranding, hydronephrosis, and the presence of two or more abnormal CT findings were significantly associated with bacteremia in patients with community-acquired UTI. In the multivariate logistic regression analysis, age [odds ratio (OR) 1.03; 95 % confidence interval (CI) 1.009-1.062], two or more abnormal CT findings (OR 3.163; 95 % CI 1.334-7.498), and hydronephrosis (OR 13.160; 95 % CI 1.048-165.282) were significantly associated with bacteremia. Physicians should be aware that appropriate early management is necessary to prevent fatality in patients with these CT findings.
[Mh] MeSH terms primary: Bacteremia/diagnostic imaging
Bacteremia/pathology
Tomography, X-Ray Computed
Urinary Tract Infections/complications
Urinary Tract Infections/diagnostic imaging
Urinary Tract/diagnostic imaging
Urinary Tract/pathology
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Female
Humans
Male
Middle Aged
Retrospective Studies
Urinary Tract Infections/pathology
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1702
[Cu] Class update date: 171013
[Lr] Last revision date:171013
[Js] Journal subset:IM
[Da] Date of entry for processing:160810
[St] Status:MEDLINE

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[PMID]: 27335796
[Au] Autor:Saljoghi R; Lipsker A; Caillet K; Malaterre J; Le Roux F; Pignot G; Saint F
[Ad] Address:Urology & Transplantation Department, Amiens University Hospital, University of Picardie Jules Verne, CHU d'Amiens, Avenue R.-Laennec, 80054 Amiens cedex 1, France.
[Ti] Title:Encrusted Uretero-pyelitis: Case Report.
[So] Source:Urol Case Rep;7:58-60, 2016 Jul.
[Is] ISSN:2214-4420
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Encrusted uretero-pyelitis is a rare and serious disease, related to the presence of calcifications in the pelvicalyceal system and ureter, associated with chronic urinary tract infection. In most cases, the causal agent of this infection lithiasis is corynebacterium urealyticum. The specific aspect of calcifications on CT scan can help to suggest diagnosis. To avoid a delay in diagnosis (which is frequent), an accurate exploration by the bacteriologist is crucial. The combination of a glycopeptides antibiotherapy and urine acidification has proved its effectiveness, as described in the medical literature. We report the case of a 77-year-old male patient, successfully treated for a bilateral encrusted uretero-pyelitis by local acidification (Thomas's solution) followed by oral acidification (ammonium chloride).
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1606
[Cu] Class update date: 170220
[Lr] Last revision date:170220
[Da] Date of entry for processing:160624
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1016/j.eucr.2016.04.014

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[PMID]: 27041755
[Au] Autor:Fabbi M; Manfredi S; Bianchi E; Gnudi G; Miduri F; Volta A
[Ad] Address:Dpt Scienze Medico Veterinarie, University of Parma, Parma, Italy.
[Ti] Title:Emphysematous pyelitis and cystitis associated with vesicoureteral reflux in a diabetic dog.
[So] Source:Can Vet J;57(4):382-6, 2016 Apr.
[Is] ISSN:0008-5286
[Cp] Country of publication:Canada
[La] Language:eng
[Ab] Abstract:A 12-year-old female dog with a 3-month history of poor response to diabetes treatment had an acute worsening of symptoms, including weakness and blindness. The dog had elevated blood glucose, alkaline phosphatase and urea concentration, hyposthenuria, glycosuria, hematuria, and pyuria. Escherichia coli was isolated from the urine. Radiographs and ultrasound examination showed that the dog had unilateral emphysematous pyelitis and concurrent cystitis associated with vesicoureteral reflux.
[Mh] MeSH terms primary: Diabetes Complications/veterinary
Emphysema/veterinary
Pyelocystitis/veterinary
Vesico-Ureteral Reflux/veterinary
[Mh] MeSH terms secundary: Animals
Diabetes Complications/urine
Dogs
Emphysema/complications
Escherichia coli/isolation & purification
Female
Pyelocystitis/etiology
Pyelocystitis/urine
Vesico-Ureteral Reflux/complications
Vesico-Ureteral Reflux/urine
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1612
[Cu] Class update date: 170220
[Lr] Last revision date:170220
[Js] Journal subset:IM
[Da] Date of entry for processing:160405
[St] Status:MEDLINE

  10 / 481 MEDLINE  
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[PMID]: 26585531
[Au] Autor:Sánchez-Martín FM; López-Martínez JM; Kanashiro-Azabache A; Moncada E; Angerri-Feu O; Millán-Rodríguez F; Villavicencio-Mavrich H
[Ad] Address:Servicio de Urología, Fundació Puigvert, Barcelona, España. Electronic address: fsanchez@fundacio-puigvert.es.
[Ti] Title:Corinebacterium urealyticum: increased incidence of infection and encrusted uropathy.
[So] Source:Actas Urol Esp;40(2):102-7, 2016 Mar.
[Is] ISSN:1699-7980
[Cp] Country of publication:Spain
[La] Language:eng; spa
[Ab] Abstract:INTRODUCTION: Corynebacterium urealyticum (CU) affects patients who are immunosuppressed, chronically ill or have undergone numerous operations. Obstructive uropathy (OU) is a complication of infection. STUDY OBJECTIVE: To demonstrate the growing increase in cases of infection by CU and OU in the past 5 years. MATERIAL AND METHODS: A descriptive study was conducted of urological patients with CU-positive urine cultures (January 2009-December 2014). We calculated the annual distribution and clinical characteristics of infection by CU and OU. Minimum follow-up: 6 months. We obtained the statistical means and ranges of clinical parameters pre/post-therapy. RESULTS: The total number of patients with CU was 115 (men, 87; women, 28). The mean age was 67.9 years (range, 6-95 years), and the annual distribution of cases for 2009, 2010, 2011, 2012, 2013 and 2014 was 9 (7.8%), 13 (11.3%), 9 (7.8%), 20 (17.4%), 31 (27%) and 33 (28.7%), respectively. The increase in cases for 2009-2014 was 300%. Multiple urological surgeries were performed in 89 cases (77.3%), with surgical complications in 77 cases (66.9%). Eighteen (15.6%) patients had OU (men, 13; women, 5), 12 had pyelitis (66.7%), 3 had cystopathy (16.6%), 2 had prostatic capsule disease (11.2%) and 1 had mesh calcification (5.5%). The analysis of the 18 cases with OU showed pre/postantibiotic therapy urine pHs of 8 (r, 6-9) vs. 6 (r, 5-7). All postantibiotic cultures were negative. Acidifying solution was applied in 5 cases, and surgery was performed in 13 cases (72.2%). The results from before/after the multimodal therapy showed renal impairment in 12 (66.6%) vs. 9 cases (50%) and glomerular filtration rates (GFR) of 45.8 (r, 6->90) vs. 52.7 (r, 13->90). The improvement in GFR was 6.94 points (T Wilcoxon; P=.102). The radiology results (incrustations) showed improvement in 13 patients (72.2%) and no change in 5 (27.8%). There was no specific mortality for CU. CONCLUSIONS: The prevalence of infection by CU and OU is increasing. Antibiotic treatment is highly effective. Acidifying solutions are an acceptable option for reducing calcifications.
[Mh] MeSH terms primary: Corynebacterium Infections/complications
Corynebacterium Infections/epidemiology
Ureteral Obstruction/epidemiology
Ureteral Obstruction/etiology
Urinary Tract Infections/complications
Urinary Tract Infections/epidemiology
[Mh] MeSH terms secundary: Adolescent
Adult
Aged
Aged, 80 and over
Child
Female
Humans
Incidence
Male
Middle Aged
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1704
[Cu] Class update date: 170823
[Lr] Last revision date:170823
[Js] Journal subset:IM
[Da] Date of entry for processing:151121
[St] Status:MEDLINE


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