Background: Children with cerebral palsy (CP) are prone to urinary tract infection (UTI), a common cause of childhood morbidity and mortality. However, there has been no report regarding the prevalence of UTI among th...Background: Children with cerebral palsy (CP) are prone to urinary tract infection (UTI), a common cause of childhood morbidity and mortality. However, there has been no report regarding the prevalence of UTI among this group of children inNigeria. Objectives: The study aims at determining the prevalence and the possible predictors of UTI in children with CP compared to age and sex matched children without CP. Methods: A prospective cross-sectional study was carried out among consecutive children with CP at the Neurologic Clinic in the Paediatric Department of the Federal Medical Centre, Makurdi, Nigeria, from December 2011 to May 2013. Results: The age range of the studied population was between 2 and 15 years with a mean age of 8.63 ± 3.83 years including 30 males and 22 females. UTI was confirmed in 20 (38.5%) children with cerebral palsy compared to 2 children (3.8%) without CP (p value 0.000). Among children with CP, Escherichia coli was the commonest organism isolated in 9 (9/20, 45.0%), Streptococcus faecalis in 4 (20.0%), Staphylococcus aureus in 3 (15%), while both Proteus spp., and Klebsiella spp., were isolated in 2 children (10.0%) each. Escherichia coli was also found in the 2 children without CP. All the organisms were resistant to co-trimoxazole, nalidixic acid, nitrofuratoin and amoxiclav, while they were 100% sensitive to ceftriazone and the quinolones. In a univariate regression, analysis only moderate to severe gross motor dysfunction predicted the risk of UTI (OR = 54.81, 95%CI, 2.27 - 1324.00, p value 0.014). Conclusion: Efforts should be put in place to aid mobility among children with CP in order to reduce risk of UT.展开更多
Obiective:To investigate whether"Fuzheng Qingretonglin"decoction can reduce urinary tract damage caused by complex urinary tract infection caused by drug resistant Escherichia coli by regulating Nod-like rec...Obiective:To investigate whether"Fuzheng Qingretonglin"decoction can reduce urinary tract damage caused by complex urinary tract infection caused by drug resistant Escherichia coli by regulating Nod-like receptor pyrin domain3 inflammasome,and to explore the feasibility of this decoction combined with levofloxacin in the treatment of complex urinary tract infection caused by drug resistant bacteria.Methods:SD rats were divided into five groups:sham group,model group,levofloxacin group(Lev group),levofloxacin+Fuzheng Qingre Tonglin decoction group(FZ+lev group),and Fuzheng Qingre Tonglin decoction group(FZQRTL group).After the experiment,urine was taken for bacterial culture to determine the urinary tract infection of rats in each group;HE staining was used to observe the pathological changes of kidney and bladder tissues in rats;The expression of NLRP3 in kidney and bladder tissues was detected by immunohistochemistry;The expression of IL-1βand IL-18 in serum of rats was detected by ELISA;The expressions of NLRP3,ASC and Caspase-1 were detected by Western blotting.Results:The positive rate of urine bacteria culture in the sham group was 0%,the positive rate of urine bacteria culture in the model group was 100%;and the positive rate of urine bacteria culture in the FZ+lev group was 37.50%,which was statistically different from that in the model group(P<0.05).A large number of inflammatory cells were observed in the kidney and bladder tissues of the model group by HE staining,while the number of inflammatory cells in the kidney and bladder tissues of the Lev group and FZQRTL group was significantly reduced compared with that of the model group.The FZ+lev group in the number and structure of inflammatory cells in kidney and bladder were similar to the sham group.The NLRP3 immunohistochemistry of kidney and bladder tissue in FZ+lev groups and FZQRTL groups was significantly different from that in model group(P<0.001).The levels of IL-1βand IL-18 in serum of Lev group,FZQRTL group and FZ+lev group were significantly decreased by ELISA compared with model group(P<0.001).The levels of IL-1βand IL-18 in the FZ+lev groups were significantly lower than in the Lev group and FZQRTL group,and the differences were statistically significant(P<0.05).The protein expressions of NLRP3,ASC and Caspase-1 in the Lev group,FZQRTL group and FZ+lev group were significantly lower than those in the model group(P<0.001).The protein expressions of NLRP3,ASC and Caspase-1 in the FZ+lev groups were significantly lower than in the Lev group and FZQRTL group,and the differences were statistically significant(P<0.05).Conclusions:"Fuzheng Qingretonglin"decoction may have a protective effect on the kidney and bladder of rats with complex urinary tract infection caused by drug-resistant Escherichia coli by inhibiting the activation of NLRP3 inflammatory bodies,and TCM combined with levofloxacin has a better therapeutic effect than TCM or levofloxacin alone.展开更多
Objective: To observe the effect of traditional Chinese medicine "Fuzheng Qingre Tonglin"prescription on rats with complicated urinary tract infection caused by extended-spectrumβ-lactamases (ESBLs)-produci...Objective: To observe the effect of traditional Chinese medicine "Fuzheng Qingre Tonglin"prescription on rats with complicated urinary tract infection caused by extended-spectrumβ-lactamases (ESBLs)-producing Escherichia coli and its possible mechanism. Methods:Specific-pathogen-free female SD rats with 7-9 weeks old were randomly divided into model group, levofloxacin group, low-dose Fuzheng Qingre Tonglin group, high-dose Fuzheng Qingre Tonglin group, levofloxacin+Fuzheng Qingre Tonglin group (n=8 in each above group), and also there was a control group with 5 rats. Each group was administered intragastrically 2 days after model establishment for 14 consecutive days. The general condition of the rats was observed. Renal pathological changes were observed by light microscopy under hematoxylin-eosin staining. The number of white blood cells and the percentage of neutral particles (NEUT%) were detected. ELISA was used for the determination of C-reactive protein (CRP), CD4+, CD8+ in the blood, and secretory immunoglobulin A (SIgA), N-acetyl-β-D-glucosidase (NAG) molecules in urine. Results: There were a large number of inflammatory cells in the kidney of the model group and the levofloxacin group. The inflammatory cells in the treatment group were significantly reduced. The NEUT% and CRP in the blood of each treatment group and the NAG in the urine were significantly lower than those in the model group (P<0.05), except levofloxacin group. Compared with the model group, except for the levofloxacin group, serum CD4 concentration and CD4/CD8 ratio in the other treatment groups were significantly decreased, and CD8 molecules were significantly increased (P<0.05). Conclusion: "Fuzheng Qingre Tonglin" can alleviate systemic and local inflammation of complicated urinary tract infections in rats. It may also have the effect of re-sensing the insensitive antibacterial drug to bacteria and may have the function of regulating immune function and protecting kidney function in rats.展开更多
BACKGROUND Urinary tract infection(UTI)is one of the most common bacterial infections.Acute pyelonephritis or upper urinary tract infection is often accompanied by bacteremia;however,bacteremia resolves in most cases ...BACKGROUND Urinary tract infection(UTI)is one of the most common bacterial infections.Acute pyelonephritis or upper urinary tract infection is often accompanied by bacteremia;however,bacteremia resolves in most cases without complication.Rarely,complications due to bacteremia occur.One of these is osteomyelitis.It mainly affects the lumbar vertebral bodies,and rarely affects other site.CASE SUMMARY An 80-year-old woman presented to the hospital with a two-month history of pain in both legs.Two months ago,she was admitted to the hospital for fever,flank pain,and urinary frequency and was diagnosed with bacteremic UTI.During hospitalization,she complained of pain in both legs;however,the pain resolved shortly after,and no abnormalities were observed on physical examination.Therefore,she was placed on 2-wk antibiotic therapy for UTI without further evaluation for leg pain.However,pain recurred after discharge and persisted;therefore,an imaging test was performed.Bone scan and magnetic resonance imaging suggested osseous infection in both femurs,tibiae and patellae.Surgical treatment was performed,and tissue-and bone cultures revealed Escherichia coli,a previously observed pathogen,which demonstrated same antibiotic sensitivities,as noted in previous UTI.She was diagnosed with disseminated osteomyelitis,as a complication of UTI,and was placed on an 8-wk antibiotic therapy.CONCLUSION Indication for osteomyelitis should be high regardless of bone pain at sites other than lumbar spine after or during UTI.展开更多
Objective:This study aimed to provide a comprehensive overview of the complications unique to ureteral reconstruction in adults,emphasizing their presentation,diagnosis,and management in the treatment of ureteral stru...Objective:This study aimed to provide a comprehensive overview of the complications unique to ureteral reconstruction in adults,emphasizing their presentation,diagnosis,and management in the treatment of ureteral structure disease.Methods:This review involves an in-depth analysis of existing literature and case studies pertaining to ureteral reconstruction,with a focus on examining the range of complications that can arise post-surgery.Special attention is given to the presentation of each complication,the diagnostic process involved,and the subsequent management strategies.Results:Ureteral reconstruction can treat ureteral stricture disease with low morbidity;however,complications,although uncommon,can have severe consequences.The most notable complications include urinary extravasation,stricture recurrence,urinary tract infections,compartment syndrome,symptomatic vesicoureteral reflux,and Boari flap necrosis.Each complication presents unique diagnostic challenges and requires specific management approaches.Conclusion:Ureteral reconstruction is a highly effective treatment for ureteral stricture disease.Having a strong understanding of the potential complications that patients may experience following ureteral reconstruction is not only critical to adequately counsel patients but also facilitate prompt diagnosis and management of complications when they arise.展开更多
文摘Background: Children with cerebral palsy (CP) are prone to urinary tract infection (UTI), a common cause of childhood morbidity and mortality. However, there has been no report regarding the prevalence of UTI among this group of children inNigeria. Objectives: The study aims at determining the prevalence and the possible predictors of UTI in children with CP compared to age and sex matched children without CP. Methods: A prospective cross-sectional study was carried out among consecutive children with CP at the Neurologic Clinic in the Paediatric Department of the Federal Medical Centre, Makurdi, Nigeria, from December 2011 to May 2013. Results: The age range of the studied population was between 2 and 15 years with a mean age of 8.63 ± 3.83 years including 30 males and 22 females. UTI was confirmed in 20 (38.5%) children with cerebral palsy compared to 2 children (3.8%) without CP (p value 0.000). Among children with CP, Escherichia coli was the commonest organism isolated in 9 (9/20, 45.0%), Streptococcus faecalis in 4 (20.0%), Staphylococcus aureus in 3 (15%), while both Proteus spp., and Klebsiella spp., were isolated in 2 children (10.0%) each. Escherichia coli was also found in the 2 children without CP. All the organisms were resistant to co-trimoxazole, nalidixic acid, nitrofuratoin and amoxiclav, while they were 100% sensitive to ceftriazone and the quinolones. In a univariate regression, analysis only moderate to severe gross motor dysfunction predicted the risk of UTI (OR = 54.81, 95%CI, 2.27 - 1324.00, p value 0.014). Conclusion: Efforts should be put in place to aid mobility among children with CP in order to reduce risk of UT.
基金Luzhou People's Government-Science and technology Strategic Cooperation project of Southwest Medical University(2017LZXNYD-T09)。
文摘Obiective:To investigate whether"Fuzheng Qingretonglin"decoction can reduce urinary tract damage caused by complex urinary tract infection caused by drug resistant Escherichia coli by regulating Nod-like receptor pyrin domain3 inflammasome,and to explore the feasibility of this decoction combined with levofloxacin in the treatment of complex urinary tract infection caused by drug resistant bacteria.Methods:SD rats were divided into five groups:sham group,model group,levofloxacin group(Lev group),levofloxacin+Fuzheng Qingre Tonglin decoction group(FZ+lev group),and Fuzheng Qingre Tonglin decoction group(FZQRTL group).After the experiment,urine was taken for bacterial culture to determine the urinary tract infection of rats in each group;HE staining was used to observe the pathological changes of kidney and bladder tissues in rats;The expression of NLRP3 in kidney and bladder tissues was detected by immunohistochemistry;The expression of IL-1βand IL-18 in serum of rats was detected by ELISA;The expressions of NLRP3,ASC and Caspase-1 were detected by Western blotting.Results:The positive rate of urine bacteria culture in the sham group was 0%,the positive rate of urine bacteria culture in the model group was 100%;and the positive rate of urine bacteria culture in the FZ+lev group was 37.50%,which was statistically different from that in the model group(P<0.05).A large number of inflammatory cells were observed in the kidney and bladder tissues of the model group by HE staining,while the number of inflammatory cells in the kidney and bladder tissues of the Lev group and FZQRTL group was significantly reduced compared with that of the model group.The FZ+lev group in the number and structure of inflammatory cells in kidney and bladder were similar to the sham group.The NLRP3 immunohistochemistry of kidney and bladder tissue in FZ+lev groups and FZQRTL groups was significantly different from that in model group(P<0.001).The levels of IL-1βand IL-18 in serum of Lev group,FZQRTL group and FZ+lev group were significantly decreased by ELISA compared with model group(P<0.001).The levels of IL-1βand IL-18 in the FZ+lev groups were significantly lower than in the Lev group and FZQRTL group,and the differences were statistically significant(P<0.05).The protein expressions of NLRP3,ASC and Caspase-1 in the Lev group,FZQRTL group and FZ+lev group were significantly lower than those in the model group(P<0.001).The protein expressions of NLRP3,ASC and Caspase-1 in the FZ+lev groups were significantly lower than in the Lev group and FZQRTL group,and the differences were statistically significant(P<0.05).Conclusions:"Fuzheng Qingretonglin"decoction may have a protective effect on the kidney and bladder of rats with complex urinary tract infection caused by drug-resistant Escherichia coli by inhibiting the activation of NLRP3 inflammatory bodies,and TCM combined with levofloxacin has a better therapeutic effect than TCM or levofloxacin alone.
基金This study was supported by Luzhou Science and Technology Bureau (Grant 2017LZXNYD-T09)
文摘Objective: To observe the effect of traditional Chinese medicine "Fuzheng Qingre Tonglin"prescription on rats with complicated urinary tract infection caused by extended-spectrumβ-lactamases (ESBLs)-producing Escherichia coli and its possible mechanism. Methods:Specific-pathogen-free female SD rats with 7-9 weeks old were randomly divided into model group, levofloxacin group, low-dose Fuzheng Qingre Tonglin group, high-dose Fuzheng Qingre Tonglin group, levofloxacin+Fuzheng Qingre Tonglin group (n=8 in each above group), and also there was a control group with 5 rats. Each group was administered intragastrically 2 days after model establishment for 14 consecutive days. The general condition of the rats was observed. Renal pathological changes were observed by light microscopy under hematoxylin-eosin staining. The number of white blood cells and the percentage of neutral particles (NEUT%) were detected. ELISA was used for the determination of C-reactive protein (CRP), CD4+, CD8+ in the blood, and secretory immunoglobulin A (SIgA), N-acetyl-β-D-glucosidase (NAG) molecules in urine. Results: There were a large number of inflammatory cells in the kidney of the model group and the levofloxacin group. The inflammatory cells in the treatment group were significantly reduced. The NEUT% and CRP in the blood of each treatment group and the NAG in the urine were significantly lower than those in the model group (P<0.05), except levofloxacin group. Compared with the model group, except for the levofloxacin group, serum CD4 concentration and CD4/CD8 ratio in the other treatment groups were significantly decreased, and CD8 molecules were significantly increased (P<0.05). Conclusion: "Fuzheng Qingre Tonglin" can alleviate systemic and local inflammation of complicated urinary tract infections in rats. It may also have the effect of re-sensing the insensitive antibacterial drug to bacteria and may have the function of regulating immune function and protecting kidney function in rats.
文摘BACKGROUND Urinary tract infection(UTI)is one of the most common bacterial infections.Acute pyelonephritis or upper urinary tract infection is often accompanied by bacteremia;however,bacteremia resolves in most cases without complication.Rarely,complications due to bacteremia occur.One of these is osteomyelitis.It mainly affects the lumbar vertebral bodies,and rarely affects other site.CASE SUMMARY An 80-year-old woman presented to the hospital with a two-month history of pain in both legs.Two months ago,she was admitted to the hospital for fever,flank pain,and urinary frequency and was diagnosed with bacteremic UTI.During hospitalization,she complained of pain in both legs;however,the pain resolved shortly after,and no abnormalities were observed on physical examination.Therefore,she was placed on 2-wk antibiotic therapy for UTI without further evaluation for leg pain.However,pain recurred after discharge and persisted;therefore,an imaging test was performed.Bone scan and magnetic resonance imaging suggested osseous infection in both femurs,tibiae and patellae.Surgical treatment was performed,and tissue-and bone cultures revealed Escherichia coli,a previously observed pathogen,which demonstrated same antibiotic sensitivities,as noted in previous UTI.She was diagnosed with disseminated osteomyelitis,as a complication of UTI,and was placed on an 8-wk antibiotic therapy.CONCLUSION Indication for osteomyelitis should be high regardless of bone pain at sites other than lumbar spine after or during UTI.
文摘Objective:This study aimed to provide a comprehensive overview of the complications unique to ureteral reconstruction in adults,emphasizing their presentation,diagnosis,and management in the treatment of ureteral structure disease.Methods:This review involves an in-depth analysis of existing literature and case studies pertaining to ureteral reconstruction,with a focus on examining the range of complications that can arise post-surgery.Special attention is given to the presentation of each complication,the diagnostic process involved,and the subsequent management strategies.Results:Ureteral reconstruction can treat ureteral stricture disease with low morbidity;however,complications,although uncommon,can have severe consequences.The most notable complications include urinary extravasation,stricture recurrence,urinary tract infections,compartment syndrome,symptomatic vesicoureteral reflux,and Boari flap necrosis.Each complication presents unique diagnostic challenges and requires specific management approaches.Conclusion:Ureteral reconstruction is a highly effective treatment for ureteral stricture disease.Having a strong understanding of the potential complications that patients may experience following ureteral reconstruction is not only critical to adequately counsel patients but also facilitate prompt diagnosis and management of complications when they arise.
