Summary: In order to study the association between lower urinary tract infection and cystitis glandularis (CG), 120 cases of CG were diagnosed by cystoscopic biopsy in the suspicious foci of the bladder. Among them, 7...Summary: In order to study the association between lower urinary tract infection and cystitis glandularis (CG), 120 cases of CG were diagnosed by cystoscopic biopsy in the suspicious foci of the bladder. Among them, 72 cases were subjected to bacterial counting culture of urine and microscopic examination of urinary sediment, and 60 cases to fluorescence quantitative polymerase chain reaction (FQ-PCR) assay to detect HPV, CMV and HSV DNA in urine samples. In the 72 cases of CG, the positive rate of bacterial counting culture of urine was 15.3 % (11/72), and gray zone rate was 18.1 % (13/72). 31.9 % (23/72) patients were positive in bacterioscopy of urinary sediment. There was statistically significant difference as compared with the control group (P<0.01). Only 4 of 60 urine samples were positive by FQ-PCR in detection of the three viruses mentioned above with the positive rate being 6.67 %. Compared with the control group, there was no significant difference (P>0.05). It was concluded that the genesis of CG was closely correlated with the chronic lower urinary tract infection, especially caused by Esch coli.展开更多
Urinary tract infection （UTI） is one of the most common childhood infections. Permanent renal cortical scarring may occur in affected children, especially with recurrent UTIs, leading to long-term complications such...Urinary tract infection （UTI） is one of the most common childhood infections. Permanent renal cortical scarring may occur in affected children, especially with recurrent UTIs, leading to long-term complications such as hypertension and chronic renal failure. To prevent such damage, several interventions to prevent UTI recurrences have been tried. The most established and accepted prevention at present is low dose long-term antibiotic prophylaxis. However it has a risk of break through in-fections, adverse drug reactions and also the risk of developing antibiotic resistance. The search is therefore on-going to fnd a safer, effective and acceptable alter-native. A recent meta-analysis did not support routine circumcision for normal boys with no risk factors. Vacci-nium Macrocarpon （cranberry）, commonly used against UTI in adult women, is also effective in reducing the number of recurrences and related antimicrobial use in children. Sodium pentosanpolysulfate, which prevents bacterial adherence to the uroepithelial cells in animal models, has shown conflicting results in human trials. When combined with antibiotic, Lactobacillus acidophilus （LA-5） and Bifidobacterium, by blocking the in vitro attachment of uropathogenic bacteria to uroepithelial cells, significantly reduce in the incidence of febrile UTIs. Deliberate colonization of the human urinary tract of patients with recurrent UTI with Escherichia-coli （E. coli ） 83972 has resulted in subjective beneft and less UTI requiring treatment. The non-pathogenic E. coli isolate NU14 DeltawaaL is a candidate to develop live-attenuated vaccine for the treatment and prevention of acute and recurrent UTI. Diagnosing and treating dysfunctional elimination syndromes decrease the incidence of recurrent UTI. A meta-analysis found the lack of robust prospective randomized controlled trials limited the strength of the established guidelines for surgical management of vesicoureteral reflux. In conclusion, several interventions, other than antibiotic prophylaxis, for the prevention of recurrent UTI have been tried and, although showing some promise, they do not provide so far a definitive effective answer. Finding suitable alternatives still requires further high quality research of those seemingly promising interven-tions.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
Emphysematous cystitis is a rare complication of lower urinary tract infection whose prognosis is conditioned by the delay in treatment. The predisposition of diabetic patients to urinary infections caused by gas-prod...Emphysematous cystitis is a rare complication of lower urinary tract infection whose prognosis is conditioned by the delay in treatment. The predisposition of diabetic patients to urinary infections caused by gas-producing bacteria is considered one of the most common factors in the occurrence of emphysematous cystitis. The currently recommended diagnostic test is CT scanning, which has definite value in assessing gas accumulation in the bladder wall and lumen. The authors report the observations of two patients aged 68 and 80 who were treated for emphysematous cystitis complicating diabetes mellitus. The evolution was favorable under treatment with antibiotic therapy, insulin therapy and bladder drainage.展开更多
Objective: To evaluate Chinese medicine(CM) formula Bazheng Powder(八正散) as an alternative therapeutic option for female patients with recurrent urinary tract infection(RUTI). Methods: A randomized double-blinded tr...Objective: To evaluate Chinese medicine(CM) formula Bazheng Powder(八正散) as an alternative therapeutic option for female patients with recurrent urinary tract infection(RUTI). Methods: A randomized double-blinded trial was performed. Eligible female patients with RUTI were recruited from one hospital and two community health centers. By using a blocked randomization scheme, participants were randomized to receive a CM formula(10 herbs) and antibiotics placebo for 4 weeks, or antibiotics for 1 week followed by 3 weeks of placebo and CM formula placebo. Clinical cure rate and microbiological cure and recurrence after treatment were evaluated. Results: A total 122 eligible patients were enrolled, with 61 cases in each group. The clinical cure rate by the intent-to-treatment approach was 90.2% for the CM group and 82.0% for the antibiotics group(P>0.05). Bacteria were cleared from 88.5%(54/61) of patients in the CM group and 82.0%(50/61) in the antibiotics group. The recurrence rate in recovered patients at the 6-month follow-up was 9.1%(5/61) and 14.0(7/61) in the CM and antibiotics groups, respectively(P>0.05). Conclusion: CM formula Bazheng Powder is a good alternative option for RUTI treatment.(Registration No. NCT01745328)展开更多
Urinary tract infections(UTIs)are among the most frequent causes for antibiotic prescription and;therefore,alternative treatment options for UTIs can potentially reduce antibiotic usage and development of resistance.T...Urinary tract infections(UTIs)are among the most frequent causes for antibiotic prescription and;therefore,alternative treatment options for UTIs can potentially reduce antibiotic usage and development of resistance.To evaluate the efficacy of nonsteroidal antiinflammatory drugs(NSAIDS)for the treatment of uncomplicated lower UTIs in women,this study implemented a meta-analytic approach to evaluate the results of available randomized clinical studies from online databases.A total of four trials involving 1144 patients with uncomplicated lower UTIs were included in the final evaluation.Results showed that symptom resolution at Day 3-4 in the NSAIDs group was significantly lower than that in the antibiotics group[pooled odds ratio(OR)=0.41,95%confidence interval(CI):0.23-0.74,P<0.05].However,there was no significant difference between the NSAIDs and antibiotics groups in symptom resolution at Day 7(pooled OR=0.43,95%CI:0.17-1.06,P=0.07),secondary antibiotic treatment rate at Day 28-30(pooled OR=1.15,95%CI:0.16-7.98,P=0.89)and adverse events rate(pooled OR=1.09,95%CI:0.61-1.96,P=0.77).Therefore,this metaanalysis suggests that,although inferior to antibiotics in fast symptom resolution,symptomatic treatment with NSAIDs can be considered as an alternative treatment option for uncomplicated lower UTIs in women.However,given the low number of randomized controlled trials that met inclusion criteria in this meta-analysis,efficacy of NSAIDs for treatment of uncomplicated lower UTIs should be further evaluated in more comprehensive clinical studies.展开更多
文摘Summary: In order to study the association between lower urinary tract infection and cystitis glandularis (CG), 120 cases of CG were diagnosed by cystoscopic biopsy in the suspicious foci of the bladder. Among them, 72 cases were subjected to bacterial counting culture of urine and microscopic examination of urinary sediment, and 60 cases to fluorescence quantitative polymerase chain reaction (FQ-PCR) assay to detect HPV, CMV and HSV DNA in urine samples. In the 72 cases of CG, the positive rate of bacterial counting culture of urine was 15.3 % (11/72), and gray zone rate was 18.1 % (13/72). 31.9 % (23/72) patients were positive in bacterioscopy of urinary sediment. There was statistically significant difference as compared with the control group (P<0.01). Only 4 of 60 urine samples were positive by FQ-PCR in detection of the three viruses mentioned above with the positive rate being 6.67 %. Compared with the control group, there was no significant difference (P>0.05). It was concluded that the genesis of CG was closely correlated with the chronic lower urinary tract infection, especially caused by Esch coli.
文摘Urinary tract infection （UTI） is one of the most common childhood infections. Permanent renal cortical scarring may occur in affected children, especially with recurrent UTIs, leading to long-term complications such as hypertension and chronic renal failure. To prevent such damage, several interventions to prevent UTI recurrences have been tried. The most established and accepted prevention at present is low dose long-term antibiotic prophylaxis. However it has a risk of break through in-fections, adverse drug reactions and also the risk of developing antibiotic resistance. The search is therefore on-going to fnd a safer, effective and acceptable alter-native. A recent meta-analysis did not support routine circumcision for normal boys with no risk factors. Vacci-nium Macrocarpon （cranberry）, commonly used against UTI in adult women, is also effective in reducing the number of recurrences and related antimicrobial use in children. Sodium pentosanpolysulfate, which prevents bacterial adherence to the uroepithelial cells in animal models, has shown conflicting results in human trials. When combined with antibiotic, Lactobacillus acidophilus （LA-5） and Bifidobacterium, by blocking the in vitro attachment of uropathogenic bacteria to uroepithelial cells, significantly reduce in the incidence of febrile UTIs. Deliberate colonization of the human urinary tract of patients with recurrent UTI with Escherichia-coli （E. coli ） 83972 has resulted in subjective beneft and less UTI requiring treatment. The non-pathogenic E. coli isolate NU14 DeltawaaL is a candidate to develop live-attenuated vaccine for the treatment and prevention of acute and recurrent UTI. Diagnosing and treating dysfunctional elimination syndromes decrease the incidence of recurrent UTI. A meta-analysis found the lack of robust prospective randomized controlled trials limited the strength of the established guidelines for surgical management of vesicoureteral reflux. In conclusion, several interventions, other than antibiotic prophylaxis, for the prevention of recurrent UTI have been tried and, although showing some promise, they do not provide so far a definitive effective answer. Finding suitable alternatives still requires further high quality research of those seemingly promising interven-tions.
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.
文摘Emphysematous cystitis is a rare complication of lower urinary tract infection whose prognosis is conditioned by the delay in treatment. The predisposition of diabetic patients to urinary infections caused by gas-producing bacteria is considered one of the most common factors in the occurrence of emphysematous cystitis. The currently recommended diagnostic test is CT scanning, which has definite value in assessing gas accumulation in the bladder wall and lumen. The authors report the observations of two patients aged 68 and 80 who were treated for emphysematous cystitis complicating diabetes mellitus. The evolution was favorable under treatment with antibiotic therapy, insulin therapy and bladder drainage.
基金Supported by Chinese Academy of Traditional Chinese Medicine Joint Innovation Research Project(No.ZZ070808)Traditional Chinese Medicine Dominant Disease Clinical Research Project(No.CACMS08Y0016)Capital Featured Clinical Application and Promotion Project(No.Z151100004015132),China
文摘Objective: To evaluate Chinese medicine(CM) formula Bazheng Powder(八正散) as an alternative therapeutic option for female patients with recurrent urinary tract infection(RUTI). Methods: A randomized double-blinded trial was performed. Eligible female patients with RUTI were recruited from one hospital and two community health centers. By using a blocked randomization scheme, participants were randomized to receive a CM formula(10 herbs) and antibiotics placebo for 4 weeks, or antibiotics for 1 week followed by 3 weeks of placebo and CM formula placebo. Clinical cure rate and microbiological cure and recurrence after treatment were evaluated. Results: A total 122 eligible patients were enrolled, with 61 cases in each group. The clinical cure rate by the intent-to-treatment approach was 90.2% for the CM group and 82.0% for the antibiotics group(P>0.05). Bacteria were cleared from 88.5%(54/61) of patients in the CM group and 82.0%(50/61) in the antibiotics group. The recurrence rate in recovered patients at the 6-month follow-up was 9.1%(5/61) and 14.0(7/61) in the CM and antibiotics groups, respectively(P>0.05). Conclusion: CM formula Bazheng Powder is a good alternative option for RUTI treatment.(Registration No. NCT01745328)
基金This work was supported by the Young and Middle-age High-end Medical Reserve Personnel Training Plan Foundation of Chongqing Health Committee,China(grant number 2018GDRC002).
文摘Urinary tract infections(UTIs)are among the most frequent causes for antibiotic prescription and;therefore,alternative treatment options for UTIs can potentially reduce antibiotic usage and development of resistance.To evaluate the efficacy of nonsteroidal antiinflammatory drugs(NSAIDS)for the treatment of uncomplicated lower UTIs in women,this study implemented a meta-analytic approach to evaluate the results of available randomized clinical studies from online databases.A total of four trials involving 1144 patients with uncomplicated lower UTIs were included in the final evaluation.Results showed that symptom resolution at Day 3-4 in the NSAIDs group was significantly lower than that in the antibiotics group[pooled odds ratio(OR)=0.41,95%confidence interval(CI):0.23-0.74,P<0.05].However,there was no significant difference between the NSAIDs and antibiotics groups in symptom resolution at Day 7(pooled OR=0.43,95%CI:0.17-1.06,P=0.07),secondary antibiotic treatment rate at Day 28-30(pooled OR=1.15,95%CI:0.16-7.98,P=0.89)and adverse events rate(pooled OR=1.09,95%CI:0.61-1.96,P=0.77).Therefore,this metaanalysis suggests that,although inferior to antibiotics in fast symptom resolution,symptomatic treatment with NSAIDs can be considered as an alternative treatment option for uncomplicated lower UTIs in women.However,given the low number of randomized controlled trials that met inclusion criteria in this meta-analysis,efficacy of NSAIDs for treatment of uncomplicated lower UTIs should be further evaluated in more comprehensive clinical studies.
